Concierge Doctors Embrace Old School Values

Like poodle skirts and the Studebaker, the days when doctors made house calls seem like throwbacks to a different era. It’s hard to imagine in today’s fast-paced health care system that there was ever a time when you could call your own doctors for help after hours, expect that they’d oversee your treatment during a hospital stay or make personal visits.

However, while it seems like those days went the way of the transistor radio, they’re making a comeback with the increasing popularity of retainer-based medicine.

“Boutique” or “concierge” physicians, as they are often referred to, offer patients a more comprehensive relationship with their doctors — one that allows patients greater access and personalized care, including all those bygone services for a monthly or annual out-of-pocket fee.

Although the cost is roughly $2,000 to $3,000 a year, for Glastonbury resident and business owner Greg Castanza, it’s worth it.

Six years ago, after a routine doctor visit resulted in a physician’s assistant confusing him with another patient, Castanza, 55, realized that he wanted more from his provider, including greater accessibility and more personal attention.

“As you grow older, you think more about maintaining your health and having an expert to assist you. I wanted a point man; someone who could take all my information, have a knowledge base, and who could help make solid decisions for my health.”

But with more than 5,000 patients in his care, Castanza’s doctor was simply unable to provide that level of service, which can often be the case with many primary care practices — too many patients and not enough time.

It was then that Castanza made the decision to switch providers and began seeing Dr. Paul Guardino, a personalized care physician out of Farmington.

Guardino, who has been practicing retainer-based medicine for almost a decade, treats patients who seek a more hands-on, in-depth relationship with their provider. And by limiting his patient base to 300, he’s afforded both the time and means to foster those relationships.

“People come here for one-on-one care. They want access and time when they need it. Some of our patients liken it to having a physician in the family. If you had a brother who was a doctor, you’d call and get an immediate response, he’d help you find a specialist, he’d call the hospital and make sure everything is OK. That’s what we do.”

He not only serves as a primary care physician, he also acts as an advocate on patients’ behalf by arranging meetings with specialists, overseeing hospital treatment, navigating insurance issues, providing direct access to his cellphone and email, and, yes, even making house calls when necessary.

Almost unheard of in a traditional practice, his office sets aside three hours for physicals so that patients have the time they need to ask questions and talk about their concerns without feeling rushed. And long waits in antiseptic waiting rooms or time spent sitting in hospital gowns on cold, metal tables are nonexistent.

Instead, patients meet with Guardino in a warm, inviting office with leather couches, and no giant desk between them.

“We try to make it a comfortable atmosphere; we never have 20 people in the waiting room, and you’re not sitting in rows of chairs that line up against a wall. We sit down together and talk so that you’re not talking to someone while sitting on a 4-foot table; that’s a tough environment.”

In Stamford, Dr. Remi Rosenberg, a retainer-based physician with Fairfield County Personal Medicine, works in a similar practice. After working for many years as a primary care physician, he realized several years ago that with more than 3,000 patients, he was not practicing medicine the way he wanted to be.

“I wanted to turn back the clock to the way medicine used to be practiced, when your doctor knew you. The practice I’m in now allows me to take care of patients in the hospital, see them when they need to be seen, and take as much time as they need to figure out what’s wrong and get the proper treatment and referrals.”

Like Guardino, Rosenberg limits the number of patients he sees, which allows him to get to know them medically and personally, and to be available when they need him.

“Most people go to medical school to practice in this way. We want to establish relationships with patients, we follow people for years. They appreciate being able to get in touch with you when they need you, even if it’s just a simple question or concern.”

Patients who choose concierge health care run the gamut from elderly individuals who need assistance with numerous health issues to busy executives who can’t afford to lose time tracking down appointments and specialists.

And then there are patients like Greg Castanza, who want more from their health care than traditional medicine provides and are willing to make the financial investment.

“There are so many things we spend our money on,” Castanza said. “But we can’t enjoy any of them if we don’t have our health. It’s a matter of priorities, and I make it a priority.”

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