DOCTOR ON CALL: New style of medical practice promises greater attention, more personal care
By Charles Oliver
March 8, 2014 – Call it the wave of the future or maybe a return to ancient practice. Dr. Stephen Carson’s medical practice sounds a little like both.
Carson sees a limited number of patients (600), people willing to pay more for an enhanced level of service. That gives him the ability to really spend time with each one. And he’s on call 24 hours a day, seven days a week.
“They have my cell number. They can contact me by email, or my answering service,” he said.
“I was looking for a better way to take better care of my patients,” he said. “I’ve always enjoyed spending time with my patients. I was looking for ways to spend more time and really focus on preventive medicine. That’s the type of practice I’ve always had, so this was really just a continuation and improvement on what I had been doing.”
Born and raised in Dalton, Carson earned a bachelor of science degree in microbiology from the University of Georgia and a medical degree from Mercer University before returning to Dalton to practice internal medicine in 2000.
Internal medicine is similar to family medicine. The largest difference is that family medicine typically involves some pediatric care but internists see only patients 14 and older.
“Dalton has an outstanding medical community, and I always knew that I would return here to practice,” he said.
So how does personalized medicine differ from a traditional practice?
“There’s a $135-a-month fee,” Carson said. “That covers an annual wellness exam, a very detailed, comprehensive physical exam. We perform an EKG. We perform a spirometry. We perform an ABI, a circulation test. We give a vision screening and a hearing screening,” he said.
Based on that exam, Carson creates a personalized wellness plan for each patient. Traditional services are billed to insurance.
“Really, all the patient is paying for is that exam. All the additional aspects of this program are just part of my medical practice,” he said.
The other parts of the practice include a strong relationship with Carson. In addition to being on call 24 hours a day, Carson says that patients generally can schedule appointments on the same day or the next day they call. They generally don’t have to wait in a waiting room, but office visits can take 30 minutes or more.
“I really wanted to build that doctor-patient relationship, and that takes time,” he said. “The hours can be very long, but I want to see my patients healthier and happier, and I get to do that. It’s exciting to see patients respond and change their lifestyles in response to dietary modifications and exercise programs we have recommended.”
Carson says he believes patients are much more likely to make such lifestyle changes if the advice comes from someone who spends more time with them and can quickly answer any questions they have as they try to make those changes.
“I’ve really gotten good feedback from my patients. They get to spend as much time as they need with me,” he said.
But Carson says that in addition to more personalized attention his affiliation with MDVIP gives his patients other benefits.
“There’s also a travel program. There are over 700 MDVIP physicians across the United States, so if someone is traveling and has an illness or other problem, they can see an MDVIP physician,” he said. “The way it works is that they would usually call me first. If it’s after hours and a medical emergency, I will usually refer them to an emergency room. But if it’s during office hours, I will call that physician and they will see the patient. If the patient needs to be hospitalized, that physician will admit them and care for them during the hospitalization.”
Carson is currently at full capacity and has a waiting list of people who want to join his practice.
“Six hundred is the maximum number of patients. That is limited by MDVIP,” he said.
Dalton businessman Ed Painter has served on two state panels looking at different aspects of health care, and he says concierge medicine is something that experts mentioned is growing.
“My take on it is that this is simply one way the free market is responding to government involvement in health care. They can say there won’t be rationing, but there will be,” he said. “And people who can pay more to avoid that rationing will.”
Greater Dalton Chamber of Commerce President Brian Anderson says he expects to see tremendous changes in the way health care, particularly primary care, is delivered in the United States and the growth of concierge practices will be one of them.
“Health care is so convoluted right now, not just in how we provide it but how we pay for it,” he said. “We are going to see a lot of changes, a lot of experiments. We’ll see the growth of medical access clinics, owned by employers, owned by hospitals, owned by governments.”