Doctor is in, for a price

Sunday, Oct. 8, 2006 | 7:43 a.m.

It has been a trend among businesses for some time now to upgrade their basic services for people who are willing to pay extra. The auto club AAA, for example, offers its Plus Card. American Express has its Gold Card. Now the trend is solidly entrenched among doctors.

Las Vegas Sun reporter Marshall Allen wrote last week about a patient who woke up feeling lousy. He called his primary care doctor at 9 a.m. and was being treated before noon.

This patient did not have to wait hours, and then be one of several patients being seen almost simultaneously by his doctor, because he had paid a $1,500 fee for premium service. His doctor was affiliated with a company called MDVIP, whose business plan revolves around every patient's dream - a doctor's office whose waiting room is not jammed.

With this setup, under which the company retains $500 of the fee in exchange for managing the doctor's reduced caseload, two people win - the patient, who gets exceptionally attentive health care, and the doctor, who gets his life back.

The patient in the case cited, for example, is assured of a doctor who will have the time to provide annual physicals and other services associated with preventing health problems. And the doctor here saw his patient load drop from 2,600 to 530.

It's a win-win, but it is also a win-win-lose, with the loser being the patent who cannot afford $1,500 a year for premium service. For every doctor who joins such a practice, a greater burden falls upon the remaining 1,300 primary care doctors in the Las Vegas Valley.

We don't blame doctors for converting to this new style of health care. Insurance providers expect primary care doctors to treat a new patient every eight minutes and they do not reimburse for preventive medicine. Doctors today, with their long hours and six- and seven-day workweeks, often feel like they are robots. Who can blame them for wanting to actually spend time with their patients and focus on healing?

So far only 10 doctors in the Las Vegas Valley have switched to this system. But if the trend grows, and it likely will, there could be greatly diminished quality of care for less affluent patients.