The Doctor Is Always In
Is Concierge Medicine for You?
Uncroweded offices, longer appointment times, personalized attention, comprehensive care, and house calls.
Concierge medicine, a growing trend in health care, evolved in response to a desire for more individualized treatment as well as increasing frustrations with overworked doctors and overcrowded offices.
In a concierge practice, patients pay an annual fee (not covered by insurance) ranging from $1,500 to as much as $10,000. While this fee may seem high, the benefits are worthwhile. Patients receive a comprehensive annual exam, 24/7 access to their doctor, shorter wait times, and a more holistic approach to treatment. The fee for concierge medicine does not replace health insurance. It doesn’t cover ER visits, hospital stays, major surgery, or tests such as MRIs. In a traditional practice, doctors see about 20 to 25 patients a day and only spend about ten to 15 minutes with each patient. Concierge doctors usually have fewer patients, allowing the doctor to give patients more individual time, with an emphasis not just on curative but also on preventative care.
Dr. Nancy Gade and Dr. Priya Iyer opened Wilton Internal Medicine in 2008. “It is a way to practice medicine the way we learned it,” says Dr. Iyer, as opposed to seeing patients by the clock. Their office, a cozy house off Route 7, exudes a warm feeling, supporting Dr. Gade’s assertion that their practice is “like having a doctor in the family.” Their retainer fee covers all in-office visits and tests and round-the-clock access. They currently see approximately 250 patients, mainly middle-aged, but also elderly patients for whom house calls are a regular service. Dr. Iyer says, “This gives peace of mind to a patient’s family who may not live close by.” If hospitalization is needed, they visit patients daily and will coordinate all health care. Long-time patient Sue Johnson can attest to the benefit of this coordination. Dr. Iyer stepped in to assist when Johnson’s visiting sister-in-law was hospitalized. “Dr. Iyer relieved our concerns by guiding us through everything,” says Johnson. While 24-hour access might seem intrusive to the doctor’s personal life, Dr. Gade finds it very satisfying, saying, “If our patients are happy, we’re happy.”
Concierge Physicians of Westport was established as a way to provide “more coordinated personal care for our patients,” says Dr. Nina Karol, one of the four founding doctors in an office that also has three RNs on staff. Their fee covers 24-hour access and coordinated healthcare, but unlike some concierge practices they take insurance and Medicare, which gets billed for patient visits. “We’re the same as a traditional practice, but our goal is to make things smoother,” says Dr. Karol. She typically sees between four and ten patients a day, allowing her to get to know them better. “Having a doctor who really knows you can save you money in the long run,” she says. Home visits are an aspect she enjoys. “It’s enlightening to see the home environment and how it might impact the patient’s health.” Patients also receive several complimentary face-to-face meetings prior to joining. “We want to make sure it’s the right fit for both of us,” says Dr. Karol. Marshall Harrison, one of Dr. Karol’s patients appreciates the extra care. “She is highly accessible, responsive to all my needs and a good friend as well,” he says.
When Dr. Robert Ruxin in Ridgefield switched to concierge medicine, he opted to be a part of MDVIP, a national network of primary care doctors. “I found their model appealing because they took care of the logistics so I could focus on the medical aspect,” he says. MDVIP differs from other concierge practices by keeping its annual fee relatively low and offering access in 45 states, a desireable aspect for frequent travelers. Dr. Ruxin specializes in endocrinology and many of his patients have chronic health issues, such as diabetes. His personalized and preventative style of medicine helps reduce the number of hospitalizations for complicated cases. His annual physical exam includes several screenings, using the detailed results to create a customized wellness plan. It was during one of these screenings that Dr. Ruxin found an abnormal white blood cell count in a patient who was eventually diagnosed with chronic lymphocytic leukemia. “It might not have been caught at this early stage without Dr. Ruxin’s attention to detail,” says the patient’s wife, C.J. Golden.
Deciding if a concierge doctor is right for you should be based on your medical needs and concerns. It is a valuable service for elderly patients, but also those of middle age looking to get ahead of health issues. Practices vary in terms of fees and what that fee covers. Patients also need to find a doctor they connect with, since the relationship between doctor and patient is a more personal one.