Concierge Care

What is my concept of concierge care?

Concierge care means there is a competent, thoughtful physician available who treats their patient Members like a relative and knows how to work in a very opaque complex medical system.

Every family ultimately faces a medical issue, important or trivial, that requires a rapid thoughtful answer.

More often than not these decisions must be made at very unexpected and very inconvenient times!

Your concierge physician should be able to calm a panicked situation and guide a patient, without self-interest, to the best available option, locally or on the road.

That’s my job. 

To learn more about the specifics of my concierge program, visit yaffeccphp.com.


How does one get to be a concierge physician?

A concierge physician needs to earn the trust through the experience of a small group of patients over a long period of time.

30 years ago, one could open an internal medicine primary care practice, develop a reputation, and develop a following. Mutual loyalty is the key.

Managed care, with limited reimbursements, arrived around 1990 which led to larger volumes of patients with shorter visit times.

After 2000, virtually all newly minted primary care doctors had large debts and were forced to take salaried positions with hospitals or large institutions, often being responsible for 2000-3000 patients.

Since employed physicians cannot legally take an institution’s patients private, It is nearly impossible for a young physician to develop an independent private primary care practice in today’s managed care world.

A small group of primary care doctors who started private practices before managed care in 2000, had enough mutual patient loyalty that allowed them to care for a small group of patients paying private fees. After some legal issues involving managed care were resolved in 2015, concierge care emerged in NYC.

Accordingly, most concierge physicians are over the age of 55, some considerably older.

During Covid, many physicians closed their practices and/or retired.

Since it is a challenging pathway to becoming a concierge physician in today’s managed care world, it is likely that there will be fewer and fewer concierge practices in the future.

Concurrently, the medical world has become more specialized and complicated.

Trusted, competent experienced physicians who understand the system and can best coordinate care are more necessary than ever.

Every 45-year-old male or a female should realize that they are paying a fortune directly or indirectly for healthcare. For a small annual premium, the marginal cost for those that can afford it is often well worth the cost in terms of time and aggravation saved. Office visits can often be avoided. As a patient’s advocate, marginal tests may be eliminated. Most importantly, the best medical decisions can be made in a timely fashion potentially saving pain, disability, and in some cases even life.

I am fortunate to be in a position where I hopefully plan on practicing for 10 more years. I work with Stacy Beaupre, a trusted 35-year-old physician assistant with 13 years of experience. Within two years I will be hiring a young seasoned physician associate. My goal is to gradually retire in 10 years, turning the practice over to two very competent people with many years of experience who have gotten to know my patients and their families very well.

I would like to think my practice has a very long lifespan.


How has Covid changed medical care and enhanced the value of concierge care?

The medical world, like the business world, has been transformed by remote care during Covid. We learned how to take care of patients remotely, even in complex situations, via iPhone, texting, and remote monitoring. For the first time, many physicians received reimbursement without having the patient visit the office.

Prior to Covid, a patient's physical presence in the office was required for medical reimbursement. New tools and new reimbursement patterns allowed effective initial care and follow-up care, using home tests, remote monitoring, and local labs. Physicians were forced to become comfortable caring for patients off-premises. During the peak of Covid, many small offices that relied upon office visit reimbursements often were forced to close permanently.

Physicians with concierge practices who were reimbursed by annual fees were able to survive without relying on in-office reimbursement. Telehealth and remote monitoring tools do not reimburse well but allow for high-quality care in many circumstances, and inefficient visits are avoided.

Many New Yorkers also moved out of the city. During Covid, they realized they could be adequately cared for remotely.

Only about 40% of my concierge patients now live primarily in The New York metropolitan area. I am able to care for my patients who live in The Hamptons, Florida, Texas, Los Angeles, and Europe. I may see those patients once or twice per year in person, and I can counsel them remotely in Florida, similarly to the way I could treat someone calling from home in the West Village during Covid. Concierge membership fees cover= my overhead. I am available to see patients or refer patients in a way that works best for my patients without the need for in-person reimbursement. When medically appropriate, a visit can be a phone call, a trip to a local lab or a local radiologist, and a follow-up phone call!


Why did I choose Castle Connolly Private Health Partners... and how does that best benefit patients?

Ethics, trust, like-mindedness, high standards, and thoughtful flexibility are all very important to me in dealing with any medical organization.

Castle Connolly Private Health Partnership, CCPHP, a bespoke concierge medicine organization of approximately 60 physicians, enables flexibility and quick innovation. If there’s an issue I can quickly get to the CEO, COO, and my CCPHP Membership Advisor, all readily available.

Led by Susan Greeley, CCPHP provides the SENS Solution® Wellness Program without charge to my concierge Members. The program is a high-quality online program that deals with solutions to stress, exercise, nutrition, and sleep.

CCPHP provides referrals for my patients locally, nationally, and in some cases internationally. They have a network of competent doctors who can cross cover and can provide support in other parts of the country. Most importantly they have been flexible in helping me support patients who have had serious financial concerns during Covid.

I am sincerely grateful to work personally with Dean Mcelwain, CEO, Sean Connolly, COO, and Salena Chu, my personal Membership Advisor overseeing my concierge program with CCPHP.

All are available and quick to respond to me and to my patients.

I am always interested in meeting new interesting people who take their health care needs seriously. My office team and the CCPHP team readily welcome suggestions and questions.