CONCIERGE
MEDICINE
Just What The Doctor Ordered
By Denise Witt (Folsom/El Dorado Style Magazine)
Remember the good old days, when doctors made house calls,
even in the middle of the night? What once was taken for granted
is now making a slow comeback, at least for those who can
afford it. It's called "concierge medicine," and it
all began in the mid-1990's, when a former team doctor for the
NBA's Seattle Supersonics and medical director for the Portland
Trailblazers, Dr. Howard Maron, decided to make available to
the public the type of personalized healthcare that basketball
players received. Thus was born the first practice of its kind,
MD2.
Also known as "boutique or retainer medicine," it
is now practiced by a small but growing number of physicians
who charge an annual fee to provide premium services such as
house calls, visits to the patients office, same-day appointments,
coordination of care with specialist, preventive health care
and 24-hour access to the physician's home and cell phone numbers.
"It's
an attempt by physicians to get back to providing more personalized
medical care, " says Dr. Robert (Bob) Nelson, president of Concierge
Physicians of California, Inc.
Because these doctors take on
fewer patients - 100 to 150 patients compared to the average
2,000 to 4,000 for traditional dooms - they are able to offer
more specialized care and personal attention. Many of them do
not deal with billing insurance companies, but instead are
paid directly by their patients. Annual retainer fees can range
from $1,000 to $20,000 a year. However, patients still require
medical insurance for catastrophic care, such as hospitalizations.
X-rays, lab tests, medication and visits to specialists.
Dr.
Nelson says that it is not just the wealthy who seek out such
premium care. Others interested in concierge medicine include
people with multiple medical concerns, and adult children
asking for such services for their elderly parents who are homebound
or in assisted living facilities.
Sammy Cemo of Orangevale
signed up 91-year-old father, who lives at home in Sacramento,
for the service. Meanwhile, Cemo, who has some medical problems
of his own, including a severe spinal problem, sought out Dr.
Nelson for advice on his shoulder and got the treatment he needed.
Now he and his wife are patients, too. "I was impressed
by the research Dr. Nelson did for my shoulder. He comes
to the house. He's come to my office. He'll go with us to appointments.
He makes himself available," he says.
Some may find the
idea of charging more for such services to be controversial especially
in a day and age when so many are without health insurance of
any kind. But patients who have become dissatisfied with the
current healthcare system are finding that this arrangement
is just what the doctor ordered. A study conducted by the U.S.
Government Accountability Office (GAO) found that concierge care
arrangements are fine as long as they don't violate Medicare
requirements (www.gea.gov).
"It's a lot like paying for
private school," says Dr. Nelson. "Public school is
available to everyone, but if you'd like to get more individualized
attention, you can opt to pay for private school." It's
a matter of supply meeting demand.
Today, there are more
than 250 concierge physicians in the United States, and the trend
is growing. The Society for Innovative Medicine Practices Design
(formerly the American Society of Concierge Physicians) was fom1ed
to assist physicians who wan! to convert their practices to concierge
medicine, focusing on healthcare providers who have a direct
pay re¬lationship with their patients.
"Not all concierge
physicians provide the same level of service," says Dr.
Nelson. While some charge only annual fees, others may charge
initiation, monthly or per visit fees.
Among the perks that concierge
physicians provide is full access to their home and or cell phones.
Patients can call any time of the day or night, a concept that
may seem scary to some doctors. But, says Dr. Nelson, '”Many
concierge physicians have found that once the barriers to access
a doctor for medical care are torn down, people for the most
part will respect your time. Because patients know we're available
to them, they have the security of knowing that they can
talk to their doctor without the traditional barriers." If
a patient cuts a finger, or his or her child wakes up in the
middle of the night needing medical attention, these doctors
make house calls.
Other perks include providing preventive medical
care, such as annual physicals, or accompanying a patient
to specialists and helping them find different options when
facing surgery or other procedures.
Dr. Nelson says he offers
his patients travel medical records for when they are on the
road. "Using electronic medical records, we can print out
a patient's entire medical record on CD, along with EKGs, X-rays
and a list of medications that they take, so patients can
take their records with them when traveling. This helps expedite
medical care and decreases the risk of medical errors," he
says, For example, if .a patient were to have chest pains while
on a business trip, he says, “these records would give
doctors instant access to the patient’s medical history.
including their normal EKG when they were not having chest pain.”
Other
concierge physicians, such as Q Concierge Physicians in Montery,
founded by Doctors M. Samir and Hisana Qamar, include in their
list of services making hotel reservations and arranging
for transportation for family members during a medical crisis,
It's this kind of personalized services that's gaining the attention
of those who are able to afford it.
Direct access to a personal
physician 24 hours a day, seven days a week, out-of-office appointments,
house calls, and personalized one-on-one attention from a physician… it's
the kind of service fit for a (Sacramento) King. It’s luxury
medical care for the pampered patient.
- Denise Witt
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