New Trend: Paying for Boutique Medicine

B O C A  R A T O N, Fla., Jan. 25, 2002 -- Dr. John Kirkpatrick of Seattle does something that's almost unheard of. He makes house calls.

It may sound like a practice of the past, but patients can get appointments with Kirkpatrick almost instantly and call him at any hour, even on his cell phone.

"The patients like it," says Kirkpatrick. "They are happy with the immediate access."

But the personal attention comes with a steep price tag: $3,000 a year. That does not cover visits, routine care, tests or procedures, which the patients or their insurance companies will pay as usual. It is, in effect, a membership fee.

It's an idea that is spreading. In Florida, seven doctors have signed up with a different company called MDVIP.

Until he trimmed his list of patients from 2,600 to 600, Dr. Bernard Kaminetsky says his practice was a "treadmill." As a result of shrinking reimbursements to doctors, many add more and more patients to try to make up for the loss of income. Hence, they have jammed schedules and patients have to wait longer for appointments, which often are quite brief.

"The difference now is I'm a physician again," says Kaminetsky.

The other difference is he's now charging patients $1,500 a year to join what MDVIP calls its "club." There are club-like touches in the waiting room, complete with a small buffet.

But the real service, says Kaminetsky, is better medicine: "I have time to emphasize wellness, nutrition, exercise physiology, preventive medicine."

And what about the extra cost?

"If you can afford a Lincoln, you buy a Lincoln," says patient Jody Perez. "If you have to drive a Ford, you drive a Ford. I prefer Lincolns."

New Fee 'Offensive' to Some

Not everyone agrees. "I think it's offensive," says Andy Simonds, who was dropped as a patient by Kaminetsky because he refused to pay the new fee.

"What they've done is change health care into wealth care," he complains.

The number of so-called platinum practices is still small, but it's growing. And so is criticism from other parts of the medical establishment.

"What we are seeing here is something new and scary evolving, because it could ultimately end up in a lot of different layers of health care," says Dr. John Goodson of Harvard Medical School.

MDVIP and similar organizations are expanding across the country, which means boutique medicine may be coming to your community. And, if you're willing to pay, it may even come to your home.