Frequently Asked Questions: Q: What do you call this new practice model? Q: What is the annual membership fee? Q: Do I need to continue my healthcare insurance? Q: Why should we change from the current healthcare structure? Q: How can I join the new practice? Q: Once I am a member, how do I contact Dr. Daly? Q: If I need emergency room or hospital care, where should I go?
Q: What do you call this new practice model? A: Several hundred physicians have already changed to this new structure or something similar. It goes by several names: Patient-Centered, Consumer-based, Retainer-based or Concierge. There are several such practices in the Boston area, involving physicians affiliated with Massachusetts General Hospital, Beth Israel Deaconess Medical Center, and elsewhere. For more information on medical practices that reestablish these kinds of physician-patient relationship, please go to www.SIMPD.org, the website for the Society for Innovative Medical Practice Design.
Q: What is the annual membership fee? A: Please click on the “Membership Rates” link, on the left side of this page.
Q: Do I need to continue my healthcare insurance? A: You do need to maintain your healthcare insurance, to cover tests, specialists and hospitalizations. My office visits and hospital care charges will be billed to your health insurer as usual, by my professional practice entity William C. Daly, M.D., LLC. I am very sorry that current laws and insurance regulations require that you remain responsible for copayments and deductibles; the membership fee is only permitted to pay for services and amenities which are not covered by your health plan.
Q: Why should we change from the current healthcare structure? A: In the standard healthcare system, the doctor spends much of his time satisfying mandates of government and insurance companies, rather than evaluating patient needs and concerns. Insurance company and government payor rules have significant impacts on the way physician practices operate, and the interests of these payors are very different from yours. We are often in the uncomfortable position of being the enforcer for healthcare policies created to serve the insurer. Physicians who spend more time with patients are penalized because payors severely limit compensation for primary care office visits. We all know that "you get what you pay for,” and payors disproportionately reward for tests, procedures and care by specialists. They do NOT pay for adequate time to tend patients' needs, and there is NO reimbursement whatsoever for availability, prompt care, good outcomes, or patient satisfaction. In our previous practice, I did my best to provide all this, while continuing medical education to advance my knowledge base. The cost-cutting pressures, and administrative and financial burdens imposed by the payors, especially upon primary care physicians, prevented me from continuing in that conventional system. When you are given enough time and energy from an experienced physician, a meticulous history leads to an accurate diagnosis at least 80% of the time, before any examination or testing. Therefore your diagnosis and treatment are usually right the first time, leading to quicker recovery, and minimizing the need for repeat visits for the same illness. Fewer tests and procedures may be necessary, reducing high-tech expenses, and preventing costly injuries sometimes caused by unnecessary procedures. Practices that have already switched to this structure have found that these savings can be greater than the membership fee. The advantage of this Patient Centered Practice is that I can provide you services that are NOT covered by your health care insurance, such as long and relaxed appointments, giving you ample time to address your concerns. I also provide 24 hour a day, 7 day per week direct access by cell phone, e-mail, and landline, and flexible appointment times, with urgent visits the same day you call. You will be seen on time, with little or no waiting. Nutrition counseling, prescription facilitation, electronic medical records, and other advantages will also be provided.
A: I will be happy to meet with you, or speak with you by phone, to provide any information particular to my new practice.
Q: How can I join the new practice? A: If you would like to join, please call, write or fax the office, and you will receive a membership agreement for your review. I will accept membership registrations with initial payment on a first-come basis, and will close the practice when full.
Q: Once I am a member, how do I contact Dr. Daly? A: During office hours (8 AM-5 PM, Monday, Tuesday, Thursday, Friday), you will get the quickest response through the office at 978-470-0001. If I'm with a patient, I will not be free to answer the cell phone. After hours, I can be reached by cell phone; you will receive my cell phone number upon joining the practice. At any time, you can e-mail me for non-emergency questions, and I'll answer within 24 hours (usually sooner). Do not use e-mail for emergencies. Also, do not send any attached files; for security reasons, I will never open them. Since I am always "on-call", please defer non-urgent issues until business hours. If I'm on vacation or ill, I'll make arrangements for a covering physician to provide medical care for you. As a courtesy to you, I will notify you of such occurrences by e-mail.
Q: If I need emergency room or hospital care, where should I go? A: LOCAL HOSPITALS: If you need emergency room or hospital services, I recommend Lawrence General Hospital, where I will gladly provide your inpatient medical care. Holy Family Hospital has hired "Hospitalist" physicians to provide inpatient medical care. If you choose Holy Family Hospital and need hospital admission, you will be assigned to their Hospitalist physician during your inpatient stay, per their policies. I will be happy to talk with that doctor at any time, but I will NOT be able to control your daily care. BOSTON AND OTHER HOSPITALS: You can continue to use any hospital of your choice, as long as it participates with your insurance plan. Since I am not on the medical staffs of those hospitals, they will not allow me to function as your attending physician during your hospitalization. But I will be happy to speak with your inpatient attending physician at any time during your hospital stay. Similarly, you can continue to use any specialists that you would like, as long as they participate with your insurance plan, and I will work with them to coordinate your care.
A: I will continue to give you the time, attention and respect that you deserve, in each of our encounters. And I am committed to demonstrating that this is the best way to practice medicine, in the hope that it becomes the new standard of care. I believe that when people realize this quality of care is available, they will start to demand it, and the healthcare establishment will have to improve in response to popular pressure. |