BOCA RATON, FL – Rushed, overworked and generally at odds with the productivity-based pay model. These are common adjectives in primary care.
Now, 150 physicians in 16 states are participating in a practice program centered on longer appointments and smaller patient loads.
But don’t call it “concierge” or “retainer” medicine, both of which are media-coined buzzwords that are objectionable to the physicians participating in MDVIP. Such words fail to convey the emphasis on preventive care and extensive personal relationships on which the program is focused, they say.
Launched in 2000 and based in Boca Raton, Fla., MDVIP describes itself as a “fraternity of individual physicians” interested in prevention and wellness. It encourages physicians to spend more time with each patient, in part by capping patient loads at 600. Most primary care physicians in the United States see 2,000 to 2,500 patients annually.
“The current system, in terms of delivery, is structured around acute care with very little emphasis on prevention, and as a result, care is inefficient, inadequate, doctors are rushed, and their lives are devoid of professional gratification,” said Bernard Kaminetsky, MD. After six years in MDVIP, Kaminetsky says he can’t imagine going back to traditional private practice medicine.
“Every physician has had the experience of the patient who comes in and says, ‘I’m going to talk to you, and you’re not leaving the room until I’m done,’” Kaminetsky said. “It’s been years since I’ve had to surreptitiously glance at my watch because I knew another patient was waiting.”
The quality of care offered through MDVIP’s member physicians sounds exemplary: patients are given a preliminary “wellness exam,” which includes a complete medical history review, EKG, urinalysis, blood work, eye exam and assessment of memory, depression levels and activity levels. Results are then dictated into an electronic medical record, a copy of which is given to the patient on a wallet-sized compact disc.
If there’s one catch for MDVIP patients, it’s the out-of-pocket costs. The program costs patients about $1,500 to $1,800 annually, and only a handful of health plans say they’ll cover MDVIP’s costs. To establish equity, the program’s physicians are required to see a certain number of indigent patients, who receive free membership under a scholarship program.
If there’s one catch for MDVIP physicians, it’s trading off lower practice revenues as a result of seeing fewer patients. Barry Josephs, MD, a Baltimore-based physician who converted his practice to MDVIP in April, doesn’t see this as a problem.
“Before, I saw 15 or 20 patients a day, and now I might see six a day,” Josephs said. He plans on capping his practice at 400 to 450 patients. “It takes me one to two hours to do a wellness exam with them the way I want to do it,” he said. “It’s really the fun part of medicine.”