Physician says ‘McDonald’s model’ didn’t work for him
Dr. Tim Kruse isn’t afraid to admit that the conventional medical model of seeing 30 to 40 patients per day and about 3,000 per year made him sick.If he would have kept following what he labels “the McDonald’s model of medicine” he probably wouldn’t have remained a general practitioner. “It wasn’t my personality to be in that situation,” he said.So he decided to switch rather than conform.This year Kruse became a boutique, or concierge, physician – one of only about 300 practicing in the U.S. He established an office in Basalt called Premier Care and is concentrating on cutting the quantity of patients and boosting the quality of care he can offer.Rather than seeing 3,000 or so patients per year as he did at a Glenwood Springs clinic, Kruse is trying to build a practice of 300 patients in his new practice.Reducing the number of patients allows him to offer more of his time to each individual. Visits to his office are just that – a visit in a low-pressure situation. There’s no waiting room stuffed with people. There’s no pressure on Kruse to address the patient’s issue as quickly as possible and move along to the next person.In his old practice with Glenwood Medical, Kruse estimated he and every other doctor were “cranking out” patients every 7.5 to 10 minutes. Even though many doctors want to spend more time with patients, the system just isn’t set up to allow it, he said.The typical office allocates 10 minutes for a patient to talk about a cold. There isn’t the flexibility for an additional five minutes for an unscheduled chat about keeping blood pressure at a reasonable level.In addition to low-stress office visits, Kruse regularly communicates with patients by e-mail in his new practice. They are welcome to write him with questions or concerns about specific issues or general preventative medicine techniques. Kruse received traditional medical training at the University of Colorado Health Sciences Center, but he also works with patients on alternative medicine approaches to problems.Kruse also makes sure each patient has his cell phone number and the confidence to use it. There’s no need to “wade through” receptionists, nurses and voicemail, he said.The personalized services come at a price. He charges a monthly fee to offset the smaller number of patients and increased accessibility.The fee ranges from $1,200 to $3,600 annually for an individual, depending on which of two programs the patient selects, and $3,000 to $7,500 per year for a family of four.Kruse, like other doctors, works with numerous insurance plans and Medicare, but his fee isn’t covered.Nancy Allison and her family were pleased to have Kruse as their doctor at Glenwood Medical. They liked the personal attention he tried to provide in that setting. When he left to start his own practice, Allison said it was a “nightmare” dealing with other doctors. So, they decided to pay for his special service in Basalt.”His fee is expensive,” Allison said. “We really had to think about it. “We’re not a wealthy, wealthy family. We just decided this is a priority.”One episode soon after making the move made her grateful for the decision. Her son had a dirt biking accident in Grand Junction. A doctor and surgeon there were giving her conflicting advice.Allison called Kruse and reached him while he was on a bicycle ride. She explained the dilemma and he told her to sit tight. Within minutes he consulted with a surgeon he works with and called Allison back with advice to go ahead with the surgery.”For me it was worth $3,000 – that one phone call,” said Allison. “If I would have called the clinic in that situation, it would have been a joke.”Allison sees the concierge service as the wave of the future in the medical industry. Like education, she said, high-quality medical care is going to come at a price.A search on the Internet indicates there are only about 300 such physicians in the country. Nevertheless, it’s garnered a lot of attention. An AARP article noted that proponents tout the increased level of service. Critics raise an ethics issue of a physician basing the level of service on the ability to pay a fee.The AARP article also questioned whether concierge doctors really offer patients greater service.Firsthand experience makes the debate simple for Kruse. He wants to practice medicine in a way where he can build a relationship with patients. So far, 113 patients from Aspen to Silt have signed on, and he’s adding about 10 per month. That meets the goals of his business plan.Scott Condon’s e-mail address is firstname.lastname@example.org.
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