Wouldn’t it be great to have 24/7 access to your physician for both urgent and non-urgent issues? Same or next day appointment availability? Unhurried office visits? A physician that addresses all of your concerns and strives to be your health care advocate? Dr. Afreen Pappa, a board certified Family Physician, medical director and owner of JAVĀNI Med Spa, and a Lifestyle Advisor to the Houston Business Show is implementing a patient driven retainer medicine model to give patients the medical attention they desire and deserve. The Patient First Medical and Wellness Program™ seeks to meet all these patient needs for an annual retainer fee. It will be available in the Fort Bend area in January 2009.

In the world of third party payers, gatekeepers and declining reimbursements, the traditional Marcus Welby type physician-patient relationship most physicians aspired for as medical students has become part of our medical and social history. 

Most patients spend at least 30 minutes to one hour in a waiting room and then in the exam room before being seen by their physician.  The average medical visit now lasts 10 minutes or less.  A phone call to the physician office for a medication refill or non-urgent question can take two to three days before being returned.  In some practices, it can take days before an appointment is available. Many retail health clinics are popping up to fill the void of accessible health care for when consumers are acutely ill.

According to Dr. Pappa, more and more primary care physicians are required to see 20-30 patients per day to meet their practice overhead, manage patient panels of 2500 to 3000 individuals, and spend hours each day in insurance paperwork and phone calls.  Fewer and fewer medical school graduates, with student loans nearing $100,000 at the time of graduation, are choosing primary care as a specialty for these reasons.  In addition, physician burnout is happening at an alarming rate, mainly in the specialties of Family Medicine, Internal Medicine and Pediatrics.  In a 2006 survey of primary care physicians by the physician recruitment firm Merritt Hawkins & Associates, only 1/3 of respondents would choose primary care specialties if they had their education and training to do over again.

Addressing this health care need is the concept of retainer medicine, also known as concierge medicine or boutique medicine.  Traditionally a service only the very wealthy could afford, the current model is more accessible to the average consumer.  Fees range from $1500 per year to as much as $20,000 depending upon the services offered.  Each practice is unique in its offering, but the end result is a higher quality of service to members.  Physicians in this model are able to keep their panels significantly more manageable, anywhere from 200-600 patients.  This allows them ample opportunity to spend time with each patient, return phone calls and emails from patients, speak with specialists to be proactive in coordinating care, stay current with the ever expanding field of medicine, and really get to know their patients to develop that ideal physician-patient relationship.  Patient First Medical and Wellness Program™ offers a comprehensive yearly physical, wellness and nutritional evaluation, a personalized exercise and nutritional plan, same or next day appointments, house calls for an additional fee if needed, 24/7 access to the physician, and $600 worth of credit towards spa services at JAVĀNI Med Spa. 

The question for consumers becomes, what is such an investment in their healthcare worth?  In many programs, the cost is no more than a pack of cigarettes a day or a fancy cup of Joe from their local coffee house.  For consumers with high deductible HSA’s (Health Savings Accounts), the pretax dollars can be used for the annual retainer fee.  In many cases, this can be more cost effective than the combined costs of taxed monthly insurance premiums, deductibles and co-pays.  To decide if this type of program is for you, Dr. Pappa recommends that consumers speak with their health insurance specialist and schedule a consultation with the physician offering a retainer medicine program to learn more about the program and whether it is right for them. Most physicians will offer this consultation as a complimentary service.
For additional information about the Patient First Medical and Wellness Program™ offered by Dr. Pappa, call 281.491.1151.

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