Doctors try new business models to improve care

Dr. Myriam Ensling made the old dentist’s office she moved to in 2012 her new place of business, even with the dental lamps hanging from the ceiling.

“I’m an immigrant, so this is what immigrants do,” Ensling, the Argentinian doctor, said. “We find a way around. We live off leftovers and hand-me-downs. That’s how we survive.”

Ensling now practices internal medicine, specializing in treating obesity, on West Broadway in Columbia. She moved to mid-Missouri in 2003 after earning her residency at the University of Florida, practicing next to Boone Hospital and teaching at the University of Missouri. But her patient list there grew too big for her to give the care she thought was necessary for them.

“I see the patient, I have to write down the diagnosis, to do the bill, to prescribe things in only fifteen minutes,” Ensling said. “So it’s a bad quality of care.”

Ensling said she split from the hospital in 2012 to practice independently, but handling the health insurance claims has been difficult. One mistake on the report means Dr. Ensling doesn’t receive money for the tests she gives.

So a few months ago, to figure out a way to get paid directly and provide care for those without insurance, Dr. Ensling set up “Primary Care Club.” A patient pays $150 on their first visit, then $70 a month for check ups, some tests and meetings with a nutrition specialist.

“I can have time to see patients with insurance,” Ensling said of the program. “So this will cover, this will assure me a certain amount of money that I will receive every month. So I can cover my basic, can cover the thing, then even make some profit.”

Three other doctors in Columbia use a similar business model, sometimes called “concierge medicine.” Dr. Gary LaMonda, Dr. Lyndell Scoles and Dr. Don Delwood all partner with MDVIP, a company that manages advertising, marketing and insurance for doctors wanting a smaller practice. Nancy Udell, spokeswoman for MDVIP said the Boca Raton, Fla.-based company only lets doctors it partners with serve 600 patients or less. Patients see their doctor one or two times a year, for one or two hours at a time. Udell said patients also can contact their doctor at any time, and receive referrals to medical centers with specialized care, such as the Mayo Clinic.

Doctors with MDVIP charge $1,650 annually for those services. Udell said MDVIP takes a portion of that based on an agreement with the doctor.

Health insurance does not cover the cost of an annual membership in Primary Care Club or MDVIP.

Dr. LaMonda told ABC 17 News the smaller patient list and longer meeting times helps him prevent his patients from getting sick, and taking on emergency medical bills.

Dr. Ensling said her plan may help those with high health insurance deductibles, as well.

“People deserve to be treated with a good doctor, and very well,” Ensling said. “Not only the wealthy are the ones that deserve a good doctor, time and all that.”