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Different Doctors---changing how you get your health care

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Photo: Video by kgun9.com

Different Doctors---changing how you get your health care

CREATED Feb 28, 2012

Reporter: Craig Smith

TUCSON (KGUN9-TV) - Middle aged moms of the future might be heard bragging about "Their son…The hospitalist."
   
What the heck is that?
   
It's one example of how doctors are changing with the times.

At Tucson Medical Center, Doctor Guruprasad Raju is making his rounds and checking his patients.

He leans over Rosalind Raffe and asks, "Can I listen to your heart and lungs?"
     
Doctor Raju is not seeing patients he's been treating in an office for years.  He doesn't meet his patients until they are hospitalized.
      
Doctor Raju is a different type of doctor.  He's a hospitalist---a doctor who stays in a hospital and takes over your care from your regular physician.  The term hospitalist was invented only sixteen years ago. Now there are an estimated 30 thousand hospitalists throughout North America.
      
Your family doctor might still visit you in the hospital, but Doctor Raju says that's hard to do with a busy office practice.

"They would come at five o'clock in the morning, make their rounds, then go and come back at seven o'clock.  But someone like me as a hospitalist, I'm here from morning to evening."
      
Hospitalists say their advantage is being able to be at your bedside in a matter of moments.

KGUN9 Reporter Craig Smith asked Doctor Raju: "You're right here and handy but you may not necessarily have the mental records that a doctor would have who's been seeing somebody for five or ten or fifteen years.  How do you compensate for that?"

Doctor Raju: "That's a very good question.  A lot of the times we, most of the primary care physicians here in town that we work with, we partner with them and they send us the records that are pertinent and what we need."
     
Rosalind Raffe does wish her regular doctor would visit.

"I'd rather have him, because he knows me so well; but I don't.  They don't do that anymore."

Craig Smith asked her: "But do you feel you're still well served by what's happening here?" 

Rosalind Raffe: Yes, I do."       

Doctor Steven Wool is another example of a different type of doctor.
       
Patients pay him a 15 hundred dollar retainer each year.  He says the fee means fewer patients are required to keep his office in business; so he can be on call 24 hours a day, and offer longer appointments.

Doctor Wool says, "Now the average appointment is laid out to be a half an hour at least and the physical exams are anywhere from an hour to an hour and a half."
       
Doctors who charge an annual fee are often called concierge doctors.  Some of them charge five thousand a year or even more.  Doctor Wool is careful to keep fees lower and call himself a retained physician, not a concierge doctor.

Doctor Wool says, "Concierge has a sense of...bias...a sense of....

Craig Smith suggested:"Elitist?" 

Dr. Wool: "Elitist approach to it and that's not what this is about."

Doctor Wool compares his retainer to the yearly cost of daily dose of fancy coffee; and says it gives patients the freedom to enhance their medical care beyond what insurance may dictate.
      
He maintains a gym and brings in exercise and nutrition specialists as part of the preventive medicine he encourages patients to embrace.

Retained physicians like Doctor Wool are still fairly rare.  A government study in 2010 said there were about 750 nationwide with only about 30 in Arizona.

Doctor Wool says, "There's lots of data and information out there that if patients had greater access to their primary care physician it would indicate that they wouldn't require referrals to emergency rooms as often.  Many diseases may be managed better because they have better access, particularly when changes occur and typically you'll prevent more complications of illnesses that won't have to wait to be seen."

And Doctor Wool says when patients pay a little more for their medical advice, they're more likely to give it more value and pay attention.

"I've had unfortunate situations where patients waited a year or two to get a physical exam and a problem developed.  If they had paid extra for their quote---retainer physician or concierge physician, guess what, they probably would have come in a lot sooner to take advantage of what they paid for."