"With one eye on the patient and one eye on the clock." That's how John Thompson Jr., MD, described the practice of most internists today. What's different about Thompson and colleague Edwin Anderson Jr., MD, is that they did something to change that.

 

Both founding partners in Nashville group practice Heritage Associates, Thompson and Anderson signed on as MDVIP physicians, a move they said has changed the way they care for their patients because, for one reason, they treat fewer of them.

 

Founded in November 2000, Florida-based MDVIP is a national network of doctors encouraged to practice preventive and wellness medicine and limit their practice to no more than 600 patients. Those patients pay an annual fee of $1,500 to $1,800 directly to MDVIP, which takes its cut and then sends the rest to the physicians, thus helping ensure salary stability for the participating doctors. According to MDVIP – and Thompson and Anderson agree – for their money, patients receive more personalized care and much more time with their doctor. The fee also buys a comprehensive annual examination with an extensive panel of screenings and tests, a wallet-size CD-ROM of their health records and a personal Web site with their health information.

 

Calling itself "the national leader in concierge medicine," MDVIP so far has signed up about 300 affiliated physicians caring for more than 95,000 patients. Those numbers are growing, in large measure as word spreads in medical circles. That's how Thompson heard about MDVIP, from a Georgia physician with whom he attended medical school at Emory University in Atlanta. "He was burned out and about to leave the profession," Thompson said.

 

For Anderson, the promise of MDVIP was appealing, taking his medical interest "full circle," he said. Like his father before him, Anderson's father was a physician, and Anderson can remember tagging along as child when his dad made Sunday afternoon house calls in Nashville neighborhoods. "I always knew I was going to be a doctor. There wasn't a discussion about anything else," he said.

 

Now Anderson and Thompson make house calls and answer a cell phone 24/7 that's dedicated to their patients. "One of the nice things about this that flashes me back is that we're making house calls again, and that's a fun feeling," Anderson said.

 

Anderson said his patient roster has shrunk from about 2,500, but neither he nor Thompson is near the 600-patient threshold yet. Rather than 20 to 25 patients daily, they usually see six to eight. "Early on, even in the first month or two, it was such a luxury to have time with every patient to do whatever needs doing," he said, adding that the more leisurely appointment doesn't make the patient feel rushed, either. Anderson said he likes to sit down with his patients at the end of an appointment to talk, and he recalled a recent exit interview with a patient he'd had for years. That's when the patient confessed having a problem with alcohol. "I feel that if we had been in the typical 15-minute scenario, that conversation never would have happened. It never had. That kind of thing happens when people just feel like they have time to talk," he said.

 

The decision to launch an MDVIP practice still under the umbrella of Heritage Associates was "a pretty radical departure," Thompson said, and a decision that took about a year to make. He acknowledged that some physicians in the practice were skeptical, yet solutions to potential problems were hammered out over time. Anderson was at Heritage's Saint Thomas offices, and Thompson moved from the Baptist office to join him. Their practice is across the hall from the main suite. Thus, MDVIP patients, who are seen usually after a short wait or none at all, aren't in the same reception area with other patients. The transition was made by August 2008.

 

"That transition was really difficult. It was a tough three months or so," Anderson said. The two physicians held what Anderson called "town-hall meetings" with their patients to explain the MDVIP model and the financial commitment required of the patients. Of course, a majority of patients opted out. "The fact that I am no longer still their doctor bothers me, and if there's any negative to what I've done, that's probably the most poignant part of it," Thompson said.

 

Asked if MDVIP is "country-club medicine," Thompson replied, "That's certainly a question I wrestled with early on." Yet both physicians said that it wasn't usually the money that was the deciding factor with most of their patients. "When you look at the socioeconomic profile of my patients, if there is such a thing, I don't think it's changed at all. I had people of means, at least from my perception, who opted not to do this simply because they couldn't see any real value in it for them," Thompson said. Yet, he recalled a patient of his who came up to him after one of the sessions and said, "I'm mad at you. I'm going to have to quit smoking to pay for this." And she did.

 

Thompson and Anderson agreed that their hours on the job haven't decreased as a result of MDVIP; they just spend more time with each patient. So, there's no more free time for leisurely pursuits. For Anderson, those hobbies are jogging, tennis and fly fishing. For Thompson, they're hiking, gardening, bird-watching and reading. Anderson and his wife, Beverly, have three grown children, two granddaughters and two more grandchildren on the way. Thompson, with two grown children, will soon know the joys of grandparenthood. He and his wife, Gail, are expecting their first grandbaby this year.