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The current choices are

1) Uniterested, slapdash care from an MD with 12+ years of training and no ability to listen or empathize but eager to make the money s/he went into medicine to make

2) The same from an assistant of some kind who uses ever-degrading search engines to look up not-your-problem and give you potentially dangerous suggestions

The future will undoubtedly be worse. As someone mentioned below, we'll pay current premiums (+inflation) for a touchscreen interface to Chat-whatever-it-will-be.




1) isn’t being entirely fair. MDs or any other practitioner are generally restricted by what they can bill insurance since only a minority of patients opt for concierge care. So if insurance allows for “X minutes for Y service”, that’s what they generally do in most “eat what you kill” practices (which is most). Some will go above and beyond, but that’s to their detriment. Insurance billing generally makes care “billability”-centric.


Believe it or not, I tried concierge care. Pretty much the same thing only with a big "cover charge" and a lot of gorilla juice about personalized attention. Left after three months - initial comprehensive exam where the practice owner/doctor was distracted by multiple phone calls and a student he was teaching on my time. I was telling him about my bad Achilles tendon which he proceeded to whack when the reflex test on my knee didn't go the way he expected. The pain was excruciating and when I found my voice, I let him have it.

He was late to the followup, couldn't explain the results his machines had given him, and then rushed me out after the usual 10 minutes.

I think family practice/primary care is on the ropes. The big lie is that some doctor will "get to know you as an individual." Reality is that s/he's given a quota and time limits by some MBA and the Epic system will make damn sure that the doctor does not use any initiative in solving the patient's problem.

I am still at the point where I can prepare and advocate for myself. When that goes, it'll be curtains.





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