At Your Ser­vice

Concierge doc­tors, imag­ine a house call, al­ter­na­tive to busy of­fices

Gulf & Main - - News - BY ANDY OAKES- LOTTRIDGE, M. D., F . A. A. F. P.

In the last few years, news sto­ries about med­i­cal prac­tice in Amer­ica have been very con­fus­ing. Re­gard­less of where you fall on the po­lit­i­cal spec­trum, there can be lit­tle ar­gu­ment the changes of Oba­macare, and now the ef­forts to make changes to those changes, have left all of us with more ques­tions than an­swers re­gard­ing the future face of med­i­cal prac­tice in the United States.

As a doc­tor who sees pa­tients, I’ve seen our re­im­burse­ment sys­tem in­cen­tivize—in­deed, force―doc­tors to see more and more pa­tients each day to re­main sol­vent. To see more pa­tients, doc­tors have had to work faster and re­duce the du­ra­tion of vis­its, which now av­er­age a mere seven min­utes each!

The av­er­age Amer­i­can pri­mary care doc­tor serves about 3,000 to 4,000 pa­tients. Since quan­tity and qual­ity are in­com­pat­i­ble in med­i­cal prac­tice, this in­crease in vol­ume has re­sulted in a pre­dictable de­crease in qual­ity, with a sim­i­lar de­crease in sat­is­fac­tion for both pa­tients and doc­tors. While I don’t have a so­lu­tion for all … or I’d be run­ning for po­lit­i­cal of­fice … my part­ners and I have found a so­lu­tion for our own pa­tients.

In the late 1990s, a new move­ment was born si­mul­ta­ne­ously in Fort My­ers and in Seat­tle. Cre­ative physi­cians―in­clud­ing my part­ner, Dr. Gary Price―dis­sat­is­fied with the sta­tus quo, opted out of the in­surance-based med­i­cal sys­tem to in­vent a bet­ter way of serv­ing their pa­tients. They re­duced their pa­tient panel size to a few hun­dred in­stead of a few thou­sand, in­creased the length of vis­its to 30 to 90 min­utes and es­tab­lished di­rect fi­nan­cial re­la­tion­ships with their pa­tients to elim­i­nate con­flicts of in­ter­est and to re-em­power pa­tients. This move­ment came to be known as “concierge prac­tice,” and is some­times also known as “di­rect medicine,” “pri­vate prac­tice” or “bou­tique medicine.”

In just 20 years this move­ment has grown from a cou­ple of out­ly­ing prac­tices in op­po­site cor­ners of the coun­try to thou­sands of main­stream ones through­out the land. To­day, even med­i­cal schools are in­clud­ing “di­rect medicine” in their cur­ric­ula, giv­ing med­i­cal stu­dents an al­ter­na­tive path­way to a ca­reer in pri­mary care.

As the mo­men­tum con­tin­ues to build, what ac­counts for the growth? It’s sim­ple―concierge medicine is a bet­ter model.

Concierge medicine re­stores the doc­tor-pa­tient re­la­tion­ship to the lofty level it en­joyed be­fore be­ing con­strained and de­graded by gov­ern­ment and in­surance. Concierge physi­cians work only for the pa­tients. We don’t re­ceive pay­ments from in­surance com­pa­nies, the gov­ern­ment or the phar­ma­ceu­ti­cal in­dus­try. We give un­com­pro­mis­ing care in an un­hur­ried, re­spect­ful set­ting. Be­cause we care and have no con­flicts of in­ter­est. In short, we work for you. Imag­ine be­ing able to reach your doc­tor at any time if you have a ques­tion, or be­ing able t o sched­ule an of­fice visit to­day, if you need it. How about a house call if you are un­able to go to the of­fice? Imag­ine hav­ing your doc­tor guide your care

through the com­plex maze of spe­cial­ists and hos­pi­tal­ists, se­lect­ing only what is the best for you, with no com­pro­mises or ex­cuses. That is the world of pri­vate (concierge) medicine. Mar­cus Welby, M.D., is alive and well!

Since we em­pha­size pre­ven­tion and have time for proac­tive care, our pa­tients en­joy much lower rates of hos­pi­tal­iza­tion and emer­gency room uti­liza­tion, which saves the sys­tem money— a lot of money. Our prod­uct is good health and healthy peo­ple.

While concierge medicine may not be a bet­ter model for ev­ery­one, it has al­lowed my part­ners and me to prac­tice the kind of medicine we al­ways dreamed of―hav­ing the time to truly treat pa­tients as we would want to be treated. It re­stores the doc­tor-pa­tient re­la­tion­ship.

So, while the prog­no­sis for health care in Amer­ica is cur­rently up in the air, the prog­no­sis for our pa­tients con­tin­ues to be ex­cel­lent. Thanks to the pri­vate medicine model, out­stand­ing health care will con­tinue to be avail­able and the future looks bright for our pa­tients. Andy Oakes-Lottridge, M.D., F.A.A.F.P. is a prac­tic­ing physi­cian with Pri­vate Physi­cians of South­west Florida, with of­fices in Fort My­ers, Bonita Springs and Sani­bel. Visit him at pri­vatephysi­cian­sof­swfl.com. Doc­tors David L. West ( left) Andy OakesLot­tridge and Gary M. Price ad­min­is­ter Pri­vate Physi­cians of South­west Florida.

Andy Oakes- Lottridge with Pri­vate Physi­cians of South­west Florida says concierge ser­vices are the future of pri­vate medicine.

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