Meeting

Report

 
DR. JORDAN LIPTON
Healthy Realities of Concierge Medicine
by Julius Melton
        
The word concierge is familiar, if one has stayed in a hotel that aspires to being up-scale. There will be an office or a desk in the lobby where someone offers advice and direction regarding what restaurants, or other off-premises establishments, may be to our liking. But the title of today's program, that associates the term with medicine, may be puzzling. A French dictionary reminds us that the basic meaning of concierge is door-keeper. That may put it more in tune with our modern concepts of a primary care physician.
 
Dr. Jordan Lipton, today's speaker, helped give the word a more defined meaning. Sometimes the approach to medicine he discussed is called, he told us, boutique medicine. Another French word! He clearly exceeds the familiarity most of us have with French words. His medical school was McGill University, in officially-French-speaking Montreal. (From there he came to a residency at our own Carolinas Medical Center, leading to board certification in Emergency Medicine and Ambulatory Medicine.) Perhaps boutique is better received on the West Coast, where the new approach has been available for several years. In Charlotte, he and his partners have chosen Concierge Medicine, to call attention to a new way to deliver and receive medical care.
 
As Dr. Lipton explains it, the new approach starts with an effort to keep a doctor's roster of patients from getting so large that truly individual care becomes only a fond hope. Statistically, Charlotte primary care doctors have a list of patients 3,000 to 6,000 names long, each. His group aspires to keep each doctor's list under 500. That measure of control is gained by building the practice on a "membership" basis. The membership (like Rotary) requires a fee or dues. Locally an annual membership could be expected to be from $1,500 to $2,500, though there are such practices in the Northwest that have set memberships at $20,000. Membership fees are not technically considered medical charges, and do not replace or offset fees-for-services, to which most Americans are accustomed. They do compensate the physicians for giving up the income which larger patient rosters would otherwise provide. The fees-for-service can, under their approach, still qualify for reimbursement, or direct payment to physician, by one's health insurance, or even Medicare.
 
By controlling volume of patients seen, a practice using this approach can promise a "member" greater ease of access to the physician. In addition to less crowding, various amenities are also available in such a practice. In this particular doctor's medical suite, one will experience more of a home or club atmosphere, with hardwood flooring, area rugs, and comfortable furniture. There are luxury hotel-type robes to wear for check-ups, and pleasant music in the background.
 
A concierge medical practice has an emphasis on primary care, and aims to provide quick and expert care in (non-life-threatening) emergency situations, rather than routing its patients to emergency rooms for such. As to referrals, the "concierge" doctor develops a relationship with specialists in the various branches of medicine to which he or she may need to refer a patient. Referral, in these cases, involves direct contact, in advance, between the concierge physician and the specialist. Thus the patient can expect the way to be "paved" for the consultation, and an informed reception in the specialist's office. Of course, by moving to the specialist, the patient will move into the more familiar American system of medical practice, and out of the "warmer" concierge setting. Concierge physicians can, however, admit patients to hospitals themselves, and care for them there.
 
Our fellow Rotarian, Alan Adler, provided the introduction for Dr. Lipton, having gotten to know him while preparing a several-part series in the Charlotte Observer, called Why Customer Relationships Matter. He came to agree with Dr. Lipton that the concierge medicine approach does exceed significantly what Americans have come to expect as medical consumers/customers/patients. He found not only the elements described above to be admirable, but also the level of preventive medicine that is fostered by making "going to the doctor" easy, pleasant and inviting.
 
We may be hearing more about the approaches we learned about today, from our visit with Dr. Lipton. It sounds like the kind of thing that may "catch on" with corporations, as a benefit they may offer, to attract special staff members into their enterprises. We may also be moved to check out with Google the term concierge medicine, and learn more about it.
     
Head Table:
Bill Blackwell, Bob Phifer, Catherine Browning, Alan Adler, Bill Stegelmeyer, Charlie Pitts
          
Visitors and Guests:
Invocation: Alice Harrison; Visitors & Guests: Bill Meanor, Song: Gregg Walker
 

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