How to Choose a Concierge Physician

Some medical doctors are fed up with health maintenance organizations. As Dr. Alan Mintz of Cenegenics puts it, "HMOs are profit making. HMOs are subject to the results of the next quarter. Their real goal is to pay out as little as they can and still provide at least a healthy minimum of care." As an alternative, a small but increasing number of physicians are opting for smaller practices that provide more individualized health care. Dr. Lida Ghaderi of CENIGENT says that "One size fits all medicine and a medical approach that waits for disease to emerge and then treats the end-symptoms of disease doesn't provide optimal health. Based on our scientific advancements we can do better." Physicians like these have restructured their services into so called "concierge practices." If you are in a position to afford the extra costs here's how to evaluate them:

Instructions

• 1

  Understand what you'll be getting. Both Cenegenics and CENIGENT do individual patient work ups in a variety of areas to determine a patient's baseline condition. Each provides specifically tailored recommendations for its patients to reach optimal health. Both of these practices specialize in healthy aging. Additionally CENIGENT treats existing chronic diseases with a personalized systems approach. Some concierge practices provide far less, simply longer appointments with no waiting and personal cell phone numbers for after hours calls. A few doctors actually offer house calls.

• 2

  Some insurance companies have received complaints that patients were charged to procedures that were covered by Medicare. Most concierge physicians work with personal contracts that are not covered by insurance, but are an adjunct. In many cases, you will probably still have to carry insurance for at least catastrophic care. When you look at the concierge practice's contract, carefully evaluate what the doctor's obligations are, and exactly what procedures, medications and hospital stays will be covered. Pay attention to any notice of a change. A procedure that is covered today might not be covered tomorrow.

• 3

  Take a close look at the fee. It can vary widely from $1000 a month per individual up to $30,000 a year and more. One way to pay for this service is through a health savings account. These were created by the Medicare bill of 2003 to help individuals save for qualified medical and health expenses on a tax-free basis. Check with your accountant for eligibility.

• 4

  AT CENIGENT, Dr. Lida Ghaderi does a thorough genetic profile as part of her patient evaluation, and a battery of predictive whole-body imaging tests to be able to better predict early signs of disease, before doing extensive personalized research prior to putting her patients on a 52 week plan designed to optimize their health. "CENIGENT is a departure from all existing medical approaches by introducing a systems approach and offering personalized genomics based medicine," she explains. By limiting her personal practice to 70 patients, she gives them the kind of individualized attention she could never provide them when she worked in an HMO. There she said the emphasis was on not spending too much time or money on a patient. Still she bucked the system by ordering whatever medical tests she thought necessary despite their costs, justifying the expense up front by pointing to her patients' low hospitalization rate. She grew tired at the constant penny pinching from the HMO, and began CENIGENT as a concierge practice that would deal with a patient's underlying health issues and fix them before a patient got sick.

• 5

  Concierge medicine suffers from the perception that it is elitist, establishing a two tiered medical system. In reality it is part of what is now emerging as three tiers: a concierge practice for those who can afford the additional fees, standard health insurance coverage that is now primarily through HMOs, and the 47 million Americans who have none at all and depend on emergency rooms in extreme cases of life and death.

• 6

  Other people contend that concierge medicine is too new to determine whether or not patients actually receive better care. As might be expected from a large HMO, a spokesman for Blue Cross / Blue Shield, Dr. Barry B. Schwartz, contends "You're not paying for better care. You're paying for better service." The final step in evaluating a concierge practice is to get permission to talk to the doctor's patients to see if the extra expense is worth it.