My Doctor, the Concierge

Forget the Hippocratic oath--welcome to a world of Gold and Platinum patients

By MERRILL MARKOE Thursday, Feb. 06, 2014
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    Patients who pay an extra $5,000 a year can reach the doctor via office phone and email, but their return call is from the support staff. Patients who pay $10,000 per year may also reach the doctor via texting, Skype, Facetime and Google Hangout, and feedback is from the doctor, who will also make house calls.

    It's not like I've never been dumped before. Still, I was ill prepared to be dumped by my GP. For 12 years I thought we got along O.K. Now I continually ask myself, "Was I not sick enough for her?"

    The first warning sign was the single-serve coffee machine in the waiting room, featuring festive flavored international coffees and chai.

    I eyed it nervously. Had there been an article in an AMA journal offering hints on transforming your drab, predictable reception area into an upscale medi-café? At my next Pap smear, would I meet a barista and be offered a selection of croissants?

    "No, no," I said to myself. "Current wisdom dictates that when her practice becomes successful, she must personalize her brand."

    If this were a movie, the tone of the music cues would begin to get darker as we arrived at the day the glass display cases containing lovingly arranged bottles of moisturizer were installed. "I guess pricey moisturizers are considered medicine now," I rationalized, wondering about the ever more porous boundaries between beauty and health.

    The music cues would grow darker yet as we cut to a scene where I had the flu and found myself waiting for an appointment, surrounded by pamphlets for "facial fillers" and "injectables" like Juvéderm. If she writes me a prescription for a spray tan, I am going to walk, I thought.

    But I remained loyal. She was my doctor. Her office still called to remind me about getting my checkups. She was entitled to branch out.

    Then, about a month ago, I got The Letter.

    "I'd like to wish you and your family a happy holiday season and a prosperous new year," it began.

    Interesting word choice, I thought. Prosperous rather than healthy.

    Her reasoning became clearer as the letter went on to explain that we were all being dropped as patients--unless we paid a $5,000- or $10,000-a-year retainer for her services, depending on the plan.

    "Our nation is faced with the most difficult time in the history of our health care system," the letter went on. "As a result, I will now be transitioning my practice to a concierge medical service."

    Concierge? Another interesting word choice. Defined in the dictionary as "a member of a hotel staff in charge of special services such as arranging for theater tickets or tours. A porter. A doorman. A janitor." Did my doctor now offer restaurant recommendations and tickets to The Lion King?

    The letter explained that there would still be a charge for medical visits and that patients would still need health insurance. But the new annual fees would entitle us to a variety of rock-star privileges like "Direct access to the doctor, 24/7."

    As it turned out, the doctor was offering a two-tiered plan with levels designated Gold and Platinum. In Gold, her patients could reach her only via office phone and email. But for an extra $5,000 a year, Platinum patients' options widened to include texting, Skype, Facetime and Google Hangout.

    I admit I was impressed that someone had figured out how to monetize Google Hangout.

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