A PA's Experience in Concierge Medicine

At its core, concierge medicine is about ensuring that patients have access to highly qualified providers who choose to work in personalized practices that focus on convenience and patient satisfaction, in addition to quality care. 

When I started as one of the first PAs in concierge medicine, I had to work closely with my supervising physician to navigate how a PA could make a difference in this type of practice. Would patients object to paying out-of-pocket for a service that didn’t guarantee seeing the doctor?

Because Griffin Concierge Medical was already an established practice and its owner, Dr. Radley Griffin, knew his patients well, we were able to identify areas where I could increase the availability of care and services and contribute to the practice’s growth and success.

Since then, Dr. Griffin has advised other physicians on how to establish concierge practices or transition a current practice to this model, including the services of a PA.

Because our practice is membership based, we limit the number of patients so we can provide timely, personalized care and grow the relationship with each patient. 

Our practice does not accept insurance. However, because we provide many services in-house, patients don’t have to access or pay for that care elsewhere.

We are available 365 days a year, making us our patients' primary, preventive and urgent care providers. We offer in-house labs, injections and diagnostics, after-hours prescribing, assistance with medical needs when traveling, house calls when patients are too ill to come in, and telemedicine. Our practice also admits to, and does rounds at, three local hospitals. Patients want and appreciate that level of care continuity.

Most patients have insurance, so when necessary the practice can refer to specialists for major tests. However, because we know our patients well, we don't practice medicine out of fear - which can lead to ordering unnecessary tests.

There are many ways Certified PAs can make an impact, here are some examples:

•Ensure same day appointments. I can treat the physicians' patients who come in with acute symptoms when the physicians are booked.

•Grow patient panel. I currently have 85 patients with the capacity to add more.

•Oversee clinical operations. I manage workload, inventory and three paramedics who draw labs and administer injections.

•Serve as the patient advocate for prior authorizations. Because of my education and clinical knowledge, I am fully able to explain what is needed and overcome objections or suggestions to go a different route. I get the patients what they need and deserve. 

•Handle occasional house calls. Recently, I visited a young girl with cerebral palsy who was having a very difficult day, and her caregiver could not get her in the car to come to the office. Sometimes an elderly patient doesn’t have transportation, and I can perform a home visit.

•Treat via telemedicine. This is getting more common with both patients who travel and college students away from home. Our practice has a HIPAA-compliant app that allows a patient to send a photo, for example, of a rash. We can triage it over the phone and get them started on treatment.

•Take call. I share the call schedule with two physicians, so we are each on call one out of every three weeks. Whether it's an out of town patient who forgets his blood pressure medication or someone who needs to be admitted to the hospital, I am available to handle the night and weekend calls.

This work is challenging but also rewarding. It's satisfying professionally to be able to support patients who would otherwise have to go to urgent care or those who are out of town and want the assurance of care from a provider who knows them personally.

At a concierge practice, we are first and foremost medical providers, but we strive for exceptional customer service. Our core value is that everyone in this practice makes things happen, and we go above and beyond to exceed expectations.

Mary Katherine Charles, PA-C, is certified by the National Commission on Certification of Physician Assistants (NCCPA). She is a 2013 graduate of the PA Program at Nova Southeastern University and is employed by Griffin Concierge Medical in Tampa.