Adjusting Care

COVER UPDATE

Adjusting Care

Dr. Jon Hemstreet, a St. Petersburg doctor, expands the services of his concierge medical practice.

Concierge medicine, a health care practice that offers patients more access to primary care doctors at home or in the office for a flat annual fee not covered by insurance, hasn't worked in all cases.

That, combined with the tougher economy in 2008 got Dr. Jon Hemstreet, a St. Petersburg physician who opened a concierge or "retainer" practice in 2007, to think more like an entrepreneur.

He adjusted. Hemstreet merged his practice, Hometown MD, with another concierge doctor, Tampa physician David Christiansen, forming Elite Care MD, and added more services to the practice. The services, through contracted professionals, include a personal trainer and a nutritionist. Elite Care has offices in Tampa and St. Petersburg.

That has helped Hemstreet's practice grow to about 60 patients in 2008 and has him optimistic about reaching about 120 in 2009.

While most primary care doctors see a few thousand patients a year, retainer doctors like to cap their patient load at less than a thousand, sometimes less than 500, to provide each patient with more attention.

"I think it will be a great year," says Hemstreet, 38. "It's a multi-disciplinary approach. Wellness will be the future of medicine"

Depending on the patient's needs and lifestyle, Hemstreet allows his personal trainer and nutritionist to do evaluations and tailor programs for his patients.

Although optimistic, Hemstreet sees 2009 as a transition year for doctors in America. A number are struggling with their relationships with insurance companies and their shrinking time to see patients.

That's what spawned concierge medicine. But the economic slowdown has hurt the growth of that practice and traditional practices. People are delaying doctor visits and procedures.

"Some are doing well, some are closed," Hemstreet says.

Still, he believes Americans are shifting more from disease solving to more preventative wellness care. Concierge care, where doctors come to patients' homes, or meet them in the doctor's office, offer more time, which is better for wellness care, Hemstreet says.

As the number of patients in concierge practices grow, the annual fees will come down, he says. He compared it to the price of cellular telephones. When they first came out, they were hundreds of dollars. Today, with more production, they are a lot less.

Despite the financial constraints brought by insurance companies, there are still a lot of options for doctors, including traditional practices. But Hemstreet admits it would be hard going back to that kind of practice after doing concierge care.

"After having time with patients, to explain things to them, to go back to 15 minutes or less, would not be rewarding," Hemstreet says.

- Dave Szymanski