Why are Local Doctors Charging Monthly Fees?

I received a letter from my general practitioner’s office that he will now be charging $50 per month. This is regardless of having an appointment with him during that month.

So if I only see him 2x per year for general blood work and check ups, I’m paying $600 per year just to be a patient that insurance does not reimburse.

What is happening to our local health care system?

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    • Most of us don’t have the kind of debt that doctors have after undergrad + med school. Much like teachers – if you can be a doctor and live in an apartment or condo in Santa Barbara, or you can be a doctor and own a home in Ventura – which are you going to pick? The market is deciding for us, whether you like it or not.

      • MM – Doctors *might* have more student loan debt but they’re also paid a lot more to offset that debt. Plus they have more options for loan forgiveness when working in underserved communities than other people with student loan debts.

      • MM1970 – a young doctor is in no way “much like teachers.” Sure, they may have a larger debt maybe (teachers also have undergrad and grad school debts), but they also have a much higher starting salary with which to pay that debt.

        A young teacher has can’t even afford rent in an apartment or condo in SB, while a young doctor can. You really can’t compare doctors to teachers when discussing the housing market in SB or even Ventura.

  1. Probably several things, all related.
    1. We have a shortage of doctors. (Have you SEEN the waitlists for an OB/GYN? Plenty of pregnant women have no choice but to go to Ventura because they cannot be seen by a local OB for MONTHS.)
    2. It’s too expensive to live here, so we cannot recruit more doctors.
    3. Therefore…the existing doctors have too many patients. Try getting an appointment with a primary physician at Sansum in less than a year. And when you DO get an appointment, it’s probably only going to be 15 minutes.
    4. For doctors who AREN’T part of huge conglomerates – “concierge” fees keep their practices at a reasonable size. You pay your $600 a year, and you can actually get an appointment sooner than a year out.

    TLDR: not enough/ too expensive housing means not enough doctors…

    • Yes there is a shortage of physicians here. Cottage and Sansum need to pay their doctors more than their admins to recruit talent.
      For the doctors opening a private practice, essentially running their own business, there are a lot of costs involved. And just like any business, they should expect good months and bad months. Personally I think charging a monthly fee is silly and shows they’re operating their business poorly but I also understand they want certain lifestyle and if catering to those that can afford their care is the way to achieve it, then its another example of capitalism in America.

  2. Yeah, sounds like you’re doing concierge? Is that correct? If so, they are essentially free to charge whatever they want. You can take it or leave it. And if so, it looks like you’ve realized you can’t buy your way into healthcare convenience here in SB. Interesting.

    • ALWAYS – hate to be that guy, but the ER isn’t there for routine medical needs or preventative care. This is the problem we’re seeing with undocumented immigrants who have no health insurance. They use the ER for everyday med issues and the lack of preventative care ends up costing the taxpayers more in the long run (as they need treatment for preventable health issues) than if they were covered with some form of insurance.

  3. “Under the reform we’re proposing, if you like your doctor, you can keep your doctor. If you like your health care plan, you can keep your health care plan.” – I have not been able to keep either. Unintended consequences perhaps.

  4. As a physician, I have no issue with concierge medicine provided it gives more benefits, such as a smaller patient base with 24 hour access. I am opposed to, and think it should be illegal, to charge access and also bill insurance, for basic access to the physician.

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