August 5, 2008

Froedtert Physician to Open Concierge Medical Practice in Mequon

By Kathleen Gallagher, Milwaukee Journal Sentinel

Aug. 5--An area doctor is planning to open a "concierge" medical office -- a practice in which doctors agree to see a limited number of patients -- in Mequon with help from an Arizona start-up that has strong Wisconsin connections.

Mark W. Niedfeldt, an associate professor at the Medical College of Wisconsin who is on the staff at Froedtert and several other area hospitals, plans to open the Port Washington Road office on Oct. 1.

Executives at Scottsdale-based ModernMed Inc. said they believed Niedfeldt's practice would be the first primary care "concierge medicine" practice in the state of Wisconsin.

Concierge medicine patients pay a fixed yearly fee to get relationships with doctors who commit to having a dramatically smaller patient load. That means they have more time for longer appointments that patients can schedule on short notice. Concierge doctors also typically provide patients with their cell phone numbers and e-mail addresses, and even agree to make house calls.

Health care industry experts said the practices were often good for the patients and the doctors, but controversial amid a shortage of primary care doctors because they don't represent a solution that could work across the entire population.

"If every primary care doctor in America goes down from a couple thousand patients to 500, where do the rest of the patients go? That's basically the conundrum here," said Matthew Holt, a San Francisco-based health care industry consultant and founder of The Health Care Blog.

ModernMed recruited Niedfeldt to become one of its affiliated practices. In exchange for 30% of his yearly patient fees, the company will help him recruit patients and build out an office, and provide infrastructure for functions such as billing, electronic medical records, practice management and communications, said Jeff Rusinow, the company's chairman and lead investor.

Rusinow, a former Kohl's Corp. executive, was the driver behind, which was sold to Liberty Media for $60 million in 2006.

ModernMed was founded in March 2007 by Jami Doucette, a Milwaukee native who now lives in Arizona. It has raised nearly $2 million from investors, Rusinow said.

The company will have six practices with Niedfeldt's and is in discussions with several hundred more physicians in 20 states, Doucette said.

500 patients yearly

ModernMed requires its doctors to commit to having no more than 500 patients a year, far fewer than the average of 2,300 a typical family doctor sees in a year, said Doucette, the company's president and chief executive officer.

"Our practices have a quality-based incentive. The incentive is no longer to see as many patients as possible; the incentive is excellent care and phenomenal service to patients so they sign up again next year," Doucette said.

The yearly fee patients pay can be as low as $100 and as high as $20,000, although most range from $1,500 to $3,000. Niedfeldt's fee will be in that range, Doucette said.

The economics of the smaller patient loads work because of the yearly fees patients pay, Holt said. Say a concierge practice pulls in $1 million a year from 500 patients who pay $2,000 each. If the doctor gets $700,000 after a 30% fee, that's probably about equal to what he would have billed for a couple of thousand patients, he said.

Niedfeldt's practice will take the patients' yearly out-of-pocket fees and continue to bill insurance or Medicare, Doucette said. It will also accept a certain number of patients for whom the yearly fee is waived, he said.

Niedfeldt will continue to teach anatomy classes in a part-time job at the Medical College and provide physician staffing at the school's sports medicine clinic at the University of Wisconsin-Milwaukee and at Wisconsin Lutheran College's student health clinic, which the Medical College staffs, said Richard Katschke, a college spokesman.

Thompson on franchiser board

Florida-based MDVIP, founded in 2000, is the oldest and biggest concierge medicine franchiser. It has no practices in Wisconsin but has several in Illinois, according to its Web site.

Former Wisconsin Gov. Tommy G. Thompson is on MDVIP's board of directors.

MDVIP said it has more than 230 affiliated physicians.

Holt estimated that only 5,000 to 10,000 primary care doctors have gone the concierge medicine route. Niedfeldt said he was willing to join that group because of the frustration involved in seeing large numbers of patients for short amounts of time.

"When you talk to patients and physicians who participate in this model, everybody's happy," Niedfeldt said.


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