Concierge medicine

BACKGROUND: In pursuit of applying universal non-biased Artificial Intelligence (AI) in healthcare, it is essential that data from different geographies are represented. OBJECTIVE: To assess the diagnostic performance of an AI-powered dermatological algorithm called Skin Image Search on Fitzpatrick 6 skin type (dark skin) dermatological conditions. METHODS: 123 dermatological images selected from a total of 173 images were retrospectively extracted from the electronic database of a Ugandan telehealth company, The Medical Concierge Group (TMCG) after getting their consent...

OBJECTIVE: Cognitive symptoms are frequently not diagnostic for underlying brain damage or disease, but secondary to other treatable medical/psychiatric factors. Neuropsychological evaluation can inform the differential, but is limited by access issues and reduced diagnostic certitude in the setting of unmanaged secondary factors. Development and implementation of a neuropsychometric screening and triage model to address these issues has flexible application across different clinical settings...

INTRODUCTION: Adolescent girls and young women (AGYW) face barriers in accessing clinic-based HIV pre-exposure prophylaxis (PrEP) services and community-based models are a proposed alternative. Evidence from such models, however, is limited. We evaluated PrEP service coverage, uptake, and early persistence among AGYW receiving services through community and hybrid models in Namibia. METHODS: We analyzed routine data for AGYW aged 15-24 who initiated PrEP within HIV prevention programming...

OBJECTIVE: To describe the infrastructure, tools, and services developed at Stanford Medicine to maintain its data science ecosystem and research patient data repository for clinical and translational research. MATERIALS AND METHODS: The data science ecosystem, dubbed the Stanford Data Science Resources (SDSR), includes infrastructure and tools to create, search, retrieve, and analyze patient data, as well as services for data deidentification, linkage, and processing to extract high-value information from healthcare IT systems...

Resource allocation generally involves a tension between efficiency and equity, particularly in health care. The growth in exclusive physician arrangements using non-linear prices is leading to consumer segmentation with theoretically ambiguous welfare implications. We study concierge medicine, in which physicians only provide care to patients paying a retainer fee. We find limited evidence of selection based on health and stronger evidence of selection based on income. Using a matching strategy that leverages the staggered adoption of concierge medicine, we find large spending increases and no average mortality effects for patients impacted by the switch to concierge medicine...

Many health care centers make so-called VIP services available to "very important persons" who have the ability to pay. This article discusses common services (eg, concierge primary care, boutique hotel-style hospital stays) offered to VIPs in health care centers and interrogates "trickle down" economic effects, including the exacerbation of inequity in access to health services and the maldistribution of resources in vulnerable communities. This article also illuminates how VIP care contributes to multitiered health service delivery streams that constitute de facto racial segregation and influence clinicians' conceptions of what patients deserve from them in health care settings...

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OBJECTIVE: To determine if a proactive employer-sponsored mental health program closed gaps in detection and treatment of mental health conditions. METHODS: Of n = 56,442 eligible, n = 8,170 (14.5%) participated in the optional screening. Participants with mental health risk were offered care concierge services including support, care planning, and connection to care. Difference in behavioral healthcare utilization, diagnoses, and prescriptions were evaluated post-intervention through claims analysis...

BACKGROUND: Pre-triage emergency department (ED) waiting times can be lengthy when presentation numbers are high. Queuing is random, affecting flow management and patient care. We investigated pre-triage wait times and barriers to triage access at an Australian ED. METHODS: A reviewer conducted a retrospective audit of triage reception security video camera footage (February-March, 2020). The reviewer manually documented self-presenting patients' wait-to-be-seen times and barriers to patient flow...

The demand for house calls is increasing because of the aging U.S. population, an increase in patients who are homebound, and the acknowledgment of the value of house calls by the public and health care industry. Literature from current U.S. home-based primary care programs describes health care cost savings and improved patient outcomes for older adults and other vulnerable populations. Common indications for house calls are management of acute or chronic illnesses, coordination of a post-hospitalization transition of care, health assessments, and end-of-life care...

We examine how patient numerical ratings and specific words in written reviews of family physicians and internists in the states of California and Florida differ based upon concierge doctor status. Data are drawn from Healthgrades.com, one of the largest providers of online reviews, and a machine-learning sentiment analysis is used to determine the predictors of concierge status and numerical patient ratings. We find that reviews of concierge doctors are more likely to contain technical words associated with health care, such as "staff" and "office," compared with traditional physicians...

INTRODUCTION: Emergency Department (ED) crowding negatively impacts patient outcomes, patient satisfaction, and patient safety. One solution involves introducing a Concierge Physician (CP) whose sole purpose is to provide a brief initial assessment (BIA) and aid patient navigation through the ED. The goal of this study was to quantify the impact of a CP on patient flow dynamics in an urban ED setting. METHODS: We performed a retrospective observational cohort study in an urban academic ED over a 6-month period...

While lifestyle medicine (LM) has been increasingly recognized for its value in preventing and managing chronic disease, the conventional primary care practice has struggled to be a financially viable model for this time-intensive, highly personalized approach. However, the concierge medicine model provides many advantages to those seeking to incorporate the tenets of LM. Concierge medicine is characterized by smaller patient panels, extended visits, continuous follow-up, and a distinctive emphasis on prevention and wellness...

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OBJECTIVES: This study evaluated the effectiveness of the Center for Executive Medicine (CEM) concierge primary care practice on preventive colorectal cancer (CRC) screening rates relative to local and national comparator data. METHODS: We performed an electronic medical record search encompassing our entire patient population who are between the ages of 50 and 75 years to determine the rate of CRC screening. We compared this rate with the average rate of Medicare Advantage plans reported by our Independent Physician Association (IPA) in 2015 and national health plans reported by the National Committee for Quality Assurance in 2014...

Universal coverage and financial sustainability are two competing aims in primary care. Patient empowerment and patient engagement have been suggested as essential ingredients of the recipe for innovative primary care models aimed at sustaining universal coverage. Concierge medicine is achieving a growing popularity among both scholars and practitioners as a direct primary care practice which allows to bridge the gap between patient empowerment and patient engagement. However, ethical and legal concerns hinder the diffusion of concierge models in the current primary care practices...

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Concierge medicine is a medical management structure that has been in existence since the 1990s. Essentially, a typical concierge medical practice limits its number of patients and provides highly personalized attention that includes comprehensive annual physicals, same-day appointments, preventive and wellness care, and fast, 24/7 response time. Concierge medicine has become popular among both physicians and patients/consumers who are frustrated by the limitations imposed by managed care organizations. From many physicians' perspectives, concierge medicine offers greater autonomy, the opportunity to return to a more manageable patient load, and the chance to improve their incomes that have declined because of increasingly lowered reimbursements for their services...

No abstract text is available yet for this article.

No abstract text is available yet for this article.