MDNews - Minnesota

While concieRge caRe can yielD benefits to PRimaRy caRe PRoviDeRs (PcPs) anD Patients alike, it takes maRkeDly DiffeRent foRms. obseRveRs uRge Physicians Who aRe inteResteD in concieRge caRe to assess the eXPectations anD DemogRaPhics of Potential Patients befoRe making the tRansition. Carve Your Niche Should You ncierge Medicine? in Co by Thomas Crocker M U.S. physicians practice concierge, or direct, care, according to the American Academy of Private Physicians. Many had become disillusioned with the patient volume-driven system. Others left traditional practice out of frustration with the copious time spent satisfying bureaucratic requirements. How those physicians approach concierge care varies, but an April 2013 article in American Medical News described it thus: "In concierge medicine, patients agree to pay an annual retainer fee in return for more personalized primary care services and better access to the practice. These physicians typically limit the number of patients they see to several hundred, and they don't always accept insurance, although some continue to participate in Medicare or with commercial payers." Beyond the broad terms of that definition, concierge medicine is hardly monolithic; rather, it mirrors the heterogeneity of U.S. health care. Direct care models range from organizations with a widespread physician 6 ore thaN 5,000 | Twin Cities MD News ■ MdNewS.CoM presence, such as Florida-based MDVIP, Inc., to independent practitioners, such as Nancy Falk, MD, an internal medicine physician and Clinical Professor of Medicine at George Washington University Medical Center who operates a concierge practice in Chevy Chase, MD. a Network approach Founded in 2000, MDVIP has approximately 650 physicians and 200,000 patients in 41 states and the District of Columbia. The company has hospital- and multispecialty group-employed clinicians as well as solo practitioners. It accepts Medicare and most insurance plans, and patients pay an annual fee that starts at $1,500. While MDVIP's physicians aid in the management of acute and chronic conditions, the centerpiece of the organization's services is an annual wellness exam, during which patient and clinician develop a comprehensive, personalized wellness plan. The company makes it a priority for physicians to spend sufficient time with patients. Indeed, MDVIP's founding was rooted in the belief that working with fewer patients would allow physicians to emphasize prevention and wellness, says Bernard Kaminetsky, MD, FACP, Medical Director of MDVIP and one of its founders. "Every primary care doctor has a fi nite number of patients he or she can see in a day and feel confident that appropriate care has been rendered," Dr. Kaminetsky says. "For me, it was about 26 or 27. I never understood those people who see 40, 45 patients a day." For PCPs considering direct care medicine, a potentially appealing aspect of partnering with a large organization is the resources it offers. Physicians who join MDVIP, for example, gain legal and marketing support, digital tools for patient nutritional and fitness analysis, and a program for referrals to top medical centers around the country. Andrea Klemes, DO, FACE, Medical Director of MDVIP, says it is vital that physicians seek out a company that has extensive knowledge of relevant state and federal laws and the commercial insurance market. "They need that legal, regulatory support," Dr. Klemes says, along with the tools to help them attract patients.

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