Vikki Aulie has 22 grandchildren, and she doesn’t want to miss a minute of their lives. After a serious problem involving her liver last year, Aulie chose to side-step medical care as she had always known it and take control of her treatment. She was tired of being at the mercy of an over-booked doctor’s waiting list and felt she deserved more than the typical 10 minutes of face time with her physician.
After all, she had 22 important reasons to stay healthy.
“My original doctor told me there wasn’t much else to do for my condition and suggested I have a liver biopsy,” says Aulie, 55. “I scheduled one, even though I didn’t feel sure about it. When I told my son, he agreed there must be other options.”
Aulie’s son was a patient of a growing practice in a field called “concierge medicine.” He got her on a conference call with his personal doctor, and the three of them discussed other options. Aulie was so impressed that her son’s physician took the time to listen to her concerns, even though she wasn’t his patient, she immediately took his advice and had the recommended medical tests performed. The results showed she didn’t need a liver biopsy and revealed the real cause of her medical issues.
That’s when Aulie and her husband decided to join their son as patients of Dr. Scott Yates at the Center for Executive Medicine in Plano. “Within six months, my liver was functioning perfectly,” Aulie says. “The difference was having a physician who took the time to fully research my health issues. This is one of the biggest benefits of using a practice like this—the time and attention you get from your physician.”
You’ll hear this growing field of medicine called everything from personal, concierge, and boutique-style medicine to executive or even gold-plated medicine. Whatever it’s called, the common denominator is doctors who are abandoning their traditional practices, where they’re overburdened with heavy caseloads, to offer personalized medicine that gives each patient more time and attention.
Plano’s Center for Executive Medicine was formed by three board-certified physicians: Yates, Dr. Michael Bond and Dr. Keith Schrader. Their patients have direct access to them and to their own medical records 24 hours a day, seven days a week. They have their doctor’s cellphone number and e-mail address. Patients are promised no wait time for appointments, same-day visits, and a written summary of each office visit. The doctors can perform exams or evaluations at the patient’s home or office. They’ll even hop on a plane to see patients who are traveling, anywhere in the world.
“In our practice, we’re done when the patient says we’re done,” Yates says. “Most people don’t expect that, and it actually takes them awhile to realize we’ll spend as much time with them as they need to discuss their health concerns. Also, because I have more time in my day, I can take the time necessary to find the right specialist for them, should they need a referral, and I have more time to do research on behalf of my patients.”
To receive these services, members pay an annual fee to join the Center for Executive Medicine. There are several membership levels available, at increasing levels of cost ranging from $3,000 to $25,000 per year based on health needs and desires. Insurance covers some of the services, such as office visits, lab work, and other medical tests. Membership fees, which are not covered by insurance, allow for a small patient base to which the doctors can devote more individual time and attention.
In his former practice, Yates served thousands of patients in any given year. In order to see every patient and address their various needs, he could only afford to spend a few minutes with each patient per visit. Now he and his partners see about 150 patients each, every year. The extra time doctors get with each patient can translate into learning an important fact about a patient’s medical or family history that prompts tests and screens they might not otherwise have received.
“We get to know our patients really well. They become friends,” Yates says. “I finally get to do what I went to school for—take care of people. This is the way health care should be.”
Needing Something More
Concierge medicine has been slowly making its way onto the health care scene since about 2000. Dr. Nelson Simmons, founder of McKinney-based Personal MD, first took notice that his patients needed something more than “the way medicine has always been practiced” in early 2001, just as the area’s telecom industry started to crumble.
“Many of the patients in our practice were using benefits from a severance package, and when those benefits started to come to an end, they began to panic,” Simmons says. “I wanted to help them, so I began researching solutions for them and came across the emerging field of personalized medicine.”
Eventually many of these same patients went into business on their own, in fields such as consulting and real estate. Their new salaries gave them the ability to afford health care but, because they weren’t part of large companies, they didn’t have access to traditional, affordable benefits packages. In 2003, Simmons left his group practice in Allen and opened his own clinic, Personal MD. He offered two options—a cash-pay program where patients only pay for the services they need, when they need them, and the Total Access Medical Plan, which has become Personal MD’s flagship program. An annual fee of $1,800 per adult, $1,000 per child, or a maximum of $4,000 per family covers all office visits, any medical test or service performed in-office, same-day appointments, ample face time with a doctor, and 24/7 physician access.
“In my former practice, I would see 20 to 40 patients a day to generate revenue,” Simmons says. “Now I can see seven to 10 patients a day, and the revenue is covered. The patients benefit because they have full and almost immediate access to health care, and I know them all by name.”
When Simmons was researching models on which to base his practice, he came across one of the first concierge-style medical programs in the country, MDVIP. It’s the largest group of affiliated primary care physicians that assists doctors with moving from a high-volume practice to a smaller preventive model. Florida-based MDVIP has more than 110,000 patients and more than 310 physicians in 28 states.
Dr. Kenneth D. Killen, a local board-certified primary care doctor, has been part of the MDVIP program for about a year. While most patients visit his office in Dallas, he makes house calls to patients throughout North Texas—from Plano, Frisco, and Richardson to Duncanville, Dallas, and beyond. He left his high-volume practice to become affiliated with MDVIP because he says he was no longer able to provide the level of preventive care he felt his patients deserved. Today his patient load is more manageable—about 10 per day.
“I don’t want my patients to get sick,” Killen says. “If we can keep them well, then we’re doing our job. Health care is about so much more than treating people who are sick; it’s also about acquiring health. My patients are thrilled to get more face time during their visits and know they can reach me at any time and get same-day appointments. Because patients stay healthier, they save not only time but also money. [MDVIP has] about a 92 percent renewal rate, which tells me this model of practicing medicine works.”
According to MDVIP, its doctors are typically able to reduce their patient load from about 4,000 to 600. Patients are required to take a Mayo Clinic executive-style physical exam, which is included in the annual $1,500 fee they pay for this highly personal level of medical care. Patients also receive a thorough wellness plan based on medical tests and receive their records—including tests, medications, and conditions—on a mini wallet-sized CD which can be used in an emergency. Other perks include same-day appointments, no waiting rooms, lengthy office visits, and around-the-clock access to their doctor.
“Everyone deserves personalized attention from their doctor and cost-effective health care,” Killen says. “In a practice like this, I can provide them with both.”
Keeping Business Healthy
The idea of concierge medicine and its benefits has extended into the corporate world as well. Several local medical practices are either specializing in or offering executive medicine, targeted specifically at corporate leaders. Personal MD’s Simmons is among this group. In addition to his Total Access program for personal wellness, he offers an executive medicine program that includes a head-to-toe physical exam, stress test or calcium score, and all related office visits, for one all-inclusive fee.
These same executives can offer their employees premier health care through Personal MD’s 40:40 Medical Care Program, which is designed to be an integral part of a small business health plan. The 40:40 program includes access to a board-certified family practice physician, reduced fees at specialists, and membership in the Personal Rx discount pharmacy program. Employers or individual members pay a monthly per-person fee of $40 or less, depending on the number of employees enrolled, plus a $40 per-visit co-pay. Family rates range from $110 to $125 per month. Members are guaranteed same-day or next-day appointments, 24/7 access to the doctor, and 30-minute consultations.
Medical Center of Plano is also urging local CEOs to empower their key employees to make educated decisions about their health with executive physicals offered through the hospital’s Center for Lifestyle Enhancement. The physicals are tailored for the executives of an organization based on demographics, personal medical history, and the specific requests of the organization. The program offers everything from virtual colonoscopies and CT calcium scoring to access to dietitians, exercise physiologists, and respiratory and physical therapists who can create personalized programs.
In the final balance, each person has to decide whether his or her health is worth the added expenses incurred for this proactive, personalized, and on-demand version of health care.
Vikki Aulie and her husband are now among the strongest proponents of concierge medicine. Mrs. Aulie says she never hesitates to write the check for her annual membership fee.
“We’d like to live forever, but we know that’s not possible,” she says. “We’ll settle for living as healthy of a life as possible for as long as we can. How can you place a price tag on your health? It’s irreplaceable. If it came down to choosing my car payment or my annual fee for personalized health care, I’d just go get a cheaper car. Having this level of health care available is priceless.”
Physicians on Call
Center for Executive Medicine
6020 West Parker Road, Suite 420, Plano
Annual Membership Fee: $3,000 to $25,000
Medical Center of Plano
3901 West 15th Street, Plano
Physicals: $500 to $2,500
Dr. Kenneth Killen
8411 Preston Road, Suite 200, Dallas
Annual Membership Fee: $1,500
2770 Virginia Parkway, Suite 301, McKinney
Total Access Medical Plan Annual Fee: $1,800 for adults; $1,000 for children; $4,000 per family