|By Alex Nixon, The Pittsburgh Tribune-Review|
|McClatchy-Tribune Information Services|
As they did in the 1950s, some doctors today make house calls.
Serbin is among an increasing number of physicians nationwide who are fed up with traditional medical practices that they say have grown complicated and impersonal. Their antidote is to form so-called concierge practices in which they collect monthly cash fees from patients instead of insurance reimbursements, and reduce the number of patients they treat to provide personalized service, such as visiting patients at home and taking calls 24 hours a day.
And many people, tired of long waits to see doctors and rushed appointments, are seeking out concierge practices.
"It's a movement that's growing at a rate of about 25 percent a year," said
As of fall, there were about 5,500 concierge doctors in
Yet only 12 doctors have concierge practices in
Growth here likely has been stymied by UPMC and Highmark, which have sought to employ large numbers of doctors.
Once employed by a hospital system, employment contracts and non-compete clauses make it difficult for physicians to start independent practices, whether concierge or traditional, said
Concierge practices appeal to some doctors because of growing dissatisfaction with large impersonal practices; insurance coding and billing headaches; and administrative burdens that take away from time spent helping patients, Krah said.
"I've heard consistently from (concierge) docs that they are much more satisfied," he said.
Krah believes more doctors in
"If people are going to be paying out-of-pocket anyway, they may just go to a concierge," he said.
Most concierge doctors charge about
Serbin, the area's only concierge pediatrician, limits the number of patients in his practice to about 320, giving him time for one-on-one care.
"They can always get an appointment the same day. They can always talk to me," said Serbin, who charges
He keeps costs low by forgoing an office and visiting patients at home.
"The downside is it costs extra money, so it's not for everyone," he said.
Despite the cost, a concierge doctor is not just for the affluent, said Dr.
"I have a nice mix of people, some affluent, some not as much," said Warshaw, who charges
He started his practice seven years ago, and some patients are on fixed incomes, he said.
"The finances are really not that big of an issue for most people. ... They value their health."
New patients usually come to Warshaw because they're frustrated with their doctors, he said.
"The typical complaint is they can't get ahold of their doctor, the wait times; they're just frustrated," he said.
Mehalick switched to Serbin's practice soon after her third child was born because she was tired of taking one kid to the doctor and having the other two come down with a bug they picked up in the waiting room.
Nine years and three more children later, Mehalick values the home visits and the ability to call Serbin directly, she said.
"It was just unbelievable. I didn't have to go through any staffing," she said. "It was just priceless to me."
The Affordable Care Act may push patients to seek concierge practices, he said.
As more Americans gain health insurance coverage under the law, Blue said, patients may find there are not "enough docs to go around."
"The trend has been going on for quite some time," he said. "But the Affordable Care Act fanned the flame."
(c)2014 The Pittsburgh Tribune-Review (Greensburg, Pa.)
Visit The Pittsburgh Tribune-Review (Greensburg, Pa.) at www.pittsburghlive.com/x/pittsburghtrib
Distributed by MCT Information Services