- Mark Abramson | Reporter | Pacific Business News
Apr 12, 2013 |
Some Hawaii doctors are switching to a business model that critics say could create a two-tiered health-care system — one for the haves and one for the have-nots.
They’re called concierge doctors, who typically have many fewer patients than other physicians in private practice do. Patients pay an annual fee to retain the doctor’s services and usually have health insurance to cover office visits and medical care.
One nationwide provider of concierge doctors, Proctor & Gamble’s MDVIP, has three member doctors in Hawaii. Their patients pay $1,650 a year for a comprehensive physical with blood and other tests, access by email and phone to their doctors, and in some cases even house calls and hospital visits from their physicians. The doctors get two-thirds of the annual fee and MDVIP gets the rest.
MDVIP calls this type of medical practice personalized medicine.
One of MDVIP’s physicians, Dr. Robert Schiff, whose practice is in Aiea, said switching to the concierge model last June has made it easier for his patients to get appointments and has meant shorter wait times for them and more face time to answer their questions.
“I got to the point where I was seeing about 30 patients, sometimes 40, in a day, and if I was lucky I was spending 10 minutes with a patient,” Schiff said. “When I saw this model it was perfect.”
He said that when he first heard about concierge medicine, he worried that it was only for the wealthy. But he has found that patients who he didn’t think could afford it have stayed with him.
MDVIP President Mark Murrison said concierge physicians help find new doctors for patients who choose to not stay with the new system. Schiff said he continued to see patients who didn’t sign up for the concierge system for up to six months.
Murrison said he believes more doctors will sign up with MDVIP in Hawaii. Nationwide, patients include school teachers, government workers, small-business owners and retirees. Patients can pay all of the fee up front or semi-annually or quarterly.
“MDVIP provides an option for doctors to provide a higher level of care to patients,” Murrison said.
Anya Montgomery, who has been one of Schiff’s patients for 15 years, said she was confused at first but now likes the attention she gets from being able to reach him at any time. She said she has high blood pressure and other medical conditions that require her to contact him after business hours. She also likes being able to see her medical records online.
“It’s very comforting,” Montgomery said. “I am going to continue with the program.”
But state Sen. Josh Green, a Big Island physician and chairman of the Senate Committee on Health, said he has some concerns with concierge medicine.
“It’s very controversial and right now we are seeing people test the market,” he said. “I would not be surprised if I have to take this up legislatively.”
The scope of legislation will depend on how pervasive the movement to concierge medicine becomes, he said. It could require increasing community health center funding if large numbers of Medicaid and Medicare patients start having a hard time finding doctors. And, it could become a problem in rural areas with doctor shortages, he said.
Green said he has heard of some doctors charging up to $2,000 for the annual fee.
Officials with the Hawaii Medical Service Association, the state’s largest health insurance provider, said they have concerns as well.
If members choose to enroll in a concierge medical service, HMSA will work with its members and their providers to pay the appropriate amount for services that are covered under their plan, Elisa Yadao, senior vice president, consumer experience at HMSA, told PBN in an email. If the member’s doctor recommends services that are not covered under their HMSA plan, the member will be responsible for the total cost of the noncovered service, she said.
Yadao said HMSA doesn’t cover MDVIP doctors because the company does not comply with its provider agreements. That has resulted in HMSA’s contracts with those physicians being terminated, she said.
“HMSA’s mission is to provide access to a sustainable, quality health-care system that improves the overall health and well-being of our state,” Yadao said. “And we do not believe that our members should have to pay extra to get this.”