Providing a more personal touch

Neal Pire, national director of wellness services at Castle Connolly Private Health Partners, hosting a New York City-based member wellness event. Courtesy Castle Connolly Private Health Partners.

When we’re not feeling well, we all want to be treated immediately by doctors who understand us as well as their specialties.

There’s a growing need for quality doctor/patient relationships on both sides of the exam table and, with it, a growing field — concierge medicine. 

 “The typical primary care doctor has a patient panel of 2,200 to 2,500 patients,” says John Connolly, MD, president and CEO of Castle Connolly, a research company that publishes the “America’s Top Doctors” book series and partners with more than 30 magazines to profile top docs. “When (physicians) convert to a concierge model, (they) reduce their patient load to anywhere between 400 and 600 patients,” Connolly says. “That gives them the ability to offer immediate appointments, either same day or next day and to spend a lot more quality time with them.”

Connolly had a growing interest in the concierge model when he met Dean McElwain, MD, a health care executive who had a decade of experience in the concierge approach. 

“I decided it was time that Castle Connolly got into this field,” Connolly says. “So, we launched Castle Connolly Private Health Partners (CCPHP) back in 2015.”

Concierge medicine seemed to fit Castle Connolly’s brand of helping consumers navigate the health care environment. “We are uniquely situated in the space,” says McElwain, president and COO, Castle Connolly Private Health Partners. Their nationwide network of physicians gave them an edge. “(Patients) have access to our database of top doctors,” Connolly says.  “It’s very useful to them.” 

Their database proved fertile ground for finding doctors who could benefit from converting their practices. “There is no cost for doctors,” Connolly says. “We handle the cost of that conversion and we also offer expertise to do it properly.”

At Castle Connolly about 30 doctors have converted their practices to the concierge approach, and “we have another three or four that are in line ready to be launched,” Connolly says. “We expect we’ll add between 10 and 15 additional doctors this year.”

Steven Schneider, MD, a 16-year “America’s Top Doctors” veteran, was the second doctor to come aboard CCPHP when it launched. Before he converted his practice to the concierge model, he had a patient panel of 2,500, seeing 20 to 22 patients in a single afternoon. His part-time practice is down to 250 patients. Now he sees a maximum of eight to 12 patients in an afternoon; four or five on some days.

He had been considering concierge medicine for years when McElwain approached him, he says, and the change has been beneficial.  

“I would greet my patients with ‘Sorry to keep you waiting,’” Schneider says. “It’s changed the quality and nature of my practice. And now no one’s waiting.”

The concierge model is no longer only for the super-rich. There are physicians who can charge $10,000 to $25,000. “People hear that and think ‘Concierge medicine, that’s not for me,’” Connolly says.

The patients who join a CCPHP concierge practice pay an annual fee of around $2,000 to $2,500. “That’s what most of our doctors (charge),” Connolly says. “Some charge more. The doctors continue to bill for insurance. But they don’t have to bill for a couple of thousand patients, they have to bill for the number of patients they’re caring for, so it’s much less burdensome.” 

Telemedicine is a growing part of the CCPHP program, which has developed its own branded wellness offering that pairs patients with a health coach at no additional cost.

“That’s part of the secret sauce,” McElwain says. “Physicians understand the added value of that.”

Annual growth in subscription private medicine services, primarily in internal and family medicine, is between 3 and 6 percent, notes Concierge Medicine Today, an industry trade publication. The obstacles to enticing doctors are twofold, Connolly says, citing increased employment of physicians by hospitals and large medical groups as well as a general fear of change and making their converted practice a success. 

But according to an August 2017 article in The American Journal of Medicine, concierge medicine will continue to grow. Even hospitals are realizing many patients are looking for a concierge doctor and are implementing programs. Massachusetts General Hospital in Boston has launched a concierge medicine program and “We have partnered with Newton-Wellesley Hospital, which has also launched a program,” Connolly says.

Critics of concierge medicine say the model further drains the pool of an already insufficient number of primary care physicians. But for Schneider, it was a determining factor in whether he continued to see patients at all.

“If I had kept the old practice, I don’t think I could do it anymore,” he says. “I was in a state of anxiety half the time.”

There is also fear of elitism and a reinforcement of a two-tier health system.

“Is it a solution for everybody? No.” Schneider says. But he sees a growing number of middle-class and blue-collar workers opting for the concierge model. He cited a patient who initially balked at paying the annual fee. During the time that he was trialing the new program, the patient suffered a hemorrhage. It was caught the day it happened. Schneider’s ability to manage the patient’s case led to quick action and saved him from dying of a stroke. More personal care was the difference between life and death.

“The major change I see is simply growth as more doctors and more patients become knowledgeable about concierge medicine,” Connolly says. “Because for those who can afford (it), it’s definitely worth it.” 

For more, visit ccphp.net.

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