Concierge Doctors

Concierge doctors used to be a luxury for the ultra-rich. Now it’s become a commonly seen way of health care. More and more doctors are switching to this type of medicine, giving some people a more personalized experience while sending others scurrying to find a new physician.

Patients pay a yearly fee ranging from $1,500 to $20,000 a year. In Florida, $3,000 to $6,000 a year is the more prevalent price. For that, they get more personalized care from a doctor who has fewer patients and more time to spend with each one. Concierge doctors do everything that a primary care physician would do, but also do house calls, can oversee your hospital care, coordinate with specialists, offer blood work and other tests in office and more.

Timothy Eiszner, of Naples, believes concierge medicine saved his life.

“I had a great normal doctor, but getting access to him was near impossible,” Eiszner began. “He was a great doctor, but if you can’t get into see him, he can’t help you.”

Veora Little gets great personalized care from her concierge doctor, Tameka Bakker. ANDREA STETSON / FLORIDA WEEKLY

So Eiszner switched to Tameka Bakker, a concierge doctor with NCH. Bakker worked with his cardiologist and neurologist to come up with a plan to improve his health. Having a doctor communicate with specialists is one of the benefits Eiszner appreciates.

“I can be at a neurologist, and he can have a question, and he can get on the phone and call her, and she answers,” Eiszner explained. “If I need a procedure from another doctor, her office makes the appointments. I don’t have to wait a month. She gets it within days.”

Eiszner also appreciates the house calls his doctor makes, especially after having a procedure done.

“The downside is that Medicare doesn’t pay for a concierge doctor, but if you are looking for the best care you can get, this is it,” he said. “I don’t think I would be alive today if it was not for my concierge doctor. I tell Dr. Bakker all the time that she saved my life.”

Veora Little, of Naples, is another fan of concierge medicine.

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“What I like about it is [that] it is very personal,” she said. “When someone sees a doctor on a regular basis, they can avert a crisis. The concierge physician, they know you, and they know your care. Good medicine — that is what this is all about.”

That’s because these doctors spend more time with each patient.

Erin Whitney, a concierge doctor with Naples Premier Concierge, said before switching she would only get to spend about seven minutes with a patient during an yearly checkup. Now she spends two hours with her clients for their first checkup and an hour for each follow-up visit.

Whitney has privileges at NCH, so if a patient is in the hospital, she can oversee their care instead of the assigned hospital doctor.

“I will meet them at the ER,” she said. “I will look over what the emergency doctor is doing. It is having an advocate on the inside.”

Like all concierge physicians, she is on call 24/7.

BAKKER

“Occasionally on the weekends and holidays people do get sick,” she described. “They can be on vacation and get COVID. There was a skier and he got hit and broke his leg, so I helped him find an orthopedic. We can refer our snowbirds to a doctor where they live.”

Whitney charges $5,300 per year, and that pays for unlimited care.

Sally DeJarnatt said the cost is worth it.

“It is the immediate response,” she began. “You can call them day or night, or weekends and she is there. It provides a whole security for you. I am an ex school teacher, and I am not a millionaire. But the money is worth it for the peace of mind and the health.”

That is what Whitney offers.

“I like being able to offer that care for patients,” Whitney stressed. “I enjoy being able to educate people about their care and their options. The other way when you have seven minutes, you don’t have time to talk about that. We are able to provide more comprehensive care.”

WHITNEY

Bakker agrees.

“The patients have a better experience,” Bakker began. “There is a better patient-physician relationship. We have easier access to our providers. It prevents delay of care for our patients. We typically have a small patient client panel. With fewer clients, we are able to get them into appointments sooner, usually same day or next day. Those are some of the benefits.”

Another big benefit is always having a doctor on call. Her patients all have her personal cell number.

“Sickness is not on a 9-5, Monday through Friday basis,” she stressed.

Bakker has only 100 patients and says she won’t go beyond 300. She said traditional doctors could have 3,000 to 4,000 patients.

“It is the time spent with patients that is the most important thing,” she stressed. “Patients in a traditional practice are often rushed through things. Our appointment times are longer. We find that patients are able to get their concerns addressed. Our patients are happier and stay healthier.”

ALESSI

Bakker said there are also personal benefits for her.

“It is less likely to have a burnout day,” she said. “It gives a better work-life balance.”

It also takes away the stress and time-consuming elements of dealing with insurance. Albert Alessi was a traditional doctor for 15 years until he went concierge in 2009. He said it was insurance that prompted him to change the way he works.

“We had a very busy practice,” the Bonita Springs-based doctor described. “It was going well. But then there were a lot of changes with Obamacare and the other changes that altered health care. As health care got more crunched, we were spending less time with patients and more time on the computers. Our job has kind of fallen apart.”

Alessi said he was spending so much time on billing and working with Medicare, that he didn’t have enough time to spend with his patients. It became harder for the smaller practices to juggle patients and paper work. That led to the creation of larger health groups, while enticing doctors in smaller practices to switch to concierge service.

“By 2010, you really couldn’t be affective if you were a smaller practice,” Alessi explained.

Alessi said he is much happier now that he spends more time with patients and very little time with paperwork.

“I don’t have to deal with the intricacies of Medicare and the insurance industry,” he stressed. “It is no longer the insurance company dictating what you can do. It empowers the patient and the patient is the customer.”

Insurance companies often specify different coding for a yearly check verses taking care of an issue. So before going concierge if Alessi found a problem during a routine check-up, the patient might be forced to make another appointment.

“If you are doing a routine physical and you see something in someone’s ear you should be able to take care of it, but the way it is set up you can’t necessarily do that,” Alessi explained. “I don’t have to be concerned about the insurance industry.”

Without insurance concerns, Alessi can answer patient’s questions or go over test results by phone, video chat or email. Doctors can’t bill insurance for a phone conversation, so traditional doctors steer away from that. Patients in a traditional practice will usually get their test results from a portal, or a phone call from a nurse, or they have to come in for another office visit.

“I just got off the phone and was telling someone their CT results,” Alessi described. “The average concierge doctor might see 4-5 patients per day and 10 more by phone, or Facetime or emails.”

The costs

Concierge doctors vary in pay structures. Whitney’s and Alessi’s yearly fees include unlimited free visits.

Bakker works through NCH so her $4,500 fee is for the membership only. Visits with her can be paid for with insurance. Concierge doctors with NCH vary in their membership fees that range from $3,000 to $4,500.

On Florida’s East coast, concierge urgent and emergency care units are opening. Sollis Health opened a second location in Boca Raton last month.

A membership there provides access to lab procedures, wound care, orthopedic and ENT medical services.

Individual memberships at Sollis Health begin at $3,500 a year.

Tampa General Hospital has also launched concierge health in Palm Beach County.

Dr. Laurie P. Rothman is the first doctor to join TGH Concierge Health.

Her office says it will offer same day or next day visits, along with after hour and weekend contact.

Concierge clients tend to be older people who need most specialized care.

“The majority are over 65,” Alessi said. “They are the ones that need more health care, and they are having more and more difficulty getting reasonable access. We don’t only act for their primary medicine, but help make the correct appointments with the correct specialists and help them get in, in a timely manner.”

That’s why people like Bob Zammito switched to concierge service.

“I am 83 years old and I had never been sick, and then it was like somebody shut off the ignition,” said Zammito, who became a client of Dr. Whitney. “She is like a general contractor. She puts me in touch with the doctors that I need. I have texted her at 2 in the morning and she gets right back to me. It has been absolutely amazing. It is too bad that not everybody can afford to have this.”

And that is the biggest problem with concierge medicine. Insurance does not pay for the upfront cost, yet you still need insurance to pay for hospital care, specialists, surgeries and tests. So when a doctor goes concierge, it leaves a plethora of patients shut out and searching for another doctor.

Amber Frederickson of Bonita Shores had been with the same doctor for 20 years when he went concierge.

“We had to look for a new doctor that was under his (her husband’s) insurance. We had to blindly pick off of a list,” she described. “That kind of stuff happens, but it is kind of disappointing.”

Frederickson said it is also having a trickle-down effect.

“With all these people that leave, these other places that are not concierge become fuller,” she said. “So they are taking everyone that is not willing to pay for concierge, and it is making the rest of the system backup up more.”

Frederickson found a new doctor that she likes, but she is disappointed that so many physicians are going concierge and leaving their longtime patients.

“I certainly see the advantage of it if you have the money,” Frederickson said. “As a patient it felt like you were just being cast aside for money. The people with money get taken care of. We are not in the poor category, but we are not in the concierge category.”

Amy Sherman of Bonita Springs feels the same way. She is a teacher who switched to seeing a physician’s assistant when her doctor went concierge. But so many other patients did the same thing.

“This year I have been sick a lot with a cough and I can never get in to see Erin (the P.A.), so I have been doing urgent care or teledoctor,” she said.

Her husband also had to find a new doctor.

“When they told us they were going to do that (concierge), there was no way we could afford it,” Sherman said. “They wanted thousands of dollars up front, and we didn’t have that kind of money lying around.”

The future

Alessi said saying goodbye to all his former patients was the hardest thing about going concierge.

“That was very difficult for me,” he admitted. “That was a hard thing to do. We did our best to refer them to practices that were available.”

But Alessi also explained that there are ways to make concierge medicine more affordable. Customers can buy cheaper insurance with a higher deductible and then use the money they save on insurance to pay the yearly concierge fee.

“It depends on how you allocate their funds,” Alessi explained. “Some people are locked in because of their employer, but if you can get a high-deductible plan, like a $10,000 deductible, you can apply it to a concierge plan.”

Alessi also sees concierge medicine as continuing to become more affordable.

“When I first started, $8,000, $10,000, $15,000 were the prices. Now some are as low at $3,000,” he said. “I know there is someone in town as low as $1,500. More and more doctors are looking at concierge medicine as a way to get away from the obligations of insurance and Medicare, so they are happy to have someone pay $1,000 or $2,000 a year and not have to deal with all the coding that goes with insurance. It seems to be coming down. That might not be as reflective in Naples. It seems like the northern states are lower priced than down here. I think we are just inflated because of where we live.”

Alessi would like to see less money going to insurance companies and more being distributed for the actual health care.

“It is not for the ultra-wealthy anymore,” Alessi stressed. “You can travel anywhere in the nation and find other private medicine that is popping up. Some of it is a monthly fee; some is a fee for service without insurance. There are all different types of models popping up because it is harder and harder for doctors to deal with the insurance industry. More and more you are going to see the price of private medicine come down. If there are more physicians doing what I am doing, that will be a better way to handle health care. It used to be only for the ultra-wealthy. In the next 5-10 years there might be more people affording it. Access is something that people should be able to afford more and more as time goes on.” ¦

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