Premium practice: When patients pay top dollar for exclusive care

It's an advanced kind of fee for service -- you charge your patients hundreds or thousands of dollars a year for special access to your practice. It sounds lucrative, but is it ethical?

By Cheryl Jackson, AMNews staff. Sept. 17, 2001.

They cost a little more, and they don't mind saying they're worth it.

Physicians are offering more boutique-style services, promising premium care, to patients who pay annual fees of up to $20,000 per family.

For example:

• MDVIP in Boca Raton, Fla., this spring had doctors closing their practices to those who wouldn't pay a $1,500 annual fee.
• Platinum Health, also in Boca Raton, Fla., charges up to $1,800 a year for a membership that includes a personal medical concierge to coordinate appointments and insurance, and guarantees same-day visits with primary care doctors.
• HealthAccess in Fort Lauderdale, Fla., is going for a less-affluent clientele with its $100 annual membership fee. But participating physicians are paid in most cases within 48 hours, and billing issues don't exist, the group says.
• Interactive Wellness System's Menlo Park, Calif., practice is so exclusive that internists Scott Wood, MD, and Sadick Alsadir, MD, don't even advertise, let alone talk to the press. Patients demand a hush surrounding the practice, explains assistant Mark Jackson. "We honor their decisions," he said. Any marketing is done by word-of-mouth.

The oldest-known such arrangement -- MD2 (pronounced "MD squared") -- fancies itself a Ritz-Carlton of health care. It charges $20,000 per couple, $13,200 for individuals and an extra $2,000 for a child 14 to college age.

Physicians nationwide are considering such moves as a way to deal with high patient loads that they say don't allow for enough time to meet with patients. The patients pay more, but it allows doctors to spend more time with them, and they get a higher level of service, say proponents of the programs. [...]