Retainer model slowly spreading to specialties

Pediatricians, cardiologists and others are employing elements of concierge medicine in their practices.

By Mike Norbut, AMNews staff. Oct. 25, 2004.

Like other physicians who have become disenchanted with the current health care system, Scott Serbin, MD, decided to start a retainer practice, where patients are charged a set fee for certain extra services.

Patients in his practice, however, will be from a different age range than a typical concierge constituency.

Dr. Serbin, a Pittsburgh pediatrician, will officially change his practice into a retainer model Dec. 1, when he will start offering longer appointment times, more same-day appointments and guaranteed return phone calls to concerned parents within 15 minutes. He realizes that it's a risk to expect parents with health insurance to add another line item to their discretionary spending budget, but "if it works, it can be a spectacular way to practice medicine."

"It's funny. Parents have said I'm going to work harder, but I don't think people realize how hard pediatricians work now," Dr. Serbin said. "Most parents are appreciative of your time, and some don't want to call to bother you. With these service enhancements, we want people to feel empowered to call."

Dr. Serbin is one of a small handful of physicians across the country who are designing models different from the standard adult, primary care retainer practice. Other specialists, such as cardiologists, dermatologists and obstetrician-gynecologists, also are making attempts to practice boutique medicine, said John Blanchard, MD, a family physician who is part of a retainer practice in Clarkston, Mich., and president of the American Society of Concierge Physicians.