Boutique Medical Services Widen America’s Health Care Divide

Super-wealthy clients get five-star treatment

As millions of Americans struggle to pay their medical bills and worry that they might lose their insurance coverage if the Patient Protection and Affordable Care Act is repealed, many of America’s wealthiest citizens receive five-star treatment from doctors and hospitals if they are willing to fork over a five-figure annual fee, according to an article in The New York Times.

These aren’t the concierge practices that everyone’s heard about, where patients pay several thousand dollars a year so they can quickly reach their primary care doctor, with guaranteed same-day appointments. With annual fees that range from $40,000 to $80,000 per family (more than 10 times what conventional concierge practices charge), the suite of services offered by boutique medical practices goes far beyond 24-hour access or a Nespresso machine in the waiting room, the Times article says.

“It’s more like a family office for medicine,” said Dr. Jordan Shlain, founder of the Private Medical group in San Francisco. Shlain was referring to how very wealthy families can hire a team of financial professionals to manage their fortunes and assure the transmission of wealth from generation to generation. Only in this case, they are managing health on behalf of clients who are more than able to pay out of pocket—those for whom, as Shlain put it, “this is cheaper than the annual gardener’s bill at your mansion.”

There are also rewards for the physicians themselves. A successful internist in New York or San Francisco might earn $200,000 to $300,000 per year, according to Shlain, but Private Medical pays $500,000 to $700,000 annually for the right practitioner.

House calls are an option for busy patients, and doctors from Private Medical will meet clients at their workplace or the airport if they are pressed for time.

In the event of an uncommon diagnosis, Shlain’s group will locate the top specialists nationally, secure appointments with them immediately, and accompany the patient on the visit, even if it is on the opposite coast.

Meanwhile, the Times points out, the typical wait to see a doctor is getting longer for virtually everyone else.

A survey released in March by Merritt Hawkins, a Dallas medical consulting and recruiting firm, found that it takes an average of 29 days to secure an appointment with a family-care physician––up from 19.5 days in 2014. For some specialties, the delays are similarly long, with a 32-day wait to see a dermatologist, and a 21-day delay at the typical cardiologist’s office.

Trevor Traina, one of Shlain’s well-to-do patients, doesn’t see much future for the conventional family doctor, except for patients who go the concierge route.

“The traditional model of having a good internist is dying,” Traina told the Times. “Even the 25-year-olds at my company either have some form of concierge doc, or they’ll just go to an HMO or a walk-in clinic. No one here has a regular doctor anymore.”

Source: The New York Times; June 3, 2017.