Starting May 29, two more doctors in Lexington will adopt a relatively limited but growing business model in primary care practice that focuses on treating fewer patients with easier access and more personalized attention—for a price.
Dr. John Borders
Dr. John Borders and Dr. Gregory Hood will officially transition their longtime Lexington medical practice to become an affiliate of MDVIP, the nation’s largest network of providers of preventative care and personalized medicine, often referred to as concierge medicine.
Patients who sign on with the new practice will pay an annual out-of-pocket membership fee of $1,650, in addition to their usual insurance premiums, co-pays and deductibles. In exchange, the doctors will limit their patient load to about 600, as compared to the national average of roughly 2,500 patients carried by traditional primary care practices. Fewer patients means physicians can be more accessible for same-day appointments or to answer questions by phone or text, they will be less overwhelmed by time-consuming insurance paperwork, and they’ll have more minutes to spend with each client during visits.
“Being able to provide highly personalized, preventive
Dr. Gregory Hood
Dr. Gregory Hood
medical care is something I value and enjoy,” said Hood. “As a primary care physician, my goal is to help patients meet their personal health and life goals at every stage of life. My new practice allows me to get to know each of my patients and to care for them well beyond their immediate needs.”
Borders, who began practicing medicine in 1982, initially opened the Lexington practice three decades ago, in 1988. Hood joined the practice, which is located on Nicholasville Road, in 2001, after relocating from an internal medicine practice in California.
While it’s not the only concierge medical group in town, Boca Raton, Florida-based MDVIP has grown since its inception in 2000 to include the largest network of providers in the nation, with about 300,000 paying members across the country and roughly 900 doctors in 45 states, including 22 in Kentucky. The company has grown its revenue, along with its pool of affiliated doctors and its patient base, for 68 consecutive quarters, said MDVIP CEO and board chair Bret Jorgensen.
“There’s continuing strong demand for this in the local market,” Jorgensen said of Lexington, which now includes five MDVIP affiliates. In addition to Borders and Hood, Dr. Michael Carr opened his MDVIP-affiliated practice in Lexington in 2010, and Dr. Barry Schumer and Dr. Debbie Fibel followed with their local practice in 2013.
Benefits and Considerations
For a small but growing segment of the patient market, the provide
Bret Jorgensen
Bret Jorgensen
d services are worth the extra money. Patient satisfaction rates are above 90 percent, Jorgensen said, and he cited growing evidence to indicate that the associated care can also contribute to better outcomes, including fewer hospital re-admissions and emergency room visits.
In light of the growing shortage of physicians, both in Kentucky and across the nation, however, the choice of some doctors to reduce their patient pool has raised concerns about availability and access to patient care for the population as a whole. A 2017 study by the Association of American Medical Colleges estimated that the United States will have between 7,300 and 43,100 fewer primary care physicians than it needs, on the whole, by 2030.
Jorgensen said the concierge model currently represents a very limited segment of the roughly 300,000 primary care physicians practicing in the national health care market, and even with steady growth, he expects it to stay that way.
“It’s a small part of the marketplace, and it will always be a small part of the marketplace, because only a small amount of consumers are willing to invest in their health in this way, out of their own pocket,” Jorgensen added.
In addition, while MDVIP-affiliated physicians are taking on fewer patients, the model has enabled overworked doctors who might otherwise be considering retirement or a career change to continue practicing.
“We have about 125 doctors practicing today who are over 65 years old, who have kind of a new lease on life,” Jorgensen said. “We are returning the passion to a lot of these doctors so they can practice longer.”
A More Affordable Approach to Concierge
Although the term “concierge medicine” may conjure images of luxury care catering to the wealthiest clientele, the MDVIP model aims to keep the retainer cost within the financial reach of more average households, Jorgensen said. Patients see the upfront investment in more personalized preventative care as a way to stave off more expensive treatment for serious and long-term conditions down the road, and the fee is approved as a qualified expenditure for reimbursement from clients’ health spending accounts, he added.
“Our model is essentially the cost of a Starbucks a day or somebody’s cable bill,” Jorgensen said. “It’s really designed to be affordable personal health care, and not high-end concierge wealth care at all. … But we understand it’s an incremental cost that’s not affordable to everybody.”
Patients of Borders and Hood were notified earlier this year of the expected transition, and MDVIP and the local staff have worked with those who have chosen not to join to find new doctors and ensure their continuity of care, Jorgensen said.
“We actually won’t proceed [in a transition] with any doctor unless we have a place for non-joiners to go,” Jorgensen said. “We make sure there is a doctor hand-off for every one of those patients.”
For those who have chosen to pay the new fee to sign up with the MDVIP-affiliated practice, the membership will come with new services, including a 90-minute annual wellness exam with health screenings and diagnostic testing to inform the development of an individualized wellness plan. Doctors are expected to schedule 30 minutes for every appointment and keep their daily schedule open enough to accommodate same-day appointments for patients with urgent issues. They also make themselves available to patients by cell, text or e-mail, and in some cases, they will even make house calls.
Members can also receive care at other MDVIP-affiliated practices when they travel out of town, and the company partners with medical centers of excellence across the country for times when second opinions or other coordination of specialty care is required, Jorgensen said.
“Affiliating with MDVIP will afford me the time and tools to build a close and constructive partnership with patients so that we can work proactively together in optimizing their current health while also preventing new problems,” Hood said. “When necessary, I am able to coordinate patient care with preferred physician colleagues, whether it be across town or across the country.”