Alternately, concierge patients are pampered. Doctors promise to
work themselves around a patient’s schedule, rather than vice versa, promising
on-call visits or same- or next-day appointments. Those seeking privacy and
confidentiality are enamored of the idea of secure, discreet offices. Renovated
waiting rooms boast juice bars and comfortable sofas on which family members can
relax. Patients who have cardiac stress tests can shower in spa-like bathrooms
before returning to work. Every patient receives the personal doctor’s home,
office and cell phone numbers.
Howard Maron is the physician credited with
creating the concept of concierge care. “The ‘Highly Attentive’ Approach”
. While serving as team physician for the NBA’s Seattle Supersonics, he
began to wonder how to provide the same kind of personalized care he gave to the
athletes on the road and at home, at all hours of the day and night. “A team
owner can’t afford for the star players to sit on the sidelines, so a team
physician is trained to detect problems before they even occur,” says Jon Moses,
a veteran health care administrator recruited by Maron to serve as chief
executive of his new venture, Seattle-based MD2.
At practices in Washington
and Oregon, MD2 physicians care for a maximum of 50 families each, or 100
families in each two-person practice. Fees run $13,200 per year for an
individual, $20,000 for a couple and an additional $2,000 for each child. “These
[services] are for people who say, ‘There is a price for good care, and I’m
willing to pay it,’” Moses notes.
| I can’t offer my patients dramatic new technologies, but I can, and do, give
them the kind of old-line service that has vanished from the rest of the health
care system. |
Moses and Maron say their patients
(clients, as Moses calls them) receive not just superlative service, but also
better health care. “Our doctors have the time to devote to their patients and
become their confidant, their advocate, their friend,” Moses says. “This
translates into a better quality of care, by far.” He is convinced that had he
and his wife been MD2 patients several years ago, physicians would have been
quicker to diagnose her cancer, which is now in remission. “It’s too easy to
delay or miss diagnoses if you don’t know a patient intimately,” he
says.
According to Connolly, concierge practices can handle this type of
preventive care and wellness service more effectively, and may be able to better
identify recurring issues, ranging from strep infections to depression. “That’s
the kind of detailed attention that our wealthiest citizens have sought from the
health care system, but that really has become harder to find,” he says.To date, however, the only thing that can be said with certainty is that
concierge care saves time and offers more personalized care in comfortable, even
luxurious, surroundings. No studies have been completed showing that a doctor
spending more time with a patient, or having a smaller patient load, lengthens
patient lifespan or ensures that cancers or other maladies are diagnosed earlier
or treated more effectively. Behind the marketing hoopla, even the staunchest
proponents of concierge care admit that no one knows whether all this cosseting
and these accoutrements ultimately result in better medical care. “I don’t think
my level of knowledge is any different from a good doctor at a regular
practice,” Katzman says. “But while I can’t tell you that people live longer,
the quality of their life is better. They know if something comes up, it will be
addressed in a timely way.” Patients assessing the value of concierge
medicine must consider some risk factors associated with this model. One of the
most common points highlighted by concierge critics concerns whether primary
care physicians convert their practices to concierge services because they truly
want to offer better care, or because they want to change their business model
to focus on high-end patients while eschewing paperwork. Manhattan internal
medicine specialist Christopher Barley, who contemplated and rejected the idea
of transforming his practice into a retainer-based service, casts a critical
eye. “With a lot of doctors who opt for retainer-based practices, you see them
make this choice for lifestyle reasons,” he says.
|
