Controversial New Way Of Medicine Spreads To San Diego

First-Class Medical Care Growing Trend

A controversial new way of practicing medicine is spreading in San Diego County.

It's called concierge care -- first-class medical care for those who can afford it.

Time wasted in a doctor's waiting room, frustrating delays just to get appointments, and after all of that, just a few precious minutes with a doctor -- that's what medical care used to feel like for Ray and Michelle Kimball. However, it doesn't feel like that anymore.

Now, they get VIP treatment and breeze by the waiting room to a private lounge.

They said they don't sit long and their appointments always start on time.

The Kimballs and their doctor, Julie Aspiras, are in a program called MD VIP.

It's a medical membership club where doctors like Aspiras take just 600 patients -- a fraction of the 2,000 to 3,000 patients typical under managed care.

"I've always wanted to have necessary time for each patient to give exceptional care," said Aspiras.

To get that time, each patient pays an $1,800 out-of-pocket annual fee.

Then, regular insurance and co-pays apply to visits.

As members, patients get preventative care, a comprehensive physical, a CD with their medical history and access to Aspiras 24 hours a day, seven days a week.

"When they call the office, we don't have an answering service. I have my cell phone provided to each and every one of them," said Aspiras.

Known as concierge care -- or retainer-based medicine -- it's a growing movement, fueled by dissatisfaction with managed care.

"They're really not adding to the experience of the doctor or the patient," said Dr. Martin Schulman.

Schulman created his own concierge practice.

He charges patients $600 a year for membership, limits his practice to 600 patients and no longer accepts insurance.

"I was just tired of practicing hamster-wheel medicine, just trying to do too much for too many patients," said Schulman.

For him, it's a reaction to a broken medical system.

But is concierge care the fix?

Critics call it medical elitism and worry it will shrink the pool of doctors to treat those without the money for membership.

"What I worry about is that this is going to create a market that will draw further for those people and make it more difficult to get care," said University of San Diego professor Larry Hinman.

Aspiras said her patients are not all wealthy.

"A lot of patients are teachers, bus drivers and secretaries," said Aspiras.

The American Medical Association takes no issue with concierge care.

Congress is watching the movement.

Some insurance companies do not support it.

Blue Shield of California said it likens it to physicians double-dipping.

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