PHYSICIAN ‘CONSULTANCY’: Seattle Docs Go It Alone
A front-page story in today's Wall Street Journal profiles two Seattle physicians whose practice -- and an "unusual medical consultancy" -- do not bill insurers or accept Medicare or Medicaid payments. Seattle Medical Associates, founded by Drs. Garrison Bliss and Mitchell Karton, provides patients with "unlimited access to a doctor they know who will guide them through the maze of hospitals and medical specialists they may encounter if they get sick." Patients age 35 and over "pay $65 a month for the service; those between the ages of 21 and 35 pay $35 a month; and children over 14 can be added for an extra $10 a month." In return, patients get "unlimited office visits, an annual physical and X-rays as needed." While the practice does not bill insurers, the doctors do "maintain relationships with some insurance-related companies so they can refer patients to specialists affiliated with those plans."
A New Trend?
Bliss and Karton established Seattle Medical Associates in response to changes in the health care system. Karton said "employers and insurers responsible for most health plans began viewing doctors as interchangeable." He said, "There was no reward at that point for better work or better patient satisfaction." The two doctors balked when a medical management firm suggested that they "increase their patient load." While Bliss and Karton enjoy their new practice, "consultants who worked with physician groups call the practice a rare success." Scheur Management Group's Ann Pietrick said "[o]thers have tried, but 'when they ran the numbers, it just wasn't feasible. It's just not feasible in any market I'm aware of to make it work without a wealthy population.'" However, Dr. Robert Elkins, CEO of Integrated Health Services Inc., "says some sort of pay-it-yourself medical care is an area he will explore if he starts another company." He said, "I think there is a huge market out there. We're going toward a two-tier medical system in a very dramatic way." The Journal notes that "personal physicians tapping into the middle and upper-middle class signals a significant change in the nation's health care climate" (Sharpe, 8/12).