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Worldwide Wellness
What happens when a medical emergency strikes while you’re on the road? A concierge doctor can put an end to your travel worries.
By Kara Wahlgren
©iStockphoto.com/gmutlu
Half an hour into his descent from the summit of Kilimanjaro, gaming exec Doug Macrae had trouble catching his breath. He was still wheezing when he reached the first camp several hours later. Worried, he pulled out his BlackBerry and fired off an e-mail to his physician in Boston: “We left for the summit at midnight and reached it at around 6:30 a.m. We then began descending and within 30 minutes I was unusually short on breath . . . Am still wheezing. Thoughts?”
It was 3 a.m. in Boston, but the reply came immediately. Dr. Rick Goldman suspected that Macrae was suffering from high-altitude pulmonary edema, a condition that causes fluid to be pushed from the blood vessels into the lungs. After consulting with a pulmonologist, Goldman instructed Macrae to adjust his dosage of medication, continue his descent, and administer oxygen if his condition worsened. “As we were descending, [Goldman] was in constant contact,” Macrae says. The climber flew home the following day; Goldman had already contacted the local emergency room on his behalf.
Nothing can ruin a vacation like a medical emergency, but the right health-care plan can make all the difference. Macrae had invested in the services of a concierge physician, a practitioner in an emerging field that offers patients the option to pay a steep annual retainer—anywhere from $1,000 to $15,000 per year—in exchange for a direct relationship with their physician.
How direct? Think same-day appointments, cell-phone access, and executive-level checkups. Concierge physicians also cap their patient rosters to allow for a personalized level of care. “Being a member of a smaller practice means that the doctor and staff have time to be extremely attentive,” says Dr. Bernard Kaminetsky, the medical director for MDVIP Inc., one of the leading national networks of concierge physicians. “We take the sting out of what people consider to be the traditional doctor-patient office interaction.”
The concept was pioneered in the late 1990s by Dr. Howard Maron, the former team doctor for the Seattle SuperSonics, who felt everyone should have access to the same medical pampering as a pro athlete. His exclusive Seattle practice, MD2, inadvertently spawned a whole new realm of health care. Today there are several hundred concierge doctors in the U.S., both independent and network-affiliated, covering nearly every major metro area. (See “Network Know-How,” below, for more about the top medical concierge providers.)
And with an exhaustive travel-care protocol built into the membership fee, it has emerged as a major boon for jet-setters. “Our clientele is highly mobile,” says Peter Hoedemaker, CEO of MD2. “They have the time and financial means to go and do whatever they want to do. And from a primary-care standpoint, we need to really be able to take care of that need.” So what can you expect on your next trek?
PLENTY OF PREP WORK
Before clients set foot on a plane, a concierge physician will research the destination, notify them of travel warnings, and schedule any necessary vaccinations. Dr. Ami Laws, an internist who has a private concierge practice in Palo Alto, California, once administered a polio shot at a patient’s house before his last-minute business trip to China. “He got it 48 hours before he had to get on the flight—on a weekend,” she says. “You definitely don’t get that from your average HMO doctor.”
For long-term travel, physicians can pack a medical kit with supplies and standby prescriptions. Dr. Thomas LaGrelius, president of the Society for Innovative Medical Practice Design (SIMPD), once built a kit for a patient who was sailing around the world. “I used yachting publications’ recommendations and integrated that with my own knowledge,” LaGrelius says. By the time he was finished, the kit was so complete that the guy “could have done surgeries aboard the ship.”
EMERGENCY CONTACTS
Dealing with a medical emergency on the road can entail a wearisome combination of hotel doctors, urgent-care clinics, and trial-and-error medication. But with one (possibly panicked) phone call, patients can have their concierge doc phone in a prescription to Paris, coordinate treatment with a cruise ship’s infirmary, or help prevent heart failure at 15,000 feet. For the most serious emergencies, MD2 can even arrange a medevac ride home.
“You live through these very dramatic stories with people sometimes, where there’s limited socialized medical care or they have a serious infection and get put on the wrong antibiotic,” says Dr. Steven Knope, a concierge physician in Tucson, Arizona, and author of Concierge Medicine: A New System to Get the Best Healthcare. “Really, what you’re doing is acting as the patient’s advocate.”
POST-TRIP TESTING
It’s not exactly the souvenir you were hoping for, but say you’ve returned from your latest jaunt with a sore throat, a parasite, or a pulled muscle. Now what? Count on a same-day appointment for even the most minor complaints. The speedy access can be crucial, because some nasty travel bugs have fairly unspectacular symptoms. Case in point: When a patient returned from Oceania with a nagging cough, Knope suggested a checkup—and discovered a rare type of infection caused by a Chinese lung fluke.
Despite the perks, concierge medicine has stirred up its share of controversy; some critics justly complain that the annual fees exclude low-income patients, triggering lopsided care. But the nascent practice has the American Medical Association’s ethical stamp of approval, and its docs believe the decision to pony up is a simple matter of investing in your health. “People have a choice of how they spend their disposable income,” Goldman says. “You can drive a Yugo or you can drive a Mercedes. You have to prioritize what’s important in your life, and I think health care is a very important decision.”
For Macrae, it’s an easy choice. “I paid for a business-class airline ticket,” he says. “Why wouldn’t I pay to make sure my health was handled with first-class care?”
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