Longtime Rochester doctor now devoted to seeing patients through Personal Medicine of Rochester
By Chris Motola
Q: How long have you been doing concierge medicine?
A: I took over the practice in June.
Q: Was it a long ambition of yours to get into this model of medicine or did the opportunity just arise?
A: I wouldn’t say it was an ambition. For a long time I was in private practice and then I was in employed in a practice doing exactly what I’m doing now: primary care medicine. I didn’t really think about doing concierge medicine until things got a little more difficult. Shorter visits and longer patient rosters made it very difficult for doctors to do medicine the way we wanted to. And then this opportunity came up. The practice is affiliated with the Jewish Home. They continuously look for ways to provide programs and services to the people they serve and an opportunity presented itself to acquire an existing practice. And then they were looking for a primary care doctor like me. And that’s how I got here.
Q: Is the focus on treating older adults?
A: It’s not. We take patients from age 18 up, which is what I’ve always done. We have some patients in their 20s. Most people are older, but by no means do we exclude anyone by age, except for pediatric-aged patients.
Q: From the practitioner’s perspective, what are the advantages of concierge medicine?
A: There’s a lot of overlap in advantages for both the doctor and the patient. It’s no fun going into work knowing that you have 20 patients on your schedule and then have to squeeze five more in that day. Switching over to concierge gives you the ability to get patients in quickly the same day or the next day and have the time to actually see them, get to know them and make sure they’re heard. So you don’t have the physician with a hand on the door handle ready to leave when the patient still has three more questions. That happens a lot in today’s medical practices. You have situations where physicians tell patients they can hear one complaint today, but if you have others they need to schedule another appointment. That happens over and over.
Q: And from the patients’ point of view?
A: From the patient’s point of view they get the time to spill out whatever they need to talk about. They get my full attention and get to see me rather than a nurse practitioner or a PA. From my perspective, I never feel like I’m being rushed. The feeling of being scheduled is a terrible feeling. When you’re feeling that all day, every day it leads to burnout. [Now] I have time to look things up, go through the patients’ record while I’m with them and know everything about them. And I can consult with textbooks and other doctors, not in real time, but I have the time to do it.
Q: I understand you have a fairly involved initial intake process.
A: It’s usually an hour-and-a-half to two-hour wellness assessment. I’ll spend that time getting your whole history and nutrition. We give patients a physical therapy screening. Compare that to the 30-minute physicals most offices can offer at most. That isn’t nearly enough time.
Q: As far as payments go, how does the system work? Is it all cash transactions?
A: There’s a membership fee. Our practice charges an annual fee that includes a variety of benefits, including a more robust physical, screenings and a wellness plan. But we charge customary things to insurance, so there are co-pays for visits and whatnot. That’s the traditional concierge system. There are some other models out there. Some doctors don’t want to mess with insurance companies at all, so they may charge a little more.
Q: Is it just you at this practice, physician-wise?
A: I have a partner, Dr. Jim Budd. He’s been in practice even longer than I have. He finished his residency in the early ‘80s. I finished mine in ‘91. So he’s here with me. We also have support staff, an RN, several medtechs. That’s who is in the office.
Q: It seems like it’s largely older physicians moving to the concierge model. Do you have any advice for young physicians who want to investigate it? Should they pay their dues in the hospital system first? Can you jump into it right after residency?
A: You can, but it might be a little risky to do it before you have any kind of reputation. The advantage older doctors have is that our patients know us, and we’re known by the community, by specialists. So we can get referrals more easily. Younger doctors need to be careful of the things they say in the hospitals because many of their contracts come with a clause that locks them in and prevents them for starting another practice in the community if they want to.
Q: Without violating patient confidentiality, can you give me an example of a time that the extra time you get to spend with patients made a critical difference?
A: Oh, it happens every day. I saw a woman for the first time as a house call, which we also offer. She was in her late 60s and housebound. At the end of the visit she said, “This was unique experience. No one has spent this much time with me and understood what’s going on with me like you have.” This is a patient with complex medical issues. I was with her for about an hour and a half. It’s something I can do because of the nature of our practice. She’s getting much better since I’ve started taking care of her.
Lifelines
Name: Mitchell Ehrenberg, M.D.
Position: Physician at Personal Medicine of Rochester, affiliated with Jewish Home
Hometown: Brooklyn
Education: NYU Medical School
Affiliations: Rochester Regional Health
Organizations: American College of Physicians
Family: Wife, two children
Hobbies: Biking, hiking, woodworking, antique hunting