Tuesday, February 19, 2008

Concierge Cardiology

Parked in the airport with a delayed flight I came across this tidbit: it seems concierge medicine now is extending beyond primary care into specialty practices:
Now, the Naples market is seeing concierge practices in cardiology, pediatrics, obstetrics/gynecology and physical therapy.

Dr. James Buonavolonta, a cardiologist, worked in traditional practices for years before starting Concierge Cardiology of Naples in February 2007.

“(Before) I had a few thousand patients. I felt like I was not giving them the time they deserved of a cardiologist,” he said. “That’s not why I went into cardiology.”

Now he will limit his practice to 150 patients and has nearly reached it. His patients run the gamut of cardiology needs, from those with congestive heart failure to others who want to prevent problems. Today, he sees 5 to 7 patients a day.

“I have patients in their 40s with cardiac risk factors who want to keep an eye on things with a strong family history ... (where) a parent had a heart attack at 50,” he said.

In the first year after starting his concierge practice, 5 percent of his patients needed a hospital stay, a low number which he attributes to better follow-up care.

“The ability to have access to your cardiologist is so reassuring to patients,” Buonavolonta said, adding that if a patient has something in the middle of the night, they call him first rather than heading for the emergency room.

With patients who are willing to be part of a concierge practice, they are more likely to be compliant with their doctor’s treatment course, he said.

Not all his patients are wealthy, which he and other concierge physicians attribute to people’s dissatisfaction with mainstream medicine and not getting the care they want.

“I do have regular people with regular jobs, and feel their medical condition is a priority in their life,” he said.
Wow. Five to seven patients a day? Seems a bit light to me...

But the point to be made here is concierge medicine is now happening to specialists, too. The reasons for this migration are probably multifactorial: (1) declining Medicare reimbursements for procedures, (2) declining revenue streams for office visits, (3) more basic medical issues being managed by specialists due to lower number of primary care physicians, (4) insurance reimbursements being less than market rates, and (5) inflation - all serve to force specialists to rethink the status quo.

The times, they are a changin'...



Conciergedoc said...

I read that same article. What surprised me is that concierge medicine has been in the specialities for years now, and it's nothing new. In Massachusetts, for example there are several different subspecialists doing it.

Anonymous said...

I know Jim, he is a good man and a good physician. I don't blame him for leaving his group and starting his concierge program. Unfortunately, I don't know if his success can be replicated easily - Naples is an extremely wealthy community with a number of patients who don't care how much their healthcare costs. I would like to see how this works in a middle-class community. If it can work, then I think its a great idea for physicians.