Two years ago, his doctor determined that he was heading toward becoming diabetic unless some life style changes were made. Mr. Recklet dropped 20 pounds, increased his exercise with his personal trainer and now the 70-year-old is in better health than some people 20 years younger. He recently went on a group “field trip” with his doctor to a local grocery store to learn how to eat healthfully and to keep the weight off.
Robert Bodio of Milford and his wife, Ann, who has several chronic health conditions, sometimes would sit in a waiting room for two hours to see a doctor. Or, they would just come back another day. Now, there is no waiting and they have 24/7 access to their doctor, via cellphone and email.
Ron Cohen of Hopkinton was in Boca Raton, Fla., recently visiting his elderly parents. His 92-year-old father wasn’t feeling well so his doctor came to his home to visit him.
All of these are great, personalized medical services that most Americans don’t have. The innovative type of medical practice is known by several names, including concierge, retainer, boutique and direct care medicine. The primary care physicians are able to give more time and care to patients because they have much smaller practices — up to 600 patients, compared with an average of 2,500 for traditional practices.
But, of course, all that comes with a price.
The Cohens, Bodios and Recklets are patients of Dr. Stephen A. Hoffmann of Framingham, a concierge physician with the Florida-based MDVIP network. Each pays Dr. Hoffmann a $1,650 annual membership fee — which can be paid quarterly, semi-annually or annually — to get the preferential treatment. This type of medical care began in Seattle in the late 1990s. MDVIP (VIP stands for Value in Prevention) was founded in 2000 and now has more than 700 physicians throughout the country with more than 215,000 patients.
Only 17 of these physicians are in Massachusetts, none in Worcester County.
The annual membership fee provides patients with several attractive amenities, including unhurried and longer office visits, no waiting to see the doctor, 24/7 availability to the doctor via email and cellphone, ability to see a MDVIP physician in another state the same day of an emergency, and patients’ children ages 16-26 have access to the physician without an annual membership fee.
One of the most important features is a comprehensive wellness program that includes an extensive annual physical and personal wellness plan aimed at identifying health risks and preventing conditions and diseases before they can occur.
The MDVIP annual wellness exam includes screenings for vascular disease, hearing, vision, depression, mental health status, sleep disorders, sexual function, pulmonary function, body composition, meal planning, nutritional life style analysis, exercise, a proprietary women’s and men’s health panel, diabetes, inflammation and online modification program.
“Quite candidly, I’ve been stunned at how many different threats to health in the making I’ve been able to help patients ward off — heart disease, stroke, cancer, diabetic complications,” said Dr. Hoffman, a Harvard-trained internist.
He said he changed to a concierge practice less than two years ago because it became increasingly clear to him that he wasn’t able to indulge in his passion for preventive medicine. Before he was seeing on average 20 patients a day. Now he sees about half that number. He has patients from 20 years of age to the mid-90s. Most patients are from nearby communities, but some are from as far away as Cape Cod and Sturbridge.
“My day is just as long now, if not longer. But, I’m spending a lot more time with all of my patients. In between visits, I’m on the phone checking on people at home. It’s a different type of busy.”
Representatives of the Massachusetts and Worcester District medical societies, did not offer a position for or against the concierge concept. But, because of the price tag for patients, they said, it’s exclusive.
“There’s a socio-economic bias in my opinion,” said Dr. Ronald W. Dunlap, president of the MMS “With concierge, you’re cherry picking the best patients. It’s like being in the (auto) insurance industry and saying you’re not going to insure someone’s car because they live in the south end of Roxbury. But, you will if they live in Dover. That’s cherry picking: taking people who pay well and their risk is lower.”
Dan Hecht, CEO of MDVIP, disagreed. He said it’s more a matter of a person’s priority. He pointed out that, while some concierge doctors may charge an annual membership fee of $10,000, the $1,650 fee charged by Dr. Hoffmann and other MDVIP doctors amounts to about $135 per month.
“That’s a price that many Americans can prioritize and make the choice to have,” he said. “I’ve heard the story where a patient has said, ‘Look, I smoke two packs of cigarettes a day. I’m giving up one for you.’ That more than pays for the membership fee. Those are choices that people make every day about a cup of coffee … about cable television or about a night out.”
Dr. Michael P. Hirsh, immediate past president of the Worcester District Medical Society, said none of the society’s more than 1,500 physicians have concierge practices. His first experience of talking with a concierge doctor was with Dr. Connie Mariano, a former White House physician from Arizona, who was fielding calls from patients while a guest at a dinner at the home of Michael F. Collins, chancellor of UMass Medical School two years ago. He said from that he learned that concierge medicine is so demanding that it’s for a select few who have the right frame of mind.
Every 20 minutes or so during the dinner, Dr. Mariano received a page, and at one point she asked to use a computer to look at an X-ray, he said.
“You can imagine if every single sniffle, ache and pain generates unlimited access to you, it takes the right kind of personality to be able to deal with as many calls as you would get,” he said. “Physicians who completely immerse themselves in their practice only let other areas of life suffer: health, marriage, raising their own children. I don’t imagine this kind of practice is going to promote that kind of work-life balance.”
Mr. Bodio, a 69-year-old retired banker from Milford, said the access to Dr. Hoffmann is phenomenal now compared to what it was before he switched to concierge medicine. He said that’s particularly important since his wife suffers with severe asthma and cardiac problems.
“He had so many patients before that some days it was impossible to see him if something was serious,” he said. “His access is tremendous now. We have 24/7 access almost instantly.”
Mr. Cohen said since his elderly parents winter in Florida, they were happy that Dr. Hoffmann set them up with an MDVIP doctor in that area.
“They collaborate. They talk and share files. It’s almost seamless,” he said.
Mr. Recklet said by helping him to prevent getting diabetes, he feels that Dr. Hoffmann’s care is extending his life and giving him a much better quality of life. That is well worth the annual membership fees he and his wife, Elaine, pay, he said.
“My personal trainer is amazed that at my age I’m in so much better shape than some of his clients who are 15-20 years younger,” said Mr. Recklet, who retired from the biotech industry six years ago. “My feeling at this point is whatever I’m investing up front now to maintain my health and well being, I think is going to end up saving society as a whole the end-of-life expenses too many people bring upon themselves.”
Contact Elaine Thompson at firstname.lastname@example.org.