Concierge physicians break from the pack

Concierge physicians are breaking from the pack, offering first class service for annual premiums. A pediatrician is profiled here. Many see CPs and their patients as greedy and self-centered, including The HealthLaw Blog. This seems overwrought. In America, consumers and entrepreneurs have the right to pay for extra services not covered by insurers or Medicare and to provide those services. There is no equality in access to health care or any other services or products and boutique medicine doesn’t and won’t change that fact of life. -more-

Concierge physicians are breaking from the pack, offering first class service for annual premiums. A pediatrician is profiled here. Many see CPs and their patients as greedy and self-centered, including The HealthLaw Blog. This seems overwrought.

In America, consumers and entrepreneurs have the right to pay for extra services not covered by insurers or Medicare and to provide those services. There is no equality in access to health care or any other services or products and boutique medicine doesn’t and won’t change that fact of life.

For an overview of the legal issues involved in concierge, or boutique medicine, read the response to the GAO at the American Society of Concierge Physicians.

Doctor to provide area’s first ‘concierge’ practice

Will patients pay more for quality care?

Tuesday, September 07, 2004
By Christopher Snowbeck, Pittsburgh Post-Gazette

At a time when health-care costs are going through the roof, pediatrician Scott Serbin is betting that some patients are willing to pay more.

This December, Serbin will become the first doctor in the Pittsburgh area to open a “concierge” medical practice, meaning he will dramatically reduce the number of patients he sees so that he can provide better service to those who remain.

That service will include everything from longer appointments and prompt return phone calls to personalized fitness plans and house calls.

For families, this will come at a cost not covered by health plans.

Parents of children up to age 6 will have to pay $100 per month for a spot in Serbin’s practice. For children 7 to 18 years, Serbin will charge a fee of $50 per month.

Serbin sent a letter to patients last month explaining the change and included a medical journal article describing the ethical questions the concierge medicine trend has raised. Foremost among those: Serbin will part ways with many of the more than 2,000 patients in his practice who have come to rely on him for care.

But concierge medicine represents a chance for medicine to be practiced in a way doctors and patients think is best, Serbin said.

“I’d really like to give patients the care we’d all like to give: A very personal relationship with our physician; a physician who’s on call all the time,” he said. “This is Marcus Welby.”

After 18 years of treating children from his North Side office, Serbin said he is turning to a concierge practice due to frustrations with the current state of medicine.

Declining reimbursements and increasing costs, such as those for medical malpractice insurance premiums, are driving many doctors to see more patients to maintain their incomes, Serbin said. He succumbed to this, too—although to a lesser extent than others, he believes—but now finds the trade-offs to be impossible.

Reducing the number of patients he sees in his new practice—called Pinnacle Pediatrics—will mean he can provide a number of new services, he said. All calls during office hours will normally be returned within one half hour, Serbin pledged, and he will deliver the care at all times, except for one weekend per month and four vacation weeks per year.

While new to Pittsburgh, concierge practices have been around elsewhere for several years.

In May, the Michigan-based American Society of Concierge Physicians held in Denver its first conference, drawing 135 doctors, nurses and practice managers. About 60 percent of those in attendance already practice concierge medicine, estimated Jack Marquis, general counsel for the society.

The first such practice was established by two internal medicine doctors in Seattle in 1996. Concierge practices modeled after the Seattle group don’t expect any reimbursement from health plans for the medical care they provide, Marquis said.

Other concierge practices charge a fee for the expanded access to doctors that they give patients, but they also bill a patient’s health plans for the medical services.

A third model for concierge care seeks reimbursement for services, but also assesses a charge at the time of each doctor visit.

The common denominator in all three is that doctors treat a reduced number of patients, Marquis said.

Serbin’s practice will be similar to the Seattle model, but with some differences, said Michael Blau, a lawyer with the Boston firm McDermott, Will & Emery LLP. Blau is helping Serbin create his practice, which will encourage patients to switch into a health insurance policy with a higher deductible for primary care.

Serbin will accept any reimbursements that health plans send his way, but the prime source of revenue will be the monthly fees. Families with three or more children will be charged just $20 per month for the third child on up.

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