The boutique doctor is in: Economic pressures prompt move to concierge-style practice.

• Author: Schwab, Robert
• Position: Attitude at Altitude - Editorial

Dr. James Benoist, at 44, is old enough to know physicians once did house calls, but he isn't old enough to remember a doctor ever coming to his own home.

In fact, when Benoist decided to cut down his private practice from 5,000 patients to about 300 and serve the smaller number as a "concierge physician," he was at first a little leery of making medical calls in the homes of his patients.

"At first I thought it would be awkward," Benoist said. "Trying to provide medical care in a person's home, making sure you have everything you need when you're used to having your office stocked. You're out of your comfort zone.

"But it has been anything but that," he said, two years into his experiment.

"It's been very, very pleasant; it's been warm, and everybody's been very comfortable having me in their home."

Benoist is one of just a few doctors in Colorado who have adopted a "concierge" or "boutique" style practice, intended to increase the time a physician has to spend with each of his or her patients, at an annual fee that can range from $1,500 to $5,000.

The doctors who have converted to such practices say it sidesteps the "cattle-call" style of medicine that some doctors say health-insurance companies and Medicare forces upon doctors' offices--which are businesses--in order to make a profit.

Benoist said his former patients who did not want to or could not afford to stick with him after he instituted his fee-for-service policy generally understood the economic pressures he faced. He said a few did complain of being discriminated against and he said he got some local press that was written from the perspective that creating a "boutique" had a naturally detrimental effect on poorer patients.

But he said the new business model has been a huge success in his mind.

"The patients absolutely love it, and I like it a lot better, too. I'm able to spend a lot of time with each individual patient. I go to specialist visits with them. I do house calls, which is a lot of fun, that I never even realized it could be."

"Concierge"...