Oct. 05--In the next decade it might become harder to find a family doctor.
As a result, some patients are opting to pay extra -- call it a retainer -- to make sure they have immediate access to quality medical care.
They're called concierge doctors.
A concierge medical practice once was limited to the rich and famous.
For a number of reasons, that is no longer true.
Dr. Nader Rahmanian, an internist and gerontologist with offices at 1416 Penn Ave., said he has opened the first concierge or VIP medical practice in Berks County. He said his practice is open to his current patients, and anyone else seeking direct access to quality care for an extra $1,500 per year.
That is a retainer paid in addition to any patient's health insurance coverage and patient co-pays.
While Rahmanian is operating under his own business model, some physicians who have opened concierge practices turn to management firms such as Total Access Medical of Bala Cynwyd, Montgomery County.
Richard Stamps, Total Access president and chief executive, said that when he started his first concierge medical practice in the Philadelphia area in November 2002, there were only about 500 in the country.
Total Access now manages seven practices in the Philadelphia area and there could be as many as 5,000 concierge practices nationwide, he said.
"The average family practitioner sees anywhere from 30 to 50 people a day and the average visit is seven to 11 minutes and they're only making between $150,000 and $200,000 a year," Stamps said. "We provide a way for them to get back to enjoying what they're doing."
Family doctors and internists might be exploring alternative business models, but the trend still isn't spreading like wildfire in the state, said Chuck Moran, a spokesman for the Pennsylvania Medical Society.
"In the past four or fi ve years there have only been a few calls asking for information about concierge practices," he said. "I don't think you could call it a trend here. It's really more of a blip.
"It's a hard transition to go from being insured by your employer and having that medical card in your hand and then being asked to pay more money to see a doctor. Whether or not he is successful will depend a lot on how good of a marketing job he does."
Tom Blue, executive director of the American Academy of Private Physicians, Richmond, Va., said there are a number of reasons concierge medicine is rising in popularity, if not by leaps and bounds.
Blue said the academy provides a workshop for doctors looking at concierge, fee-forservice and other forms of health care delivery characterized by a direct, fi nancial relationship between physicians and their patients.
Since 2002, medical school students choosing family practice have dropped by 30 percent.
Family practices already are struggling to balance rising costs, the need to see more patients to meet those costs and doctors' desire to have the time to maintain doctorpatient relationships.
The number of aging baby boomers is growing, and when health care reform goes into effect fully in 2019, it is expected to add another 30 million Americans to the ranks of the insured looking for doctors.
"If you add all that together, thoughtful patients, and people who are conscious of these dynamics, are starting to seek out relationships with private physicians that they know will be stable," Blue said. "I don't think it will overtake the entire medical profession, but it would not surprise me to see 20,000 to 30,000 physicians pursuing these types of private business models over the course of the next four or fi ve years."
Lastly, Blue said, in an eff ort to cut their health care costs, employers increasingly are offering their workers highdeductible health plans.
"So you've got more and more consumers out there who are now stewards of their own health care dollars, thinking for the first time as health care consumers," he said. "They're thinking, 'I've just saved a fair amount of money in premiums, maybe I should invest some of this in prevention and managing my future health claims.' "
That's where the concierge medical practice comes in, he said.
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