concierge medicine

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Critical Thinking (part 1)

Terrence L. Bauer, SpecialdocsJ. Pat Tokarz, MD, Specialdocs Teresa Iafolla, eVisitConcierge Medicine:A Guide for the Risk-Averse Physician

Who We Are

Teresa IafollaDirector of Content Marketing, eVisittiafolla@evisit.comTerrence L. BauerCEO, @eVisit


J. Pat Tokarz, MDChief Medical Advisor,

Terrence L. BauerChief Executive Officer, Specialdocs Consultants LLCFor Specialdocs: accelerate growth and enhance the portfolio of value-added services for physician-clients.Three decades of experience, including:Co-founder, president, CEO and director of Orion HealthCorpCEO of Bauer Health, LLCPrincipal and strategy practice leader at healthcare consulting firm Stroudwater Associates Connect

J. Pat Tokarz, MDChief Medical Advisor, SpecialdocsMore than three decades at Northern Virginia Family PracticeTransitioned to concierge medicine in 2005, followed by three other physicians in his groupUndergrad at Stanford, MD at the University of Tennessee, Center for Health Care Sciences in MemphisFamily Practice residency and a teaching fellowship at Hershey Medical CenterBest Doctor in America (2005-2010) and Top Doctor (1995, 1997, 2010, 2011, 2012)

A Short History of Concierge MedicineFirst practice started by two Seattle physicians in the late 1990s

Fee: almost $15,000 per person annually

Patients included the Seattle Seahawks, among others

Benefits included immediate same-day appointments, 24/7 direct access via their cell phones; accompaniment to other medically related appointments, and other personalized, unique amenities6



Approximately 10,000-12,000 physicians actively practice some form of concierge medicine

Membership medicine is estimated to grow 3-6% a year

Source: Concierge Medicine Today7


Concierge Medicine ModelFull concierge:

Membership fee to patients, typically $1,800 - $2,000 a year300 to 600 patients vs. 2,500 patients seen by typical physicianMultiple benefits, including 24/7 access to personal physician, house calls, annual physicals, a broad range of primary care services

Direct primary care (DPC):

No third party payer involvement - reduces overhead expensesMonthly fee (generally from $25 to $85) covers all primary care services performed in office, regardless of number of visits Access to and relationship with personal physicianTypically appeals to younger patients



The Case for Concierge MedicineChanging healthcare environment leads to a different type of medical practice:No time for personalized careNo time to focus on preventionNo time to treat the whole patient

Demand for concierge medicine increases:Patients want to become more active participants in their own healthcarePhysicians want to remain autonomous and practice medicine the way it used to be



Physician Burnout10

Source: Medscape, Monday April 11, 2016

Physician Burnout: It Just Keeps Getting Worse.

This year, 46% of all physicians responded that they had burnout, which is a substantial increase since the Medscape 2013 Lifestyle Report, in which burnout was reported in slightly under 40% of respondents.

The Medscape chart shows physician burnout by specialty.


Why Dr. Tokarz Made the Change

Dysfunctional system, approaching burnoutPatient requests for more time with the physician who knows them bestChange to concierge: provide services such as comprehensive health risk assessment and development of a personal wellness plan Practice became patient-centered, not insurance-centered Reduced costs, improved outcomes and patient satisfaction



12Key to attracting more students to primary careBest hope for independent primary care to survive and thrive

Long Term

The Value of Concierge Care

The concierge model works on every level, providing doctors with income that is not driven by volume, as well as providing time to treat their patients for an entire range of complex issues.



Hallmarks of Concierge MedicinePatient-centeredA powerful focus on long term health and wellnessA strong physician-patient relationshipA better understanding of patient and family medical history and concernsMore time for physician to research and provide treatment options for unique health issues 14


Hallmarks of Concierge MedicinePatient-Centered

Extended office visits: 30 minutesAppointments: within 24 hours of a patients callThe doctor is always in: not a physicians assistant or nurse practitionerCalls to the office answered promptly by real people with a real concern for patients health and well beingDirect access to physician during office hours, and extended office hoursPhysicians personal cell phone number, email access after office hours15


Enhancing the Patient Experience

Specialdocs survey of thousands of patients98% very satisfied with care they receive from their concierge physician



Enhancing Outcomes17

Good medicine: better outcomes reported for concierge patients in numerous studies

The healing power of a strong physician-patient relationship is evidence-based

Research shows:

Patients in concierge practices experienced significantly reduced utilization rates for emergency department visits and inpatient admissions.

Personalized medicine models achieve positive outcomes in terms of health care expenditures and improved health.


Enhancing Physician Satisfaction

Fewer patients than those in conventional practices allows for more time with each patientPut patients at the center of care, not medical managers or institutionsLess stressIncreased opportunity for maintaining and enhancing the physician-patient relationshipReduced time needed for paperwork/EMR requirementsMore time to focus on preventative care for patientsPractice sustainability and increased revenues opportunitiesA remarkable transformation of professional and personal life



Concierge Medicine Continues to GrowBeyond Primary Care

Primary care and family medicine account for most concierge practices, but

Sub-specialty concierge practices continue to grow as reimbursements shrink for:Cardiology EndocrinologyPulmonologyPediatricsOB/GYN



CardiologyLeading cardiologist and Special Doc John R. Levinson, MD, PhD, founder of the countrys first concierge subspecialty practice, AllCare Medical, LLC, in Boston




Endocrinology, with its focus on complex metabolic issues, also fits well within the concierge medicine model.

Personalized medicine provides the best opportunity to combine my expertise in endocrinology with internal medicine and primary care. My practice gives me more time to think outside the box and care for patients without onerous financial disincentives.- Special Doc David A. Chappell, MD



Functional and Integrated MedicineSpecial Doc Uday Jani, MD, board-certified internist, has a fellowship in integrated medicine and advanced training in functional medicine



PediatricsMichael Friedlander, principal at Specialdocs Consultants



Why Specialdocs?

IndependenceYour name at the forefront A proven record of success A trusted alliance



Learn More about Concierge Medicine:Call us: 847-432-4502

Email us: Terry: Take the next STEP Specialdocs Test for Evaluating Physicians 25



Teresa IafollaDirector of Content Marketing, eVisittiafolla@evisit.comTerrence L. BauerCEO, @eVisit


J. Pat Tokarz, MDChief Medical Advisor,

Will I Retain Ownership Of My Practice?

Will My New Practice Reflect My Philosophy and Values?

What Are The Terms Of My Contract?

Who Controls My Fee Revenues?

Will I Receive Regulatory Guidance?