May 31, 2009

Concierge Medicine or Direct Medical Practice?

First it was Hello Health, now it is Personal Pediatrics.

Dr. Natalie Hodge is the "first iPhone doctor" for pediatrics.
She is going back to the basics of primary care by doing what a lot of doctors no longer can afford by reducing her overhead, moving out of the office and into your home.
“We intend to be an entirely mobile platform –there is no need for an office, at least for pediatricians,” Hodge said. “I have found that everything I need for my practice could fit in the trunk of my car,” Hodge told mobihealthnews in a recent interview.

“Some would call Personal Pediatrics a ‘concierge medical practice,’ but I prefer to call it a direct medical practice,” Hodge explained,”because we’re connecting patients who want house calls to physicians who want to make them.”
I love this idea. It is the Ideal Micro-Practice... just you and your doctor. There are many situations where such a model will breakdown, but it does reduce the barriers to care that so many people complain about. No more long wait times at the office. No more late appointments, made months after a phone call. No more problems calling up the doctor in the middle of the night when there's a problem. Best of all, no more 15 minute visits!

This is a small business model that ADAPTS to new technology. It UTILIZES resources so much more effectively to care for patients without any clunky outdated systems. (Disclaimer: I am a huge fan of paper charts over electronic medical records in terms of access and organization. However, EMRs as they stand today are terrible because they are designed with ancillary personnel in mind instead of physicians. As a result, hospital "chart review" becomes an exercise in "Where's Waldo" searching for the single line on a page of text that has been altered from the "Copy Note" function by nurses and docs alike.)

I am not sure where I fit into this picture, but I know I would like to practice in a similarly independent and free manner.

However, I also would like to care for a population of the lower socioeconomic status... and that is where the Concierge model fails. How can patients on medicare afford a subscription with a retainer fee for a personal physician? Especially (from their perspective) when it is "cheaper" to go to the Emergency Room for care?

Hmm. Questions that need answers. Someday, I hope to provide a solution that makes me happy.

For now, Drs. Jay Parkinson in NY and Natalie Hodge in CA(?) have their solutions that they hope to spread. Good luck to you both!

Jay Parkinson at Pop!Tech from Jay Parkinson on Vimeo.

Jay Parkinson at Pop!Tech talking about Hello Health.

He created a new kind of medical practice on September 24, 2007 summarized by:
1. Patients would visit his website.
2. See his Google Calendar.
3. Schedule an appointment online and provide a chief complaint.
4. His iPhone would tell him.
5. He’d do a house call.
6. and get paid via PayPal!

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