Boutique Medicine Plan Provides Personalized Health Care

Critics say it's creating two-tiered health care system

It's called boutique or concierge medicine. Doctors charge patients a membership fee to have better access to their practice. That's in addition to health insurance costs. It's a new trend that has plenty of fans -- and critics.

"It was difficult getting an appointment," said George Nemcosky. "I never felt at ease before because there was always such a time restraint."

Sound familiar? The 63-year-old Bethesda, Md., resident is talking about his typical trip to the doctor's office. That was six years ago.
Now, he said seeing the doctor is a whole lot different.

"I'm made to feel that I really matter," Nemcosky said. "First of all, when I see the doctor he knows my name. He knows all about me. He knows my health issues instantly."

He said it's because his doctor is a member of MDVIP, a network of doctors who say they give "personalized health care." Patients can get in to see the doctor more quickly and can spend more time talking.  Doctors say it's because they cap the number of patients in the practice at 600.

"Now with MDVIP, I take care of fewer patients, about 80 percent fewer," said Dr. Alan Sheff. "I have more time with them and we spend that time on the annual physical really talking about the health issues before they become major problems."

Sheff, a Bethesda internist and MDVIP member, said he sees about eight to 12 patients daily. That's compared to 18 to 25 a day before he joined the MDVIP network. That allows for longer office visits. Appointments are 30 minutes long compared to about 8 for other doctors.

But there's a price tag for this. Patients pay a membership fee of $1,500 a year. That's just to be able to see the doctor and includes an annual check up. Patients still need to have health insurance.

"I have retirees on fixed income," said Sheff. "I have teachers and school principals. I have self-employed small business owners, so this appeals to people who really are interested in additional prevention and wellness services."

But critics say programs like MDVIP are creating a two-tiered health-care system, providing quality care for those with money, but leaving out those who can't afford a membership fee.

The Maryland Hospital Association says this kind of program is a direct result of the financial pressure doctors face from health insurance companies, which they say, don't reimburse doctors enough for their services.

Sheff said it's a matter of priority for him and his patients.

"When you come to think about what is your health worth, this is a very reasonable amount of money, especially for somebody who can afford to live in a suburban community."

For George Nemcosky, a retired teacher, he said he was hesitant to spend the money, but thinks it's the best decision for him.

"I'm very fortunate that I'm able to do this and I've put this in my priorities because health is my number one priority."

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