Personal physicians a growing trend

Saturday, September 1, 2001

SEATTLE -- If David Heerensperger isn't feeling well, he calls Dr. Howard Maron on the physician's personal cell phone, whether it's 3 a.m. on a weekday or noon on a weekend.

And Maron will happily make a house call to the 65-year-old executive or send a nurse to his patient's office for tests. And he'll guarantee same-day results.

The catch? Maron and his partner, Dr. I. Scott Hall, charge patients up to $20,000 a year in cash for primary care.

Maron compares his Seattle practice to private golf courses or expensive restaurants.

It's a growing trend. Five years after opening his practice MD2 (pronounced MD-squared) in Seattle, Maron is planning to open as many as 100 franchises across the country. An increasing number of doctors nationwide are beginning to charge anywhere from $1,500 to $20,000 to let richer patients opt out of traditional health-care headaches.

Patients say they are spared the frustration of long waits for appointments, rushed, impersonal treatment and delayed lab results.

With traditional health care, Heerensperger says, "the prices are going up so much and the service is so bad, that this is just great."

"I'm fortunate to be able to pay for it," said Heerensperger, who runs a chain of lighting stores.

Doctors say it gives them more free time, and lets them spend more time with patients without budget-conscious insurance companies looking over their shoulders.

Idea from athletes

Maron said he got the idea while traveling as the team doctor for the Seattle SuperSonics. He noticed the athletes got VIP care while the rich team owners struggled with the frustrations of traditional health care.

"I thought, 'Isn't it ironic that a player can get a response like that, while the wealthy and the powerful have to sit in ER waiting rooms as if they are a nobody -- or an everybody?"' Maron says.

Other medical professionals sympathize with the frustrations of the current health-care system. Lowered insurance reimbursements mean that many doctors' salaries are decreasing as their patient loads are increasing.

But they question whether most physicians would be comfortable practicing "concierge care."

"I don't think they're unethical, but I don't think they take into account the overall needs of the community," said Frank Riddick, a New Orleans physician and chairman of the American Medical Association's council on ethical and judicial affairs.

Critics, including patients dropped by doctors who switched to the new system, complain that such services hurt those who can't afford it. In Florida, some politicians have called for an end to such practices.

Duane Dobrowits, the CEO of MD2, is a former patient of Maron's who couldn't afford to switch to the $20,000-a-year model. He asks of critics, "Are you angry because doctors are doing this or are you angry because you can't have this?"

More time with patients

Maron says he's never run a charitable practice.

"None of these doctors is Mother Theresa," he said. "We're not saints. We're just practicing medicine."

At his peak, Maron says he was seeing 20 to 30 patients a day from a roster of 4,000. Now he has fewer than 100 patients and he may see one or two a day. In addition, his salary has increased considerably.

"It's allowed me to focus on being a doctor again," says Robert Colton, who left his private practice in Boca Raton, Fla., last year to start MDVIP, which charges $1,500 a year above regular insurance and per-visit fees to keep his patient load down to 600.

"I can spend more time with patients," Colton said. "I can see them whenever they're ill."

MD2 has only primary care physicians, whom patients can see an unlimited number of times after paying their annual fee. Specialists must be paid by the client's personal insurance, but Maron said they often give MD2 clients preferential treatment.

"It's a point of pride because our patients are a lot of the movers and shakers in the city," said Maron, who accompanies his patients when they visit specialists.

Marketplace decision

William Dowling, chairman of the department of health services at the University of Washington's School of Public Health, says such practices are a natural product of the U.S. health-care system.

"Some people can afford to pay more to get prompt service, and so the marketplace will respond by some physicians providing that service," Dowling said.

Said Colton, who is looking at opening other MDVIP branches across the country: "That's what's great about America, that you have choice, that you don't have socialized medicine here."

Riddick says very few people can afford to pay for such services, and there will always be new doctors willing to take on patients dropped by physicians switching to pricey practices.

Meanwhile, MD2, which opened a second office in Bellevue, is considering doctors in Portland, Ore., Chicago and Denver. Dobrowits says he's convinced the model will thrive, even despite the weakened economy.

"We don't need tons of millionaires," he quips. "We just need enough millionaires to run our business."

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