Doctors opting for a different treatment

By Jeremy Oberstein

Frustrated by the inherent limitations of the healthcare industry, Dr. Mark Gerard joined a growing group of physicians who are opting for a program that allows them more time to spend with patients.

Gerard, a personal care physician in Burbank, converted his primary practice to a concierge-style service that he says allows him to more thoroughly treat patients and avoid some of the hassles created by the rush of thousands of patients that used to scuttle through his office.

“There were more than 2,400 patients in my practice,� he said. “I shrunk it to 600 with this model.�

Gerard is part of a medical trend in Burbank, and around the country, as an increasing number of doctors are opting for this change, said Wayne Lipton, managing partner of Concierge Choice Physicians, a private company that helps doctors convert their practices.

“This is a longer-term plan to keep people healthy,� he said. “That doesn’t happen in five to seven minutes.� For an annual fee of $1,800, concierge medicine patients receive a yearly physical examination, a wellness assessment, and a written report of the results and recommendations, Gerard said. They can book extended appointments with little or no waiting time, have 24-hour-a-day direct phone and e-mail access to their physicians, and obtain physician-to-physician coordination of specialty referrals. The idea, though, is not to cut out the insurance industry altogether, as medical services usually covered by insurance continue to be paid for by the patient’s health plan, he said.

But as Gerard extolled the virtues of the concierge program, he admitted that the price of personalized care is not for everyone.

“For some people, cost was definitely a factor,� he said. “If you are in your 20s or 30s, then I would say that it is more of a luxury than a necessity. But for those who are in their 60s or 70s, the focus is more on prevention and for them it makes more sense.�

Annual fees for the program can range from about $1,800 to about $5,000, Gerard said, depending on the location of the practice and the patients’ needs.

But the price does not represent a financial boon for the doctors who choose to convert their practices, Lipton said.

“We don’t create millionaire doctors, we create competent doctors,� he said. “One of the biggest misconceptions these days is that primary care physicians are among the highest-paid people in society. The irony is that for the amount of training and responsibility they have, their income level has dropped dramatically. This is an opportunity to stabilize their income.�

For Gerard, the switch to concierge program, which he made in 2007, was not about money.

“It’s about shrinking the size of my practice to where it was in 1960s and 1970s,� he said. “I’m rarely late for appointments. I’m not as hurried. That whole concept of being able to be present for a half-hour at an appointment is a big asset.�

The added time was a driving force behind the switch for Gerard, as his patient time and the number of general practice doctors out there has dwindled.

The number of primary care physicians in the United States has dropped by nearly 35%, increasing the amount of time people may spend in a waiting room, according to the Center for Studying Health System Change, a nonpartisan policy research organization in Washington, D.C.

Gerard hopes that as people’s frustrations increase, more will gravitate toward the concierge model even as the number of doctors who have switched to the specialized model are still a relatively small percentage of the nation’s primary care physicians.

About 1,000 out of 200,000 primary care doctors have ditched the traditional system, according to Lipton.

“Right now, it’s a small niche in the practice of primary care physicians,� Gerard said. “But hopefully, it’s something that will grow.�

But the growth of doctors buying into this specialized model might come at the cost of patients who can’t afford to pay the annual fee, Providence St. Joseph Medical Center spokesman Dan Boyle said.

“What’s happening is that . . . there are more patients out there and a smaller number of doctors,� he said. “There are a low number of doctors in California because of the high cost of living and their salaries tend to be lower in comparison to the rest of the country.

“There is not an impact on other doctors, not an impact on the hospital, but the impact is on the people in California.�

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