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Home Health Care: Concierge medicine comes to Door County

After longtime Washington Island resident Helene Meyer was involved in a horrific car accident last year she started to discover just how difficult accessing a general practitioner could be to talk with and ask questions about her medical concerns.

It was about this same time that she learned about Dr. John Kiser’s concierge medical practice. He and his wife Barbara Kiser, a registered nurse, visited the island to participate in a discussion about the concierge medicine model and how it would work.

“For $1,000 per year I would have access to Dr. Kiser to ask questions and he would make home visits to the island,” Meyer said. “Of course, if additional medical tests were needed he’d call those in and I would go to the mainland for the tests. But he would get the results, often in 24 hours, and call me and we’d discuss them together. I felt this type of personalized care helped me recover faster. And the $1,000 annual fee is more than worth it. I’ve spent more going to the clinic.”

Concierge medicine is also known as retainer medicine, cash-only practice, direct care and membership medicine. It is a medical model of personalized care based on patients paying a physician a fixed annual fee and in return having access to the doctor via home visits, emails and telephone virtually 24 hours a day. It’s not meant to replace insurance but to supplement it, especially for those who carry a high deductible medical insurance policy. Your regular health insurance will continue to cover laboratory tests, other diagnostic testing and specialty services and treatment. Often concierge doctors will work with Medicare.

The number of doctors adopting this model is growing. In a March 2010 MedPAC report, there were listings for 756 concierge doctors nationally, a fivefold increase from the number identified in a 2005 GAO survey. In 2012, the number grew to 4,400.

Kiser trained and interned at the Medical College of Wisconsin in Milwaukee. After graduating in 1979, he served as medical officer in the U.S. Navy for two years, after which he spent the past 30 years as a practicing physician in family medicine in Green Bay.

Kiser started his concierge medical practice two-and-a-half years ago. Initially, he was involved with a company that provided this type of medical model for all of their employees. He then left the organization to start a concierge medicine practice on his own.

“I believe there is a need for personalized care such as there was years ago,” he said. “Though it would seem like I’d have less time making home visits, it is actually just the opposite. A more informed and educated patient tends to need a doctor less. The driver is the patient.”

In another instance, Kiser tells of a gentleman in Green Bay he sees in a hospice. “I keep in contact with this patient daily and the advantage is the patient’s comfort zone,” he says. “It also allows me to closely monitor the patient’s condition and provide guidelines for care.”

The annual fee varies by geographic location. “Washington Island is not as accessible as other parts of the county so the annual fee is a bit higher to offset the ferry costs and overnight stays,” Kiser explains. “In general, my goal is to see annual fees of $500-$700 per person. Of course, the fee is pro-rated for families.”

Ideally, he says he hopes to serve up to 500 patients throughout Door County and Green Bay, as opposed to the 2,000-2,500 typical patient caseloads. To date Kiser says a couple of dozen Door County residents have joined his concierge medical practice.

A March 2013 Forbes article cited a recent study published by the concierge medical group MDVIP in the peer-reviewed American Journal of Managed Care showing that the concierge model approach to primary care saved $2,551 per patient due to decreased hospitalizations. It also resulted in a 72-79 percent reduction in hospital readmissions for serious illnesses.

“It’s the holistic approach to medicine that I really like,” Meyer explains. “A visit can last between 45-60 minutes, allowing the doctor to really delve into their patients’ problems and craft individual treatment and prevention plans. The doctor sees firsthand the environment the patient lives in and that leads to better health care management.”

For more information contact Dr. John Kiser at 920.265.8888 or by email at [email protected]. For more general information about concierge medicine go to https://conciergemedicinejournal.wordpress.com.