• Kagen MD Blogger

Chronic disease affects 6 in 10 Americans, but people are spending less time talking to their doctor

Concierge Medicine is one answer to this issue


According to the CDC’s National Center for Chronic Disease Prevention and Health Promotion, 6 in 10 adults have a chronic disease in the United States. At the same time, Statistica reported than in 2018, physicians spent 16 minutes or less with a patient during an average appointment. Prevention and management are key when addressing chronic disease, but the current system, where insurance companies and large healthcare groups are continually pushing for more efficiency in order to address more patients every day, it’s nearly impossible for doctors and patients to spend the time needed to partner in an effort to maximize their health. On the heels of this issue is the emergence of a different type of healthcare paradigm: Concierge Medicine.



A 2018 U.S. News and World Report article* called to attention that some specific changes in health care, such as increased documentation and productivity requirements, as well as new quality metrics, were increasingly squeezing the time doctors can spend with patients during an appointment. Beyond just the truncated time spent, patients are missing out on quality time, where the doctor’s undivided attention is on the patient in unhurried conversation. Imputing data into a computer while documenting what the patient is saying leaves the subtle, unspoken body language of a patient in pain or emotional turmoil left undetected. A lack of eye contact and back and forth interaction also leaves patients feeling unheard and may discourage them from having meaningful conversations with their doctor. Unfortunately, as long as large health care groups and insurance companies roll out more and more systems, metrics and aggressive financial goals, this trend will continue to escalate. At the same time, the growing population of people dealing with chronic health conditions just keeps climbing.


Concierge medicine is one answer to this growing problem. Concierge doctors offer a membership-based healthcare option, free of insurance company intervention or pressures from a healthcare system. Typically, these boutique medical practices offer their members appointments that are structured around them, rather than a strictly scheduled and timed criteria. This can mean extended, unrushed time with the doctor at the physician’s office, video calls or even house calls. This flexibility leaves the option to the patient to connect with their doctor in a way that’s comfortable and convenient for them. While the convenience of this and the lack of pressure on the doctor to move to the next patient are obvious benefits with these options, the other is that the patient can choose times and settings in which they feel most at ease and able to have open, honest conversations with their doctor. This ability to talk candidly about symptoms, concerns or general health questions is the ultimate way in which a doctor and patient can form a relationship in an effort to maximize the health of the patient, whether it be managing a chronic disease or taking steps to prevent them.


Direct primary care practices also eliminate the often-confusing insurance system from the doctor visit experience. There are no co-pays or explanation of benefits documentation to sort through since the visits are covered in the annual or monthly membership fee. Because of this, any hesitation to contact the doctor or schedule time with him or her is eliminated, potentially leading to patients being more proactive about asking questions or raising new concerns. This is especially important when managing chronic conditions so that intervention can begin right away, oftentimes preventing larger health problems. Removing barriers to delivering ongoing health guidance on lifestyle, medication management, nutrition, activity and more is key to preventing or managing chronic conditions.

With the high incidence of chronic disease in the United States, people need to foster an open, ongoing relationship with their physician now more than ever. Chronic disease prevention and management requires a holistic approach to health, which includes addressing diet, exercise, medications and more. While large healthcare groups are moving more and more towards maximizing the number of patient visits per day, decreasing the time and quality of time patients spend with their doctor, concierge medicine (also called boutique medicine or direct primary care) is one model that effectively allows for the time needed. For those looking for more quality and quantity of time with their physician to address or take steps toward preventing chronic health issues, concierge care may be the answer.


* https://health.usnews.com/health-care/patient-advice/articles/2018-01-10/heres-why-your-doctor-seems-pressured