The MDVIP network consists of nearly 800 doctors who offer a personalized wellness and prevention program and limit their activity to a maximum of 600 patients. Patients pay a membership fee to register with an affiliated physician at an average cost of $1,800. The patient limit is intended to improve patient member access and allow physicians to spend more time per visit. In most practices, no additional staff are required, Jacobson pointed out. “Five to 7 years ago, probably 80% of doctors didn`t have a nurse. Today, it is reversed; 80% to 90% have nurses, and many are underutilized, so there is no additional cost to the program. So you added $250,000 to $7500,000 in additional revenue without having to add your expense line. And this model “bypasses the moral problems that doctors may or may not have about patient interruption.” “If they become responsible, if something happens to one of their 800 doctors, it could be a turning point,” Priddy said. “It can also change the way companies are set up to manage groups of doctors.” It could also put GPs at risk every time they refer a patient to a specialist, he said. The jury held MDVIP responsible for a diagnosis that was overlooked by a janitor, although it was also overlooked by a specialist that a patient was referred — a finding that could have troubling implications, according to a trade group advocating such practices. Another concierge company, Signature®, also offers its physician clients a segmented or “dynamic” model, where the physician focuses their time and attention on program members and hires a physician extender to manage non-member patients. “Our other big differentiator as a company is that we view the physician as a customer and not as an end user or patient,” said Matt Jacobson, CEO of Signature®, in Santa Monica, California. “About 15% of our physicians are fully converted without non-member patients; they have an average of about 400 patients per doctor.
Many reports say that the membership fee is worth it. However, it is up to each patient to weigh the benefits and costs of this service before signing an agreement. The best-known and oldest concierge company is MDVIP, which began in 2000 in Boca Raton, Florida, and now has nearly 950 doctors in 43 states. Physicians who have registered with the MDVIP — the company says it does not accept everyone who wants to enroll, but instead reviews them to make sure their practice is a good fit — agree to significantly reduce the size of their patient panel, typically to 300 to 600 patients. Patients who stay in an MDVIP practice agree to pay the annual fee, which started at $1,500 but went from $1,650 to $1,800. When he first got involved in starting a concierge business, Jacobson said, “I found that the full conversion model had two major flaws: it required doctors to take a significant risk when converting their practice – if they converted to full conversion and didn`t reach their number, they couldn`t put the toothpaste back in the tube. and second, doctors had to leave patients who knew they were heading to the most severe primary care shortage we have ever heard of. That`s why we`ve changed our branding from “segmented” conversions to “dynamic” conversions – after 1, 2 or 3 years with a segmented model, a doctor might say, “I want to simplify my life” and can move on to full conversion at any time. Priddy runs Priority Physicians, a concierge practice with five doctors in Indianapolis that offers a variety of services for a flat rate and does not accept insurance. While he doubts the decision will discourage doctors from choosing the concierge model, he fears it could have other implications.
Jacobson did not elaborate on the services doctors offer to members, except to say they are tailor-made for each practice and “our business owners.” However, he added that “we do not sell access and we do not sell annual physical access; in my opinion, this is not a recommended service offer. The national network consists of 900 physicians serving more than 300,000 patients in 45 states and the District of Columbia.  Each doctor serves up to 600 patients, compared to an average of 2,500 to 3,500 patients in a traditional GP practice. Patients with MDVIP receive a comprehensive physical exam and follow-up wellness plan, as well as electronic medical records and a personalized patient portal focused on nutrition, exercise, communication with physicians, and more. The company says additional benefits for patients include acute visits, same-day or next-day availability, on-time appointments, 24/7 physician availability, and better coordination of specialized treatments.  Karen Terry, a lawyer at Searcy Denney Scarola Barnhart & Shipley, the firm represented by Beber, took a closer look at the implications in this regard. The case will only affect specialist referrals by GPs “if they refer the patient to the wrong specialists or an insufficient number of specialists,” she said. Like other concierge companies, Signature® does not accept all practices that apply, Jacobson said. “The vast majority of applicants don`t have the right patient demographics, medical common sense, or the right way to do it at the bedside. Measuring the quality of physiotherapists in care is incredibly complex, and I don`t know if even the largest medical institutions have mastered it. What we do is measure patient loyalty, patient affinity for their doctor and the nature [of the doctor], as well as patient demographics in terms of age, socio-economics and level of education.
MDVIP was founded in 2006, making it one of the first promoters of the modern telemedicine platform. Since then, MDVIP has grown to provide personalized remote care to more than 300,000 patients. Their smaller patient base contrasts with other telemedicine platforms with over 1 million patients. .