A Doctor With a Zero-Wait-Time Policy

Dr. Joseph Mulvehill, owner of Park Avenue Concierge Medicine in New York City, said he knows his hundreds – but less than 1,000 -- of patients intimately, some more than others.

Mulvehill sometimes sees patients at their homes and/or offices, and he helps arrange care for them if they are traveling out the country. A visit at his office requires a wait time of zero minutes and can run over 30 minutes, all one-on-one with the doctor. Coverage with Mulvehill’s practice runs between $2,500 and $5,000 annually – or between $50 and $100 a week.

Mulvehill said he switched to concierge medicine nearly 10 years ago, as he was seeking a more patient-intensive form of practicing.

“This is for people who are very busy,” he said of concierge medicine. “Time is a major factor. I take time to know what is going on in their lives, their family’s lives. A regular practice today probably has 2,500 patients and under-managed care, doctors see a patient for less than 11 minutes.”

Concierge medicine, which medical experts say came on the health-care scene in the late 1990s, was once perceived to be an exclusive, luxurious form of care for the rich. Today, with some plans as low as $60 per month, this personalized form of medical care is more accessible to the masses, at a time when uncertainty over health-care reform weighs heavy on the minds of many Americans.

This form of medical coverage goes above and beyond the average consumer insurance plan, according to Independent Consultant Greg Scandlen of Health Benefits Group. At its core are primary care physicians who are able to cut back on their typical patient loads by charging an additional fee for service, and therefore provide more personalized care.

“They can reduce their caseload dramatically, so they are able to spend a lot more time with patients,” Scandlen said. “A lot of people are frustrated with doctors—they go in, wait for an hour and the doctor comes in for five minutes and scurries out again. Essentially [in concierge medicine] the doctor becomes the patient’s advocate in the health-care system.”

Aside from those stretched thin for time, concierge medicine also works well for those who are older, or the chronically ill who may be consuming a lot of health services. Having this more intensive care may cost more, but Scandlen said it is quite possible that it saves money for patients by reducing potential hospital visits.

“They avoid going to the hospital in the first place, because there are early indicators picked up on by physicians,” he said.

Pricing has come down on concierge programs, according to Tom Blue, executive director of the American Academy of Private Physicians, however the stigma of luxury is still attached to the name.

“Shockingly, it has little to do with a patient’s wealth,” Blue said. “It’s about how they prioritize health in their lives. The orientation is very relevant to someone who is on a high-deductible plan.”

Health-care reform has alerted the public to the perception that there is a shortage of doctors in primary care, and the reform itself has pushed more doctors to consider the own stability of their practices, Blue said.

“I think its driving a greater value on the physician relationship,” Blue said. “People are beginning to realize that even if you have insurance, it doesn’t guarantee that you have access to a doctor who is attentive to your needs.”

Although more people will be covered under the president’s health-care reform act, it will come at a cost for patients, Mulvehill said.

“The cost is less care available to them,” he said. “More people will get care under that pot of money, but there will be less services. People will have to choose if they want more personalized care than that. I think there is going to be more of a place for people who are busy and need personalized care.”

There is a shortage of primary care physicians right now, Scandlen said, and although nurse practitioners are available, many feel more comfortable going to a full-fledged physician, and therefore may opt for the concierge.

“They are willing to pay more for a doctor,” he said. “Also, they don’t have to wait for an hour in the waiting room and there is a lot of non-office care going on too, like home visits, consultations, e-mail responses—that kind of thing most physicians these days are not doing.”

Those interested in finding a concierge physician can search for a doctor at www.conciergemedicinetoday.com.