Dr. Diana Hashimi might not be able to single-handedly heal an overburdened system, but her new truly private practice, Access MD, aims to restore the care in healthcare one Mobile patient at a time.

“There’s no question there is a need for this style of practice. It’s about individual attention and continuity of care, but it’s also about more informed consumers who now recognize health is an investment and time is a precious commodity,” said Hashimi, a board-certified internal medicine physician whose 22-year career has spanned everything from large, traditional practices to urgent care.

“While I was doing (urgent care), I typically saw 100 patients per day, and the first question you ask is, ‘Who is your primary care doctor?’ but the answer you get is, ‘I don’t have one,’ or ‘I couldn’t get an appointment,’” Hashimi said.

“The longer I did it, the more I realized that was the rule and not the exception. People just didn’t have primary care, and if they did, it wasn’t accessible. I realized quickly patients deserve more options,” she said, noting she would prefer to limit her new practice to no more than 300 patients.

In turn, Hashimi has joined a quiet revolution of primary care and internal medicine physicians nationwide shrugging off the confines of traditional practices in an effort to refocus time and energy on the doctor-patient relationship, preventive care and comprehensive wellness.

Directing healthcare

Hashimi characterizes her Mobile practice as concierge medicine, but the trend extends to a variety of classifications, including boutique, direct-care and retainer-based practices. In turn, patients often pay an annual membership fee or retainer that grants them practically unlimited access to their physician and often a host of other services, such as wellness coaching, coordinated care with a network of specialists, travel care, executive health programs and even – on occasion – house calls.

The majority of these practices are aimed at eliminating the bureaucracy of modern healthcare – including financial dependence on insurance and Medicare reimbursements – that over time have swelled patient rolls, crowded waiting rooms and ultimately reduced the average interaction time with a doctor during an office visit to eight minutes.

“With increasingly busier lives, patients are looking for health care that fits their schedule,” Hashimi said. “While urgent care facilities provide quick access for a diagnosis, a patient-physician relationship can’t be established due to doctor availability and high patient volume. Access MD not only caters to busy people with health care needs but also allows the ability to create a relationship with and provide direct access to their physician.”

Primary care shrinking

Of course, the concept of direct-care medicine is hardly a new phenomenon, but statistics indicate a growing dearth of physicians nationwide specializing in primary care and increasing pressure on private practices to meet healthcare reimbursement requirements are pushing more doctors toward boutique care.

Specifically, research published in the November-December 2012 issue of “Annals of Family Medicine” projected an additional 52,000 primary care physicians will be needed in the United States by 2025 to meet increasing healthcare demands. While the majority of that figure, 33,000 physicians, are tied directly to anticipated population growth, the research revealed another 10,000 doctors will be needed to meet the growing demands of an aging population and at least 8,000 will be required to cover previously uninsured patients.

Meanwhile, some 4,400 physicians nationwide now characterize their practices as concierge-style, representing a 30 percent increase compared with 2012. The American Academy of Private Physicians includes some 35 Alabama doctors among those figures, a roughly three-fold increase in less than five years.

Hashimi joins only two other doctors who claim the specialty in Mobile and Baldwin counties, while the majority are clustered in Birmingham and Huntsville with a handful scattered in Tuscaloosa, Slocomb, Coy, Killen and Prattville.

Hashimi said she considered franchise opportunities with established companies such as Boca Raton, Fla.-based MDVIP – which account for at least 12 of Alabama’s practicing concierge physicians in Birmingham and Huntsville – but opted instead to remain independent.

“Mobile just has an excellent supply of healthcare resources and business support, and I really wanted to keep my operations local. I feel like my company is a good example of a new small business,” she said.

For the cost of a daily frappuccino

Above all, Hashimi said concierge medicine is gaining traction nationwide because what was once billed as a luxury afforded only elite corporate executives and other upper echelon patients has evolved into a retainer-based system that – on average – translates to no more than $5 per day for coverage.

“It did start originally as executive medicine and executive physicals, and part of that was because the corporations were footing the bill and wanted to keep (their executives) healthy and working, but over the past 10 to 15 years, the typical patient has changed,” she said.

Hashimi said she personally sees three trends among her most prevalent patients:

• A more informed, involved patient who wants to analyze the data, look at their results and understand the medical decision process. “You just don’t get that with a 10-minute office visit, and these are regular, everyday people who want to be more involved in their care,” she said.
• Patients with health issues that require more complicated care and more time. “These patients realize the cost of a concierge physician is an investment on a personal level. It’s about relationships and the average person realizing there’s a value in this model you don’t get with the traditional herd-em-in, herd-em-out mentality,” she said.
• Executives, business owners, professionals and people who just want the convenience of no waiting and direct access.

Expanding options

So what exactly does Hashimi’s $1,500 per person or $2,700 per couple annual fee provide?

“Membership gets you in the door. For me, it’s pretty much inclusive of everything except for labs, diagnostic tests or if you need to see a specialist or have surgery. The fee covers things like telephone calls and emails – I’m the one answering the phone – but it also covers extras. I also do medical research, detailed health-needs assessments and lifestyle coaching,” she said.

“I just feel like patients have a right to spend their medical care dollars in a way that restores a little control over the care they receive. It’s about choice, and it’s very important to me that people in Mobile have an additional choice for a healthcare option.”

For more information on Access MD call 251-895-4345 or visit www.accessmdmobile.com. For more information on the American Academy of Private Physicians, visit www.aapp.org or click here.