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Ask Dr. Gott 1/4
'Concierge doctoring' wave of the future?
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DEAR DR. GOTT: I am writing about your recent response about "concierge doctoring." In your response, you suggested that limiting the number of patients seen and charging those patients a fixed fee is driven by the desire of some doctors for greater reimbursement to compensate them for interference in their profession.
    My neighbor recently signed up for just such an arrangement, enthusiastically. She had found, as have lots of other patients, that many doctors today are doing just the opposite of concierge doctoring. To satisfy their compensation requirements (or perhaps to meet some quota imposed on them by HMOs or PPOs), they are cramming as many patients as possible into their schedules. This results in rushed visits, limited time for patient questions (let alone in-depth discussion), delays in being seen and so on.
    The current process leaves many patients (and their doctors) frustrated. Concierge doctoring offers a solution for both doctors and patients. It provides the luxury of time, accessibility and thoroughness. The doctor does not necessarily make more money than if he or she were seeing many more patients in the same amount of time, but can practice medicine at a less frantic pace. The patient does incur additional costs, because he or she pays a fixed fee plus the normal charges for specific services provided. However, patients who elect for this medical relationship believe they get better "doctoring" and are willing to pay for it.
    Based on my limited experience, I see concierge doctoring as patient-driven as much as it is doctor-driven.
    DEAR READER: I am publishing your articulate letter because it addresses a new phenomenon that I believe should be reviewed: concierge doctoring. I'll withhold my opinion until I receive more input from readers.
    DEAR DR. GOTT: I want to help the lady who has facial hair. I had this problem and corrected it with a product called Hair Block, which I got from Cosmetic Lab Sales. It is a roll-on and, if used as directed, it removes the hair gently, and the hair stays off for four or five weeks. As long as hers seems to be, she should probably leave it on for 15 minutes and rinse with warm water and then cold. I then use an alcohol-free freshener followed by Oil of Olay moisturizer. Do not scrub the face with a washcloth afterward. It is a wonderful product, it is safe, and it costs only $7.99 for a roll-on that lasts for months.
    DEAR READER: Thanks for the tip. I was not aware of this product, but it certainly sounds like a reasonable (and cheap) solution for the problem of facial hair on women.
    DEAR DR. GOTT: You stated that nitroglycerin spray is effective in relieving the pain of neuropathy. I am not diabetic, but I suffer severe neuropathy pain in my feet. Could you please give me more specific information regarding the administration of the spray?
    My family doctor was not aware of the fact that the spray could be used to relieve neuropathy pain, and she suggested I write to you for specifics on this usage.
    DEAR READER: The pain of nerve malfunctions can be a challenge to diagnose and treat. Although it isn't always an effective therapy, nitroglycerin spray applied three or four times a day can help many patients who have neuropathy. Ask your doctor to prescribe nitroglycerin on a trial basis.
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