When she first opened her concierge internal medicine practice in 2010, Juliet Mavromatis, M.D. an Atlanta-based physician, found herself apologizing to patients.
She felt guilty about charging patients an additional annual fee for her concierge services, writes Mavromatis, in Georgia Health News.
“After several years in the practice, however, I gradually realized that I had nothing to feel sorry about, that I was providing a very valuable service to my patients, a service that traditional primary care was failing to provide,” Mavromatis says. As well as working for her patients, the model works for her.
And for doctors committed to high-touch patient care, the concierge model may provide a useful alternative to navigating the administrative overhead involved in coordinating with third-party payer organizations, she says.
When she decided to open her own practice, Mavromatis found herself drawn strongly toward the benefits of a patient-centered medical home, with its focus on highly accessible, team-based care. She quickly found that setting up such a practice required a substantial financial commitment. While third-party payers had begun to see promise in those types of practices, the criteria required for payment varied enough she would need to employ a full-time administrator just to ensure she and her team got paid for their work. That made the concierge model, in which patients pay a regular fee to cover some portion of their care, an attractive option.
Mavromatis’ practice uses the patient fee to provide what she calls “extra care,” with insurance companies covering regular services. The practices employees two physicians, plus a licensed practical nurse and a medical assistant, with each doctor covering 500 patients. Despite her early worries that patients would be put off by concierge fees, Mavromatis says she’s found that not only do her patients prefer the model, but that they were looking specifically for doctors who followed such an approach.
While her practice has created a successful niche with what she calls “demanding” patients and those with chronic illnesses, Mavromatis admits that the smaller patient panels seen by her practice could strain the system if widely replicated, especially in the face of the ongoing physician shortage. Nevertheless, she says, “this model of care is extremely valuable to some patients and provides care that patients are not guaranteed to receive in our traditional healthcare system.”
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