ST. LOUIS (KMOV.com) - Some local patients are learning their doctor will soon start charging a membership fee and they're faced with the choice: pay thousands of dollars out of pocket or find another doctor.

It's a model that's gaining traction all around the country. So, will your doctor be next? Recently, Marlene Nolan received a letter from her primary care doctor, whom she had been seeing for quite a while, announcing a switch over to a Concierge Medical Practice. It’s basically a membership, with additional out of pocket fees direct to the doctor’s office, often on top of insurance and co-pays.

“It’s $1500 so I can call her my doctor,” said Nolan. Nolan, who is relatively healthy and on a fixed-income, was livid.

“You do want the best care you possible can afford, but who can afford this?” she said. “This isn't Sam's Club. It’s my doctor, it's my medical care.” 

The doctor's marketing materials list a number of perks: same day appointments, little or no waiting to be seen and longer, unhurried medical visits, but Nolan wasn't impressed.

“When you really look at it, you are getting the same stuff that you should be getting from a physician anyway. There are no additional perks to this. all the perks are on her end,” she said.

And she had no choice. She has to pay up or no longer be a patient.

“This is so wrong on so many levels, for so many people,” said Nolan.

She says it's just a way for doctors to make more money.

‘It’s greed at our expense,” she said. “I am afraid for other people, because you are disenfranchising all the other people, all the older people, all the lower income people”

It turns out, Nolan isn’t alone. A quick Google search reveals a number of St. Louis-area doctors are now offering concierge service.

“It’s definitely not going to be the wave of future, it’s a niche market for folks who need it,” said Dr. Doug Pogue.

Dr. Pogue is head of the BJC medical group, which Nolan’s doctor is not a part of. He says only 500 of their 600,000 patients are currently on a concierge model. He says, it can be beneficial for a select few.

“Some patients this will make sense and in other patients, it really won't, so that's the beauty of it, patients can choose what they need and the amount of medical care they would like to have,” Dr. Pogue said.

He says a relatively healthy person in their 30's might not need much of a doctor's time, compared to someone older with chronic illnesses. He says concierge allows for a personalized, in-depth approach to long-term health. More on-one time with your doctor, which can actually save a patient money in the long run.

“Concierge doctors take only about 500 patients into their panel, that’s about 15 percent of what a normal physician would carry in a normal medical practice,” he said. Having fewer patients just isn't sustainable under a traditional business model, Pogue says.

“The problem is economics. the overhead in a primary care practice is about 70% or so, so by the time someone cuts their practice by even 30% they are not making money at all,” said Dr. Pogue. He says it's not just about the bottom line.

“Concierge physicians generally make a little bit more than the average primary care physician will, but its not a lot more,” Dr. Pogue said.

He stresses that most doctors in BJC and across the region won't offer concierge services.

“We definitely see that the traditional models we have now, will be the model going forward, but there are different niche models for specific patients, and this will be in the mix,” said Dr. Pogue.

Dr. Secil Schodroski's practice offers a combo of concierge and traditional billing.

“They get that 24/7. 365 care, holiday time and evenings, whereas they would have to go an urgent care or ER,” said Dr. Schodroski.

The patients choosing concierge, she says, often are higher income.

“We have a lot of professionals, business owners, a lot of politicians and St. Louis celebrities, ball players, they just want to be more private,” she said.

She says it is frustrating dealing with the paperwork and waiting with insurance, wanting to have enough time with each patient.

“You don't want them to feel like a number or like they are on an assembly line approach. I just think we should have more time with each person.

But she says she would never go to a full concierge business, knowing many patients just can't afford it.

“There is no way I could cut anyone out, I would never do that. they need me and I need them, I love them,” said Dr. Schodroski. Feeling for Marlene, she is offering her services, instead.

“Can still see them here, if they want to come to the Health and Wellness Center come right ahead, we will be happy to help you,” Dr. Schodroski said.

News 4 reached out to Marlene's current doctor, who declined an on-camera interview, but in a statement said the change was made after careful and thoughtful consideration.

The statement reads: "Most important is the time we have to further develop the essential physician-patient relationship and care for patients in a holistic, proactive way."

Copyright 2021 KMOV (Meredith Corporation). All rights reserved

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