CLINICAL INNOVATORS
care who has to take care of about 1,500–2,000
patients to earn a reasonable living. The hours aren’t
fewer—they are on call 24/7—but the pace is less
crazy. The only reason we decided to do it was to bring
a little more income into our primary care pool. I do
think the concept is a good one—everybody wins.
How do patients feel about it?
Unlike many other concierge practices, our traditional patients did not lose their primary care
physicians—they were not abandoned and were not
forced to establish care with another provider. The
patients in the concierge practice are comforted by
extra time with their doctors. They may not be all
that ill, but the social aspect of the visit is as important to them as the medical part. My parents aren’t
alive, but if they were, I would want to enroll them
in the concierge practice—they always felt that their
doctors didn’t spend enough time with them.
A very interesting thing happened early on.
We had a couple of patients enroll in our program
who were part of another concierge program, and
I asked them why they switched. They told me it
was because with our practice, they felt that their
money wasn’t just helping them but going to another
purpose—helping us take care of free care patients,
underserved patients in the middle of downtown
Boston. It made me feel great to know that some patients share our vision and mission. It may be a minority of the patients, but at least some people have
felt that way. I wish we had more of these patients,
because if we could have more we’d do better.
Has recruitment been an issue?
Recruitment slowed down when our economy
crashed. That was one issue. To give you an idea of
the scale, we have over 35,000 primary care patients at Tufts Medical Center in medicine, and the
concierge service is about 700 patients. It’s a small
percentage of the primary care population, but it still
generates some money. If we could get it up to 1,500
patients, it would help a lot.
Our neighborhood in downtown Boston is transforming, which gives us a lot of opportunity to build.
When I first came here this was called “the combat
zone.” Now Chinatown is becoming extremely developed with baby boomers buying apartments and moving in from the suburbs. We are starting to market our
program more now in the hopes that we can get more
patients enrolled, because we do have the capacity.
3 WAYS
Could this hybrid model be applied to a
cardiology practice?
I think the model could be applied to a specialty
service, and it already has. If there’s anything outside
of primary care that this would work in, it would be
cardiology. For one, there are a lot of patients. There
would be opportunity for a significant number of
patients to enroll depending on the demographics of
the area where the hospital is located. I do think that
if it’s applied to a cardiology practice, cardiologists
would also be doing some primary care for patients.
I’ve been approached by several institutions in the
past to learn about what we are doing here—I think
people recognize that we have a mission-driven
model that can improve care for everyone. ■
Katlyn Nemani, MD, is a physician
at New York University.
to read the news magazines of the
American College of Cardiology:
ACC.org/CSWN
Online
Print
iPad
36 CardioSource WorldNews
February 2016