Patients Pay Membership Fees For Concierge-Style Practices

Dec. 13--f Rebecca McElfresh gets sick at night or on the weekend, she can call or text her doctor's personal cellphone.

And instead of waiting days or weeks for an appointment, she usually can see her primary-care physician the same day.

McElfresh and her husband, both retired educators, pay $125 each per month to be patients in Dr. Melodie Phillip's Fairlawn practice.

"I was concerned about the cost of it, investigated it further and decided it was a high priority for us to get high-quality health care," said McElfresh, 59, of Akron. "We are not wealthy people at all. For us, it just became a matter of priorities."

A small but growing number of physicians are adopting so-called concierge practices that promise immediate access and other perks to people willing to pay a premium to be a patient.

Phillips is one of more than 750 physicians nationwide participating in MDVIP, a Florida company that provides consultation and support for doctors adopting the retainer-based practice model.

MDVIP doctors limit their practice to 600 patients instead of the typical 2,500 or more. Patients are promised same-day or next-day appointments, "no waiting" waiting rooms, 30-minute or longer appointments and around-the-clock access via email and cellphone.

Consumers pay an average annual fee of $1,650, which isn't covered by insurance, to be a member of the practice. The membership fee includes a free, comprehensive wellness program with a thorough annual physical and more advanced screening tests than typical yearly exams, said Bred Jorgensen, MDVIP's chairman and chief executive.

MDVIP practices accept insurance for other medical services provided by the physicians.

By charging an annual membership fee, doctors can limit their practice and spend more time focusing on prevention and wellness with patients without financially hurting their business, Jorgensen said.

"What they get is a more personalized approach to their medical care," he said.

MDVIP keeps a portion of the membership fees, typically 20 percent to 30 percent, to provide services and support to participating doctors, Jorgensen said.

Dr. Mark Hostettler, an internal medicine physician in Alliance and Minerva, recently converted his practice to the MDVIP model as a way to return to providing more personalized care like he was taught 30 years ago.

By reducing his practice from 2,500 patients to fewer than 600 patients, he said he's able to offer more flexible, longer appointment times and immediate phone access.

"I'm absolutely ecstatic that I've done it," he said.

Healthy results

Phillips converted to an MDVIP practice about four years ago.

"After 25 years in this business, things have really changed in health care," she said. "Over the last part of my career, I found I couldn't spend as much time with the patients as they needed. I just couldn't deliver to patients what they needed."

By taking the time to talk to patients about ways to improve their health and coaching them to improve their diets and exercise, she said she's able to prescribe fewer medications.

"I know my patients are healthier now," she said.

Phillips said her practice makes about the same amount of money as it did before the conversion.

"The biggest reward I have is I'm taking better care of patients because I have more time," she said. "I can't put a price tag on that."

Critics, however, say charging patients a retainer to get care accentuates the differences between the "haves" and the "have nots" when it comes to health care.

Raising concerns

An article last year in Virtual Mentor, the American Medical Association's ethics journal, raised concerns about limiting patients' access because of unwillingness or inability to pay for "extra services."

"Simply running away from the problems and inefficiencies of our current health care system and into the comforts of 'retainer medicine' does little to advance health and well-being for the vast number of patients or address some of medicines biggest challenges (e.g., cost and access)," the article authors said.

But MDVIP's Jorgensen said the program is an option for people who are more interested in their health and wellness.

"It's not like a 'wealth care,' it's healthy care," he said. "It's basically the cost of your cable bill or the cost of your Starbucks coffee a day."

Members ultimately can save money by staying healthier and by avoiding trips to the emergency room because of better access to their doctor, he said.

When McElfresh became an MDVIP member four years ago at the recommendation of a friend, she was struggling to find help for an immune-system problem.

Phillips spent an hour or longer with her at each appointment and helped her get better, McElfresh said. The doctor also is helping her find ways to prevent future health problems.

"It's very, very worth it to me," Phillips said of the membership fee. "I don't think I would be better."

Cheryl Powell can be reached at 330-996-3902 or [email protected]. Follow Powell on Twitter at twitter.com/CherylPowellABJ.

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