Pros and cons of concierge medicine: Why experts say it’s not for everyone

Patients pay hefty fees to get unfettered access to their doctors
(Source: WMC Action News 5)
(Source: WMC Action News 5)(WMC Action News 5)
Updated: Feb. 18, 2019 at 10:30 PM CST
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MEMPHIS, TN (WMC) - It was just before Christmas when Gail Nix and her husband Wayne received a letter from Wayne’s doctor, warning them their time together could soon be over.

The doctor said growing demands to see more patients were not the ideal way to practice medicine.

“In order to devote this level of attention to each patient,” the letter read, “I will significantly reduce the size of my practice.”

It listed a toll-free number for patients who wanted to stay on with the doctor to call. Gail called and found out for Wayne to keep his doctor, they’d have to pay an $1,800 annual retainer fee.

"My immediate reaction was what the hell?" Nix recalled. "Because we can't make the payment. No way can we budget it in."

It turns out Wayne’s doctor is among a small but growing number of doctors switching to concierge medicine.

"Concierge medicine is a relatively new concept. It's really only been around the last 20 years," said Dr. Paige Powell with the University of Memphis School of Public Health.

Powell said concierge medicine allows doctors to provide more personal care.

Concierge medicine doctors encourage patients to call or text them any time, day or night. They also provide same-day appointments and longer visits, including annual exams that can last hours.

"I think it's a good investment for me," said Sherron Biggers.

Her internist, Dr. James Ensor, is affiliated with MDVIP, the largest network of concierge medicine doctors in the country. The company was founded in 2000 in Boca Raton, Florida.

MDVIP said it has 950 MDVIP-affiliated physicians serving more than 300,000 patients who focus on patient wellness and disease prevention.

"Every time people leave this office the last thing I tell them 'Now you know I'm on the phone if you need me,'" said Ensor.

Ensor and his partner each see about 350 patients at their Germantown practice, compared to some 1,500 to 2,000 patients before.

MDVIP said with smaller practices, its doctors can devote more time to patients.

“He always has time to listen if there are things that I’m concerned about,” said Biggers. “If I’m out of town and I become ill, or on the weekend if I’m sick, instead of going to an urgent care I can call Dr. Ensor. I have his cell number.”

Powell says this type of unfettered access can bring peace of mind to patients, especially those with chronic conditions.

“So, if you’ve got diabetes and high blood pressure and a number of other factors, concierge medicine can help better manage those chronic conditions and has even been shown in some case to reduce hospital admissions,” said Powell.

A 2012 study published in the American Journal of Managed Care showed patients in MDVIP-affiliated practices were hospitalized 72- to 79-percent less than patients who received care from traditional primary care practices.

But concierge medicine is not for everyone. Consumer experts say patients need to understand what they’re signing up for.

The AARP, for instance, reminds its members that concierge medicine is not a replacement for insurance. It also reminds them those retainer fees, which are usually paid out-of-pocket, will not cover trips to the emergency room, out-of-network care or visits to specialists.

"That's the main disadvantage to concierge medicine is that not everyone can afford that," said Powell. "So, it's got its good and its bad points."

Powell said another criticism of concierge medicine is that it has the potential to create a “two-tiered” health system. The average concierge medicine retainer fee in Memphis ranges from $1,600 to $1,800.

MDVIP said its fee can be paid annually, semi-annually or quarterly.

“It’s the cost of most people’s cable bill or their Starbucks,” said Bret Jorgenson, chairman and CEO of MDVIP. “On some level it’s no different than somebody deciding to join a gym. It might cost you $100 a month and maybe it promotes your health.”

But people on fixed incomes, like Gail Nix and her husband Wayne, cannot afford it, no matter how the costs are calculated.

“We’re both retired and on social security,” said Nix.

Now she’s left to find Wayne, who has battled cancer and has early dementia, a new doctor, someone who understands his specific needs.

“I’ll have to start all over and he’s not going to handle it good,” she said. “He’s not going to handle it good at all. And he’s 73 years old, come on!”

MDVIP said it helps patients who are not staying with their doctor under concierge medicine to identify new doctors.

If help is not offered, Powell advises those patients to ask for recommendations.

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