A specialized medical service that’s been growing during the last 15 years bucks a trend toward managed care, and allows physicians to spend more time with patients.
Concierge medicine, also called retainer-based medicine, is a blip on the radar when compared to how most medicine is practiced. National health care statistics estimate that a small percentage of Americans participate in these specialized – critics say expensive and exclusive – practices.
Either way, there’s no denying that the concierge practices are popping up more and more. Offices in Sandy Springs and Buckhead pull in hundreds of patients from around the area.
For the doctors, a common theme emerges as to why they’ve decided to go this route: They’ve seen the thousands of patients that are managed by general physicians to make many private practices and hospitals profitable, and they don’t like it much.
Dr. Edward Espinosa, who used to work for Piedmont Hospital in Atlanta, said internists in a traditional practice must maintain a patient load of 4,000 to 5,000 people to turn a profit. Espinosa’s practice, near Roswell and West Wieuca roads, opened in 2008. He has about 100 patients.
“I know my limits. I didn’t see it working for my quality of life and, indirectly, my patients,” he said about operating a traditional practice. “I took a leap. You’ve got to have some guts to do that, but I knew what I wanted.”
Espinosa’s concierge medicine charges an annual fee that is typical of similar practices: $1,500 a year. The practice accepts most major insurance plans.
For the annual fee, patients receive a cell phone line to the doctor, an ability to schedule appointments with little waiting time and the knowledge that their doctor is managing fewer patients.
Ken Thorpe, professor of health policy at Emory University, said concierge medicine is a growing a niche. “It will never be big, but I think these practices will continue to grow,” he said.
Dr. Gladstone Sellers, who sees patients at 755 Mount Vernon Highway, charges a retainer fee of $3,000 per couple.
The physician, who has practiced medicine for 27 years, said that the modern healthcare environment doesn’t allow for the level of patient care that got him interested in medicine.
“We saw the coming depersonalization of medicine and the constraints it would have on time with the patient. This is not how I was trained, and this is not how I envisioned the way to practice,” he said. “I didn’t see being the harried doctor seeing to one problem before heading off to the next.”
Sellers’ office resembles a typical doctor’s office. It does, however, lack a waiting room full of patients.
On a recent afternoon, he spent a few minutes on a personal phone call to a patient, also a former professor of Sellers’ from Georgia Tech. He advised his patient not to take a prescribed medication before a procedure. A personal medical assistant knows to follow up on the advice as well, Sellers said.
“It provides a level of care that’s above – they are working with someone who knows them and someone they already know,” he said.
Both Espinosa and Sellers spoke about the follow-through that concierge-based doctors are able to provide. Espinosa knows specialists at Piedmont and Northside hospitals. Sellers also maintains personal ties with the specialist he refers patients to.
Sellers said that the smaller patient load inherent in concierge-based practices means that a primary care physician can follow through on a complicated medical procedure, such as a heart bypass or an ACL tear.
“We basically intervene on your behalf. It doesn’t mean that you get to the front of the line over anyone else,” he said. “The reality is that (the normal) primary care physician doesn’t have the resources to walk a patient through.”
In the local area, a concierge-based practice has popped up for pediatrics. Dr. Marc Tanenbaum recently started his own concierge practice, a niche within a niche of medicine, say experts. Most parents feel comfortable with the care provided in a traditional way for children, Emory’s Thorpe said. Concierge doctors, as a whole, care for patients that are older than 65 and have more periodic medical needs than those who are younger.
“It’s increasingly popular with Medicare patients. That’s a population that has higher health care needs on a much more routine basis,” Thorpe said.
Espinosa said that, though many of his patients are older than 65, many are busy professionals in their 40s and 50s who don’t want to wait in a doctor’s office and do want preventive care.
“They are very interested in prevention, and they make sure they are getting their screenings,” he said.