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The Separation of a Traditional Concierge Practice vs. a Hybrid Concierge Practice Print E-mail
Written by Jay A. Shorr, BA, MBM-C, MAACS-AH, CAC I, II, III   
Sunday, 14 July 2013 00:00

"Doc, you realize your office is a lot like Disney World," an unhappy patient quipped to Mark R. Wheeler, an internist in Louisville. "It's a three-hour wait for a 20-second ride."

This quote, from Wayne J. Guglielmo's 2003 Medical Economics article, hits the nail on the head. This is what has defined traditional medical practices for family practices and internal medicine practices until the late 90s when concierge medicine, or subscription-based practices, started to become popular. Many physicians transformed their practices from insurance-based, and converted to a VIP type of entity. If patients wanted direct access to their doctor, anytime appointments, annual physicals, and even hour-long office visits in addition to house calls, this was for them. For approximately $1,500 - $2,000 per year per patient, or $2,500 - $4,000 per year per couple, you could have a limited practice of approximately 300-500 patients. Many upscale practices were charging considerably more

This concept became a franchise-type operation in Florida around the turn of the century with the start of MDVIP, a company that coordinated a handful of physicians and put them on the road to becoming what was known as "concierge medicine." When this became popular, they even expanded to several other states. The idea was welcomed and became very successful. MDVIP charged approximately one third of the annual patient fee to help physicians maintain the start of something new. Mark Murrison, MDVIP's president of marketing and innovation said in an interview with PBS's NewsHour, "Our doctors are primary care doctors and doctors who have really become frustrated with what has become conveyer belt medicine. They're seeing 30, 35 patients or more a day. They're spending less and less time with their patients."

While most of the concierge medical practices became cash only with an annual membership, this allowed physicians to get away from having to bill insurance companies and do away with billing and collections, concentrating on preventative medicine. This sure sounds like a novel concept, doesn't it?

In a hybrid concierge medicine practice, the primary care physician makes it an option for his or her patients to participate in subscription-based care. The patients can choose to pay a fee for one-on-one, concierge services from the physician, or choose to continue receiving care traditionally from the same physician. That way, insurance-based patients can continue to receive care.

This model works to attract newer physicians since new graduates have chosen to step away from family practice or internal medicine due to feeling overworked and underpaid by having the traditional insurance based practice. At least this way the patient has a choice on how they would like to receive treatment, while the physician can have a mixed flow of patients.

The field of medicine changes all the time and no one knows what's next. At least both the physician and patient now have options to choose from, and that's the beauty of modernized medicine in the United States.

Jay A. Shorr is the founder and managing partner of The Best Medical Business Solutions, assisting medical practices with the operational, financial and administrative health of their business. He is also a professional motivational speaker, an advisor to the Certified Aesthetic Consultant program and a certified medical business manager from Florida Atlantic University.  He can be reached at

Last Updated on Monday, 15 July 2013 09:25
On the Importance of Coordinated Care Print E-mail
Written by David Hirshfeld   
Wednesday, 26 June 2013 10:13

By training and trade I am a health care lawyer. Recently, I was forced to take a look through the other end of the telescope, thru the little part, the part my clients are used to. I became a patient; with almost no notice, and with very serious symptoms.

The short version is that I contracted something that was diagnosed as chicken pox about three months ago...

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Source:  Jeffrey L. Cohen's Blog

Last Updated on Thursday, 04 July 2013 10:58
Hospital-Acquired Medical Practices: Buyer Beware? Print E-mail
Written by   
Tuesday, 25 June 2013 00:00

An article in Futurescan 2012: Healthcare Trends and Implications 2012-2017 outlines the huge shift in favor of hospital-owned medical practices. Those of us who've been around the block a time or two can't shake the déjà vu of the 1990s or the disastrous outcome. This time, though, the outcome of a medical practice acquisition plan can be different as hospital systems vow to heed Santayana's adage, "Those who cannot remember the past are condemned to repeat it."

Some big factors in favor of a positive medical practice purchase experience include: the healthcare landscape looks almost nothing like it did in the '90s; physicians appear less resistant to hospital employment, perhaps due, in large part, to demographic factors; the market is open to novel compensation programs such as pay for performance/outcomes; and hospital management teams are adapting to the new normal by including physicians and embracing technology specific to the physician practice realm.

However, no different than undertaking any investment, knowledge is power, and it helps to know what you're getting into. A successful medical practice acquisition plan must include a thorough assessment of the 'acquiree' before the deal is done - in fact, before the deal progresses much past the early stages. 

Business metrics can vary widely and be completely unrelated to the technical proficiency or clinical quality of the physician and his or her patient care.

Some medical practices are well-oiled machines and the owner's motivation for acquisition is a win-win; the transition is smooth and the result is a high-performing practice that causes no headaches for its parent organization. At the other end of the spectrum are...

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Lakeland Based Group Practice Merges with Regional Health System Print E-mail
Written by Jeffrey Herschler   
Tuesday, 25 June 2013 00:00

Clark & Daughtrey Medical Group comes to its merger with Lakeland Regional Health Systems as a well-endowed partner.  By the end of summer, nine more doctors and another nurse practitioner will join the clinic. There currently are 45 doctors and 17 nurse practitioners on its staff.  "That's a very aggressive increase," said Adil Khan, chief administrative officer for the group, calling it the biggest number brought on board in such a short time.  A larger walk-in clinic and family practice office, which could someday include pediatrics, is being established on the north side of Lakeland.

With those signs of strength, why did the 34 doctor-shareholders eligible to vote unanimously endorse the merger that becomes official July 1?

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Credit Card on File: A Simple Way to Enhance Medical Practice Cash Flow Print E-mail
Written by   
Sunday, 09 June 2013 00:00

At Manage My Practice, we are big proponents of the credit card on file system as a road to financial viability. This program changes your patient collections from a back-end collection program to a front-end collection program, effectively collecting 95% of the patient responsibility within 45 days of the service.

In a credit card on file (we abbreviate it "CCOF") program, the patient's credit card information is securely stored off-site so that co-pays, co-insurance, deductibles, non-covered services, and balances after insurance has paid can be charged to the card automatically.

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