Novant Health starts Charlotte’s latest concierge medicine practice

Monday, Nov. 04, 2013

Novant Health Hallmark Care doctors Christopher Snyder III, left, Lillian McKay Teigland, Kenneth D. Weeks Jr. and Thomas Hayes Woollen Jr. The service they offer is a subscription medical practice, integrated with the full service of Novant Heath system. T. Ortega Gaines - NOVANT HEALTH

Novant Health Hallmark Care doctors Christopher Snyder III, left, Lillian McKay Teigland, Kenneth D. Weeks Jr. and Thomas Hayes Woollen Jr. The service they offer is a subscription medical practice, integrated with the full service of Novant Heath system. T. Ortega Gaines – NOVANT HEALTH

Patients who want to continue seeing Dr. Lillian Teigland will soon pay more for the privilege.

Backed by three other Novant Health physicians, she is starting a “concierge” medical practice that will offer patients more time and attention – for a fee.

The new group, Novant Health Hallmark Care, opens Nov. 18 at 2801 Randolph Road.

For longer appointments, 24/7 access and more personalized care, patients will be asked to pay $2,400 a year, in addition to having health insurance. In turn, Teigland will limit the number of patients she sees to 300, compared to the 3,000 now on her roster at SouthPark Family Physicians.

Hallmark Care is the first so-called concierge medicine practice for Winston-Salem-based Novant. But it’s not the first in Charlotte.

Drs. Jordan Lipton and Elizabeth Perry launched the concept here in 2003, with Signature Healthcare in the SouthPark area. It now has five doctors serving 1,250 patients who pay annual fees ranging from $1,250 and $3,500. The group plans to open an uptown Charlotte office early next year on Tryon Street.

Last year, Carolinas HealthCare System opened Perspective Health & Wellness, a SouthPark concierge practice with Drs. Lorri Ayers and John Benedum, formerly of Mecklenburg Medical Group. Ayers has reached her maximum of 300 patients and has a waiting list. Benedum is still accepting patients, and they are recruiting a third physician.

Three other doctors in Charlotte, Denver and Rock Hill work for MDVIP, a Florida-based company that contracts with doctors across the country to offer the concierge model of care.

The idea of charging patients a retainer for better service got traction in the 1990s in response to doctors’ frustrations with managed care and financial pressures to see more patients each day.

Today, about 5,500 doctors practice concierge medicine across the country, according to the American Academy of Private Physicians, the professional association for concierge and direct pay practices. A spokesman said the number of doctors adopting the concierge concept has grown by 25 percent annually in recent years.

“Patients are asking for it,” said Dr. Thomas Hayes Woollen Jr., a Novant physician-administrator who will share on-call duties with Teigland. “It’s a demand that we feel like we have to be able to meet.”

The logistics of concierge health care

Woollen said Novant has been investigating the concierge model for several years. Lipton, with Signature Healthcare, said he and his partners had met with Novant officials multiple times to talk about a collaboration.

But over the years, Lipton said it seemed that Novant wanted to buy Signature Healthcare instead of being partners, and he and his colleagues were not interested in selling to a hospital system.

“We don’t want to become a Novant doctor or doctor’s practice,” Lipton said. “We (have) a nonbiased referral pattern, and we’re not going to compromise that.” While there are “great physicians at both systems” in Charlotte, Lipton said, he and his partners want to feel free to refer to other hospitals and specialists if they feel its appropriate.

Doctors are wrong if they think a concierge practice will make their lives easier, Lipton said. “I work more hours, but they’re much more enjoyable hours.”

Teigland said she’s not expecting to work less, but by restricting the number of patients in her practice, she’s looking forward to spending more time with each one without feeling rushed.

“I saw this as a way to continue practicing family medicine the way I think it should be practiced,” Teigland said. “I was finding it more and more difficult to make myself accessible to my patients on a timely basis and deliver the kind of care I want to deliver.”

Teigland will be the lead physician in the Hallmark practice, sharing on-call duties with Woollen and Drs. Christopher Snyder and Kenneth D. Weeks Jr. Weeks, a cardiologist who also has a sleep medicine practice, and they will coordinate care for patients if they have to be admitted to a hospital.

Office appointments will be scheduled for either 20 or 40 minutes, and a new patient exam will be 90 minutes. Same-day appointments will be offered. If patients call after hours, they will speak to a nurse for triage. But if they ask to speak to the doctor, Teigland or one of her backups will return the call immediately.

Instead of being on call once every 30 days, as she has been in her SouthPark practice with several partners, Teigland will be on-call every other week. But that’s a trade-off she accepts.

“That’s part of the personalized care we want to give,” Teigland said. “I love spending time with my patients and getting to know their families.”

Better care for the elite?

The rise of concierge practices has raised questions about establishing a two-tier medical system, with an elite group able to pay for extra care. But Woollen and Teigland both said it’s just an option. “It’s a model,” Teigland said. “It’s not the only model.”

Woollen emphasized that Novant doctors volunteer at free clinics and also raise money for treating low-income patients through the Physicians Impact Fund. “We feel it’s incredibly important to take care of the community as a whole.”

Critics of concierge medicine also suggest that doctors who leave an existing practice are abandoning patients who can’t afford to follow them. But Teigland said she’s confident her patients are “not being abandoned.”

Her partners at SouthPark Family Physicians are recruiting her replacement and have promised to take care of her patients. “I know that I’m leaving every one of my patients in good hands,” Teigland said.

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