Mass general hospital primary care

Mass general hospital primary care DEFAULT

Founded for the Poor, Mass General Looks to the Wealthy

“We’ve made the institutional commitment that these patients will get the best of the best at a phone call,” said Dr. Michael R. Jaff, the medical director of Mass General’s Center for Specialized Services.

Can a hospital founded more than 200 years ago to treat the poor also adopt a form of medicine some criticize as health care for the rich?

The answer may come in August, when Massachusetts General Hospital, the third-oldest general hospital in the nation, plans to open a concierge medicine practice.

Based in Boston, the hospital, whose $800 million annual research budget is among the nation’s biggest, is affiliated with Harvard Medical School and is perennially ranked No. 1 in many categories of U.S. News & World Report’s listings of the country’s best hospitals.

Despite its reputation, Mass General — as it is known — was established in 1811 to care for the city’s poor and indigent. Patients in concierge medicine are likely to be anything but that.

For $6,000 a year (and whatever their insurance pays), patients in its new Concierge Medicine Practice will get round-the-clock access to their doctors (initially, there will be three in the practice), as well as personalized nutritional, exercise and wellness counseling.

The idea of wealthy people paying doctors a retainer for exclusive service is not new. With concierge medicine, which was introduced in the 1990s, patients pay physicians a monthly or annual retainer and expect more personalized care and greater access. “A concierge patient who signs up for a practice is not only looking for quality care, they are looking for unfettered access to their provider,” said Dr. Michael R. Jaff, the medical director of Mass General’s Center for Specialized Services and a professor at Harvard Medical School.

There are pros and cons to concierge medicine — or direct primary care, a similar model — which, according to the industry trade magazine Concierge Medicine Today, is embraced by about 6,000 doctors across the country. (Another 6,000, the magazine estimates, are in practices that offer some form of retainer or concierge service.)

“The upside is that it gives more time for patient-physician interaction, and the data shows that generally the more time a patient has with a physician, the better the outcome,” said Dr. Wanda D. Filer, president of the American Academy of Family Physicians. “The downside is that it can be very exclusive and difficult for middle- and low-income patients to afford. So there’s a concern that you’ll have a two-tier system.”

In recent years, concierge medicine and similar types of programs have spread from private practices to hospitals. Mass General’s embrace of it may prove influential.

“It’s a significant development, simply because of the name and the prestige,” said J. Catherine Sykes, publisher of Concierge Medicine Today. “To have an organization that has the core values Mass General holds enter this arena adds momentum to the movement.”

To critics of concierge medicine, Mass General’s foray into the field is no cause for celebration. “It’s worrisome, unless you’re rich,” said Pauline Rosenau, professor of public health at the University of Texas Health Science Center in Houston. As for the hospital’s historical mission, she added, “I’d say it’s in jeopardy.”

“Health care economics are such, as well as the needs and wants of some different patient populations, that we’re offering this concierge model,” said Misty Hathaway, Mass General’s senior director for specialized services. “It won’t be the right model for everybody, but it will help us generate different sources of revenue in a way to fund the core mission.”

Mass General’s concierge practice will be housed at 50 Staniford Street, a 10-minute walk from the hospital’s main building on Fruit Street, in Boston’s West End. The location was chosen for symbolic and practical reasons.

“We didn’t say, ‘Let’s just open a private office in Beacon Hill and put the Mass General logo on the door,’” said Dr. Jaff, who will oversee the new service. “We wanted the practice to be integrated into the institution.”

The proximity to the main hospital will give concierge patients easy access to Mass General’s specialists (something not typically offered in private concierge services). “We’ve made the institutional commitment that these patients will get the best of the best at a phone call,” Dr. Jaff said. “So if I call and say I need a general surgeon, they’ll have a world-class general surgeon that day.”

As for benefits of the concierge practice for the rest of the hospital’s patients (Mass General has about 1.5 million outpatient visits a year), Dr. Jaff admitted they were a little less tangible, though still critical. “With dwindling reimbursement,” he said, “there needs to be other sources of revenue to help us support our mission to the community at large.”

What some call “health care for the rich,” the hospital says it believes, can be one such source.

Sours: https://www.nytimes.com/2016/02/14/your-money/founded-for-the-poor-mass-general-looks-to-the-wealthy.html

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NOTES:
- "Affiliation" is the local physician organization to which the doctor belongs.
- A primary care provider (or PCP) is a doctor or in some cases, a nurse practitioner or physician assistant, who sees patients for everyday medical issues, such as colds and annual wellness visits. PCPs often are your first point of contact for your general health concerns.
- Providers who are "accepting new patients" are able to book new patient appointments within 90 days. "Accepting new patients" is subject to change. Please confirm when setting up your appointment.
- Primary Care providers who have "near-term availability" can book new patient appointments within 30 days. "Near-term availability" is subject to change. Please confirm when setting up your appointment.
- "Concierge Medicine" is a unique offering in which providers care for a limited population of patients. Patients can opt into this "direct primary care" model with an annual membership fee.
- Providers may accept more insurance plans than shown. Please confirm when setting up your appointment.

Sours: https://physician-finder.partners.org/search?filter=is_primary_care%3AT%3Fid%3DFADHelpPg&filter=is_primary_care%3AT&page=38
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Massachusetts General Hospital Guide to Primary Care Psychiatry, 2nd ed.

This handbook on primary care psychiatry is one of several similar books, all with similar names. In the spirit of full disclosure, I should note that I am the coeditor and coauthor of one of these books, but I am also pleased to note that I am excited about Massachusetts General Hospital's contribution to this genre of primary care textbooks.

The first edition of this outline-based but hefty compendium was published in 1998, and the second edition has been expanded in a targeted and helpful fashion, with several new chapters and appropriate updating of most chapters. While a substantial majority of the authors of the first edition continue into the second edition, many new authors are listed, suggesting fresh ideas and constructive turnover. The editors imply that there is substantial collaboration and coauthorship between psychiatrists and primary care physicians, but a majority of the chapters appear to be written exclusively by psychiatrists, although presumably with some primary care oversight. Of the 97 authors, 76 are listed as having psychiatric appointments or affiliations.

The first edition was organized according to the patient's presenting symptom or psychiatric complaint, followed by a lengthy list of chapters on therapeutic strategies, counseling strategies, and pharmacologic approaches. The second edition reorganizes these chapters and adds several helpful sections on therapeutic complications, quality-of-life–enhancing strategies, and physician-assistance strategies, including particularly helpful new chapters on natural medications in psychiatry and treatment decisions at the end of life. Many, although sadly not all, chapters have helpful figures and tables that summarize the most critical information. Other chapters would have benefited from substantial revisions, such as “Screening Tests for the Detection of Psychiatric Disorders,” in which several common instruments are described but not provided, thus lessening the practical value of the information.

This deficiency is emblematic of a larger issue, which is that the specific target audience and use for the book are not entirely clear. The book is too big to carry around, too detailed to be used by medical students, too limited to be employed as a comprehensive textbook, and too textual to function as a point-of-care decision support tool. However, it is an authoritative and substantive assemblage of clinically useful information, especially for primary care residents, teachers, and clinicians with a special interest in primary care psychiatry.

Sours: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC474740/
The Stoeckle Center Perspectives on Primary Care

Search results

NOTES:
- "Affiliation" is the local physician organization to which the doctor belongs.
- A primary care provider (or PCP) is a doctor or in some cases, a nurse practitioner or physician assistant, who sees patients for everyday medical issues, such as colds and annual wellness visits. PCPs often are your first point of contact for your general health concerns.
- Providers who are "accepting new patients" are able to book new patient appointments within 90 days. "Accepting new patients" is subject to change. Please confirm when setting up your appointment.
- Primary Care providers who have "near-term availability" can book new patient appointments within 30 days. "Near-term availability" is subject to change. Please confirm when setting up your appointment.
- "Concierge Medicine" is a unique offering in which providers care for a limited population of patients. Patients can opt into this "direct primary care" model with an annual membership fee.
- Providers may accept more insurance plans than shown. Please confirm when setting up your appointment.

Sours: https://doctors.massgeneralbrigham.org/search

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