Five years ago, Dr. Marcy Zwelling called a medical timeout.
"I had had enough of what they call the traditional medical system.
There's no time to do the job I need to do when I can only give five to eight minutes to a patient.
"I couldn't do my job."
So she quit.
Quit in the sense that she ended her traditional medical practice serving some 3,000-plus patients at her Los Alamitos, Calif., office.
She invited these patients to "Evenings with Marcy," wine and cheese conversations over six months. She promised she would not abandon anyone in treatment. But she needed closure with her general practice.
Zwelling had decided to become a concierge physician, a relatively new approach in medicine. As an internal medicine specialist, she now interviews potential patients at the same time they are interviewing her.
Everyone is paying attention because there is money at stake.
Today, she has some 350 patients who pay $1,800 a year for 24/7 access to her services.
It's a medical approach that's not for everyone, she says. And while it sounds like there's a lot of money at stake, she said "I'm not making any more money, but I have more control over what's happening so I can make better decisions with less anxiety."
Q. This sounds like an elitist approach to medicine - serving only the few who can pay you a concierge fee on top of regular insurance.
A. Some of my patients have insurance and some have none. Some are even enrolled in Kaiser or a Medicare plan that requires them to use certain doctors if they want insurance coverage.
Please understand that about 10 percent of my patients are "scholarships." I am committed to doing volunteer work in the community. And since the recession, some of my patients have lost their jobs. I'm not throwing anybody off the bus.
Q. Compare what you do to current medical care systems.
A. In the current system, care follows the financing. How many times do you go to see a doctor to ask a question and then wait and wait in the waiting room?
Instead of financing, care is the central theme of concierge medicine. I don't care how many times I see you. I sell access.
We keep talking about insurance being access to care, but that's an unreasonable statement. Your insurance card lets you get into the emergency room to sit in line. It doesn't "buy" you what you want - care and legitimate access to a doctor.
Q. Has this switch changed your attitude?
A. I'm happy to go to work. I'm happy to be a doctor because that's what I do.
One of the things we forget is that your time is valuable, too. Instead of focusing on the greenbacks exchanged, how about focusing on the value of knowing your doctor is always there? That's what you buy with me.
You don't get a husband or a hairdresser from a list some insurance company gives you. Why should you get your doctor that way? All doctors are not the same. Your relationship with your doctor is very valuable.
Q. I'm wondering if, by using a concierge doctor, a person actually cuts down on the number of doctors monitoring "pieces" of care?
A. Absolutely. I can monitor blood pressure, for example, and you don't need to see a cardiologist for that. You don't need to be followed by a lot of doctors and pay co-pays to them.
Q. You have just been named first woman president of the Society for Innovative Practice Design, an association of concierge physicians. You say you are the answer to health care reform?
A. We are talking higher quality, lower cost. We offer increased access and decreased cost of care. If we save people a couple of tests and give them confidence for a day, I think this matters. And we are open about what we do. You can read about me and my practice at z-doc.com.
As far as being the first woman in this national leadership role, well that may be interesting!
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(Jane Glenn Haas writes for The Orange County (Calif.) Register. E-mail her at jghaas@cox.net)
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(c) 2009, The Orange County Register (Santa Ana, Calif.). Distributed by Mclatchy-Tribune News Service.