After almost 30 years at Oyster Point Family Practice in Newport News, board-certified family practitioner J. Drew O'Neal knows what's important to him and his patients.
"Time is what matters. Doctors don't have the time to do what they want. They have eight to 10 minutes a visit, 15 at the most," he said. He knows many physicians who've burned out, many others who want to get out of the practice of medicine.
So, starting Tuesday, O'Neal will be in the same physical location in Oyster Point, sharing overhead with the same physicians, but he will be affiliated with MDVIP, a national organization started in 2000 in Florida by two family practitioners.
In its model, used by 40 doctors in Virginia and 800 nationwide, patients pay an upfront annual fee of around $1,600 for access to a doctor 24/7; the access also includes longer appointments, more intensive screenings, and an emphasis on a personal medical plan and health and wellness, according to company spokesman Chris Lillich.
O'Neal, 59, who has battled his own health issues stemming from an accident nine years ago that shattered his foot and led to an amputation three years ago, believes that MDVIP's restriction on patient load to 600 — at one time he was seeing as many as 3,000 —- will allow him to not only improve the care he delivers, but also extend his time in practice another decade. He contends it will be revenue-neutral for him, though much of the upfront fee goes to pay for an in-depth 90-minute annual physical.
"The smaller numbers will allow me to do the job I want to do for these folks. I want to promote health, work with a patient for a period of years to avoid that first stroke or heart attack," he said, adding that it's still a lot of patients.
Indeed, Susan Ring, 61, an internal medicine doctor in Virginia Beach who made the transition to MDVIP three years ago, maintains a patient census somewhere below 600. "Where I am today is where I want to be. It gives me time to do what's best for the patient. The biggest advantage is for the patient," she said. She blamed herself for still working longer hours than her ideal. However, she's now able to take the time to make house calls and provide care to those who otherwise wouldn't receive it.
Exercise programs outside the office, walking groups — even shopping and label-reading with patients — are typical of the additional personal services that MDVIP doctors provide, said Lillich. Other benefits include a travel reciprocity program and a family plan that includes patients' children as a courtesy. Patients are guaranteed 24/7 access to their physician and next-day appointments. "With today's electronics that's not a problem. Many times I can solve it over the phone," said Ring.
MDVIP physicians are not necessarily solo practitioners. Some are in large group practices and others are hospital-owned, so they run the gamut, said Lillich. Most have been in practice for more than a decade, and the company has a 92 percent retention rate, he said. Ring enjoys the support the company gives for the business side of the practice, including with paperwork, electronic health records, and compliance with Medicare rules, which free her up to spend time with patients.
MDVIP publicist Nancy Udell cited seven studies supporting the benefits of the program in lower rates of hospitalization, lower readmission rates and higher compliance for recommended preventive care. Approximately 50 percent of patients are Medicare-eligible, age 65 and older. "A good percentage is managing chronic illnesses. The physician is the quarterback of their care," said Lillich, calling it an affordable option for about $135 a month. "It's a choice a lot of people can make; it's affordable for people who want to prioritize their health."
O'Neal said the patients who have followed him into the new model represent all walks of life, not just those of means. However, some have balked at the $1,600 annual fee. Newport News resident Brian Hanna, 55, anticipating college costs for his daughter, is reluctantly looking for a new doctor. "A lot of people are getting dumped," he said, while conceding that O'Neal is "doing the right thing for him and his practice. I don't blame him personally — he has got a family too. I think it's a business decision and his patients are probably going to benefit from it."
After initial skepticism, Kim Lewis of Yorktown decided that the benefits would be worth the additional cost. The 55-year-old, who has been going to O'Neal for two decades and is also a Quest Diagnostics lab services vendor for the Oyster Point practice, first talked her new mother-in-law into signing up. "I didn't think I needed the extra attention," she said, describing herself as pretty healthy but wanting to lose weight. After learning more about the services offered, Lewis did a rapid turnabout.
"It's going to improve my health. I'll get things done that I wouldn't if I had to go to different places or if I had to wait," she said. "No one knows me like Dr. O'Neal."
Those are the relationships that O'Neal hopes to nurture. "They've been eroding. That therapeutic relationship between patient and doctor is slipping away. … It's exciting to have the time to listen and explain so they can understand. As a patient myself, I have that perspective," he said.
Salasky can be reached by phone at 757-247-4784.
What is MDVIP
A national organization that has 800 doctor-members nationwide serving 230,000 patients with primary care. Patients pay a $1,600 to $1,800 annual fee (depending on location) to the physician for greater access and more personalized attention.
MDVIP takes care of marketing, legal, regulatory and insurance matters for the physicians; it limits their patient census to 600, compared to an average of more than 2,000.
The model is compatible with Medicare and most private insurance plans; it places an emphasis on prevention and wellness through personalized medical plans. Other benefits include access to other MDVIP physicians when traveling and referrals to specialists from the Medical Centers of Excellence network that includes the Cleveland Clinic, Johns Hopkins, the Mayo Clinic and MD Anderson.
For information, call 1-866-948-6357 or go to http://www.mdvip.com.