From Tom's Desk
The New York Times, the "Velvet Rope", and You
This week, as part of its ongoing series about the “velvet rope economy,” the New York Times published a feature on the ultra-high-end medical service industry. The details of catering to the wealthiest are about what you would expect.
In the article, there’s much discussion from physicians about how their personalized care coordination justify five figure retainers, how they simply could not provide the same level service in their former practices, how providing this level of care is so rarified that only clinicians from “Ivies or Ivy League-esque schools need apply.”
Reading it left me quite sad. Most of these clinicians are driven to serve in the highest tradition of the profession. Yet, save for being “asset managers” for their few uber-wealthy clients, they can see no other way they could practice medicine to their own satisfaction, sustainably, for the population at large. You can hear the discouragement in their own words. It's a cry for help.
Too bad they didn’t ask us.
Every service they provide in their high-dollar retainer practice with such satisfaction, my partners and I provided in ours. For more than twenty years. And we took all comers.
Need to get in today?—come on by.
Need to see a cardiologist right now?—let me pick up the phone and call John’s cell. He’ll see you personally. Today.
Need to call about a symptom in the middle of the night?—Here's my number.
We didn’t burn out. We were fully engaged and our compensation was every bit as good as described in the article.
All because of a couple of reasonable risk-sharing contracts.
And care systems we generalized to our entire patient population.
You don’t have to cater to the very rich to get the life you want.
Get a reasonable gain-share contract, recruit 300-500 patients and go for it.
At the very least you won’t find yourself crying for help in the pages of the New York Times.