Doctors Eager for Elite 'Concierge' Service

My longtime doctor dumped me — and soon after, so did my replacement primary physician. Will it be happening to you next?

At least three old friends, Tom, Dave and I had something new to talk about during our weekly lunches. Amazing how our favorite topics have changed over 15 years. Of course, there will always be sports talk and yelling at the coaches. Nowadays its all medical problem. Enter concierge medicine.

Five years ago I was sitting with “Dr. Alpha,” nurses and secretaries flitting in and out, when he broached the subject. Paging through my medical records he noted that I'd been with him longer than any patient. Nevertheless, he was going into a new kind of practice, taking a lucky 600 of his 3,500 patients with him. Would I be one of them?

While he explained how it was going to cost me an extra $1,600 a year, I was busy multiplying 1,600 by 600 in my head.

It was difficult to turn him down, perhaps because we lived on the same street. We'd become friends and developed a relationship more or less like a concierge ideal. We liked fishing so we'd often talk about that. When the occasion arose we'd discuss the attributes of the stunning young widow and former Rockette who lived nearby.

Several times I'd seen his junior partner, Dr. Beta, and liked him so I thought I'd just sign with him. But before I left his office, Dr. Alpha handed me a letter regarding his offer saying I had a few weeks to reconsider. Later I read it in detail. It stipulated that I couldn't sign up with Dr. Beta. I'd have to find another doctor.

At our lunches, even though I was the one dumped, Dave and Tom were more anti-concierge medicine than I was. Basically, concierge works like this. From a patient's viewpoint, the personalized care one receive results in better preventative results. There's no waiting. Doctors are available 24/7.

For the doctor, concierge medicine means the chance to spend more time with a patient. There's less paper work. Its a better way to get to know a patient without the pressure of a string of patients in the waiting room.

Concierge medicine is spreading. Firms are springing up around the country with names like MD-Squared (MD2) and MD-VIP, which until recently, was owned by the pharmaceutical giant, Procter & Gamble.

Several months after my dumping, Tom decided to change his primary physician. He asked about my new doctor, but I suggested he contact Dr. Beta. Tom asked whether he'd go concierge and I said no, he wouldn't.

For the next two years Tom kept saying how grateful he was that I recommended Dr. Beta, so decided to ask Dr. Beta whether I could rejoin. He said yes.

Things went smoothly for Tom and me for more than two years until one morning we both received letters. Dr. Beta was going concierge.

Tom didn't give it a second thought. He was so happy going to Dr. Beta he'd gladly pay the extra $1,600. “I now feel completely relaxed and satisfied about my healthcare,” he said.

I couldn't afford the $3,200 extra that includes my wife.

Dave still thinks its grossly unfair. He asks: “What about the middle- and lower-income patients? As more primary care physicians join concierge practices, less physicians are available to provide them with general medical care. It will be left to practical nurses.”

My wife's friend Jennifer is another opponent. She and her retired podiatrist husband were enthusiastic about joining a concierge practice. They left after 15-months when they realized they weren't getting more timely appointments at all. Jennifer exploded when another friend told them he'd been seeing a lot more of their doctor recently — on the golf course. “I think its a big rip-off, an early retirement scheme,” Jennifer said.

She pointed out that to become a concierge doctor the primary physician doesn't have to take any further training.

One thing Tom, Dave, and I agreed on was that we live in a capitalistic society. Some of us can afford to sit on the 50-yard line at every ballgame and some of us can't. There's no difference when it comes to medicine.

Still, several leading doctors have reservations, among them cardiologist, Dr. Harlan Krumholz, professor of medicine at Yale University, who said: “We know that it works very well on the convenience side. But we do not know yet if it's a good model on the science side. Getting more care doesn't actually mean getting better care. Concierge care could lead to over-treatment and over-testing, neither of which benefits the patient.”

Malcolm Balfour worked as a producer for the CBS affiliate in Miami, was bureau chief of Reuters in Miami, and then became an article editor at the National Enquirer in the 1970s. He was a New York Post Florida correspondent for 27 years and worked as a freelance for numerous popular publications and television shows, from "Entertainment Tonight" and "Inside Edition" to "Hard Copy"and "Good Morning America." For more of his reports, Go Here Now.