After all the furor, David Stutz's first week as a "concierge physician" was a quiet one.
by Jan Schlain
From the May, 2018 issue
"We're just ramping up slowly," says the U-M internist by phone. His first "Victors Care" clients were mainly patients who'd followed him from his former practice at the East Medical Campus. For $2,700 a year, they'll now get an extensive "executive physical," can schedule after-hours appointments, and reach him via phone, email, or text round the clock.
Though Stutz is now on call 24/7, the thirty-year veteran thinks that even when things speed up, he may end up putting in less overtime than he did in his last job. There he had more than 2,000 patients and, like many primary-care docs, often worked nights updating their electronic health records ("The Trouble with EHR," March 2017). At the Victors Care office in the Earhart Corporate Center, he'll have at most 500 patients--and he won't have to document every move for insurance companies, because his services aren't covered by insurance.
Kim Eagle, head of the U-M cardiovascular center, is coordinating specialty care for Stutz's patients. He was also the first patient to sign up. "I work long hours," he explains. "I travel a lot. I want this kind of access to my doctor." After an early-enrollment period ends in June, the cost will rise to $3,600 a year, but Eagle says he's "more than willing to pay $300 per month to be able to access my physician anywhere I am in the world."
As he describes it, Stutz is sort of like an old-fashioned solo practitioner. "With the high cost of organizing primary practices and providing all of the infrastructure needed to support them, it's hard for smaller, more tailored practices to survive," he says. Concierge medicine "is one way we sort of get back to that."
But only for those who can afford it. "We've tried very hard to price this in such a way that it's not ridiculous," Eagle says. Some patients he sees for cardiovascular care, he offers, "live in New York, and they
pay $10,000 a year for their concierge medical doctor. I have a couple of patients who live in Palm Beach. They pay $8,000 a year."
Against those benchmarks, Victors Care could be called a bargain--but it's expensive enough that more than 200 Michigan Medicine faculty signed a letter calling the program "elitist" and "exclusive." The doctors asked the health system to "stop recruiting our patients to this program and advertising it as providing much better care than all the rest of our primary care clinics."
Michigan's medical marketing often trades on affection for the U-M's sports teams. But in naming Victors Care, no one seems to have noticed that in sports, there are no win-wins. "Having introduced a two-tiered, upstairs/downstairs style healthcare system with the unveiling of so-called 'Victors Care,' perhaps you should likewise name the level of care provided to those lacking the big bucks," patient Aviva Nobel commented tartly on a Michigan Medicine online portal. "May I humbly suggest that to the impecunious and undeserving masses, you offer 'Vanquished Care.'"
Eagle stresses that when Stutz's patients need care elsewhere in the Michigan Medicine system, they'll be treated the same as everyone else. "Access to hospital beds is based on medical need," he emails, "not whether a patient has Victors Care or more traditional primary care." And he says that Victors Care patients won't bump other patients from existing waiting lists--"that's not going to happen with this practice."
Eagle describes Victors Care as just "another primary care service. It's not meant to displace anything else. And quite honestly, the numbers that are served are really quite small compared to the number of primary care patients that are seen in the health system." A second physician will start in July, and if enrollment takes off a third is possible--but even then Victors Care would have fewer patients than Stutz alone saw at his former practice.
What about the patients who couldn't afford to follow him? Stutz says his former group hired a new physician even before he left, and "many of the patients were transferred to her."
[Originally published in May, 2018.]
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