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Bonita & Estero Magazine

Concierge Medicine - A Fresh Approach To Restoring And Building Your Doctor-patient Relationship

In the last few years, news stories about medical practice in America have been very confusing. Regardless of where you fall on the political spectrum, there can be little argument that the changes of the Affordable Healthcare Act, and now the changes to those changes, have left all of us with more questions than answers regarding the future face of medical practice in the United States.

David L. West, M.D.; Andy Oakes-Lottridge, M.D., F.A.A.F.P.; Gary M. Price, M.D. , F.A.C.P.

As a doctor who sees patients, I’ve seen our reimbursement system incentivize—indeed, force―doctors to see more and more patients each day to remain solvent. To see more patients, doctors have to work faster and reduce the duration of visits, which now average a mere seven minutes each.

The average American primary care doctor serves about 3,000-4,000 patients. Since quantity and quality are incompatible in a medical primary care practice, this increase in volume has resulted in a predictable decrease in quality, with a similar decrease in satisfaction for both patients and doctors. While I don’t have a solution for all—or I’d be running for political office —my partners and I have found a solution for our own patients.

In the late 1990s, a new movement was born simultaneously in Fort Myers and in Seattle, Washington. Creative physicians―including my partner, Dr. Gary Price―dissatisfied with the status quo, opted out of the insurance-based medical system to invent a better way of serving their patients. They reduced their patient panel size to a few hundred instead of a few thousand, increased the length of visits to 30-90 minutes and established direct financial relationships with their patients to eliminate conflicts of interest and to re-empower patients. This movement came to be known as “concierge practice” and is sometimes also known as “direct medicine,” “private practice,” or “boutique medicine.”

In just 20 years this movement has grown from a couple of outlying practices in opposite corners of the country to thousands of mainstream ones throughout the land. Today, even medical schools are including “direct medicine” in their curricula, giving medical students an alternative pathway to a career in primary care.

As the momentum continues to build, what accounts for the growth? It’s simple: For many patients, concierge medicine is a better model.

Concierge medicine restores the doctor-patient relationship to the lofty level it enjoyed before being constrained and degraded by government and insurance. Concierge physicians work only for their patients. We don’t receive payments from insurance companies, the government or the pharmaceutical industry. We give uncompromising care in an unhurried and respectful setting because we care, and we have no conflicts of interest.

In short, we work only for the patient.

Imagine being able to reach your doctor at any time if you have a question, or being able to schedule an office visit today, if you need it. How about a house call if you are unable to go to the office? Imagine having your doctor guide your care through the complex maze of specialists and hospitalists, selecting only what is the best for you, with no compromises or excuses. That is the world of private (concierge) medicine. Marcus Welby, M.D., is alive and well!

Since we emphasize prevention and have time for proactive care, our patients enjoy much lower rates of hospitalization and emergency room utilization, which saves the system money—a lot of money. Our product is good health and healthy people.

While concierge medicine may not be a better model for everyone, it has allowed my partners and me to practice the kind of medicine we always dreamed of―having the time to truly treat patients as we would want to be treated. It restores the doctor-patient relationship.

So, while the prognosis for healthcare in America is currently still up in the air, the prognosis for our patients continues to be excellent. Thanks to the private medicine model, outstanding healthcare will continue to be available and the future looks bright for our patients.

Andy Oakes-Lottridge, M.D., F.A.A.F.P., is a practicing physician with Private Physicians of Southwest Florida, with offices in Fort Myers, Bonita Springs and Sanibel. Visit him at