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PHYSICIANS/POLICY: Concierge Medicine-Interview with Ed Goldman MDVIP

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Does primary care have a future? And is that future a version of concierge medicine? It’s very early days, but yesterday I had a great conversation with Ed Goldman, CEO of MDVIP, a franchise concierge medicine company. He has some very interesting things to say about how concierge care may not just be for the worried wealthy.

The conversation is in this podcast
.
There’ll be a transcript available in a couple of days.

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102 replies »

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  4. DR’s who do not like their Concierge Practice. There are physicians who became disappointed with changing their traditional practice and cannot go back. Why? Numbers? non-responsiveness of purveyers of the model? What can we know about those who face that predicament daily? Your thoughts please.

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  6. A concierge doctor, also known as a VIP concierge doctor or a private doctor is a primary care physician who provides enhanced care to a patient. Concierge practice is also called boutique medicine, internal medicine practice, retainer-based medicine, and innovative medical practice design. Some of the advantages of Concierge medicine include coordinated wellness programs, coordinated prescriptions, more time with the doctor, availability of the doctor via cell phone or e-mail at any time of day or night, availability of home visits and more. An example of a VIP Concierge doctor is Dr. David C. Rosenberg of Jupiter Concierge Family Practice. The address to his office is 2141 Alternate A1A South, Suite 200 Jupiter, Florida. It is located near the Calle Vija shopping center at the corner of Old Dixie Highway and East Indian Town Road in Jupiter. Visit his website at http://www.jupiterfamilypractice.com or call 561-743-0005 to get more information about concierge medicine.

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  14. Interesting comments, it stuck me that when watching the news the other day that the autoworker at 160,000 actually makes more than the doc, at 120,000.
    And given the importance of your health vs your car seems odd, but then Britney Spears makes alot more than any fireman, I suppose all this is indicative of the human condition.
    Whether MDVIP is a bad thing is same as asking if any premium service is a bad thing. There is no guarantee to health care, perhaps if we all remembered that we’d stop over eating, drinking, stop smoking, and exercise.
    The fee these docs charge is less than smoking, gambling, etc…….for me 1500 for primary access to a highly rated Doc is a better investment than any of those….so that’s where my money would go.
    But that’s a choice I make, and why I bust my butt each day to earn a good living, so I can live a good life or at least the best I can. I don’t expect anyone to be compelled or volunteer to be my doc, landscaper, waitress, teacher, etc…..I earn the prviledge of other peoples time and attention.

  21. hearing the Podcast Make the Deep impact my Psychi, Well I have a lot of experience in Medical field and seen lots of insurance facts.
    I already have a huge deductible and relatively high premiums (due to pre-existing conditions). How do the insurance companies figure into concierge medicine?
    Mens health is tottaly hesterical and i think for general Public that They should have proper guidance for the insurance plans

  26. I do appreciate the stories by the doctor’s telling us how their practice has changed and some of their motivation for their decision. I think it boils down to:
    1) An economically attractive model for the physician. And no, I don’t believe the physician gets to pocket $900,000. There are costs involved. But the financial model is part of the attraction for the physician
    2) The ability to see fewer patients and concentrate more on the ones they have.
    3) Most doctors agreeing to this model are near retirement age and would just retire if this option were not presented. In the case of my doctor, he is openly advertising to move you to one of the new PCP’s in their practice if you choose not to go with him.
    I don’t see it as a terrible thing – I see it as a choice. One I haven’t decided upon whether it’s worthwhile or not.
    However, I do have one request: doctors, please stop the “woe is me” stories. I understand doctors work very hard and are getting squeezed from many angles. However, the assertion that your average bus driver is living better than your average doctor is just asinine. Doctors make a LOT of money. And for the most part it’s well deserved. Don’t apologize for it, but don’t try to pretend it doesn’t exist.

  27. I was recently abandoned by my physician of 15 years because the group he is with decided to switch over to this form of elitist healthcare. In this case, the greedy third party outsider that brought this all about is MDVIP. If I wanted to continue on with my physician, I would have to sign a contract and pay MDVIP $1,500.00 per year simply to have access to my doctor. My primary insurance company would still be forced to pay for all office visits, lab tests and any in-house procedures. In retrospect, I never needed a third party outsider to get quality care from my physician and I’m not about to line the pockets of some greed driven outsider who has absolutely no interest in my well being. This concept is very unethical and patients are the real losers under this particular business model. Medicare and all insurance companies should refuse reimbursing physicians who adopt this approach to patient care.

  29. Primary care still has a function, in fact I expect a return to healing the body with those almost forgotten home visits.

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  33. I left a busy group practice in Fort Myers, Florida in 2005 to start my house-call based concierge practice. Originally I tried to deal with insurances but since none pay for house-calls, and Medicare only reimburses minimally, I couldn’t make it viable. In our area it’s not uncommon for me to drive 30-45min between visits and I typically spend 45-60min with a patient. Hence I was drawn to the concierge business model. I am still the ONLY concierge physician in South-West Florida exclusively making house-calls in Lee and Collier counties.
    No mistake, my services are a luxury item and convenience for most of my patients. I charge $2000-$6000 a year per person, depending on age, size of family, and location.
    I know it’s not the answer to our health care crisis, but I certainly love my job again! Besides I get to see my kids more.
    2 other key points for the lay-person to understand. Just because I charge above what insurance pays, doesn’t make me rich. I actually made less than our city pays buss drivers for the past 2 years, although admitedly the potential is significant. Also, even though most of my patients are the “rich and famous” of our area, doesn’t absolve me or any concierge phsycian of our responsibility to the community. In fact this is a responsibility of each of my patients as well.
    I continue to be an active office in the US Army Reserve, chair the Health Advisory Committee of the Lee County School District, volunteer as a Guardian ad Litem serving abused and neglected kids, teach Head Start program moms about child care, etc…
    No, concierge medicine isn’t for everyone, but it certainly has worked for me and my patients.
    Andrew Oakes-Lottridge, MD
    Personalized Health Care, Inc.
    (239)694-6246
    http://www.DrAndy.us

  34. I already have a huge deductible and relatively high premiums (due to pre-existing conditions). How do the insurance companies figure into concierge medicine? Am I meant to pay the same copay, deductible and premiums on top of the $1500 annual fee? Ouch.

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  42. Wayne M. Burr, MD
    239-333-DR4U (3748)
    http://www.concierge-physician.com
    9407 Cypress Lake Dr., Ste. C
    Fort Myers, FL 33919
    Make sure that when you speak to a concierge practice that you have all the information in regards to billing. Our practice puts all of this in writing in the form of a patient/physician agreement so that all charges are explained and all covered services are listed. Make sure that you get this same information from any practice that you consider becoming a member.
    Some groups that belong to a larger franchise will not only charge a “concierge” fee, but also will bill your insurance. This arangement is not allowed in most insurance contracts, so I suppose that these practices are filling “out of network”. In contrast, my practice only charges the concierge fee for all of our services-no hidden fees or other attempts to try to collect above that of the membership fee.
    Members in this type of practice can submit patent claim forms to their insurance to try to recoup some of the cost of the membership. Most practices will give you a bill of each visit to submit to your insurance company. Discuss this with your insurance and your accountant to see what may be the best way to approach handling your medical expenses. Above all — do your homework and get the facts.

  43. Can anyone tell me how insurance and HSAs are handled for MDVIP patients? The patients still pay the same premiums? Pay the same deductible? Is there a need for an HSA if you’re an MDVIP patient?
    I have been with the same PCP for about 12 years, and she is affiliating with MDVIP. I am trying to decide whether to switch over to MDVIP with my doctor or search for a new PCP. I would like to stay with my doctor, but I’m not sure I can afford to. I can certainly understand her decision to make the switch, but there are still a few issues that are unclear to me.
    I already have a huge deductible and relatively high premiums (due to pre-existing conditions). How do the insurance companies figure into concierge medicine? Am I meant to pay the same copay, deductible and premiums on top of the $1500 annual fee? Ouch.

  44. dvip is just the beginning when it comes to alternative or concierge or boutique or as I like to call it in my pediatric field “attentive care” New practice models are emerging that make mdvip obsolete. Try a marriage of tech and personalized care in the form of Personal Pediatrics administrative support system that is actively practiced by Natalie Hodge MD. As opposed to Goldman, she has invented a new practice, or reinvented an old, model the communication system and treatment for Bowel problem of which makes the entire office obsolete. Providing care for children where they need it most when they are sick, AT HOME. Watch the story of Personal Pediatrics unfold. Maybe I am being snowed, but if this approach can really show that paying the primary care doc more to look after fewer patients saves money overall, then it’s very interesting–and has huge implications for the future of primary and secondary care. If it’s just rich people trading up for a better class of waiting room and the doc’s cell phone, then it’s less so.

  45. Health care will continue to evolve as costs skyrocket. Concierge medicine represents an alternate choice, and choice is the key to satisfying the patients.

  46. hi,
    i am sort of a convinced by his idea about concierge medicine. May be, for the reason because I have been in the buisness of concierge for a while now.

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  53. “For all the poorer people to get left out of good health care because they can’t afford to pay extra for it (remembering that insurance still pays the doctor), this is shameful.”
    What about all the poorer people who get left out of ANY healthcare because they can’t afford insurance?
    We already have a “quality of care” issue in this country. The insured versus the uninsured. Frankly, I think that is far more worthy of shame than doctors who want to do this.

  54. Considering that the vast majority of posts here are by doctors or people in the health care business, this blog is horribly lopsided in opinion. For all the poorer people to get left out of good health care because they can’t afford to pay extra for it (remembering that insurance still pays the doctor), this is shameful.

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