Insurance hassles transform physician services market

When it comes to the health care industry, the times are a-changing. Just ask Country Club Shores resident Bob Gault.

Gault has been the patient of Sarasota Memorial Hospital cardiologist Dr. Daniel Cooper for the last 13 years.

When Cooper made the decision to turn his medical practice into a concierge practice that allows him to spend more time with his patients, Gault was eager to be a part of the new practice.

There’s one big tradeoff with that decision though: Cooper and a growing number of physicians around the country are opting not to accept Medicare, Medicaid or any other insurance.

At the June 12 Kiwanis Club of Longboat Key breakfast meeting, Cooper spoke about his decision to morph his practice into a new business model called Cooper Concierge.

“Visits with patients when accepting Medicare resulted in fewer time with patients and huge amounts of staff time to process bulky medical claims,” Cooper said. “After 27 years, I had enough.”

The concierge service with annual fees and no access to Medicare, Cooper said, began back in the 1990s.

In 2001, Cooper said 1,000 doctors nationwide transitioned to the concept. By 2012, Cooper said 4,000 doctors nationwide and counting are leaving the insurance process behind to create smaller practices to offer better care to their patients without the hassle of filing claims.

“This allows me to be a better doctor and patients to start taking charge of their care,” Cooper said.

Being a patient of Cooper, Gault said, now involves paying an annual fee of anywhere from $2,000 to $7,000 per year, depending on your age and complexity of care. That fee also surrenders your right to file for medical insurance claims for services he has rendered. The annual fee includes as many doctor visits as needed and all tests and expenses needed to care for patients.

In return, Gault receives 24/7 care when needed, has access to Cooper’s cellphone and can even request that his doctor make a house call if needed.

Cooper, Gault said, also became not just his cardiologist, but also his doctor of internal medicine and his family physician.

“For me, that’s one-stop shopping,” Gault said. “I have the doctor I have known for the last 13 years available for virtually every service or health issue I’ll ever need.”

Cooper said the move requires more work on his part, but it’s more rewarding work.

“Being available 24/7 means I take less vacation time,” Cooper said. “I took one week of vacation last year and average two weeks of vacation a year now.”

Doctors who still follow the medical insurance business model, Cooper said, are retiring earlier or changing jobs.

After his speech, Kiwanis Club of Longboat Key President Richard Crawford expressed frustration with the Medicare and insurance company model as a whole, especially after Cooper noted that fewer college students are becoming doctors because of the business hassles now involved with getting paid through insurance claims.

“We as a society have allowed thebureaucrats to take over our health care, and it has to stop,” Crawford said. “We need to take it back.”

Contact Kurt Schultheis at [email protected]