American physicians have become the latest professionals to join the niche- market craze. In the US, luxury (boutique) medicine can mean 24-hour phone access to a “private” physician and same-day appointments. It can also carry a heafty price tag, with patients paying annual retainers of up to US$20 000 to buck managed care's restraints.
Dr. Howard Maron, founder of MD2 [MD Squared], is one of the pioneers. Once a team physician for the Seattle Supersonics, Maron found it odd that injured basketball players got the finest care immediately while other wealthy patients did not.
He left his existing practice and its 4000 patients and started MD2. He and his partner care for fewer than 100 “very upscale” families, each of which pays US$20 000 annually to get the cosseting that pro athletes take for granted: no-wait appointments, same-day lab results, house calls. When patients have to see a specialist, Maron accompanies them.
In Boca Raton, Florida, Dr. Robert Colton set up MDVIP last year. Although he charges only US$1500 annually per patient, he bills the insurer for primary care and specialist services and charges $50 to $75 per visit. He retains a larger roster of patients than Maron — 600 — but had 3000 in his old practice. The $1500 buys 24-hour pager access.
MD2 already has 2 practices in the Seattle area, and CEO Duane Dobrowitz predicts “clones” will be successful elsewhere. “Every major city has 100 families that want this kind of access. We don't need a lot of millionaires ... only enough to run our business.”
Dr. Albert Schumacher, past president of the Ontario Medical Association, noted that such practices might be legal in Canada “if you could prove you were providing only noninsured services.” However, he noted that many physicians in Canada already charge an annual fee, perhaps $50 per individual or $100 per family, to cover paperwork, insurance reports, telephone advice and prescription refills.
“It certainly would be hard to rack up fees of that magnitude in Canada,” Schumacher said. — Milan Korcok, Florida