If there’s one thing concierge pediatricians know how to do (besides spend a whole lot of extra time with your little ones), it’s to sell you on their practice — particularly when they answer their cell phones within three rings.
Ed Kulich is one such doctor. Based in New York City, he operates solely on a house call basis. His service has none of the tensions typical of a doctor’s office visit. “If you’ve ever taken a kid, or a couple of kids, to a doctor’s office, it’s an awful experience. I know, I used to have an office,” he tells The Financialist. “There’s at least an hour wait, and imagine that with a sick cranky kid. Whenever they have a question, my patients just call me, and I’m going to answer them.”
The Ideal Practice Environment
A growing number of parents are signing up their children for the sort of pediatrics run by Dr. Kulich. They pay, almost always out of pocket, for a highly personal service that’s well-equipped to track any and all aspects of their children’s health, 24 hours a day.
Eric L. Weiss, the founder and director of retainer-based practice The Village Doctor in Woodside, California, has two pediatricians on staff. The doctors are each limited to seeing 200 patients, which is 10% or even less than a traditional practice. Patients pay around $295 per month with no added costs for visits. House calls are not the norm, but offered as needed. Members can come in as often as they want and are encouraged to call with questions to help manage their care.
For Dr. Weiss, his own young children were the impetus to launch a concierge pediatric service in 2004. “I wanted to create the ideal practice environment, one where I wanted to bring myself and my own family.” He says one of the secrets to a successful boutique practice is to remain relatively small. “When you feel like you’re too busy, you’re done. You need to cap your practice,” he says.
For this category of physicians, the service really is all about, well, the service. Concierge pediatricians spend a substantial amount of time with their patients. “I catch things others don’t — things I couldn’t catch in an office, because I wouldn’t have the time to spend with someone,” Dr. Kulich says. “Now I have time to get comfortable with the kid and do an effective lung exam.”
One mother, who agreed to speak to The Financialist on the condition of anonymity, feels that moving to concierge pediatrics has possibly helped alleviate the need for regular doctor’s visits. “I don’t know if my daughter’s just grown out of it, but we definitely, without question, see the doctor less.” She sought out a retainer-based pediatrician after a severe bout of illness when her daughter was two. Her calls to her traditional pediatrician — with around 10,000 kids in his practice — “were blown off.” She was told she was being overly concerned.
The sickness came to a head when her daughter had a febrile seizure in the lobby of their building on Manhattan’s Upper East Side. After the medical crisis, a neighbor pointed her in the direction of Dr. Seth Gordon. Her daughter is now eight and her mother could not be happier with the physician: “He’s amazing, my daughter likes him, he gets to you within hours, in your home, and he has admitting privileges.” She and her husband find they almost never need more than one wellness visit per year. Sometimes, the doctor gives the whole family flu shots.
Cheaper Than Filling Your Car
Given the rising costs of medical care, should this level of service even be considered that extravagant? Dr. Kulich points out that he’s “cheaper than a pack a day habit or your Exxon bill for the year.” While none of the three physicians argued that what they offer is inexpensive, all three spoke more than convincingly to the issue of relative cost and value. Dr. Seitz’s practice costs $2,000 per year (billed quarterly) and an individual home visit is $300. Yes, he has celebrities in his service, but also people of lesser means, and he believes they would leave the practice if he raised prices. According to Dr. Kulich, “some people think it’s a bargain — why spend three hours going to an office, when you can get it done at home in just 45 minutes?”
Both Dr. Weiss and Dr. Seitz are reluctant to use the term “boutique medicine” to describe what they offer, noting that it implies a level of exclusivity that doesn’t reflect some of their patients’ socioeconomic profiles. Dr. Weiss points out that while concierge physicians “started with people charging more, trying to make it work, now it’s about trying to make care work. There’s a huge spectrum.”
A final anecdote from Dr. Weiss is perhaps the best testament to the practice of on-call pediatrics: “I knew that this was working when kids would bike by on their way to school, and they would stop in just to say hello.”