'Concierge' Medical Care Unfair?

Imagine this: a doctor who answers his own phone, never keeps you waiting, and even makes house calls.

No, it's not Hollywood.

As The Early Show medical correspondent Dr. Emily Senay reported Thursday, it's a reality. But it comes with a hefty price tag.

It's called "concierge," "retainer," or "boutique" medicine.

With "the old days" of "Marcus Welby"-like care long gone, replaced by hurried visits with specialist after specialist, some physicians are putting on the brakes and turning back the clock.

As Senay explains, some doctors, frustrated with the current medical system, are charging an extra fee to give their patients extra, VIP-like attention.

One such doctor, Perry Wyner, who practices in Rockville Centre, N.Y., on Long Island, told Senay, "We want someone to pay attention to us, to care about us, to feel like we have their interests at heart."

Wyner engages in concierge medicine through MDVIP, a Boca Raton, Fla.-based company that provides support services for his practice. His patients pay an extra fee of $1,500 a year over, and above insurance.

"That fee," Wyner says, "allows me to have the time with the patients that I need. Therefore, I can give the patients the time they really deserve."

Wyner used to care for 2,500 patients, but now is down to fewer than 400.

One Wyner patient who made the transition, Nancy Frankel, says the cost doesn't bother her at all: "We sat down and said, 'You know what? People spend hundreds of dollars to go to health clubs. People spend thousands of dollars to go on vacation. Every family has priorities. Our priority is health."

Concierge-style businesses sprang up 10 years ago and are now in at least 15 states, Senay says.

MDVIP, just one of many such companies, says its sales have gone up 1,841 percent in the past three years.

But not everyone thinks that's a good thing."By making your life better, and taking fewer patients, it will make somebody else's life worse," asserts Dr. Richard Cooper of the Institute of Health and Economics at the University of Pennsylvania.

He observes that, though concierge medicine benefits individual patients, it leaves lower income people with fewer choices.

"If all the primary care doctors were to see half as many patients as they now see, so they can spend twice as much time, we'd essentially have half as many primary care doctors, and that wouldn't be enough for everybody," Cooper worries.

Wyner says: "I would love to practice this way for everybody. I'd love to do it for 2,500 patients. I just don't think it's possible."

Although concierge medicine is on the increase, Senay notes, it is still relegated to mostly urban areas. And, while experts on the healthcare industry disagree over whether it creates a multi-tiered system, it is one more example of a movement toward consumer-driven healthcare.

Some 300 doctors in the United States practice concierge medicine, Senay says, with an estimated 135,000 patients. So, though the number of such doctors is growing, it is still only practiced by a small number of physicians located mainly on the East and West Coasts.

As for insurance coverage, Senay reports it depends on the provider: Most insurance companies do cover the additional charges for extra procedures and tests. There are, however, some insurance companies that have dropped some concierge doctors from their networks due to contractual provisions. So, if someone is looking into this, they need to find out from that particular doctor what the initial fee covers, and what the insurance will cover.

If the doctor accepts Medicare, and about 76 percent of these practices do participate in Medicare, the membership fee must not result in additional charges for items or services that Medicare already reimburses, Senay adds.