A concierge practice without the price

Key Points

Changing the model of physician (in)accessibility we have come to expect not only has improved my patient care and led to an exponential growth of my business, but it also has brought me a great deal of admittedly unexpected self-satisfaction.

It began with a moment of utter disgust when I realized my answering service was billing me close to $500 a month. It didn't take much introspection to realize that the mediocre service I was getting in no way justified the astronomical price tag.

I had, on occasion, handed out my cell phone number to patients who were particularly ill and to family members who were distraught. From those few experiences, I learned that patients, for the most part, are quite respectful of my time and privacy. I never received a call from a patient on my personal number that was not completely justified. So I went for it.

Soon after firing my usurious answering service, I made my cell number public to all patients. When the office was closing for the day, a recorded message would encourage the patient to call my phone directly in the event of an urgent medical problem. The incredible amount of positive feedback from this one small step set off a chain reaction that had me examine and improve all aspects of patient communication in my practice. The end result was an office complete with all of the advantages of a concierge practice - and patients didn't have to pay for it.

Here is what I came up with:

1. Remove the barricades.

The image of the iconic, too-important-to-be-disturbed doctor has been shattered. Patients now are partners in their healthcare decisions, not subordinates to their omnipotent doctor. They want to communicate directly and easily with their physician.

By making my cell phone number and e-mail address readily accessible, patients' frustration is greatly diminished. With my mobile e-mail account, I can respond to an e-mail message in just a minute or two. Better yet, I can e-mail a patient back during the less-hectic early hours of the morning or late evening.

To allow myself much-needed breaks, I record a simple greeting on my cell informing patients that I am either off for the weekend or on vacation. I provide my covering physician's name and contact number. I then make it a point to put away the phone.

2. Use technology.

Thanks in part to the Internet, patients are more knowledgeable than ever before about symptoms, conditions, and treatments. Being technologically savvy is critical to maintaining a high level of quality care and patient satisfaction.

I have a computer set up in each examining room. I am able to access the Internet and UpToDate (a subscription medical information service) during the patient encounter. I believe that patients actually appreciate it when I say, "I don't know the answers to that, but give me a second to look it up." I can answer clinical questions, print information, and show pictures or graphics. The few minutes this takes are invaluable. Patients appreciate that I am honest about what I know and don't know. They also feel that they have been educated about their condition along with me.

We are building a Web site to provide information about the practice and to post news, blogs, and links to relevant healthcare sites. Patients will be able to download registration forms and request appointments.