Every day, Dr. Jeffrey Ng of Jacobs Medical Associates receives more than 40 calls from Las Vegans with the same question: Is he taking new patients? The answer is yes, but with one big caveat: He’s booked solid until September.
According to Ng, the influx of calls is the result of the growing medical concierge industry in Las Vegas. Essentially, it is a model in which patients pay annual fees or retainers directly to their doctors instead of using insurance. Concierge doctors practice mostly family medicine and internal medicine, with a small number of dentists also offering the service. In the past decade, more doctors have made the switch from a standard practice to one operating under a concierge model.
It’s hard for new physicians to stay here when they realize they have to see volumes in order to keep their doors open. That’s where the concept of concierge came up: What if we just charge?–Dr. Jeffery Ng
“We don’t get reimbursed as well for seeing the same type of visits as other states, where they get a little more reimbursement per visit,” Ng says. “It’s hard for new physicians to stay here when they realize they have to see volumes in order to keep their doors open. That’s where the concept of concierge came up: What if we just charge?”
In the last six months alone, at least four doctors who Ng knows of have switched to concierge, rendering many of their 2,000 to 3,000 patients doctorless, leaving non-concierge physicians like Ng to absorb these patients.
“After building a large practice and trying to accommodate 25 to 30 patients a day, we came to the realization that quantity was possibly interfering with the quality we wanted to give to our patients,” says internal medicine doctor Jerry Schwartz of Schwartz & Tung, MDs. “It was very apparent that we needed to make a change to a membership type of practice to ensure quality at the highest level.”
So what do you get as a patient when you opt for a concierge service? Something standard-practice physician offices don’t offer: extensive face time with the doctor and appointments on the fly, all for an annual membership to the tune of about $1,500 to $5,000 (in addition to other charges that may arise).
It’s all about access, and this model grants exactly that.
For many, it’s a small price to pay for the convenience of having a doctor they can visit nearly immediately (some even make house calls), speak with on the phone and, most importantly, get to know and trust. It’s all about access, and this model grants exactly that.
“I wanted to go to a doctor who worked in a plant-based healing system, but I also wanted to go to a doctor more often and have access to blood work and visits on demand,” says Stacey Miller, who has an autoimmune disease and is treated by Dr. Evan Allen, a concierge doctor in Green Valley. “I’ve been going every two weeks to get blood drawn and then have a follow-up visit two days later. If I was going to a normal doctor, it would be too expensive, and scheduling wouldn’t be easy. … My doctor listens to me and we have an open dialogue. Sometimes I’m in there 45 minutes, and I never feel like he is rushing me or that I’m not important. … It’s probably the most positive medical experience I’ve had.”
At Schwartz’s practice, he and his partner limit the number of patients they see each day to between 10 and 14, guaranteeing each individual receives at least 30 minutes of their time, as well as two-hour physical exams with extensive diagnostics that he equates to being on par with the Mayo Clinic or Scripps Health.
A lot of folks have tried to be more creative, using concierge and maybe a critical illness [insurance] plan.–Jared Vargason, vice president of Pathway Insurance Inc.
Aside from the physicals, Ng affirms the quality of care from primary care physician is still the same. “We are all licensed doctors, not smarter than any other doctors,” he explains. And at the end of the day, any patient who is referred to a specialist for treatment (an oncologist, for example) will be seen simply as a patient, regardless of who is giving the referral.
Concierge doctors aren’t for everyone, though.
“An ideal patient would be one who wants to spend a lot of time talking with their primary care doctor in one stint … especially complex patients,” he says.
Ng is quick to note the idea that if someone only needs to see a doctor once a year, the concierge practice isn’t a match, pointing out it’s one of the reasons his practice is so slammed at the moment.
In terms of insurance, Schwartz says that most concierge practices, including his, take some form of insurance (which does not cover the annual fee).
If a doctor isn’t covered in a plan, PPO plans may also pay for out-of-network office visits, Jared Vargason, vice president of Pathway Insurance Inc., says. But they would be insured at a reduced rate and usually after the deductible is met for the year.
“A lot of folks have tried to be more creative, using concierge and maybe a critical illness [insurance] plan,” Vargason says. “Rather than going traditional or fully insured, people go with a concierge relationship and try to ensure some of the events that might occur.”
Don’t expect all the doctors in town to jump onto the concierge bandwagon, though. For practitioners like Ng, his patients keep him coming to work every day.
“The concierge concept is nice,” he says, “but if I go [full] concierge, I will lose some of my favorite patients because they won’t be able to afford it. It’s what’s stopping me. I want to figure out a hybrid model where I can keep my practice and help serve Nevadans without a fee.”