Concierge medicine: Just a high-end luxury?

Fed up with a business model that could barely keep the lights on, Sandy Ibrahim left her job as a McLean primary care physician in March 2008, bringing her stethoscope and a handful of patients to a new practice less than a mile away.

By joining PartnerMD, Ibrahim hopped aboard a burgeoning trend in medical care, one that is pulling back from the breakneck pace of many modern medical practices.

At PartnerMD, Ibrahim is now a concierge doctor — a cross between the lawyer you keep on retainer and the Marcus Welby M.D.-like doctor who lives mostly in your imagination. Yes, in a pinch, Ibrahim makes house calls.

“A few people from my old practice followed me here to this practice, and I didn’t even recognize them,” she said, sheepishly.

That’s hardly surprising, given the 2,000-plus patients Ibrahim was juggling at her old practice, where high volume had to make up for low insurance payments.

By relying primarily on annual membership fees paid by each patient, PartnerMD and other concierge practices aim to carry just 20 percent of the patient load the typical family practice has.

Despite the hefty fee — as much as $4,000 for true white-glove treatment — PartnerMD’s patient rolls include horse farmers, teachers and homemakers, along with CEOs and at least one former head of state. (Wisely, Ibrahim declined to identify the political leader, but let’s just say her eyes widened, her breath quickened and — she says — her heart started racing when she discussed the thrill of working with this person.)

PartnerMD got its start in Richmond in 2003, when entrepreneur Linda Nash fell off a horse and couldn’t reach her doctor.

“A light bulb went off for me,” Nash said. “I realized that modern medical care left much to be desired.”

PartnerMD opened the McLean office, its second location, in April 2008. Locally, it competes with a few other concierge-type practices, including Virginia Hospital Center’s executive health program in Arlington, The David Drew Clinic in Chevy Chase and Executive Healthcare Services in Reston.

In exchange for the annual fee, which does not apply against most insurance companies’ annual deductibles, PartnerMD’s patients get intense personal attention.

Tim Massick, a vice president at Ernst & Young LLP, came to PartnerMD’s McLean office as he approached his 50th birthday — after decades of eating burgers, downing Cokes and having no idea how to monitor and improve his health.

“I was fed up with traditional doctors, who would just take my blood pressure and temperature and say, ‘You’re fine — get out of here,’ ” Massick said. “Yes, I knew burgers were bad for you, but now I know why they’re bad, and they’ve given me guidance on healthier habits.”

PartnerMD patients coming in for an “executive” level physical, like Massick got, are greeted in the spalike lobby by name, escorted to a suite where they can wait and work in private (using the provided computers and phones) and then whisked off by limo to a panel of outside and in-house specialists who run a daylong series of tests.

While that executive physical fee can run as high as $4,000, the basic annual membership is $1,900. It includes a scaled-down physical and personalized attention such as 24/7 phone and e-mail access to the doctor and same- or next-day appointments. (Memberships for spouses and children run lower.)

Dozens of area companies, including Ernst & Young, General Dynamics Corp. and Capital One Financial Corp. provide the executive physical for key employees.

Concierge medical practices have increased tenfold over the past four years, resulting in at least 5,000 such practices now, compared with just 500 in 2005, according to the Society for Innovative Medical Practice Design, which projects that by 2012 there will be 17,000 concierge practices.

The society’s chairman, Dr. Thomas LaGrelius, said those numbers are a “guesstimate,” based on a 2008 Physicians’ Foundation-sponsored survey of 300,000 primary care doctors. In that survey, nearly half the respondents said that in the next three years they plan to reduce the number of patients they see or stop practicing entirely.

Primary care physicians “hate their professional lives and can’t make a living,” LaGrelius said.

PartnerMD’s practice has grown every month since its opening. It enrolled 60 patients in September 2008 — more than in any other month — even as Wall Street was crumbling at an alarming rate.


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