Hanover doctor goes back to basics with membership-based practice — Dr. Kurt Thomas hopes a smaller patient workload will help him focus on prevention
By Jennifer Wentz
Kurt Thomas, a doctor in the Hanover area, is a member of MDVIP, a national group that gives doctors the opportunity to spend one-on-one time with patients. He began a months-long transition period in the fall before switching to MDVIP completely in late December. (Submitted)
MARCH 17, 2015 – More than 20 years ago, Kurt Thomas, fresh from a residency at York County’s Memorial Hospital, made a decision: he wanted to be a family doctor so he could help patients with every aspect of their health care, from prevention to treatment.
As the years wore on, though, that goal seemed further out of reach as the Hanover doctor’s workload grew. On an average day, he would see 35 to 40 patients, leaving little time to address anything but the patients’ most pressing issues. Topics like healthy living and preventative testing fell by the wayside.
Then a patient told him about MDVIP, a national group that gives doctors the opportunity to spend one-on-one time with patients. The group limits doctors to 600 patients, about a fifth of the number of patients Thomas saw in his regular practice last year.
The program, Thomas said, seemed like the opportunity to start providing the level of health care he always wanted to give his patients. He began a months-long transition period in the fall of 2014 before switching to MDVIP completely in late December. Many of his long-time patients made the switch with him.
Personalized care, though, comes at a price: specifically, between $1,650 and $1,800 per year for each patient, on top of insurance costs.
Patients who have stayed with Thomas at his Penn Street practice since he made the switch say the one-on-one time with an experienced doctor is worth the price.
But nationally, MDVIP and other concierge medicine providers have sparked conversations about whether these models promote a two-tiered medical system in which only the wealthiest can afford premium care.
“That’s great for patients who can afford it,” said Tracy Koval, director of medical practice advocacy for the Pennsylvania Academy of Family Physicians. “But for patients who are in rural communities and on medical assistance or Medicare, they can’t afford to pay $1,800.”
Changing models
MDVIP is a nationwide network of physicians founded in Florida about 15 years ago at the cusp of the concierge medicine movement. The group, like other concierge providers, charges patients an annual fee of between $1,650 and $1,800 per year, on top of insurance and other costs, in exchange for personalized care.
For Thomas, switching to MDVIP has meant going back to the reason he became a doctor in the first place: providing the best possible care for his patients.
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Patients are guaranteed 30 minutes of face time with him at every appointment. He can make house calls, something he hasn’t been able to do in years. And because Thomas can spend extra time with his patients, they all receive two-hour annual wellness checks, during which they can discuss preventative care and screenings.
“The fact that I can actually spend that time is a little different for me,” Thomas said. “Previously, it would feel like I was stamping out fires. Now I feel like instead, I’m helping to prevent them.”
More than 5,000 doctors across the country used concierge models in 2013, according to the American Academy of Private Physicians. Some operate under national management firms like MDVIP, which has a network of more than 750 doctors, while others operate independently.
Thomas is the first doctor in the Hanover-Adams area to join MDVIP, according to the website’s doctors listings. The American Academy of Private Physicians also does not list any other concierge providers in York or Adams counties.
Concierge medicine has existed for decades, but its prevention-focused philosophy is especially relevant in today’s healthcare reform discussions, said Chris Lilich, MDVIP’s chief marketing officer.
Patients in MDVIP between 2006 and 2010 were about 75 percent less likely than their peers to be hospitalized, according to a study published in the American Journal of Managed Care. Another study showed that the decline in hospital visits and other medical expenses among MDVIP patients resulted in significant savings for the nation’s healthcare system.
So why do patients have to pay extra for personalized care?
It comes down to payment models, Koval explained. Insurance companies pay doctors according to productivity, meaning most doctors’ livelihoods depend on fitting as many patients and tests as possible into every workday.
MDVIP and other concierge models address this issue by guaranteeing doctors a fixed income. The issue isn’t that other doctors don’t want to spend more time with their patients, Koval explained; it’s that they don’t have the time to do it and still make a living.
“There’s only so many hours in the day, and a lot of providers are pretty stretched right now,” Koval said.
The price of prevention
Thomas’s MDVIP program is still in its infancy, but he already feels better able to provide his patients with the kind of care for which he had always strived.
With MDVIP, he said, he can address all aspects of his patients’ health `— fitness, heart health, chronic illnesses — before they get sick.
“I liken myself to the old stage coach driver in the movies,” he said. “You have six horses running in different directions. My job is to get them all going in the direction they’re supposed to go.”
Moneywise, the costs-savings of prevention don’t compensate for the annual cost of MDVIP, according to the American Journal study. While patients might save $170 annually on hospital visits and other sick care, they are still paying ten times that amount for the ability to see a MDVIP physician.
But for some patients, good health is worth the price.
Hanover resident Alan Leppo has trusted Thomas with his health for almost two decades. When Thomas announced his decision to switch to MDVIP, Leppo and his wife Barb, didn’t hesitate to go with him.
They, along with the rest of Thomas’s patients who have stuck with him, will continue to see the doctor at his office at 136 Penn St. in Hanover. Patients declining the MDVIP model could stay on with another doctor in the practice, Thomas said.
Leppo and his wife, who are both retired, had to look at their finances before making the switch, Leppo said. Like many concierge patients, the Leppos are not rich. In fact, about a third of patients who pay for this model have a combined household income of less than $100,000 per year, according to Concierge Medicine Today, an online magazine specializing in the health care model.
Thomas’s MDVIP rate, $1,650 annually, is also on-par with that of other concierge providers throughout the country, that study states.
It’s a cost Leppo is more than willing to pay.
“I feel like at this point in my life, I want to receive the best health care that I can,” Leppo said.
SOURCE: http://www.ydr.com/local/ci_27728046/hanover-doctor-goes-back-basics-membership-based-practice
