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Now Trending: Concierge Medicine, the Fast-Pass to Personalized Medical Care
by Chris Salboudis
2017 rings in an increasing demand for more personalized healthcare treatment and guidance. What does this mean for patients and doctors? We reached out to Dr. George Liakeas – medical doctor, owner of Lexington Medical Associates, manager of Smooth Synergy Spa, and President of the Hellenic Medical Society of New York – to share the benefits and drawbacks of the Concierge Medicine model to Concierge Members and participating medical providers.
The earliest version of this forward-thinking initiative started in Seattle around 1996 and gained momentum in parts of Florida, California and other regions within the U.S. with predominant communities of elderly patients requiring extensive personalized attention and extra care that were not included by their standard medical insurance providers. More fast-paced metropolitan areas like New York City have gradually adopted the model to cater to individuals whose work-life schedules may not allow them to seek necessary medical treatment within the confines of their physician’s regular business hours.
Due to overlapping pressures from insurance companies, hospital administration and other socio-economic factors since 2009 it has become very common for doctors to rush through medical examinations to ensure that they see as many patients as possible during their office hours. Doctors faced a growing struggle to meet patient demands while wrestling with a variety of rules and restrictions and pushing to meet additional demands to train new medical practitioners, conduct medical research, publish, etc. Little thought has been given to the doctor’s real time and effort or to their own real needs for work-life balance and stress reduction. The result was multi-tiered dissatisfaction and frustration: Administrators fought to keep medical providers to a strict timetable; patients complained about long waits, feeling rushed and a lack of time and attention for their medical concerns; physicians were burnt out from trying to meet the fundamental principles of their Hippocratic Oath. In short, no one was happy.
Mounting tensions caused by internal and external audits as well as various shifts in standardized insurance coverage – which don’t necessarily take a patient’s best interest into account – led to medical providers’ decision to consider drastic measures like opting out of accepting standard insurance or not accepting new patients altogether. Neither of these meets the needs of the doctor or the community.
The truth is that there is no easy fix to address the complexities of running a good medical practice that meets every patient’s demand, however Concierge Medicine (also known as “Boutique Medicine”/”Direct Care Program”) allows for a viable alternative to lend much needed support to doctors and patients. The system allows patients (“Concierge Members”) to enjoy a more personalized level of care with more hands-on features than what popular insurance programs currently cover.
Concierge Members pay an annual fee. In exchange, participating doctors carry less of a patient load to cater to the needs of their Members. Services include prompt same-day or next-day appointments at times that are convenient for the patient, round-the-clock access and advisement, an enhanced advisory network, health coaching, and – perhaps most immediately appreciated by patients – the return of the extended office visit.
Dr. Liakeas recently joined with Castle Connolly Private Health Partners, LLC (CCPHP) to form Liakeas CCPHP after a careful review of the new trend and the needs of his own patients. The vast network of administrators and participating healthcare providers available through CCPHP share his level of commitment to offering patients quality medical care. “People ask why not just stop taking insurance?… Because doing that across the board would feel like we were abandoning our patients, who are all people we care about! I recommend this new Concierge model to my colleagues, which allows me to offer a more personalized approach to my patients’ care.”
IS CONCIERGE MEDICINE A RESPONSE TO THE SHIFT TOWARDS “SOCIALIZED MEDICINE” IN THE U.S.?
Dr. Liakeas explains that there are currently various opinions about Concierge Medicine. At this point it’s up to individual healthcare practitioners to review the specific needs of his or her office. “For almost two decades, I’ve been practicing medicine like a ‘small town doctor in our big city.’ Practicing medicine has always been very rewarding to me, but, in the current healthcare environment, it has become more and more challenging to devote enough time and attention to every single patient. Consequently, as I continued to treat my patients comprehensively, I constantly found myself caught up in a game of ‘cat and mouse,’ running from exam room to exam room, working hard to limit long wait times. Practicing medicine in the way that I wish to had become unsustainable in this increasingly complex healthcare system. With this realization, I chose to collaborate with Castle Connolly Private Health Partners to create the new membership-based concierge practice, Liakeas CCPHP. This model is best for my team and my patients because it allows me to provide a more connected, convenient and personalized approach to patient care.”
Concierge Medicine gives patients back some of the comforts they enjoyed prior to all the ruthless administrative cutbacks in healthcare. “What their insurance chooses to cover is not an issue anymore. Easily half of the services needed by those who would benefit from Concierge Membership are non-reimbursable by their insurance. Now, when Members see me in my office, I spend as much time with them as needed to address their concerns fully, to follow up as needed, and so on. I’m also available to communicate with them via phone, e-mail, or text, which can be a convenient alternative to an in-person office visit when appropriate.” Benefits along these lines include earlier hours, house calls, homecare options, coverage by medical affiliates on weekends, evenings or holidays, and more. “There used to be nothing available to patients on days that the office was closed other than to advise them to go to the nearest ER or urgent care center. Now there is someone available to address patient needs around the clock.”
The Concierge model generally helps expedite care for Members, ensuring same-day or next-day service. “It’s similar to the difference between flying Coach versus First Class. The First Class get some advantages in terms of timing or seating, but it doesn’t mean that there will never be a common delay that affects all the passengers regardless of where they are sitting. Concierge Medicine is not an attempt to be elitist or selective at all. The membership perks are designed to cater to patients who require the extra care. It may be the thing that makes all the difference for some patients.”
Another benefit is enhanced connectivity with other CCPHP affiliates – a network of over 50,000 healthcare practitioners around the world – which helps ensure that patients receive the most efficient, effective care possible from their general practitioners and specialists.
Another major advantage is the emphasis on preventative care and more holistic medical advisement. To this end, a SENS (Sleep, Exercise, Nutrition and Stress Management) Health Coaching program is available to Members based on the principle that having adequate support for these four “pillars of wellness” is an important aspect of preventative medicine; it can also be a very helpful stepping stone for the comprehensive treatment of existing ailments. “Members would have connectivity to a SENS Health Coach who provides them with customized support and education, helping to identify and resolve potential barriers to a healthier lifestyle.”
MEMBERSHIP FEES & COSTS
Because the current range of health insurance premiums varies so drastically the question on many a patient’s mind is, “Do I have to become a member to stay with my doctor? Will this affect my current health insurance plan?” Dr. Liakeas explains that existing healthcare services that are already covered by the traditional standardized insurance plans are not affected by the decision to sign up for the additional amenities provided for patients who become Concierge Members.
The Membership fee covers much more than just the direct cost of the medical treatment and service coverage is designed to be comprehensive without overlapping. “A third of the membership fee goes towards administrative costs, another third goes towards customer service, and another third goes towards medical services that the standard insurance company doesn’t reimburse.” Even with the Membership fee in place there is still a great deal of behind-the-scenes work (like the extra time needed to evaluate test results, review notes and messages, contact pharmacists, etc.) for which the healthcare provider is never compensated. “It’s not about the money on many levels. It’s just part of what needs to be done to make sure patients are well cared for.”
IS CONCIERGE MEMBERSHIP RIGHT FOR YOU?
Membership Fees cannot be reimbursed to the patient by his/her insurance plan, so it’s important to consider weather Concierge Membership is necessary and right for you.
The Membership plan is best suited for those who wish to “invest in their health” by obtaining a stronger level of care than what’s currently supported by their standard insurance plan. Normally, these are patients who require one or more of the following:
(1) a high-level of contact and treatment from the physician and his/her team (to ensure the patient is taking/receiving their medications correctly, following instructions, etc.;
(2) enhanced preventative medicine plans; and
(3) special additional team/network services like a health coach.
The program is also well suited for patients who travel extensively and therefore need require a global network of physicians to work with when they can’t see their regular provider. “I know the best local facilities and resources for my patients, but having the stronger network available through CCPHP’s global network improves patient service and brings it to a new level.”
The Concierge Medicine program isn’t for everyone. In many cases, modern-day insurance plans and major medical facilities clearly focus on the quantity rather than the quality of patient care, yet the standardized insurance plans are often adequate for patients who do not require an abundance of specialized treatment or guidance. There is no absolute necessity to become a Concierge Member if you
(1) have health insurance coverage that already meets your needs;
(2) don’t mind scheduling appointments during your doctor’s regular office hours; and/or
(3) don’t urgently require same-day service on a regular basis.
While Membership perks may differ from one Concierge Medicine practice to another, at Liakeas CCPHP members and non-members receive the same terrific care available that has always been the standard at Lexington Medical Associates, with the same testing, treatment and referrals they receive now.
According to Dr. Liakeas, the integration of the Concierge Medicine model allows the team at Lexington Medical Associates to shine and always put their best foot forward when it comes to providing excellent customer service. “Dramatically, my patients often say, ‘But you already give me the time and effort I need. What they don’t realize is that as we’ve gotten busier, which means that this time and energy are a luxury that most doctors today don’t provide anymore simply because they struggle with the time crunch. At some point a doctor – even a really good doctor – will either run out of time or energy and I’m honestly not sure which is worse. But with the new plan we can promise that you’ll get the best care no matter which member of our team is seeing you – the same blood tests, the same treatment and personalized service. By no means are we trying to throw anyone aside. We are very fond of all our patients and work hard to develop positive and lasting relationships with each of them.”
BENEFITS TO PARTICIPATING PHYSICIANS
Concierge Medicine holds many benefits for physicians, but most importantly, it allows them to spend more time with patients and provide personalized care. “Running out of time is a common issue. Patients don’t want to feel rushed, so doctors are under pressure to see as many patients as possible to be able to cover monthly costs but also want to make sure their patients don’t feel rushed so they don’t choose to leave for another provider just because we can’t meet their need to have more time to address their questions. Naturally, it takes time and effort to build good relationships with our patients and we don’t want to lose people who insist on the handholding.
“To avoid getting to the point of not taking insurance or refusing to take on new patients, the Concierge model is a great option. It tells patients ‘This doctor genuinely loves and cares and respects every patient who walks into his office.’ The Concierge Medicine model allows this to continue uninterrupted. The new Concierge model allows us to have the time and energy to provide quality medical care to. We take every measure to make sure our patients know that their doctor is here and cares about them.”
Additional benefits include: a reduced administrative burden, a more manageable and realistic schedule, connectivity with a larger group of top notch healthcare providers, and professional administrative guidance from legal advisors, marketing strategists, billing specialists, etc., allowing for the improved overall management of the practice.
COSTS TO CONCIERGE PHYSICIANS?
Concierge Physicians may experience a direct decrease in the intake of new patients during the initial integration of the Concierge model. This can be difficult for participating physicians in terms of concerns related to the coverage of monthly operating costs, however it is a necessary step for those who are serious about providing an elevated level of personalized healthcare service to their patients. A small portion of the annual Concierge Membership fee is meant to help offset this financial drawback, even though the amount of the fee is not necessarily equal to the physician’s costs.
For Dr. Liakeas and his team, however, the minor loss is not as important as being sure that their patients’ needs are met. “I don’t care so much about the money because it’s not about the money for me. There’s really very little financial reward for putting in the extra time that people need, but that’s not what you’re doing it for. That’s not why you practice medicine. It’s about making time for the people. We love all our patients and want them to get the best care possible…. Concierge Medicine allows us to hire the additional help we need to make sure that the patients get the time and attention they require.”
WILL THE TREND TOWARDS CONCIERGE MEDICINE LAST?
The bottom line is that health insurance companies are not very likely to be more inclusive of their patient’s special needs regardless of their increasingly inflated rates. Simultaneously, the number of patients seeking above average preventative care and supplementary healthcare services is steadily on the rise, so it seems that the Concierge model is here to stay.
BECOMING A CONCIERGE MEMBER
Those who are interested in learning more about Concierge Medicine options are invited to call Liakeas CCPHP’s Member Advisor at 646-973-5098. Additional information and the option to become a Concierge Member are also available at www.liakeasccphp.com.