Howard Maron, former team doctor for the NBA’s Seattle Supersonics, is considered the pioneer of the retainer-based model and a leader in the field of concierge medicine. In 1996, Maron started MD2, the first company to offer concierge medical care.

What is concierge medicine and what need does it fill in the current market of medical services?
First of all, let me clarify that I only came up with the concept—not the term “concierge medicine.” I know what a concierge is, but to describe what I do as simply opening doors and directing people diminishes the other important thing that I do. I am the primary care physician for my patients. I prefer “highly attentive medicine.”

So what is highly attentive medicine?
At the risk of coming up with a poor analogy: I’m a member of a golf course that has 300 members, and that course is incredibly underutilized. The value of having very few members is that when I show up to play, I can play. As a consequence, the course gets fewer players and it’s in better shape. Similarly, highly attentive medicine means having a staff-to-patient ratio that is strongly in favor of the patient. They’re paying me to keep my practice small—not to be too busy—so I can meet their needs when they need me. Unfortunately, there are other retainer practices that are spin-offs of what we do. Yes, they are retainer-based, but their numbers are different. I have nothing in common with another retainer-based practice if it is not highly attentive.

MD2 offers personalized medical services to upper-income patients. Wouldn’t these patients already get this type of service from their personal physicians?
You mean, do they already have some influence that could have them jump a little higher? Some of them are hospital contributors, so naturally the hospital would do everything it can. But if the only doctor they have is me, as high as they thought I could jump for them, if I already have 30 patients in my schedule that day, how could I? What could I do? Most rich people don’t want to carry a big stick and muzzle others, but even if they did and tried, they couldn’t, because their doctor was booked.

MD2 charges up to $20,000 a year, while others claim to provide the same service for as little as $1,200. What accounts for the difference in price?
In general, what matters is how many patients you have. I take care of only 50 families. Some retainer practices say they have limited their practices to 600 families per doctor. They’re walking the middle ground when there is no middle ground. How can they be available to make house calls if they have 10 times the amount of patients? 
    
Describe a typical patient experience at MD2.
We don’t have a waiting room. Our office is locked. It’s fully staffed. The door is closed, but it’s available all the time by appointment. When a patient comes to the door, the door is locked behind him and he has the entire office to himself. We’re not in a hurry. If a patient needs to do business in the meantime, needs to attend to a phone call, fine, we’ll wait. Again, how can a doctor do that unless he has very few patients? 

If the patient needs to see a cardiologist, I can be there. When the patient is undergoing cardiac catheterization, I will often be there in the procedure room with him. That’s because I’m interested—I want to see it with my own eyes—and I have a great rapport with the cardiologist that I’m using. For the patient, having me there, seeing a familiar face, actively discussing the situation at his bedside inside the cath lab, that could be comforting.

It is not rare for somebody who is literally sitting at Boeing Field, on a plane about to take off, to realize he forgot that he needed to get his blood drawn or maybe needed a flu shot. The staff or I would go down there and do a house call at his private jet.