For 27 years, Warren Steinberg‘s waiting room was always filled.
The Westport internist had a thriving practice. He saw 30 patients a day — there were 2500 in all — and they loved him.
Soon, things will slow down. He’ll have only 600 patients. But instead of 15-minute appointments, they’ll enjoy a leisurely 30. They’ll have his cell number and email address, for direct 24/7 access.
Plus a “free” physical and lab tests, and coverage for a few more incidentals.
The fee for this more personal touch — called “concierge medicine” — is $2,000 a year.
Soon, some of Warren Steinberg's patients will spend as much time with him as Marcus Welby did with all.
Dr. Steinberg’s 1900 patients unwilling — or unable — to pay the $2,000 up-front fee will have a new physician. Dr. Steinberg is working to get at least 1 new person into his office. He will transition slowly to the new model, and will not leave any current patient without a doctor.
It was not an easy decision, says Wayne Lipton. He’s the founder of Concierge Choice Physicians (CCP), a private Long Island-based company that offers marketing, accounting and design services to concierge doctors. Dr. Steinberg joins CCP’s 180 doctors, in 18 states.
Lipton has known Dr. Steinberg since the 1990s. “I always thought he’d be a good candidate for this,” Lipton says. “He’s warm and genuine. He knows his patients on a real, personal level.
“But as he was getting older — as everyone does — he realized he couldn’t continue to see so many patients a day. Medicine has become a revolving door. With rising costs, doctors have to see more patients just to maintain revenue. That means they have less time with each of them.”
Steinberg’s decision was not easy. “I believe it took Warren at least 4 years to do this,” Lipton says. “Change is not easy. Warren’s commitment to adding a doctor, or doctors, to his practice shows how important his patients are to him.”
Steinberg is not the first concierge physician in Westport. Six of the 7 members of Internal Medicine Associates are affiliated with Lipton’s CCP — though in a hybrid model. A small number of their patients pay for concierge medicine; the rest are part of the doctors’ traditional practice.
One consolation for anyone lamenting the move to concierge service: The $2,000 fee may be tax-deductible. (Lipton advises patients to check with their tax advisors.)
Also worth noting: The $2,000 fee is nowhere near the top of the scale. Lipton says at least one Fairfield County concierge physician charges $10,000 a year.
He is not, Lipton quickly adds, a CCP doctor.
Ha Ha Ha
Concierge is thinly veiled one-shot cash grab by some of our local MD’s to show us that money comes first. Now it’s a two week wait to see one of these hippocritic oath MD’s at IMAW (I’M A WEASEL), or you can call in and hope a rich guy cancelled the day you are sick. Forget that these same Md’s got successful over many years treating loyal patients on a sick first basis. Now, those “older, less wealthy” folks can wait 2 weeks while the new rich arrivals go to the front of the sick line. Concierge is a euphemism for GREED.
It is an interesting trend. The doctors, after enjoying outrageous billing of the ’80s (GREED I) became controlled by the insurance carriers with HMO’s, PPO’s and like of the 90’s (CARRIER GREED II). They didn’t much like that coupled with rising malpractice costs because they screwed up a lot (LAWYERS GREED III). Along comes our first Black President and his sidekick Nancy and they concoct a 3,000 page health care law dealing with the stagnering costs (SOCIALISM) and God Forbid, insurance for those with none (WEATH DISTRIBUTION) The first thought of the misinformed public is that they will now have to wait in long lines like the English (SOCIALISM II). Doctors figure out that their profit margin is minimized and that they have to see patients every 8 minutes to actually make a decent 6 figure income (GREED III). And thus, the concierge service is devised where the doctors get a base guaranteed salary per year from their loyal patients who can afford it and the rest get Doogie Hauser (GREED IV).
Warren Steinberg is a fine doctor in a long line of fine unrelated Steinberg doctors in this town. I find it somewhat interesting, however, that the good doctor had a “closed practice” of 2,500 patients and now, if you have the $2,000.00, you can go right to the front of the line. Welcome aboard (GREED IV).
And will you be needing theatre tickets with that colonoscopy, sir???
They should pick up your dry cleaning, make dinner reservations, have your car detailed & do your grocery shopping too.
Many people forget that the patient is the customer, and you get what you pay for. We left one doctor that we really liked, because the front office was a mess and we could never get an appointment. When a young, energetic, smart MD we knew decided to open a concierge practice, we signed up. We have direct email access for the simple things, phone access when needed, and our office visits are the perfect balance of professional and personal. He even did a quick pre-college physical for our daughter, no extra charge. Many of us are willing to pay extra for a good meal or a better seat on a plane or in the theater, so why not have the option for first-class medical care? So far, the annual fee is not reimbursed by medical “insurance”, but it can be covered by Flex plans.
As an aside, name another profession where you don’t get paid what you bill? Lawyer? Teacher? Car mechanic?
Many attorneys, including myself, bill out at far greater amounts than the state or county is willing to pay for criminal proceedings or ad litem representation. Accountants also do the same with public audits. Many doctors “inflate” their bills so they can get the maximum amount paid by Medicare or carrier contracts. So, while I am glad to hear of your experience, I don’t think your last paragraph is pertinent or accurate.
How nice for you that you have the income to afford it. Your analogy is accurate, for some, it’s worth the extra expense to fly first class, or shop at Balduccis or Saks Fifth Avenue. But this is an individual’s health. I’m not naive, physicians have outlayed hundreds of thousands of dollars to receive their initial training, plus additional costs in continuing education to be proficieht in new techniques, etc. If I had the money, I would absolutely do it.
Again, lets not bullshit ourselves about how extra rewarding and
mutually beneficial the bucks enhanced doctor-patient
relationship will be. It’s reminicient of prostitution. Those who
have more money get better service and get to spend more time
with the service provider. Except the whore is your family
physician. It has all the class of shoving to the head of the line in
a busy resturant and awkwardly passing the maitre d’ a couple of
bills to get preferential seating. And, if all the fatty food you eat at that meal contributes to heart disease later on, you can be comforted with the knowledge that you will be whisked into your next appointment. Main question: Does the receptionist offer you hot towels, macadamia nuts, and a light snack of Beluga caviar while you’re waiting for your appointment. OH! That’s right, you won’t have to wait. Bottom line: Generally a good idea if your priority is to value your patients literally for their value. If you have any lingering guilt when you leave and the less priviledged patients are still waiting to be seen, your status entitles you to a free massage after your appointment. That will sooth your frayed nerves caused by having to brush elbows in the waiting room with the rest of us poor, unwashed slobs.
I have been a patient at Internal Medicine Associates for the last 25 years. Or, was a patient. Until my doctor retired because of the craziness that his office had become.
When I was hospitalized last year for a serious infection- and was in for 12 days- Internal Medicine Associates never even called to check on me- much less a visit from my doctor, the replacement. When I got out and came in for a check up, I was met with a shrug and the comment that the office doesn’t deal in hospital matters any more. That it’s the doctor’s choice and they now, most of the practice, use “hospitalists”, people who don’t know you and have never met you and don’t give a sh-t. They work for the hospital.
So what is the point of going to a long standing medical practice anymore? You have to wait 2 weeks for an appointment, your doctor doesn’t follow your health- and we’ve been aggressivly marketed to, to take on this concierge. Which I didn’t.
So now, instead of paying $150.00 for sub-par care and even less service,
I pay a $35.o0 co-pay and use St. Vincent’s Walk In as my primary care.
Sad but true. Service is faster- I can go in whenever I am sick and see a doctor- something I cannot do at IMA.
I have been with Dr. Steinberg since the 80’s. I have not needed him much but I am in my 60’s and want to start traveling. I lke the fact I will be able to call Dr. Steinberg who knows my history even when I am out of the area. My understanding is he will provide his patients with a CCP Medical Profile Device, an electric device for carrying your medical history and information. I can afford it, it works for me. I am an Obama fan and I do not mind helping provide health services for those that have less than me, especiaslly preventive medical care. There is always more than one answer to ever problem. It is time to start thinking outside the box.
If you are 65 and on Medicare it will not pay if you are out of the country.
Most people do not know this.
Regarding the “tax deductible” aspect of the article, Congress
has passed legislation creating Health Saving Accounts (HSA).
It is designed for individuals with high deductible health coverage.
One can deduct up to $4,050 of unreimbursed medical costs per year.
Such must be done through a separate banking account. I suspect that the $2,000 mentioned here will be billed as something besides its true nature of initiation fees.
When I am ill, my doctor will see me the day I call her office. For physicals, I wait about two weeks for an appointment. My physicals last a few hours as my doctor spends as much time as I need with her. She never rushes me. She tells me which specialists to stay away from and makes great recommendations for other local doctors. She does not take a dime from the drug companies; the magazines in her office all have a label that says, “Enjoy the magazine; ignore the drug ads.” This is not conceirge service, but good, old-fashioned customer service.
My mom goes to a doctor in Westport–he might be with Internal Medicine Associates. The waiting list for physicals is a minimum of TWO YEARS! I wish she would switch to my physician, who is the last of a dying breed.
Please tell me you physican is?
I mean please tell me her name.
Sally Bergwerk in Wilton. 203-762-0024.
Thank you.
“The waiting list for physicals is a minimum of TWO YEARS! ”
I’m throwing up the B.S. Flag on this one.
Sad to say, Wrecker. Keep you BS flag in your pocket. Call Dr. Altbaum’s office and ask. In retrospect, I shouldn’t have said “a minimum” but “about two years.”
Painted lady speaks the truth, Wrecker… hard to believe.
BTW, Painted lady, does your moniker refer to the body painting famous in Key West and New Orleans?!
She is correct. I was a patient of doctor Altbaum’s from ages 20 to 45. The wait to schedule a physical exam back then was close to a year, and that was years ago.
I had concierge service as a kid. We had the doctors home phone number [EVERYBODY DID]. He would come in the middle of the night, park his black Cadillac with his “MD” license plates in the FIRE HYDRANT – BUS STOP – NO PARKING space, and come right into my bedroom with his little black bag. He’d tell me I’d be OK, then give me something to make me sleep, and a shot of penicillin to fix me up. But there was no extra charge, no fee, just service that elevated MD’s in our minds to a higher breed of mankind.
Excellent.
“Doctors are men who prescribe medicines of which they know little, to cure
diseases of which they know less, in human beings of whom they are know
nothing.” Voltaire
I prescribe to the Republican
Health Care Plan: Don’t get
sick and if you do, die quick.
I was really taken aback at the mean spirited comments on this post. This doctor is, by all accounts, well liked and does a good job. Under the current compensation structure for doctors, he has to see a whole lot of people, many more than he probably did in years past. So, now he has found a way to create more balance in his professional life by seeing people instead who can afford to pay him directly. Why is this so offensive to you all? He is making a rational choice that allows him to practice medicine in a way that doesn’t turn his examination room into an assembly line with productivity targets instead of patient relationships. If this bothers you so much, consider that you might not ever get the full picture of how your doctor gets paid for the services he or she provides to you. All you pay, probably, is a co-pay. Maybe this hints at the future — a return to individually negotiated payment arrangements with your professionals. After all, you see the bills and negotiate payment with your lawyer, accountant, or even your lawn care guy (if you have these). Why not with your doctor?
I don’t know this doctor but I am really bummed by some of the vitriolic comments on this post.
Dan, did the tone of the comments on this post bother you?
Honestly? No, I was not surprised. Healthcare is a huge, possibly intractable, problem in our society, and because it affects people’s lives directly, and impacts their pocketbooks profoundly, they’re passionate about it.
I didn’t see the comments as attacks on Dr. Steinberg. He seems to be a very popular guy, and I think most people understand that this was a lifestyle decision for him, after many years of practice. I think most of the frustration was aimed at our healthcare system in general.
What did surprise me was that this did not really veer off into a discussion of “Obamacare,” as I thought it would. I’m keeping my fingers crossed that the comments will remain more on point than they usually do.
Since you asked, the movement to concierge service is another example of the deeper gap between those who can afford excellent health care and those who can not. As pointed out above, Jeremy, the doctors were greedy in the 1980’s (to their own admission) and let their profession be taken over by the insurance carriers. Now the entire system is unraveling under a cost factor that is, most likely with the arrival of us boomers, going to bankrupt the medicare system. Folks are scared/mad and our comments reflect that. As to the Professor’s comment on ObamaCare, it is has become a 3,000 page clusterf$%$. Why they didn’t just gradually extend Medicare to the young and as we could afford it, to others, is beyond me.
Oh Dude,
Because your girlfriend Nancy Pelosi had to put her mark on something! She was determined to shove that bill down our throats no matter what! And, we still don’t really know what’s in it. But this concierge service has been alive and well in Manhattan for years. The top doctors can do this and there are many people who can and do pay for this. One beef I have had in the past years, is that the local radiologists who do mammograms refuse to read the film on the same day as they used to. You used to have a face to face discussion about your test and results. Instead they make you wait until the next day and they have one person spending a day reading film after film after film. I have no doubt that some cancers are missed because of this.
I chose to go to Manhattan after that and my radiologist not only gives me a complete physical exam, reads my films and has another Dr. look at them independently. The office is always booked – People are willing to pay for it.
Sure people are willing to pay for it. The problem arises when they can not afford to pay. I am not knocking the concept and my lady has signed up with Warren. But it is an offshoot of an underlying problem with the system that will eventually put Marcus Welby out to pasture. Specialists will remain and those with money will pay. I am worried about those less fortunate. At Norwalk, they either can not read my lady’s mammo or misshoot it. She has to go back three times. Paying each time. Cheaper to go to Houston. Correction: Nancy is hot but not my girlfriend. Not into pearls. Rahm pushed health care and then ran to Chicago. “Boner” ain’t no prize either.
The move on the part of some doctors to restrict patient roles is an unintended consequence of government intervention into the market for healthcare. Every level of healthcare and every dimension is and has been regulated by either state or federal governments. The gap between the heathcare received by the rich and the rest will only increase under Abamacare. The data from other countries with government run healthcare supply ample empirical evidence to support the expectation that healthcare for the average American will only get worse and more expensive after 2014.
But for those who have no health insurance, that can’t be true. We have discussed the study that analyzed the health care of Japan, Taiwan, Switzerland, England and Germay. The consensus was the following: (1) everybody has to be in the insurance pool; (2) the insurance carriers have to be non-profit (Switzerland battled with this but apparently the insurance carriers are doing well now) and (3) the government has to set the prices.
Your contention may very well be right about the average health care by 2014 but the problem is that once 70 million Boomers hit the Medicare lists, we are bankrupt if something is not done.
Americans will not tolerate the level of healthcare delivered in Engl;and, or Canada or the vast majority of those countries with government run healthcare. Your contention that everyopne must be in the pool is not correct. Everyone must be in the pool if Obamacare is to be funded. If Obama were not trying to nationalize healthcare, not everyone would need to be in the pool. In France, the number of those with private health insurance has risen from 15% to 85% in the last few decades. People in countries with government run healthcare are voting with their money. According to the CBO, under Obamacare, healthcare cost increases will not slow down, thus the babyboom problem will not be solved. Obamacare is merely a huge increase in tax rates that will not bring better or less expensive medical care, and according to his own people will cost jobs. Finally, if Obama tries to cut Medicare reembursements by up to 30% doctors will stop taking patients with Medicare coverage and there will be riots in the streets as old codgers in motorized wheelchairs descend on DC to throw the bastards out.
Oh, I am not defending Obamacare at all but certainly something had to be done. What about just extending Medicare to the young and then gradually lowering the age???
Who will pay for it? The Toothfairy? As long as the government interferes in the healthcare system, healthcare will become more and more unaffordable.
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Everyone is talking about foreign healthcare and what the future will be. I and another friend cannot afford this new concierge thing, but we need to be seen when we’re sick. After this started, i tried Norwalk Medical and am happy there. They don’t have this concierge medecine and i can get an appointment the same day as a walk in. My friend has also switched because she can’t afford the cost and needs to be seen when she is sick, not weeks later.
Everyone is talking about foreign healthcare and what the future will be. I and a friend cannot afford this new concierge thing, but we need to be seen when we’re sick. After this started, i tried Norwalk Medical and am happy there. They don’t have this concierge medecine and i can get an appointment the same day as a walk in. My friend has also switched because she can’t afford the cost and needs to be seen when she is sick, not weeks later.
This is not the first time I have heard about concierge service. However, I have not been able to make sense of it for myself or for anyone who is healthy.
As I understand it, I still need to pay for my health insurance premiums (~$2400 annually) plus pay for specialists, diagnostic tests and prescriptions and now $2000 for a GP that I might only see once a year. Its an easy decision = no thanks to concierge.
Concierge Choice Physicians are the greedy ones. I signed up (when I was employed) because I like my doctor. On the Concierge Choice Physicians web site they claim you have a choice of payment methods, but I do not recall being offered that option at the time. To use a credit card to pay Concierge Choice Physicians force you into auto renewal, which they do with out warning. So if you don’t want to renew, or if you lose your job, they still charge your card anyway without asking. They are pushy and rude. I do not like them one bit. I suspect it is they who are raking in the dough vs. the physician. I wish health care reform would put Concierge Choice Physicians out of business.