The newest of these boutique practices, Lerner/Cohen Health Care, will open Oct. 1. Dr. Brad Lerner, who is currently chief medical administrative officer at First Physicians, decided he did not want to continue seeing so many people.
“I did not like never having enough time to spend with a patient, al ways feeling that we were putting out fires, not having time to take care of prevention, wellness, health-related issues. I was never able to visit patients in nursing homes when they ended up there, and never had enough time to make house calls. The volume of a full-size practice prohibits those things.”
Lerner/Cohen will limit its practice to 300 patients per doctor. Lerner says, “That compares to a national average of almost 3,000 patients per doctor in a standard practice.”
There will be an annual fee for services: $2,800 to $4,800, based on a patient’s age, under 50, 50-64 and 65 and older. “The presumption is that older patients will require more care than younger ones,” says Lerner. “Our fee will cover everything we do for 12 months. There is no additional fee if we make a house call or see a patient in a nursing home. We will have a full-time dietician who is also experienced in physical therapy. Staff will take care of the patients instead of taking care of the paper work.”
Lerner emphasizes that the new practice is not a replacement for having insurance. Patients will still need insurance to cover tests ordered, consultations with other doctors and hospitalization, he says. The yearly fee will not be reimbursable by any insurance company.
Each kind of practice has advantages and disadvantages you will want to explore. What is right for you will depend on your personal requirements and your state of health. For instance, some people with chronic conditions, such as heart or kidney problems, prefer their primary care physician to be a specialist. The difficulty in doing that is if you have heart trouble and then come down with an intestinal infection, the specialist will have to refer you to a primary-care physician.