photograph courtesy dreamstime
Although he didn’t actually coin the term “concierge medicine,” a doctor in Seattle is generally given credit for developing this new type of medical practice. In 1996, Dr. Howard Maron was the team physician for the Seattle Supersonics, the city’s NBA team, while also maintaining regular office hours as a primary care physician. One day, so the story goes, he walked through his crowded waiting room and thought it was “very odd” that everyone sitting there “was only allowed a 15-minute slot.” That’s usually the amount of time most patients, then and now, are scheduled to see a doctor or nurse practitioner.
Thinking there must be a better way, Maron and a colleague, Dr. Scott Hall, formed MD2 (“MD squared”), a radical departure from the patient-doctor relationship. For one thing, instead of seeing hundreds — maybe thousands — of patients throughout the year, each doctor would limit his “patient load” to only 50 families, which would allow them to devote more time to each case. The doctors would not work with health insurance companies. Instead, those lucky 50 families would pay a premium for such personalized care. In the beginning, MD2 charged anywhere from $15,000 individually to $25,000 for a family of four for an annual “membership.”
In return for that fee, they would benefit from more time with the doctor, more individualized treatment plans, and no extra or “hidden” costs for lab work and procedures. And because no insurance companies were involved, there would be no additional — and often unexpected — billing for procedures and tests, and no worry about co-pays, deductibles, authorizations, and other financial elements of a typical health insurance policy.
What’s more, the patients would have 24-hour access to the doctor, could arrange same-day appointments, and if necessary could request something nobody had encountered since the days of the old TV show Marcus Welby, M.D. — house calls.
“Delivering exceptional medical care must fundamentally revolve around, honor, and protect the most sacred of relationships — that between physician and patient,” according to the MD2 website. “This is only possible when you limit your patient threshold to so few.”
The new project was an overwhelming success, with a waiting list of patients hoping to become MD2 members. Across the country, other doctors — and patients — heard about this new approach and paid attention. Other medical practices came to follow this model, calling it retainer medicine, membership medicine, direct-care, and other terms, but eventually most them settled on one term: concierge medicine.
photograph courtesy dr. lynda freeland
Dr. Lynda Freeland is a Memphis physician affiliated with MDVIP.
In 2000, a group of physicians in Boca Raton, Florida, created MDVIP, the nation’s largest concierge medicine network. The company oversees more than 1,000 physicians, who treat some 350,000 patients across America. Each of those doctors pays MDVIP an annual franchise fee of $500 per patient, in return for administrative, branding, and marketing support, but the group does not own, or otherwise manage, the doctors’ offices.
Here’s how it works. On average, MDVIP physicians see only a dozen patients a day, compared to 20 or more in a typical practice. Same-day appointments are considered the norm, and patients see the doctor they have selected — not another physician in the group. Waiting rooms are rarely crowded. What’s more, on the patient’s first visit, the doctor makes a thorough exam and develops a comprehensive “MDVIP Wellness Program,” which they will monitor throughout the patient’s relationship with them. In addition, patients can receive wellness screenings, physicals, and other preventive measures, which are often not covered by typical health insurance plans.
The cost varies, depending on what part of the country the physician is located, but in the Memphis area, MDVIP patients pay a membership fee of $450 every three months — or $1,800 a year. Here, as of September 2020, nine physicians were affiliated with MDVIP — seven internal medicine specialists and two doctors who focus on family medicine. They’re not in a group; each maintains an individual practice in East Memphis or Germantown.
Every health insurance policy is different, with varying deductibles and other factors affecting the cost of a patient’s annual premium. But in most cases, the annual fee an individual pays to any of the physicians affiliated with MDVIP would be considerably less than the premium they would pay to Aetna, Humana, Blue Cross Blue Shield, or any traditional insurance company.
All the MDVIP-affiliated physicians focus on primary care, and that’s fine for a “whole body” approach. What’s missing from the group, however, are cardiologists, OBGYN doctors, neurologists, orthopaedic surgeons, and other specialists. Patients should understand that MDVID isn’t directly affiliated with specialists or hospitals. Any visit to a specialist, or any treatment in a hospital, isn’t covered by that membership fee. For this reason, most concierge doctors, including MDVIP, recommend that patients continue to carry their regular health insurance.
Even so, concierge doctors feel the benefit of a more personalized approach to healthcare is worth the cost. “All my patients are unique, with their own specific, particular circumstances and concerns regarding their health,” says Dr. Lynda Freeland, a primary-care physician who sees patients at her clinic in East Memphis. “I enjoy practicing medicine in partnership with my patients — developing plans for prevention, diagnosis, and treatment of their medical problems. I believe that partnering with MDVIP will allow us to offer more availability as well as more time, so I can give them the optimal care.”
Dr. William Bucy, a family medicine practitioner in Germantown, echoes that philosophy. “As an MDVIP-affiliated family practice physician, I will utilize all my resources to help patients achieve health and wellness,” he says. “We will work closely to address your needs. Compassion, communication, and planning are keys to our success, and my desire is not only to be your doctor, but your friend and partner in health.”
photograph courtesy züpmed
Dr. Shannon Finks, president and director of pharmacy services at ZupMed, makes a house call.
In March 2020, Drs. Shannon and Lloyd Finks opened ZüpMed, which they describe as a “hybrid” concierge practice, in Laurelwood.
Shannon is the group’s president and director of pharmacy services, and Lloyd is the senior physician and director of operations. They are complemented by a staff of nurse practitioners, radiological and lab technicians, an acupuncture specialist, and even a fulltime concierge, who schedules appointments and ensures the ZüpMed experience goes smoothly. The comprehensive suite of services includes preventative, wellness, chronic, and acute healthcare.
Patients have two ways to access healthcare here. The practice offers “a la carte” care, meaning they accept walk-in patients who select from a menu of treatment options — a visit with the doctor or nurse, immunizations and vaccinations, pharmaceutical needs, pregnancy testing, and more. All these treatments are clearly spelled out on the ZüpMed website, and they are cash-only. As with other concierge practices, no health insurance company is involved.
“At the same time, however, we provide patients with an itemized invoice for everything we have done,” says Dr. Lloyd Finks. “We are considered out-of-network with most insurance companies, such as Aetna and Humana, but they may still pay a portion of your bill.”
A half-hour medical consultation is $95; the cost is $150 for a full-hour. Pregnancy tests are $20, x-rays are $25, and vaccinations start at $35. A “telemed” visit (via Zoom or other online platforms) is $75, and anyone who really seeks the personal touch can arrange a house call for $325. Either of those last two options is invaluable, says Finks, “for somebody like a mother with a sick child, who simply can’t get to our office very easily.”
ZüpMed also offers a concierge membership program, with pricing dependent on the patient’s age. Young patients up to age 21 pay $30 monthly. For ages 21-45 the cost is $55, ages 45-65 pay $75, and for those 65 and older, the monthly membership fee is $125. Finks points out that any of these “is often less than what you are paying for your cellphone service.”
The membership fee eliminates most, if not all, the costs for medical services. (House calls aren’t entirely included in the membership costs, but the fee is reduced to $245.)
There’s another difference between ZüpMed and traditional doctors’ offices. “We have no waiting room,” says Dr. Lloyd Finks. “As soon as you arrive, our concierge escorts you directly to the exam room, maybe hands you a drink if you want one, and you see the doctor right away.” Afterwards, patients can pick up any needed medications from ZüpMed’s in-house dispensary.
“The whole point of a visit here,” says Finks, “is to make things as pleasant as possible for our patients.”
Is concierge medicine right for everybody who can afford it? It depends on their finances and medical needs. If patients already have a comfortable relationship with their primary-care doctor, and they feel their health insurance covers most of their care, despite the premiums and deductibles, there may be no need to change.
But if they would prefer access with a physician who can spend more time with them, without having to wait days (or sometimes weeks) for an appointment, then the concierge medicine model may be a good choice for what ails you.
For more information, visit mdvip.com or zupmed.com
