For many, “Concierge Medicine” (CM) is a foreign concept. It didn’t exist when I was growing up. The CM model (created in 1996) began as a response to the burgeoning issues of “Managed Healthcare” (itself begun in the 1980’s) and which is now ubiquitous in the US.
Those issues — reduced access/availability, reduced efficiency, poorer quality care, denied services/coverage, healthcare fraud/abuse, etc., are well documented. While we have the most sophisticated and expensive healthcare system in the world, it typically doesn’t translate into better healthcare. A 2024 Commonwealth Fund study found we rank last in access to care and administrative efficiency. Doctors and patients are burdened by complex insurance bureaucracy, high costs for documentation or denied care, while still having high out-of-pocket expenses. And for all of that, we have the lowest life expectancy at age 60 and the highest rate of preventable deaths among the Western nations studied! Ironically, Managed Care was supposed to improve all of that.
Last month, I wrote about my positive childhood memories of my pediatrician. I talked with my mom, and she also remembers feeling cared for/about. CM focuses on enhancing the quality, accessibility to healthcare and the individualized aspects of that care. Providers transitioning to this model are combatting the limitations of conventional, high-volume insurance-based systems, seeking more time with their patients and better results.
The results of the few available studies find that CM enhances overall patient satisfaction, patients’ experiences with organizational aspects of care (care coordination, access, interactions with office staff). Because of its emphasis on proactive care, studies have found patients are more likely to undergo screenings and access preventative care, resulting in improved management of chronic conditions and timely interventions when needed.
Audiology is a natural fit for this model. Hearing loss is a chronic, progressive neuro-degenerative condition. There is only one known treatment, amplification (i.e. hearing aids). While extremely sophisticated, hearing aids are only a tool. To be done properly, the treatment process requires dedicating significant time and expertise because it is highly individualized and unique to every patient.
Consistent day-to-day performance and long-term prophylactic benefit requires proactive care, long term management and timely intervention when something goes wrong. What’s more, for the vast majority of people, there’s no insurance for hearing healthcare. And even for those who do have some sort of benefit, they often still have significant out-of-pocket expenses. It’s an investment.
Managed care is not suited to doing Audiology well. For example, Kaiser has excellent audiologists. But the availability of and limited time for appointments impacts patient education, counseling/instruction on device use & care, etc. The emphasis on reactive (versus proactive) care means issues may go unaddressed or are not addressed in a timely fashion. The lack of quick access/availability means that patients have to wait to address issues, even ones that could be addressed quite simply by a technician rather than the audiologist.
I didn’t know about CM until well after it was ‘a thing,’ yet I’ve been effectively practicing it for 25+ years. I saw/practiced the alternative at the VA, Kaiser, and other hospitals/clinics. That’s why Berkeley Hearing Center exists, so we can give patients the best healthcare possible, not what some insurance company says we’re limited to. Bottom line, folks are going to be spending a lot for hearing healthcare regardless. The best value doesn’t necessarily mean spending less. It means getting the most for what you pay.
Please continue to show that you love your community by supporting our local businesses and remembering the humanity of those around you.
