During a break from house calls the other day, Dr. Marc Tanenbaum talked about the joys of being able to tend to his young patients without the constraints of managed care. Or the constraints of a traditional office.
No more shuttling his patients in and out in 10- to 15-minute slots so that he can work 40 patients into his day. He gets to take as long as he wants or as his patients need.
The whole notion might seem foreign to those who have grown up in the era of medical centers, HMOs and outpatient surgery centers. But it’s true: This pediatrician actually sees his patients in their homes. Have black bag, Dr. T will drive. His mobile office can come right to your front door, whether your child is sick or simply needs a wellness check-up.
“It’s been remarkably satisfying to see families in the comfort of their own home,” Tanenbaum said.
The Atlanta physician launched Priority Pediatrics PC about two years ago, becoming part of a small but growing number of physicians across the country who have established a concierge pediatric house call practice.
He is available 24 hours a day, seven days a week. He has no office and accepts no insurance. His fees are comparable to most out-of-network physicians. But he’s having the best time of his life, he said.
The day when doctors treated patients at home disappeared decades ago in most of America, as house calls gave way to more cost-effective office visits. For more than 30 years, Tanenbaum had been part of such traditional group practices.
But over time, he said he became disenchanted with practicing medicine under pressure to see more patients in less time in order to pay the ever-increasing overhead.
“That didn’t make me happy,” Tanenbaum said recently. “It drained the satisfaction from the joy of caring for children.”
And so in April 2009, Tanenbaum made the tough decision to leave traditional practice. He was about to sign a lease on another office when he realized he was re-creating the very thing he’d found unsatisfying.
Six months later he opened his concierge practice, where doctor-patient relationships, personalized care, time for the patient and availability are top priority.
Although his patients enjoy the convenience of having a doctor on call 24/7, they say Tanenbaum always makes them feel like they are his only priority.
That’s why Meaghan Timko and Renee Dothard, both of Marietta, were all too happy to retain him when they learned he’d launched Priority Pediatrics.
“When this came up, we jumped all over it,” said Dothard, a 42-year-old mother of two.
Dothard said she was fed up with waiting for an hour or more to see a doctor for only a few minutes before being shoved out the door.
Having Tanenbaum virtually on-call makes her busy life less complicated, she said, because both her sons can be seen at the same time and on the weekend when she isn’t traveling.
“It’s efficient, convenient and personal, and you know your child is well cared for,” she said.
Aside from being knowledgeable, Timko said Tanenbaum is “probably one of the most personable doctors I’d ever met in my life. You almost don’t feel like you’re talking to a doctor.”
Although home care practices for the elderly have been growing in popularity at least since 1984, Tanenbaum’s practice may be the only one providing pediatric care in metro Atlanta.
According to the American Academy of Concierge Pediatricians founded by Dr. Edward Kulich, Priority Pediatrics is one of about 14 practices in the country that exclusively provides house calls to their patients.
Kulich founded the academy because he himself had a house call practice, KidsHouseCalls, based in New York and discovered a few other pediatricians were providing the service as well.
“It’s a network of like-minded, board-certified pediatricians who provide a higher level of service than the typical doctor’s office,” Kulich said.
While not a revolution, he said that concierge medicine is a small trend he hopes will grow because it puts patients’ care back into the hands of doctors and their patients’ parents.
“Doctors don’t like to be rushed, and patients don’t like to be rushed,” he said. “This essentially removes the middle man.”
The only downside, perhaps, is doctors like Kulich and Tanenbaum charge and collect a fee for the service at the time it is provided. They give parents paperwork to file for out-of-network reimbursement from a private insurer or a health savings account.
“The feedback from people with good insurance is that they are generally reimbursed 75 to 80 percent,” Tanenbaum said.
Tanenbaum sees about 50 families and has plenty of room to grow.
“I want to cap my practice around 200 families so I can be available,” he said. “I can’t serve the entire metro area, so I’ve chosen to limit my practice geography to a 20-mile radius around Children’s Healthcare of Atlanta at Scottish Rite Hospital.”
Tanenbaum sees patients from birth through the college years. His practice also offers personalized care for families with multiple children and children with special health care needs where travel to a traditional office can place hardship on parents.
Shelly Tanenbaum, the doctor’s wife and practice manager, says that in a traditional office practice, technology and office staff can often increase the distance between physician and patient.
“You get answering services, digital telephone trees, nurses that call you back and messages to go to the emergency room,” she said. “It’s impossible to just ask a question.”
Patients can ask Tanenbaum any question anytime they want.
“When I talk to colleagues, every one of them asks me if my patients call me at all hours of the night,” he said. “Amazingly, no! Because my patients know they can reach me directly when they need me, they are very respectful of the evening hours.
“I have a theory about why that is. They know they are calling me directly. I answer the telephone and not the advice nurse. They know that if my medical advice is needed, I will be there for them in the middle of the night.”
Having a doctor at your beck and call is just one of the benefits of concierge medicine. Home visits offer insights not always available during a 10-minute office visit and parents say doctors learn more about a patient’s lifestyle, eating habits and other things relative to a healthy lifestyle.
“Plus I have the healthiest waiting room of any physician in the city because my waiting room is my patient’s home,” Tanenbaum said.
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How to reach Dr. T
Phone: 404-654-0426
Website: www.priority -pediatrics.com
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