Despite Recession, Personalized Health Care Remains in Demand

Thanks to patients who still value their health in hard times, the recession has barely slowed the growth of concierge medical practices, which charge hefty membership fees for highly personalized care and around-the-clock access.

From Seattle, where the movement began in 1996, to South Florida, where its largest concern is now based, physicians with boutique practices say they are losing far fewer patients for financial reasons than they had expected. While some new practices are not filling as quickly as they might, they continue to attract a steady flow of patients willing to pay thousands of dollars for the privilege.

The practices typically charge at least $1,500 a year, with the most elite services asking $25,000 or more per family. The fees cover a thorough physical exam and enable physicians to limit the number of patients they see so they can provide premier service.

Doctors give patients their cellphone numbers and schedule leisurely same-day appointments with no waiting. Some make house calls, though patients still need health insurance to pay for hospitalizations and specialists.

Most of the 20 physicians and executives interviewed said that a small number of patients had decided not to re-enroll in recent months, citing lost jobs or devalued portfolios. They tend to be like Susan Schwartzman, a book publicist from Yonkers who said she had given up her concierge doctor because of declining income, but only after first canceling her gym membership and swearing off restaurants.

For the most part, however, boutique practices have shown resiliency. Doctors said the recession seemed to have reaffirmed the importance of health care to their patients. With jobs scarce and stress at a peak, many may see a link between continued health and continued employment. And with savings depleted, they recognize that assiduous preventive care may help them avoid costly chronic conditions and hospitalizations.

As the economy crumbled last fall, Dr. Cynthia L. Williams of Torrance worried about the unfortunate timing when she sent letters in November informing her 2,200 patients that she would be converting to a $2,000-a-year concierge practice. Nonetheless, she said, she had signed up 315 patients and was adding one a week. “On my busiest day I’m seeing 14 patients, but on a lot it’s eight,” she said. “In the old practice, I was booked about one patient every 12 minutes, about 25 to 30 a day. I love it, and I think my patients love it.”

Many of the doctors boasted of their ability to keep patients out of emergency rooms by intervening by phone for conditions like diverticulitis or an abnormal heart rhythm. They said their deep knowledge of their patients helped them detect subtle changes and danger signs.

“A close personal relationship with a physician is not something that’s easy to find anymore,” said Dr. David L. Elliott, an MDVIP physician in Phoenix. “People find it valuable.”