August 17, 2011
Concierge medicine coming to blue-collar neighborhood
Another local physician is converting his practice over to a concierge, or retainer-based, style of medicine, but this time the doctor making the switch isn’t located in an affluent neighborhood.Dr. Brian Stein, a private practice family physician in Northeast Philadelphia, serves a largely blue-collar community. Stein decided to change to the concierge model in large part because of concerns he has over health-care reform, which he thinks will result in 35 million new patients “flooding the system” and not enough primary-care doctors to care for them. The result, he said, will be patients receiving care in “five-minute increments” from anonymous providers.
“What I want to do is have a more personalized model of health care,” Stein said.
Concierge medical practices typically charge patients an annual retainer fee of around $2,000 in return for quick access
to the doctor and longer appointments. The annual fee allows the doctor to reduce the number of patients in his or her
practice and spend more time with each patient.
The Philadelphia region already has more than a dozen concierge medicine practices led by the seven managed by Total
Access Medical of Bala Cynwyd. MDVIP Inc. of Boca Raton, Fla., has six practices locally and another two set to join this
fall.
Stein is switching over to a concierge practice in October by linking with SignatureMD of Santa Monica, Calif.
SignatureMD was founded in 2007 by Matthew Jacobson, a former insurance executive.
“Philadelphia is an ideal city for personalized medicine because of its scope and diversity, and because of its progressive
nature,” Jacobson said. “Dr. Stein is a well-respected and well-established doctor who has chosen to make the transition
to personalized medicine because he values his relationships with his patients and sees many opportunities in bettering
the way primary-care medicine is practiced. SignatureMD anticipates working with other Philadelphia-area doctors who
also wish to improve their patient-doctor relationships and embrace a more holistic approach to medicine. SignatureMD
empowers physicians to finally practice the way they have always dreamed of. They can truly get to know their patients
as people, rather than a collection of symptoms.”
Under the company’s concierge model, members pay an annual retainer fee — in quarterly installments — of between
$1,500 to $2,000. A discounted rate is available for couples who join together.
In return for that fee, members are assured same-day or next-day appointments, unhurried exams and consultations,
and a customized “pro-active” wellness program.
Members retain their health coverage. SignatureMD physicians who are in the member’s managed-care network will
continue to bill the insurer for covered services. The annual retainer fee is not reimbursed by insurance.
Stein is the first Philadelphia-area physician to join SignatureMD’s physician network. The company has doctors in seven
states and the District of Columbia. A spokeswoman said they are not disclosing the total number of doctors with whom
they are working.
He said one reason he went with SignatureMD is the company spends a lot of time surveying communities and
developing appropriate pricing models.
“People think this kind of model is set up only for the rich,” he said. “It’s not that way. Our model can save people
money if we can help them stop smoking a pack of cigarettes a day.”
The retainer fee for Stein’s patients will be about $1,500 a year, which works out to about $4 a day.
“This isn’t about money,” Stein said. “It’s about better patient care. The system the way it is now is forcing people to
make compromises.”
With the new model, Stein said he will be able to spend more time with patients and focus more on preventing illness.
Today, primary-care doctors increase their revenue by seeing more patients — which creates an incentive to conduct
shorter appointments.
“Now I’m always running behind because I give people the time they need,” he said. “I feel like a corkscrew. I’m going
to twist myself in the ground if I continue with the current model.”
Stein has about 4,000 patients in his practice, but that number will be capped at 600 under the SignatureMD model. He
plans to add a nurse practitioner to help provide patient care and will have the ability to expand the staff based on
demand.
The shift to the concierge model by Stein is coming at a time when his practice is growing by about five to 10 patients a
week as a growing number of primary-care doctors in Northeast Philadelphia are selling their practices to hospitals, or
accepting jobs as hospitalists — doctors who work full-time caring for patients admitted to hospitals.
“I’m one of the youngest primary-care docs in the area and I’ve had a practice here for 11 years,” said Stein, 41.
“[Switching to a concierge model] is one of the hardest decisions I’ve ever had to make in medicine. People think
doctors are doing it to get rich, but it’s not that way. We’re doing this to survive. I’m doing it so I can continue to
practice medicine for the next 30 years.”
