October 13, 2013 – Dr. Robert Colton once was a founding partner of a hugely successful concierge medical practice called MDVIP that catered to those who could afford to pay doctors for their undivided attention.
Now Colton and another set of partners have a new Boca Raton-based venture — ClearlyDerm — and a new challenge, seeking to provide dermatology care to the masses by offering extended hours and appointments within a day — instead of weeks or months.
“I relish the opportunity to disrupt medicine as I did once with MDVIP,” the 61-year-old Colton said.
MDVIP, founded more than a decade ago in Boca Raton, was the first network of primary care physicians to provide concierge medicine service to patients on a national scale. The company was acquired by Procter & Gamble in 2009 for an undisclosed price. Today, the multimillion-dollar company has more than 670 affiliated physicians in 41 states and Washington, D.C.
After his work with MDVIP, Colton attempted to retire two years ago.
It didn’t work.
Meanwhile, his wife, Dr. Andrea “Andi” Colton, was tired of the grind of trying to keep up with a huge daily patient load as a Delray Beach dermatologist.
“I was burnt out,” she said. She had so many patients that even her doctor-husband couldn’t refer a patient to her.
For a new patient in South Florida, the wait to see a dermatologist can be as long as six months, said Paula Baumgardner, executive director of the Florida Society of Dermatology and Dermatologic Surgery. A shortage of dermatologists is a national problem, but it’s even more severe in South Florida, she said, as many new graduates go into more lucrative fields of cancer surgery or cosmetic surgery.
ClearlyDerm is seeking to break the mold of the traditional dermatology practice model by offering patients greater accessibility to dermatology care, eliminating any incentive for overdoing or underdoing health care, and providing alternatives that cost less.
The company has two shopping plaza locations — in Boca Raton and Boynton Beach — and provides dermatology services to eight primary care practices in Broward and Palm Beach counties. Revenues tripled from 2011-2012, and the company expects to reach $5 million this year, the partners say.
“We can provide great care at a lower cost. If we save money, we’ll save patients’ money,” said Colton, who is chairman and “chief strategist.”
Corin Wiser of Boca Raton turned to ClearlyDerm when a member of her family had a medical issue. She had been to other dermatologists and found that that insurance declined to pay for the recommended treatment.
But at ClearlyDerm, “they really worked with me on a price and months later, the insurance company came around,” Wiser said.
Baumgardner said as a patient, she would want to know that a doctor is always being consulted. “My biggest concern is ‘how well are those people trained who are seeing patients?’ ” she said.
Les Alt, ClearlyDerm’s chief executive, said nurse practitioners and physician assistants shadow and train with a doctor for a minimum of year before seeing patients on their own. The bulk of those hired already have experience in dermatology practices, the Coltons said.
The concept works for Boca Raton primary care physician Shari Rosenbaum, who says her patients can get dermatological issues addressed quickly through ClearlyDerm.
She recently saw a patient in his 50s who had a lesion on his lip and was about to leave the country for a business trip. She quickly sent photos of the patient to ClearlyDerm and they were able to tell him there was no immediate concern.
Primary care doctors “are not trained to look at skin,” Dr. Rosenbaum said.
ClearlyDerm also believes in presenting its patients alternatives to risky and expensive surgery for minor or pre-cancerous skin conditions.
Medical personnel and other staff members at ClearlyDerm are paid straight salary or hourly wages, and there’s no pathologist on staff. “There’s no incentive to over-biopsy,” said Andi Colton.
Staff dermatologist Dr. Angela Weatherall prescribed an FDA-approved chemotherapy cream to erode a basal cell carcinoma — a common cancer that rarely spreads — on a 79-year-old woman who didn’t want surgery. The cream worked, saving the patient the pain — and expense — of surgery.
“It saves Medicare money, too,” said Weatherall, who opted to join ClearlyDerm in March from a solo practice.
She said providing extended hours also promotes preventative care. Patients who work during the day are less likely to put off a mole check if they can get an appointment after work or on Saturday, she said.
“If patients are coming in and getting their skin checked, you’re finding things more often so it doesn’t turn into a bigger deal,” she said.
Boca Raton patient Rhonda Levy said she stopped going to a local dermatologist because “she was more interested in doing plastic surgery than checking my body.”
After what she said was a “thorough” exam by a nurse practitioner at ClearlyDerm, Levy said she appreciated the office calling her as soon as her biopsy results came in, even though it was at 9 p.m.
“I felt like a person instead of like a number,” she said.