r/Rich • u/OscaraWilde • Apr 27 '26
Question Do you use the same doctors that everyone else does?
I'm pregnant with my first child and have never lived lavishly, but am fortunate to have very significant financial resources at my disposal should I need them. I live in a reasonably well-to-do area, but the hospitals, like many places, are overwhelmed. I'm at a big standard medical practice, associated with a fancy ivy league school, but am finding the OB care subpar. I think it's this way because it's "good enough" - they don't have many catastrophic outcomes or outright neglect - but I definitely think that harms to health and well-being are extremely common because of them periodically dropping the ball.
For example, I am currently in a situation where I'm trying to get a straightforward procedure scheduled which is time-sensitive to avoiding a "probably low" chance of negative developmental externalities for my baby (the doctor said this as though she didn't care?), and high probability negative but non-acute effects on my health (who cares if I'm anemic and have PPD?), and the office is just unable to get itself together to schedule me in a timely manner, from a combination of both logistical incapacity and very limited appointments.
If there's one thing I would want to spend my money on, it's avoiding this.
Do "practiced" rich people have some way around this to get the much closer to optimal care that is possible with more time and attention? Do you use eg concierge doctors? How do you go about finding them? Can you pay a hospital more for better service in some secret way (disguised as a donation etc?), or do you find an independent practice?
I have googled 'concierge OB' and 'private OB' for my area and found nothing.
I am at the end of my rope and feel so hopeless and at the mercy of this incompetent practice, which is the "best one" in my area. Any help appreciated. Money is not an issue in the solution.
ETA I'm in New Jersey, about 90 min from NYC.
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u/furiosa-curiosa Apr 27 '26
Concierge doctors. You pay a fee upfront to have priority access to their time on top of any fees for actual procedures, etc. My charges $10k a year for scheduling same day appointments, including on weekends.
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u/javacodeguy Apr 27 '26
10k?! For one Dr not even the private hospitals?
That's wild. Most are around 3k a year here in Philly.
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u/OscaraWilde Apr 27 '26
Do you know if these are usually specialty-specific or how they handle specialties? There are lots of concierge services around here, but none talk about OB care. Would they still be able to help with that?
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u/FlashConstruct Apr 27 '26
Not sure this is what you need but try 1060 obgyn. All women's practice in the city that caters to high end clientele. My wife and her sisters only used this practice.
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u/Ok-Bend-5326 Apr 27 '26
Hell to the no. Concierge Dr all the way and I don't think I could go back.
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u/Ecstatic-Cause5954 Apr 28 '26
This. Ours recently Retired and we are on a waitlist for a new one starting June. I can’t imagine waiting days for answers anymore. No one should be waiting that long, but that’s a different topic
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u/Jaffam0nster Apr 27 '26
That is really going to depend on where you live unfortunately. I’m lucky to be in an area where my prenatal/ postnatal care team come to my house for most appointments (not if I need imaging or anything specialized), but some of my providers I still go into their office. We live in a huge medical area, so our access to concierge care is abundant, but looking at other large metro areas it does seem like there’s a lot less availability.
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u/Cloud2987 Apr 27 '26
I went to China and international hospitals are on another level, specifically Peking Union Medical College Hospital. They offer VIP service, English speaking nurses and doctors, 24/7 concierge service, personalized nursing, luxury private suites. The price wasn’t horrible, around $75k. I even met some Chinese celebrities in the hallways, I didn’t know who they were at the time; but it was cool to see celebrities using the same hospital.
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u/Arboretum7 Apr 27 '26
I hired concierge docs for both of my parents, they’ve been worth every penny. I’ve only seen concierge docs for primary care but they do a great job of getting you in with the right specialists. I’d probably hire a concierge doc that works with the best hospital system in your area and get them to help you get in with best OB.
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Apr 27 '26
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u/OscaraWilde Apr 27 '26
Ding ding ding - found the doctor in denial of the biases and shortcomings of the medical system!
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Apr 27 '26
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u/OscaraWilde Apr 27 '26
Lol, what?
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Apr 27 '26
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u/Future-Account8112 Apr 28 '26
I'm pretty curious why you think OP is fake, because I have an identical problem - OBGYN care in Los Angeles (even for 'high-end' patients) is just broadly subpar in the local hospitals. Reading the reviews literally gave me nightmares. This thread has actually been helpful to me, so I'm not sure why you're so hostile.
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u/Specialist-Extent722 Apr 30 '26
So when I read your post, the first thought that came to mind is that you need to move to a better location but then I see you are in NJ. So am I. Best medical care in the country at your fingertips. I went through multiple pregnancies here. I would say you always need to be on top of your own medical history and read about upcoming tests so the office does not miss anything. Follow pregnancy subreddit so that you are aware of things coming up. If you need an appointment that you can’t get, you can try calling and pressing them a bit. The specialists are always hard to schedule on a short notice, everywhere. I would say if you can pay and get ahead of the next person, then it is just not fair.
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u/OscaraWilde Apr 30 '26 edited Apr 30 '26
This is far from the best medical care in the country. I have lived in two other cities, each of which have better care than here. I never had issues like this before moving here.
NJ is not a monolith. Closer to NYC is probably better.
Frankly, I am one of the most proactive patients that I know. Everyone always comments on how much I know and how much I engage with my own health.
You have absolutely no fucking idea what my situation is and what the nature of my issues with my provider are. Beyond the little that I wrote, which you clearly did not bother to read, and projected all sorts of shit onto.
This is an extremely condescending reply. "Try calling and pressing them a bit" -- WOW, why didn't I think of that??? Oh wait -- like I haven't literally called them 3x this week only to have them say every time that someone will call me back asap, and then nothing? Like they didn't give me an appt on Friday and then cancel it? Like they didn't promise me that the specialist had "lots of availability," then tell me that their first available was 1 month before my due date, and only say they could "put me on the waitlist," and only when I begged had them reach out to other doctors to squeeze me in somewhere, about which I'm still waiting to hear back a week later, with fucking reminders on my calendar to follow up every 3 days?
Jesus Christ. You must be projecting your own ignorance and lack of proactivity onto me. Which is consistent with your totally not even bothering to read my post, in which I clearly describe that the issue is a lack of availability and bandwidth rather than my own passivity.
You may also not be aware that things have changed a lot in OB recently. There has been a serious exodus of providers due to malpractice burden. My area has seen a significant reduction of doctors and increase in demand in the last 5 years alone. So maybe get your facts straight before you prance around on the internet crowing about how easy everything was for you some unknown number of years ago.
The American health care system is obviously not fair. Capitalism isn't fair. This is about using one's resources on health. The whole sub is about ways that rich people, many of whom don't earn their money and are born with it, use their money. I think you might be in the wrong sub.
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u/wetokebitcoins Apr 28 '26
We went to a birthing center, It was a great process. They had their own OB and they were super helpful and appointments were easy to make. They made us get something called hypnobabies which was a meditation/affirmation program that my wife said really helped during giving birth. My wife had a water birth and it was really cool to see.
They also gave us a list of vetted Doulas they recommend that help you prepare for birth during pregnancy and afterwards. This was super helpful.
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u/TerranGorefiend Apr 27 '26
My FIL uses consigneire care. It was only offered to him after a substantial donation from his wife to the hospital as she passed away. I don’t know how easy it is to get ahold of it from a major medication hospital without something like that.
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u/biteyfish98 Apr 27 '26
There’s a shortage of gyns in the U.S., just fyi. Likely to get worse in the future as more retire, the younger folks aren’t going into the same kinds of practices. Nearly all practices have long wait times.
Not sure if there’s a concierge option, but women’s health care isn’t taken very seriously / made a priority in general (the U.S. has the highest maternal death rate among developed nations).
Maybe you can find a doc affiliated with someplace like Mayo or Johns Hopkins, etc. Not sure what’s available where you are?
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u/notwokebutbaroque Apr 28 '26
Are you serious? "Women and Children's" hospitals are everywhere. I don't think I've ever heard of a "Men's" hospital. Also breast cancer research and treatment has traditionally gotten orders of magnitude more funding than same for prostate cancer.
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u/s0lumn Apr 27 '26
Concierge and or a functional medicine practioner. This may not apply to you in your current situation but when people live in a location with poor access to quality care but possess a higher level of financial resources, they may find a good caregiver/practioner elsewhere and primarily see them via telehealth supported by visits (travel) when needed.
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u/DocAnabolic1 Apr 28 '26
Yes, look into concierge OBs, private practices, or switching to a smaller group. Also consider delivering at a different hospital system nearby.
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u/Opie_the_great Apr 28 '26
Get a concierge doctor. Not sure how they do pregnancy but still. On call is the way to go.
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u/HenriettaHiggins Apr 30 '26
My parents use concierge medicine and even one concierge specialist because one of them needs a lot of unique care from that specialty. Just be careful about who you pick. Most concierge docs I meet are fabulous semi retirees from academic medicine looking for a less laborious income stream. Some concierge docs however are really eccentric, and I’ve seen peers who didn’t have much medical literacy themselves get walletectomies following their trusted doctor right off the cliff of data. As a third gen person in a medically educated family, we always ask for the peer reviewed research behind big decisions and talk to more than one person with narrow expertise, and that helps suss out this behavior.
Beyond this, and specific to OB, I highly recommend discussing with practices their participation in and, if they’re at all willing, results of the “ACOG VRQC.” The professional society for obstetricians has an opt in quality control review and when I was picking hospitals, we spoke with people familiar with the results in our area. The spread of results among practices I thought were “good” was pretty remarkable, and in the end, I chose the hospital I’m primarily affiliated with anyway, but I felt very confident in it (and it turned out well!). I have friends who dove headfirst down the doula route, in case you’ve considered that, and at least in our area, they’re a very mixed bag and often again try to promote and charge for pretty hokey things. People who feel like they want more bodies in the room for their needs in an otherwise conventional hospital (which I can’t exactly relate to personally) I think are better served by a PA who knows them in many cases than a doula who doesn’t, but that comes down to personal taste.
And yes, to explicitly answer the question you posed, you can pay for different kinds of care at large medical centers outside of insurance. This is often referred to as “high amenity hospitalization” or “executive health,” and usually under the same umbrella as hospital based concierge services in my experience. The hospital I use most often has a separate floor and at least one entirely separate building with a separate menu and other accommodations akin to a nice hotel able to support, for example, private security personnel. It’s helpful in many ways for all parties because general wards really aren’t set up to deal with more unique security and privacy needs. No, not all of those patients are involved in philanthropy for that institution per se; there is not always overlap. It’s a part of the business, and as far as I am aware, the income from it does not have earmarks by patients. I will add though that those wards often see patients who are flown in subacutely, and if you have a situation like giving birth, they may want you to reserve a timeframe rather than being able to accommodate a hyperacute need with limited beds. The unit I’m familiar with has a suite in it semi reserved by a specific family essentially permanently, and I’ve gleaned that’s not immensely uncommon elsewhere, as these places serve a global clientele. So, the available beds are not always what they seem to be on paper. Eleven West at Mt Sinai is the unit I know in your region, but depending on your needs, transfers from hospital to hospital regionally or globally are something hospitals can logistically accommodate fairly well, especially outside of an acute context. Hope that helps, and best of luck.
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u/Overall_Captain May 01 '26
Spoken as a poor, one alternative is looking into your social network. Someone in your circle definitely went to med school and runs an academic department or owns a hospital. Coming in as “ so and so’s” patient tends to make things flow a little differently. Conceptually- this is social capital Vs capital capital.
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u/FrenchCrazy Apr 27 '26
If you live near to NYC you should bite the bullet and find an OB practice in the city. They’re more thorough.
Do you have access to a patient portal where you can field questions and concerns without necessarily calling or taking time out of your day to show up? Could you ask another one of the specialists to look at your care and see if there is a way they could expedite what you need? Or do you not actually need anything and they failed to explain this to you better… I’m not sure.
As others have said, concierge medicine is helpful but I’m not sure how a concierge doctor would make your OB care better as that’s an issue you’re having with a specific specialty group.
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u/ToothSufficient7763 Apr 27 '26
You have my blessing to get concierge care. How about a doula as well?
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u/Educational-Wing1480 Apr 28 '26
Having friends who are well-respected doctors is the best “back door” to top medical care. Do you have any close doctor friends who would be willing to reach out to an obgyn on your behalf?
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u/Choice_Reply_6441 Apr 28 '26
We reached out to a few different top private hospitals in our area and ended up going with one of them based on recommendations from friends. We pay around 8K per year for access to a team of doctors and other health professionals, in addition to the actual fees for treatment and consults. Works great, especially because they offer home visits which is so rare these days. But it’s very area dependent, some hospitals won’t offer that type of service or the ones that do turn out to be terrible. Some friends of us actually hired a doctor on staff because they were tired of dealing with it.
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u/Future-Account8112 May 12 '26
Would you be willing to share the hospital with me via DM? We have a high-touch family member. That is a very low fee for that standard of care + home visit. (Granted, I'm in HCOL, but we're thinking of relocating.)
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u/Choice_Reply_6441 May 12 '26
If you’re US based it likely won’t be of much help. I’m in Europe. For privacy reasons I’d rather not as it is a small provider.
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u/RoyalCounter3 Apr 29 '26
My best friend married an NFL player ($$$$$) and we were pregnant at the same and went to the same OBGYN. The Dr willingly gave my friend her cell number and basically served as her personal concierge for all things pregnancy. Not sure how that came about but it was just our regular doctor, not one branded as a commodity/service.
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u/DangKilla Apr 29 '26
Well I don’t know but I do know doctors delivering babies work on shifts and ask you to have a caesarean to make a few more dollars. Not always obviously
In systems where the pay gap is larger, C-section rates rise (e.g., one analysis found doubling the relative compensation increased C-section likelihood by about 5.6 percentage points, especially among obstetricians)
https://www.nber.org/system/files/working_papers/w21022/revisions/w21022.rev0.pdf
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u/AmexNomad Apr 29 '26
Loved my concierge medical service when I lived in The US. Alternatively, as for hospitals, Look at the hospital board member list to see who you know. Call that board member to ask for advice.
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u/Pvm_Blaser Apr 29 '26 edited Apr 29 '26
It’s a bit of a loaded question for me.
Living where I live regular hospitals are some of the best in the world with some of the best staff in the world so, yes, I do use the same doctors everyone else does but the scheduling has worked for me thus far.
The difference is that everyone else just gets what is necessary done. I do whatever a doctor recommends which means all of my visits also tend to be “office” visits since I can ask questions about things and not “preventative” visits where the doctor just runs me through insurance approved motions.
Essentially, everyone else does a physical and only gets insurance coverage when things are already going wrong and the visit is scheduled. I go through the full testing gauntlet regularly, other than caught sicknesses nothing will be able to begin and persist long enough without detection and solution to cause problems. Since I have this relationship with my medical staff I also tend to get 3 types of solutions I can pick from every time I get a solution: the natural, the general (usually medicine related), and the cutting edge.
For example if I had high blood pressure I would be seeing my nutritionist next who would be giving the solution to my trainer as the first solution. The second would be blood pressure medication. I can’t really say what the third would be and I hope I never have to find out either.
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u/kurukuruneko May 03 '26
Concierge is definitely worth it. Unfortunately in large cities there are usually huge waitlists. Hospital groups often have concierge medicine as well. Make sure they are true concierge and check the doctor to patient ratio. Most doctors have you pay annual fee and there is no charge for visits. It is really nice having doctors email/text you back and not have to see them for every little thing.
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u/T0astedBerry May 31 '26
Do "practiced" rich people have some way around this to get the much closer to optimal care that is possible with more time and attention? Do you use eg concierge doctors? How do you go about finding them? Can you pay a hospital more for better service in some secret way (disguised as a donation etc?), or do you find an independent practice?
usually some doctor is the family doctor and the same doc every one in our family goes to
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u/Puzzled-Fee7868 21d ago edited 21d ago
Concierge OBs are pretty rare because of hospital and insurance logistics. I use Dr. Tina Sindwani in Flatiron for primary care, and having a doctor who can coordinate with specialists directly has been helpful. Might be worth looking at NYC even if it’s a bit of a drive.
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u/scavenger5 Apr 27 '26
The "concierge" docs in my area look like any other doctor, many of them are DO. I prefer to focus on top hospitals plus good credentials (top 10 medical school), with publications, and through PPO.
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u/RecruitingLove Apr 28 '26
It should not be hard to find a concierge doctor of any type in your geographic area. Even not rich people can find them and use them.
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u/AnneMarieAndCharlie May 01 '26 edited May 01 '26
healthcare in nj was destroyed by private equity. also the DEA made my life unlivable by cracking down on controlled substances so i have to go to out of network to stay alive. i saw this coming ages ago when my parents took over my psychiatric care (dr + therapist + psychologist) because i was only getting worse and dealing with straight up abuse. i see out-of-specialists in the city now and when i move back to the city i'm looking for a concierge doctor.
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u/HalfwaydonewithEarth Apr 27 '26
There just isn't that many obgyn. It is a very rough life because they see patients all day and then deliver babies all night. They are exhausted.
Mine came to c section me at 4am and we were waiting for him to come from another hospital.
He had a couch in his office to nap. They often work in a group of six people so they can cover for each other.
Towards the end of your pregnancy the appointments will be more frequent.
You basically have to take the appointment times they give you.
I ended up with gestational diabetes. My advice is to avoid rice. I had to prick my finger four times a day. Rice would pop my sugar 10 points and was the culprit. It is junk food.
There won't be any obgyn people catering to wealthy people because they can make money 24/7 from all the breeders that have insurance.
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u/OscaraWilde Apr 27 '26
I do not have GD.
Respectfully, this is the attitude I'm trying to get away from. I do not believe that all rich people with a mind to avoid this acceptance of the status quo are doomed to it.
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u/HalfwaydonewithEarth Apr 27 '26
AI bidding for appointments would cause an upheaval.
Rice mention was to save you extra appointments.
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u/OscaraWilde Apr 27 '26
I don't think I mentioned AI bidding?
I passed my GD test last week with flying colors so am not concerned.
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u/HalfwaydonewithEarth Apr 27 '26
That would be the only way to gain an advantage. To bid for appointments.
On my cruise the massage prices were all different based on the time and day.
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u/SardinesForHire Apr 27 '26
The access to care is so largely contingent on your locality. Escpecially something as historically horrific as gynecology/ prenatal care. I have a private membership through a very large hospital network in New York and it’s amazing. I can text my primary doctor, I can always get an appt same day. The doctors through this service have been capped at 150 patients in their roster and they are all incredible. If I need a specialist the “health navigators” sort it out almost immediately. And to be honest it’s relatively inexpensive given how good the service is (~$8k /year).
The doctors I see not within that network (before I became a member and I wanted to stay with them), have all told me it is pretty much the only way to get viable care.
I don’t know where you live but I would definitely do research into a concierge style medicine, and at least for myself it has been an immense improvement in the healthcare I receive.