Terrence L. Bauer, SpecialdocsJ. Pat Tokarz, MD, Specialdocs Teresa Iafolla, eVisit

Concierge Medicine:A Guide for the Risk-Averse

Physician

Who We Are

Teresa IafollaDirector of Content Marketing, eVisittiafolla@evisit.com

Terrence L. BauerCEO, Specialdocstbauer@specialdocs.com

@eVisit

@Specialdocs

J. Pat Tokarz, MDChief Medical Advisor, Specialdocsptokarzmd@specialdocs.com

Terrence L. BauerChief Executive Officer, Specialdocs Consultants LLC• For Specialdocs: accelerate growth and enhance the

portfolio of value-added services for physician-clients.

• Three decades of experience, including:

• Co-founder, president, CEO and director of Orion

HealthCorp

• CEO of Bauer Health, LLC

• Principal and strategy practice leader at healthcare

consulting firm Stroudwater Associates

specialdocs.comtbauer@specialdocs.com Connect

J. Pat Tokarz, MDChief Medical Advisor, Specialdocs• More than three decades at Northern Virginia Family Practice

• Transitioned to concierge medicine in 2005, followed by three

other physicians in his group

• Undergrad at Stanford, MD at the University of Tennessee,

Center for Health Care Sciences in Memphis

• Family Practice residency and a teaching fellowship at Hershey

Medical Center

• Best Doctor in America (2005-2010) and Top Doctor (1995, 1997,

2010, 2011, 2012)

Connect specialdocs.comptokarzmd@specialdocs.com

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A Short History of Concierge Medicine

• First practice started by two Seattle physicians in the late 1990s

• Fee: almost $15,000 per person annually

• Patients included the Seattle Seahawks, among others

• Benefits included immediate same-day appointments, 24/7 direct access via their cell phones; accompaniment to other medically related appointments, and other personalized, unique amenities

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Today…

• Approximately 10,000-12,000 physicians actively practice some form of concierge medicine

• Membership medicine is estimated to grow 3-6% a year

Source: Concierge Medicine Today

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Concierge Medicine ModelFull concierge:

• Membership fee to patients, typically $1,800 - $2,000 a year• 300 to 600 patients vs. 2,500 patients seen by typical physician• Multiple benefits, including 24/7 access to personal physician, house

calls, annual physicals, a broad range of primary care services

Direct primary care (DPC):

• No third party payer involvement - reduces overhead expenses• Monthly fee (generally from $25 to $85) covers all primary care services

performed in office, regardless of number of visits • Access to and relationship with personal physician• Typically appeals to younger patients

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The Case for Concierge Medicine• Changing healthcare environment leads to a different type of medical

practice:• No time for personalized care• No time to focus on prevention• No time to treat the whole patient

• Demand for concierge medicine increases:• Patients want to become more active participants in their own

healthcare• Physicians want to remain autonomous and practice medicine the

way it used to be

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Physician BurnoutSource: Medscape, Monday April 11, 2016

Physician Burnout: It Just Keeps Getting Worse.

“This year, 46% of all physicians responded that they had burnout, which is a substantial increase since the Medscape 2013 Lifestyle Report, in which burnout was reported in slightly under 40% of respondents.”

The Medscape chart shows physician burnout by specialty.

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Why Dr. Tokarz Made the Change

• Dysfunctional system, approaching burnout• Patient requests for more time with the physician who

knows them best• Change to concierge: provide services such as

comprehensive health risk assessment and development of a personal wellness plan

• Practice became patient-centered, not insurance-centered • Reduced costs, improved outcomes and patient satisfaction

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• Key to attracting more students to primary care

• Best hope for independent primary care to survive and thrive

Long Term

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The Value of Concierge Care

The concierge model works on every level, providing doctors with income that is not driven by volume, as well as providing time to treat their patients for an

entire range of complex issues.

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Hallmarks of Concierge Medicine

Patient-centered• A powerful focus on long term health and wellness

• A strong physician-patient relationship

– A better understanding of patient and family medical history and concerns

• More time for physician to research and provide treatment options for unique health issues

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Hallmarks of Concierge Medicine

Patient-Centered

• Extended office visits: 30 minutes• Appointments: within 24 hours of a patient’s call• The doctor is always in: not a physician’s assistant or nurse practitioner• Calls to the office answered promptly by real people with a real concern

for patients’ health and well being• Direct access to physician during office hours, and extended office hours• Physician’s personal cell phone number, email access after office hours

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Enhancing the Patient Experience

• Specialdocs survey of thousands of patients• 98% very satisfied with care they receive from their

concierge physician

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Enhancing OutcomesGood medicine: better outcomes reported for concierge patients in numerous studies

• The healing power of a strong physician-patient relationship is evidence-based

• Research shows:

• Patients in concierge practices experienced significantly reduced utilization rates for emergency department visits and inpatient admissions.

• Personalized medicine models achieve positive outcomes in terms of health care expenditures and improved health.

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Enhancing Physician Satisfaction

• Fewer patients than those in conventional practices allows for more time with each patient

• Put patients at the center of care, not medical managers or institutions

• Less stress• Increased opportunity for maintaining and enhancing the physician-

patient relationship• Reduced time needed for paperwork/EMR requirements• More time to focus on preventative care for patients• Practice sustainability and increased revenues opportunities• A remarkable transformation of professional and personal life

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Concierge Medicine Continues to Grow…Beyond Primary Care

• Primary care and family medicine account for most concierge practices, but…

• Sub-specialty concierge practices continue to grow as reimbursements shrink for:

• Cardiology • Endocrinology• Pulmonology• Pediatrics• OB/GYN

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Cardiology

• Leading cardiologist and “Special Doc” John R. Levinson, MD, PhD, founder of the country’s first concierge subspecialty practice, AllCare Medical, LLC, in Boston

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Endocrinology

Endocrinology, with its focus on complex metabolic issues, also fits well within the concierge medicine model.

“Personalized medicine provides the best opportunity to combine my expertise in endocrinology with internal medicine and primary care. My practice gives me more time to ‘think outside the box’ and care for patients without onerous financial disincentives.”

- “Special Doc” David A. Chappell, MD

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Functional and Integrated Medicine

• “Special Doc” Uday Jani, MD, board-certified internist, has a fellowship in integrated medicine and advanced training in functional medicine

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Pediatrics

• Michael Friedlander, principal at Specialdocs Consultants

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Why Specialdocs?

• Independence• Your name at the forefront • A proven record of success • A trusted alliance

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Learn More about Concierge Medicine:

• Call us: 847-432-4502

• Email us: – Terry: tbauer@specialdocs.com – Pat: ptokarzmd@specialdocs.com

• Take the next STEP – Specialdocs Test for Evaluating Physicianshttps://specialdocs.com/welcome

Questions?Teresa IafollaDirector of Content Marketing, eVisittiafolla@evisit.com

Terrence L. BauerCEO, Specialdocstbauer@specialdocs.com

@eVisit

@Specialdocs

J. Pat Tokarz, MDChief Medical Advisor, Specialdocsptokarzmd@specialdocs.com