Remember the good ol' days? Used to be when you got the sniffles, you just picked up the phone and not too much later there would be a knock on your door. Is that Avon calling? No...its your family doctor, on your doorstep, ready to take care of your sniffles.

With the advent of HMOs and managed care plans, the days of good ol' fashioned house calls are gone for good...or are they? Well, not necessarily, at least not for the ‘well-to-do'. You see, house calls are making a come back, but with a twist. ‘Concierge medicine', also referred to as ‘retainer' or ‘boutique medicine', puts a new spin on an old idea. The idea is simple; the patient pays a retainer fee of anywhere from $1000 to $20000 a year, much like a lawyer would charge. In exchange for this fee, the doctor makes themselves available for your healthcare needs. Practices vary, but in some cases, these fees may be applied to medical expenses you may incur during the year.

One of the advantages of concierge medicine is the emphasis on the doctor-patient relationship. Today, the average office visit in a doctor's office is eight to eighteen minutes. Limited time with the doctor is an unfortunate side effect of an HMO-dominated society. Doctors must scramble to see the 2000 to 4000 patients they must see each year. With concierge medicine, the average visit is approximately 1 to 2 hours.

One can argue that the added time spent with patients allows for a focus not only on the acute illness at hand, but also on preventative care. Prevention is key to preventing further illness, increasing quality of life and decreasing overall medical costs. Unfortunately, most current health care models seem to be lacking preventative care provisions.

 Further, many doctors would argue that not only do they feel like insurance companies are telling them how to practice, they are also frustrated by the limited time they are able to spend with patients. The most valuable information available to a doctor is that which is learned from interviewing a patient. The patient-doctor relationship is a sacred relationship, one that many feel has been compromised by modern medicine.

Patients who sign up for concierge medicine enjoy many perks including 24/7 access to the doctor, no visit wait times and same or next day appointments.  Patients also enjoy many of the amenities of traditional medicine such as immunizations and annual exams. They may also enjoy some not-so-traditional amenities such spa settings and facilitated access to hospitals and specialists.   

One such doctor who has made the switch from practicing traditionally to practicing the ‘concierge way' is Dr. Connie Mariano. A former physician to Presidents George Bush Sr., George Bush Jr., and Bill Clinton, she now practices concierge medicine in Scottsdale, Arizona.

So how can the rest of us get the VIP treatment when it comes to our health care? Well, for starters, we must be proactive in our health care, empower ourselves with knowledge and take an active part in our health care decisions. As health care consumers, we must demand nothing short of ‘excellent care'. Everyone deserves access to quality medical care. It is up to us to make sure we get it.