medialifemagazine.com
Return of the family doctor, for a price
By Heidi Dawley
Jan 14, 2008 - 1:11:28 AM
Norman Rockwell thought so much of him that he drew him again and again through his long years as an illustrator famous for his iconic images of American life, and that he was, the family doctor.
He was there on the corner, or the next block over, his offices a convenient walk. He delivered children, gave them their shots as they grew up, patched busted limbs, attended to the dying. He may have been ill-schooled--so much of the science of medicine didn't exist 50 years ago--but he knew his patients and their families and what ailed them, giving the best advice he could from that knowledge.
Then he was gone.
A revolution in medicine came, and with it health plans and co-pays and HMOs, and with all of that assemblyline medicine. If it is the best in the world, as many argue, it's also the most expensive, and at its root there is a lingering dissatisfaction over the sense that something had been lost. That's individual care.
Now the family doctor is returning. It's an emerging approach to healthcare called variously concierge or boutique medicine, but in essence it's old-fashioned family doctoring.
For all the huge advances in medicine, especially in detecting illnesses at their earliest stages, a major flaw of assemblyline medicine is that it's build to treat illness once it sets in.
The aim of boutique medicine is to prevent illness, or better promote wellness, by reconnecting the patient with doctor who can read charts but also read his patients, truly knowing them, their histories, their family histories, and all the quirks of their bodies.
It works like this. A patient pays an annual fee, say $1,500, to sign up with a family doctor who has committed to taking on a set number of patients, 600 or so, no more, versus the 2,500 an HMO doctor might see.
The doctor provides the patient with a comprehensive annual exam but also a wellness plan. And the doctor is always in, so to speak. He's a phone call away, ready to dispense whatever advice the patient seeks. A patient can pop in without having to wait weeks for an appointment.
“In terms of what we do, it is reminiscent of 'Marcus Welby, M.D.' and 'The Donna Reed Show,'” says Dr. Bernard Kaminetsky, referring to early TV shows centered around family doctors. Kaminetsky was a co-founding physician of MDVIP, a concierge healthcare franchise founded in 2001, and one of a growing number around the country. MDVIP now has 200 doctors in the network and nearly 80,000 patients.
One key advantage, says Kaminetsky, is this new approach allows doctors to be doctors, where they can use their knowledge to prevent illness rather than reacting to it when it appears.
“The way this model came about was in response to the professional dissatisfaction of doctors who were seeing 30-plus people a day and rushing,” says Dr. Kaminetsky. That system left both patients and doctors dissatisfied.
But concierge medicine has its shortcomings, and they could well limit its growth.
For one it’s only family doctoring for those who can afford it. It does nothing to address the needs of millions of Americans who cannot. It creates a two-tiered system in which hypochondriacs get the best treatment for sniffles while folks with serious illnesses are left out in the cold.
Another criticism is that America already suffers from a shortage of general practitioners, and boutique practices, by limiting the size of participating doctors' patient rolls, will worsen that shortage.
Kaminetsky argues America already has a multi-tiered medical system. Some people have no insurance, some have Medicare, others a range of other insurance plans offering various levels of cover. Boutique medicine offers yet another option. That it's not for everyone is beside the point. It's rather how well it serves it patients.
As for worsening the shortage of GPs, Kaminetsky points out that if this new way of practicing were not available to doctors, some would simply stop practicing altogether.
But even if boutique medicine falls short of the ideal model for all Americans, it addresses the flaws in the existing system, and at a critical time, the coming elections, in which how to fix the county's ailing healthcare system is at the heart of some of the debate among candidates.
Meanwhile, elsewhere in popcult, the new comedy “The Bucket List” topped the box office over the weekend, bringing in $19.5 million. Another new comedy, “First Sunday,” debuted at No. 2 with $19.0 million in ticket sales.
In DVD rentals for the week ended Jan. 6, according to IMDb.com, the new release “War” debuted at No. 1, pushing last week’s No. 1, “Rush Hour 3,” to No. 2.
On iTunes this morning, Flo Rida’s “Low” was No. 1 for the ninth straight week, while Sara Bareilles’ “Love Song” remained No. 2.
And in books, Elizabeth Gilbert’s “Eat, Pray, Love” was No. 1 for the fifth week in a row on The New York Times’ paperback nonfiction bestsellers list for the week ended Jan. 5, and was again No. 1 on USA Today’s chart for the week ended Jan. 6.
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TOP MOVIES
Weekend Box Office Estimates
Weekend of Jan. 11-13, 2008
|
|
Rank
|
MOVIE
|
Engagements
|
Box office (millions)
|
|
1
|
The Bucket List (Warner Bros.)
|
2,911
|
$19.54
|
|
2
|
First Sunday (Sony)
|
2,213
|
$19.00
|
|
3
|
Juno (Fox Searchlight)
|
2,448
|
$14.00
|
|
4
|
National Treasure: Book of Secrets (
Buena Vista)
|
3,377
|
$11.48
|
|
5
|
Alvin
and the Chipmunks (Fox)
|
3,384
|
$9.10
|
|
6
|
I Am Legend (Warner Bros.)
|
3,353
|
$8.13
|
|
7
|
One Missed Call (Warner Bros.)
|
2,240
|
$6.13
|
|
8
|
P.S. I Love You (Warner Bros.)
|
2,323
|
$5.01
|
|
9
|
The Pirates Who Don't Do Anything: A VeggieTales Movie (Universal)
|
1,337
|
$4.42
|
|
10
|
Atonement (Focus Features)
|
950
|
$4.30
|
|
Source: Yahoo Movies
|
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IMDb TOP DVD RENTALS
Week ending January 6, 2008
|
|
Rank
|
TITLE
|
Last week
|
|
1
|
War
|
-
|
|
2
|
Rush Hour 3
|
1
|
|
3
|
The Kingdom
|
2
|
|
4
|
The Simpsons Movie
|
3
|
|
5
|
Resident Evil: Extinction
|
-
|
|
6
|
The Heartbreak Kid
|
5
|
|
7
|
The Bourne Ultimatum
|
4
|
|
8
|
Shoot ‘Em Up
|
-
|
|
9
|
Harry Potter and the Order of the
Phoenix
|
6
|
|
10
|
Stardust
|
7
|
|
Source: IMDB
|
|
ITUNES TOP 8 SONG DOWNLOADS
for week ended Wednesday, January 14, 2008
|
|
Rank
|
TITLE
|
|
1
|
Low, Flo Rida feat. T-Pain
|
|
2
|
Love Song, Sara Bareilles
|
|
3
|
Take You There, Sean Kingston
|
|
4
|
Paralyzer, Finger Eleven
|
|
5
|
Apologize, Timbaland
|
|
6
|
Clumsy, Fergie
|
|
7
|
No One, Alicia Keys
|
|
8
|
Kiss Kiss, Chris Brown feat. T-Pain
|
|
Source: iTunes
|
|
NEW YORK
TIMES BESTSELLING BOOKS
Week ending January 5, 2008
|
|
Fiction (hardback)
|
|
Rank
|
TITLE
|
Last week
|
Weeks on chart
|
|
1
|
A Thousand Splendid Suns by Khaled Hosseini
|
1
|
33
|
|
2
|
Double Cross
by James Patterson
|
2
|
8
|
|
3
|
The Shooters by W. E. B. Griffin
|
-
|
1
|
|
4
|
World Without End by Ken Follett
|
4
|
13
|
|
5
|
T is for Trespass by Sue Grafton
|
3
|
5
|
|
Nonfiction (hardback)
|
|
1
|
In Defense of Food by Michael Pollan
|
-
|
1
|
|
2
|
I Am America (And So Can You) by Stephen Colbert
|
1
|
13
|
|
3
|
Born Standing Up by Steve Martin
|
3
|
7
|
|
4
|
An Inconvenient Book by Glenn Beck and Kevin Balfe
|
2
|
7
|
|
5
|
Boom!
by Tom Brokaw
|
4
|
9
|
|
Fiction (paperback)
|
|
1
|
Iron Kissed by Patricia Briggs
|
-
|
2
|
|
2
|
Blood Brothers by Nora Roberts
|
1
|
7
|
|
3
|
I Am Legend by Richard Matheson
|
2
|
10
|
|
4
|
The Overlook by Michael Connelly
|
-
|
1
|
|
5
|
The Shape Shifter by Tony Hillerman
|
-
|
2
|
|
Nonfiction (paperback)
|
|
1
|
Eat, Pray, Love by Elizabeth Gilbert
|
1
|
50
|
|
2
|
The Innocent Man by John Grisham
|
2
|
7
|
|
3
|
Three Cups of Tea by Greg Mortenson and David Oliver Relin
|
3
|
49
|
|
4
|
Into the Wild by Jon Krakauer
|
4
|
137
|
|
5
|
Charlie Wilson’s War by George Crile
|
5
|
4
|
|
Source: New York Times
|
|
|
|
|
|
|
|
|
|
|
|
|
USA
TODAY BESTSELLING BOOKS
Week ending January 6, 2008
|
|
Rank
|
TITLE
|
Last week
|
|
1
|
Eat, Pray, Love by Elizabeth Gilbert
|
1
|
|
2
|
Atonement by Ian McEwan
|
3
|
|
3
|
The Pillars of Earth by Ken Follett
|
4
|
|
4
|
The Kite Runner by Khaled Hosseini
|
5
|
|
5
|
I Am Legend by Richard Matheson
|
11
|
|
6
|
Skinny Bitch by
Rory Freedman and Kim Barnouin
|
29
|
|
7
|
A Thousand Splendid Suns by Khaled Hosseini
|
8
|
|
8
|
The Innocent Man by John Grisham
|
-
|
|
9
|
You: Staying Young by Michael F. Roizen, Mehmet C. Oz
|
9
|
|
10
|
Three Cups of Tea by Greg Mortenson and David Oliver Relin
|
23
|
|
Source:
USA Today
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