Up front: December 2012

Laws of physic

Talk is cheap, but not when it’s with a doctor. Getting the time and attention I want from mine cost me $2,750 this year ­— my membership fee to Signature Healthcare, one of the retainer-based medical practices you’ll read about in the story that starts on page 60. That’s with a discount, since my wife already was a member when I joined in January, and on top of what Signature bills for visits and treatment to my insurance company, to which I’m paying an annual premium of $9,058.68 for health coverage. Since our company has a high-deductible plan, let’s not forget the $1,500 that came out of my pocket before those benefits kicked in — though all that went toward other medical expenses.

Healthy, wealthy and wise. It certainly helps to be the second if you want to stay the first, but how smart is it to pay a hefty fee for what is essentially increased access to a primary-care physician? It’s not for everybody, because not everybody can afford it. Some Signature members, many of them busy executives, see it as an investment. If that’s the case, has it been a savvy one for me?

Having to pay more for health care has made me pay more attention to my health, if for no other reason than to make sure I get my money’s worth. But I probably never would have taken that step if the doctor I had been going to for more than a decade had not grown so frustrated with his practice that he decided to leave the medical group he helped start. It’s now part of a giant hospital system — replete with the bureaucracy and pressure for financial performance that entails — and he had become one of those harried, hurried physicians whose lot is described in Senior Contributing Editor Ed Martin’s story. His departure prompted mine.

It’s different with my new doctor, the hirsutely bereft fellow you see in the photos that accompany Ed’s article. He never seems rushed. If I have a question, I’ll call or email, and he gets right back. He’s inquisitive. He’s not quick to pull out a prescription pad, rather taking the time to ask more questions. Then to listen. It’s this — not the flowers, snacks, decor or fancy robes — that make it worthwhile.

Still, I can’t help but feel somewhat guilty, for this is the kind of care all patients deserve and, I believe, most doctors want to deliver but that the economic reality of modern-day medicine cannot afford. The old saw that talk is cheap may have lost its edge, but this one holds true: Time is money.

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