Tuesday, October 16, 2012

"Pain-Free Medicine"

The man was a Maestro.  I was in awe of his abilities.  A self-described businessman, I looked on in amazement as, with deftness, subtlety and expertise, the man ingeniously went about his business.

Not long ago, along with other interested patients, I attended a gathering, hosted by the “Maestro”, at which a new wrinkle would be unveiled in my “Primary Care” doctor’s medical practice.  It’s what they call “Concierge” service.

“We take your blood pressure, and get you tickets to hit shows.”

No.  It’s not that.

With “Concierge” service, patients willing to pay nineteen hundred dollars a year, would be provided, along with a comprehensive annual physical, extended office visits, a variety of “Wellness” consultations, and the doctor’s private phone number and e-mail address for direct and instant contact.  The “Maestro” represented the company – or for all I know owned the company – that would administer the program.  

(This is not an “all included” program.  Regular office visits would continue to be paid for through insurance.  With the “Concierge” service, those office visits would now, however, be longer.)

We were ushered into a brightly lit room in a Marina Del Rey hotel, the glass-sided entryway offering a panoramic vistas of boats of various sizes and luxuriousnesses, bobbing in the harbor. 

Set out on tables was a generous array of fruit and cheese platters, along with a tray of oversized cookies (that, to my eye, did not appear to be that healthy.)  Coffee and tea were also available.

Though I have never been to one, the entire operation conjured the image of a seminar hawking “Time Shares” on Maui.

As the attendees settled in, the “Maestro” moved confidently to the podium where, in relaxed and easy manner, he outlined the event’s itinerary, assuring us it would be wrapped up in an hour.  After offering an introductory overview, the  “Maestro” would introduce our doctor who would briefly address us.  There would then be an eight-minute promotional video, after which the “Maestro” would explain the program in further detail.  The event would conclude with fifteen minutes where the “Maestro” welcomed questions from the audience.

It was pain-free medicine.  Easy-peasy.

Before introducing our doctor, the “Maestro” confided that some doctors feel extremely nervous addressing large groups.  On a previous occasion, the “Maestro” had advised a stage-frightened doctor to just imagine the entire audience naked.  The doctor replied that that wouldn’t work, because he had already seen the entire audience naked.  After the appropriate laughter, the “Maestro” assured us that that was a “true story.”   

Our doctor got up and addressed up, explaining that, among other advantages of the “Concierge” program, with the now longer office visits, he would not be required to talk as fast, adding that we probably had never heard him speak this slowly before.  The odd thing was that, when he said that, he was speaking as fast, or faster, than ever.

Regaining the reins of the proceedings, the more sure-handed “Maestro introduced the video, which explained how the “Concierge” treatment approach would return us to the “Good Old Days”, when doctors had ample time to spend with each patient, and could therefore more successful administer to their needs, an arrangement lost because, in order to make ends meet, doctors were required to see more and more patients per day.  

The “Maestro” then ended with a truly agonizing story of personal misfortune, not to garner sympathy, but to exemplify the fact that the crisis was considerably worsened by the lack of a personal and direct relationship with a doctor, which the “Concierge” system was now available to alleviate.

The audience questions were highly illuminating.  You could not have scripted them to more astutely challenge the premises of the program.  Question:  “I’m young and healthy.  What do I need this for?”  The “Maestro’s” response:  “The ‘Concierge’ program will help you stay healthy. ”

Question:  “Understanding that the ‘Concierge’ system will only be in effect a couple of hours a day, how will this change things for patients who choose not to sign up?”  The “Maestro’s” response:  “There will be differences, but you will not feel like ‘the sky is falling’, due to ‘natural attrition’ – the doctor will not be taking on any new patients, some patients will be moving on, and some will no longer need medical services…because they have passed away.” 

The “Maestro” actually said that.  And got away with it.

The “Maestro” negotiated the Q and A, and the entire seminar for that matter, with remarkable dexterity.  He said precisely the right things, never a wrong word, never an endangering misstep.  It was a virtuoso performance.  Like watching a veteran combatant, negotiating a minefield, entirely unscathed. 

Basically, what was being offered to us was a system that required patients to pay nearly two thousand dollars extra per year for medical services that had once been considered normal and expected, but were lost because doctors bloated their “Patient Rosters” to maximize their incomes.  They now no longer had to do that, because they could make just as much money, or even more, by going “Concierge.”

The underlying issue here was money.  The “Maestro’s” absolutely “genius” performance, however, left the overpowering impression that they were doing this for us

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