VIP treatment: Just what the doctor ordered?
Primary care doctors across the country are changing
the way they do business and that could be good news or bad news for
you -- depending on your health-care needs and the size of your bank
Still small, but ever increasing, numbers of physicians
are converting their practices to "concierge," "luxury,"
or "VIP" practices -- offering patients same or next-day
appointments with no waiting time, unhurried visits with their doctor,
an annual comprehensive physical, a wellness plan and the ability
to reach their physician 24 hours a day via personal pager or cell
To make this possible, these doctors are downsizing
the number of patients they treat from a few thousand to a few hundred.
If you're worried about or already struggling with
health-care costs, the growing trend might be something new to fret
about. But if you've got plenty of excess cash and are more upset
over waiting times and rapid-fire exams, a concierge practice may
be just what the doctor ordered.
To make up for the reduced billings doctors making
the switch are charging hefty annual retainers ranging from $1,500
to $20,000 on top of insurance payments, co-payments and out-of-pocket
What's more, they're closing their doors to longtime
patients who won't come up with the annual fees.
No long lines
The practice isn't widespread yet. There are fewer than 500
doctors across the country operating concierge practices today,
according to Dr. John Blanchard, a concierge practitioner in Michigan
and president of the American Society of Concierge Physicians. But
if your doctor makes the change, or if you're considering making
a switch yourself, here are seven things you should know about concierge
- Internists and family practitioners are most likely
to become VIP doctors, not pediatricians, cardiologists and surgeons,
- While concierge doctors say they can spend
more time treating patients, experts say there is no evidence
their patients actually get better medical care.
- If you're considering joining a concierge
practice, make sure you examine your contract carefully to learn
which services are included in your retainer fee and which aren't.
- Some practices will bill your health insurance
and some won't, but not all concierge practices accept Medicare
and traditional insurance coverage. Find out before you make a
- Even if you have health insurance, and your
doctor will accept it, you will be responsible for co-payments,
deductibles and out of pocket costs.
- Even if your doctor tells you to pay up or
find a new physician, he's still required to continue to treat
you until you find another physician and to facilitate the free
transfer of your records to a new practice.
- The number of doctors changing their practices
is expected to be very limited. "Even if there were 1,000
doctors in the country doing this, that would be from an overall
pool of 300,000 primary care doctors," says Andrew Ripps,
CEO of MDVIP, a Florida-based company that helps doctors convert
their practices from the traditional model to the concierge model.
The fees and services vary widely. Here
are some examples:
- In Seattle, Wash., MD2 (pronounced
"MD Squared") charges $20,000 and includes marble showers
and personally monogrammed robes for its patients. MD2 is the
brainchild of Dr. Howard Maron, a former team doctor for the Seattle
Supersonics of the National Basketball Association. Launched in
1996, it was the nation's first concierge practice.
- In Boston, Personal Physicians
health care charges an annual membership fee of $4,000 a year
in addition to fees for services. "We want to be able to
spend more time with patients," Dr. Steven R. Flier told
the Boston Globe. "We're desperately struggling to create
a system that lets us do that within the limitations of managed
- In upstate New York, Dr. Paul
DiEgidio was the first Rochester-area physician to launch a concierge
practice. He says it's a way for him to escape the crushing load
of 2,000 patients, and for his patients to get better health care.
Dr. DiEgidio offers standard care for $2,500 and platinum care
for $5,000 ($10,000 for families). Standard care patients get
his cell phone number and house calls, while platinum patients
get additional benefits such as immediate appointments and he'll
even accompany them on visits to specialists. "Doctors are
overloaded," he says. "Everybody I know is dissatisfied
with the health-care system. I'm offering a way out."
- In Cincinnati, Ohio, internist
Douglas Magenheim quit a high-volume practice with 2,700 patients
to open his "luxury primary care" practice. For $1,500
annually, he promises same- or next-day appointments and personally
returns patients' phone calls and e-mails day or night, holidays
or weekends. Dr. Magenheim plans to limit his patient load to
800, which means he stands to pocket $1.2 million in fees alone.
"There have been a lot of
complaints about how people have to wait too long to see a doctor.
This is my answer to fix that," Dr. Magenheim says.