Wednesday, April 18, 2007

Who Moved the Cheese?

“After much consideration, I have decided to change the nature of my practice effective immediately.

I will be limiting my practice to no more than 600 patients in order to provide a level of individualized service and care that is not possible in the current medical environment. This reduction in practice size will afford me the time to focus of proactive, preventive care….”

So begins a letter I received from one of my referring physicians today. He’s a good guy, but he must have wanted to make a change. As I read his letter, I noticed it was printed on some fancy stationary emblazoned with a fancy “MDVIP” logo. MDVIP, I learned, is a company “focusing beyond concierge healthcare.” So I wondered how this company marketed this to my referring doctor.
This approach to internal medicine cannot be offered in most traditional primary care practices. A physician in a typical practice of 2,500 patients could not provide a comprehensive annual physical examination to all patients, as to do so would require approximately 2,500 hours, or one year. In that case, a physician would have no time available to deliver any care to patients other than the physical examination. By limiting their practice size MDVIP physicians have time to provide both extensive preventive and wellness care and treatment of acute and chronic illness.
I found impressive statistics on their website demonstrating how such a practice can provide reduced hospital admissions:
Reductions in hospitalizations are up to 65% for Medicare beneficiaries and up to a staggering 80% for those with commercial insurance. The results are scientific, not anecdotal and are because MDVIP physicians have the time to have much closer relationships with their patients.
And then I noticed that you can refer patients to other like-minded “MDVIP” physicians via their network in other cities. Even global rescue exists.

Wow. Our two-tiered health care system is here now, isn’t it? The cheese was moved long ago. And some business-minded primary care doctors have been smart enough to skim the walking well with insurance off the top early.



Anonymous said...

"I just wonder what will happen when the U.S. market becomes saturated with low-cost imaging devices."
Isn't it happening already, though not as cheap as $8? Aren't there radiology practices and mobile services visiting areas where seniors and hypochondriacs congregate, to offer "screening" tests that are passed on to the clients' hapless PC physicians to deal with? Dr Wes, you must have seen a few EBCT results brought in by patients; or demand for u to justify an EBCT to your patient's 3rd party...what a waste of time to go back and forth with these boomers and pre-boomers looking to live forever ;-)
There are services also by ultrasound practitioners offering souvenir 3D photos/videos of pregnancies? During the ACOG recommended sonogram for pregnant women, somehow the gender information is worked in?

Unknown said...

I am the VP of Marketing and Communications for MDVIP. For years we have been providing a copy of "Who Moved My Cheese" to prospective physicians as they consider making the change.

MDVIP ( was designed by doctors, for doctors- who want to take exceptional care of their patients...for doctors who want to feel passion again when they drive to work in the morning...for doctors who want to have the time to focus on the "oh, by the way doctor, there are a few other things I'd appreciate sharing with you..."...issues that are often more significant to the patient's well being than the reason he is in for an appointment.
The letter referenced in the blog is part of an invitation for a patient to come to a meeting to learn all the MDVIP program has to offer. We want patients to have all the information about the MDVIP program they need to make the right decision for themselves.

And no, we are not "concierge healthcare" although the media has coined us as such. We are personalized, preventive care. We are about the best doctors practicing the best medicine. We are about freeing doctors from the constraints of the system so they can have professional, personal and financial freedom. We are about giving doctors the tools to love practicing medicine again.

Thank you for the opportunity to introduce myself.