WAVE 3 TV Louisville, KY | New primary care practice provides 24-hour access to doctors

New primary care practice provides 24-hour access to doctors

By Lori Lyle - bio | email
Posted by Charles Gazaway - email

LOUISVILLE, KY (WAVE) - If more time and access with your doctor sounds too good to be true, think again. For $1,500 a year, patients in an MDVIP practice get VIP treatment. With two more Louisville doctors joining a growing list of physicians signed on with MDVIP, there is some growing concern from the patients they are leaving behind.

To provide the type of VIP care that is the hallmark of this type of practice, MDVIP doctors drastically downsize their existing patient lists to no more than 600. Phil and Judy Coffman are among the patients that recently received the letter from their doctor, Salvatore Ciliberti, explaining the transition and asking them to be a part of the new MDVIP plan. That led Phil, a trucker by trade, to start doing the math.  

"I go to the doctor about every three months. If you break it down, just say five times a year, that's $300 a visit just to walk in the door," said Phil.

In addition, the Coffmans would still pay insurance premiums and co-pays, so they started weighing the $1,500 annual fee it would cost to keep their doctor of 25-plus years.

“That panicked, sick, ‘Oh my gosh, I'm losing my doctor. Oh, can we do this, can we come up with the funds,’” said Judy.

To the Coffmans, Dr. Ciliberti has been a lifesaver. Phil suffers from COPD (chronic obstructive pulmonary disease) and 9 years ago went into respiratory failure which hospitalized him in intensive care for over 30 days. The reason for Phil's frequent visits with Ciliberti is to keep him as healthy as possible and out of the hospital. Phil takes numerous medications each day and sleeps with oxygen at night and said Ciliberti has been vigilant with his care.

Judy said they already pay so much in co-pays that the get to write it off on their taxes, so to add another $1,500 or $3,000 on top of the insurance and medical expenses would cause a hardship, especially looking down the road.

"Then I started thinking, yeah, we can do it this year and maybe next year, but over a ten-year period it would probably drain our life savings," said Judy.

According to Judy, she went from feeling gratitude, love and trust toward their long-time physician to feeling betrayed and searching for a new doctor. Now Judy is looking for someone that remembers why they became a doctor. But according to MDVIP, that is the reason doctors join their practice - to practice medicine like they know they should be.

"You realize there are other things you should be doing in medicine that just aren't available in our current model," said Ciliberti. The reason said Ciliberti is time.

"What MDVIP represents truly, a paradigm shift in the way one approaches primary care with an emphasis on prevention and wellness," said Dr. Bernard Kaminetsky, MDVIP medical director, who started the first MDVIP practice in California in 2001.

MDVIP now reaches over 120,000 patients with some 330 doctors in 28 states. Each MDVIP patient receives an annual comprehensive exam that includes everything from extensive blood work and x-rays to allergy and dementia screenings. The results are given to patients on a pocket sized CD-Rom for emergency access to their medical records.

Dr. Robert Ellis was the first to join MDVIP, starting his practice a year ago. Ellis said the decision was based on something very simple - to really treat people the way they should be treated." 

Ellis went from seeing 30 to 40 patients a day down to no more than 10. Before making the switch, Ellis said he knew that, "When I left in the afternoon or evening, I was always sure there was something that had fallen through the cracks." 

Ciliberti seconds that feeling. “You definitely can miss things when you're seeing that patient at that that rate."

MDVIP patients typically see their doctors the same day they call. They have 24 hour access to their doctor's cell phones and the appointments.

"I'd say I generally see him for an hour every time I come in," said Martin Del Prince, one of Dr. Ellis's patients.

Bettie Miles joined Ciliberti's new practice immediately. She admits that it created a hardship, but said it has helped her put her health at the top of her priority list. Still others who are getting the notification letters from Ciliberti question the motives. Kevin Lush is not only focused on the extra cost to him, "you cutting back 2/3rds of the workload." 

Judy goes even further with accusations. "They call it boutique medicine, concierge medicine. I call it greed medicine."

The doctors say it would be impossible to downsize without the extra charge, but Phil asks why so much?

“Everybody needs to make money, but I do not understand the $900,000," said Judy, which is the sum of annual fees with 600 patients. 

$1,000 goes to the doctor, $500 to MDVIP to oversee the transition and administrative details. When you subtract the overhead and the insurance reimbursements, Ellis said, "Financially, I'm not quite as good as I was before, but I'm more comfortable with what I do." 

"It's just wonderful care," said Ciliberti."

Still, it is care for those willing and able to pay for it. While people like Kevin, Judy and Phil search for new doctors, another of Ciliberti's patients to sign on, James Hood, said he has no problem with the fee.

"I'm paying more on that overhead to help him free up time to be able to service and work with me. It's only money, can't take it with you," said Hood.

New data shows that if you have the money, MDVIP may help you stay here longer. Kaminetsky said hospitalizations and ER visits drop significantly for MDVIP patients; down 42% in 2006, 47% in 2007 and 54% in 2008.

Ciliberti and a colleague, Dr. Harry Renco, will begin their new MDVIP practices in January 2010. 

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