What a Concierge Practice Should Be

So, you’re curious about this thing they call “concierge medicine”, eh? Your neighbor has been bragging that he has a “concierge doctor” complete with secret cell phone number and same-day appointments. And how about the last time you went to see your physician, after waiting several weeks for an appointment, and sitting for almost two hours on a hard plastic chair in a stifling waiting room with a dozen or so of your closest friends, each anxious to share their particular flavor of the pandemic virus? Your reward was face time with your doctor measured in microseconds. This whole “concierge” thing is starting to sound pretty darn good, isn’t it?

Ready to write the check? Just before you do, let’s just take a closer look at this growing phenomenon of concierge medical care.…

May I speak with the Concierge, s ‘il vous plaît?

It’s generally accepted that the “Concierge medicine” model dates back to 1996 when something called “MD Squared” (MD²) was started by two physicians who were working at the time for the Seattle SuperSonics. Their idea was to provide the same luxury care to the general (read paying) public as was available at the time to their elite ballplayers. To provide more personalized service, the MD² model envisioned a physician-patient load of only 50 families. And for the privilege, each of those individuals and families paid between $13,000 and $20,000 per year!

You must realize that the conventional medical office at that time served about 3,000* patients with just one physician. Thus, the advantages offered by MD2 were obvious: easy, 24-hour access to a doctor, same-day appointments, no time limits for visits, and even reciprocal care in any of the 10 major cities that were ultimately included. It was heaven for hypochondriacs!  That is, if you could afford a spare $20k a year. (*By the way, today the official published number is about one-half that, somewhere between 1,200 and 1,900 patients per physician, largely due to insurance companies moving patients around. That’s still a lot of patients!)
And, oh, didn’t doctors love the math! Fifty times an average of $15k each year (all cash), minimum office staff, minimum office size, and lots of extra time for golf and all that other stuff that doctors do. MD2 was a hit.

Fast-forward to the year 2000 when a couple of other enterprising doctors practicing in ultra-posh Boca Raton, Florida formed “MDVIP”. Obviously bored with caring for just 50 families, their model expanded to allow for up to 600 patients per physician, which was still significantly less than the norm, but at a greatly reduced fee structure of less than $2000 per year.

And again, patients frustrated with the old ways beat a path to their door, this time though for this much more affordable option. Now twenty years later, and claiming nearly 1,000 participating physicians across the country, MDVIP clearly filled a gaping niche. But, now it’s time to note that there’s a theme here. The evolution and success of “concierge medicine” has largely been driven by two forces: patients who desire a better service experience from their medical doctors and are willing to pay for it, and doctors who are very happy to make more money by seeing fewer patients.

But, to paraphrase an old Wendy’s hamburger ad, “Where’s the Concierge?”

 

Truth in Labeling

If practices advertised as “concierge” were completely honest, they would instead be called “exclusive” or perhaps “private”. Joining MDVIP or one the many clones that have popped up around the country really only grants the patient access to the practice and to the physician. It’s true that patients do get a cell phone number, and there is plenty of time (most days) to visit and address patients’ needs. Patients aren’t required to wait for days or weeks or even months for an appointment and, often to meet insurance rules, there’s usually a “special” annual examination or series of laboratory tests.

In most cases, however, once you look closely, there’s not much more. The privileges and special services that a Concierge practice should be expected to offer simply are not there. Aside from membership and access, the typical Concierge practice is one of name only.  We clearly have our own ideas about what it means to be a true Concierge practice, but that’s because we pride ourselves in being one. Here are 10 things that we believe every Concierge Medical Practice should offer:

• The highest-quality, evidence-based medical practice – Look, isn’t that why you’re here? None of the flashy design or fresh flowers can mean anything unless you, the patient, are confident that prescriptions and treatment are the result of careful study of reliable resources combined with years of practice experience. NO voodoo for you!
• A focus on feeling better, living longer, and enjoying life more – In medicine, “best” is not only measured by how closely practitioners follow published recommendations, but how well their patients feel and function. A Concierge practice should help you live your best life!
• Provide the Keys to the Kingdom – When expert help is needed, your Concierge doctor should always be able to say, “I know Doctor So-and-so… Let me give them a call and see if we can’t get you in quickly.” Rapid access to subspecialists, imaging, or procedures when you need it reduces worry and even suffering and could even save your life!
• Offer technical expertise – A Concierge practice should maintain special relationships with vendors and other providers to be able to offer the very best solutions available. Whether it’s a new compact wireless cardiac monitor or a painless wound closure device, top Concierge medicine practices remain at the forefront of technology.
• Serve as your health ombudsman – A true Concierge practice goes beyond providing medicine alone and serves as the patient’s representative and champion when called. Here at ZüpMed, a parent may ask that we speak with a school headmaster about a change in a child’s grades or behavior. During the peak of the pandemic, we often were asked to speak with employers about conflicting COVID test results. A Concierge doctor represents you.
• Be a reliable guide and navigator – Look, this medical stuff ain’t easy! It’s common to be confused about tests and test results, especially when different providers and subspecialists get involved and order things even we haven’t heard of! It’s the job of the Concierge doctor to figure it all out.
• Interpret reports and results – Sure, “anemia” means “low blood”, and low blood is caused by “low iron”, except when it isn’t. Everything in medicine, from blood tests to x-rays to nuclear medicine studies must be taken in context, and the job of a Concierge physician is to sort it all out and communicate clearly.
• Be your professional matchmaker – Some doctors like to chat; some doctors are direct. Some are multilingual; some only speak Southern. Some trained at Harvard; others did mission trips. A real Concierge physician knows you and your preferences and can find surgeons or subspecialists that are a perfect fit.
• Manage your medications – Americans are the most over-medicated population in the industrialized world. We believe that responsibility to the patient doesn’t end with the prescription. Instead, it’s there that the real obligation begins. The Concierge physician should maintain a constant watch over the patient’s medications, including those prescribed by other doctors! Here at ZüpMed, we take things a step further with our clinical Pharmacist and state-of-the-art electronic medical record system.
• Offer the utmost convenience – Those who travel by private aircraft can bypass the long lines at check-in and TSA. Once aboard, there are favorite drinks and snacks, Wi-fi, and roomy, comfortable seating. Most importantly, weather permitting, it’s “wheels up” on your schedule. A true Concierge practice offers a similar degree of luxury.

 

Look, nobody is going to compare a visit to the doctor with two weeks in a villa in the south of France. But a visit to a Concierge practice like ZüpMed can and should provide the very best healthcare available, personalized to your needs. Any additional services, like lab, x-ray, and even prescription medicines, should be onsite or easily available, and the focus should always be on you, the patient, and your preferences.

This is how we built ZüpMed, and we continue to work hard every day to serve every patient the way that we would wish to be served, be it in a fine hotel, a legendary restaurant, or a doctor’s office.  To us, it’s clear: when a Concierge greets you with, “How may we assist?”, they should really mean it!

Drs. Lloyd and Shannon Finks combine their commitment to high-quality medical practice and years of clinical experience with technical innovation and personalized, white-glove service. Interested in sharing the experience? Call today to schedule an appointment.

Posted by ZüpMed