The U.S. Bureau of Labor Statistics predicts that the number of jobs for physicians and surgeons will increase between now and 2031, which is a slower than average rate.
The Association of American Medical Colleges states on its website: “As our population grows and ages, the demand for physicians continues to grow faster than the supply, resulting in an estimated shortfall of between 37,800 and 124,000 primary care and specialty physicians by 2034. Doctor shortages pose a real risk to patients – especially for those in rural or underserved areas. It is critical that we invest in training enough doctors so that patients have access to the timely, appropriate care that they need.”
Dr. Melvin Brown of Charleston Medicine and Behavioral Health, a concierge medical practice on James Island, spoke about the physician shortage issue and the dire need in primary care especially. He has worked as an emergency room physician for the past 14 years. In medical school, he studied emergency medicine and pediatrics but ultimately set out on a path to primary care.
Dr. Brown reflected on the number of patients he saw during his pediatric residency and how he wasn’t able to spend enough time that was desperately needed with his pediatric patients.
“So many of the couples I worked with in pediatrics were very young, and what they really needed was counseling on how to parent. Things like what formula to use or what to do about antibiotics. It was just tough because I didn’t have the time that I really wanted to spend with them,” he said.
So instead of pediatrics, he shifted to emergency medicine residency training and practice, where he said that 40% to 60% of his patient interactions were primary care matters. Although he spent 14 years doing ER work, which he said he absolutely loved in many ways, there was a corporate atmosphere that didn’t suit him.
And that’s where concierge medicine came in and swept Dr. Brown off his feet – so to speak. He said that when he heard about concierge medicine, he instantly realized that so much about the concept fit exactly what he was looking for as a primary care physician.
Many primary care physicians have between 2,000 and 5,000 patients. With the concierge model, the primary care doctor has around 400 to 700 patients, which, as Dr. Brown puts it, “is much more manageable.”
Many concierge practices do not take insurance at all. Sometimes referred to as “retainer” medicine, concierge medicine is a relationship between a patient and the primary care physician in which the patient pays an annual fee or retainer. In exchange, patients gain enhanced care from their primary care physician – no wait times, personalized attention and care and more time for appointments. Concierge medicine allows physicians to really get to know their patients on a deeper level since their appointments are not rushed.
Charleston Medicine and Behavioral Health, where Dr. Brown works, does the retainer fee but also files insurance for its patients. Dr. Brown calls it more of a “hybrid” model of concierge medicine.
“We will collect a co-pay and bill your insurance,” he said. “But the fee that patients pay allows them to have increased access to us.”
He added that under the concierge model, Charleston Medicine and Behavioral Health doesn’t have to have 5,000 patients. And due to that increased personal attention, Dr. Brown is able to do more for his patients. He said that he actually met with a patient early in the morning recently at the last minute.
“I don’t think you would find that level of care with a traditional corporate primary care model,” he said.
His patients run the gamut as far as age and demographics go, but he does not see children at this time. He said seniors really love the concierge model because of the personalized attention to their care. When they call to speak to him, they don’t have to wait long for him call back, and they can make as many appointments as they want since insurance isn’t a hindrance.
“Concierge care is really about having a direct relationship and access to your primary care doctor,” he said.
He added that he will refer to his patients to specialists as needed, just like all other primary care doctors, but he is not affiliated with just one system of doctors. “
I can link them up with the best according to their specific needs,” he said.
Dr. Brown is hoping that the concierge model will attract more young doctors to specialize in primary care. For him, becoming a doctor was all about helping his community, and he said he sees how that feeling has been lost with all the corporate issues that many doctors must deal with.
He also pointed out that medical school is expensive and that primary care may not be as lucrative as other specialties when it comes to paying off all the loans.
“But the other specialties will not have that connection to the community like primary care does,” he added.
As medical care continues to evolve along with the population’s ever-changing needs, it’s apparent that doctors will always be needed.
For more information on Dr. Brown and Charleston Medicine and Behavioral Health, visit charlestonmedicine.com.
By Theresa Stratford