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Bedside Manor


By: Courtney Phillips

            In the current political climate, the definition of healthcare is changing for many patients and doctors. As mandated by the Affordable Care Act, most Americans will be required to have health insurance. According to research by the Annals of Family Medicine, family physicians will experience a dramatic 22 percent increase in patient visits by 2025. In addition to traditional insurance filing, the number of diagnostic and charging codes will increase fivefold for physicians and their support staff.

            An increase in paperwork and the resulting decrease in hours for direct patient care are leading some doctors to change how they work… now.

            Dr. George Pantelakos, a Fayetteville native and board-certified family medicine physician, founded Highland Family Practice P.A. in 1993, where he serves toddlers through geriatric patients.

            A few years ago, he became intrigued by concierge medicine, a fledgling concept characterized by a physician’s enhanced care in exchange for an annual fee paid by the patient. 

            Depending on the practice and specialty, the annual retainer might afford perks like extended appointments, little to no wait time, easier direct access to a physician and house calls. 

            While some physicians seek the services of a consulting company to integrate this level of care into their offerings, Dr. Pantelakos attended seminars and developed his own, tiered system of relationship-based patient care. “I still love what I do and want to continue. Doctors in their 50s are changing course. I want to do what I trained to do,” said Pantelakos, who, as a physician and small-business owner, enjoys the extra time with patients and appreciates the reduction in paperwork.

            Since Highland Family Practice began offering concierge services two years ago, five to 10 percent of Dr. Pantelakos’ patients have registered for the enhanced services. They have retained 100 percent of participants.

            A new concept in Fayetteville and doctoring in general, some patients seek out Dr. Pantelakos specifically for an enhanced level of care. Currently, fewer than 5,000 physicians offer the concierge services in the U.S., most of who specialize in internal and family medicine. Somewhat unexpectedly, demand is not specific to large markets. “Different models of healthcare are practiced in cities even smaller than Fayetteville,” said Pantelakos, whose practice offers three models of service: traditional, direct/e-medicine and concierge.

Highland Medicine Direct

            “A patient who may be younger, work a busy schedule, or may travel a lot might prefer the medicine direct program, which includes communication through a web portal. It’s very easy to relate issues when traveling and establish a relationship beyond office visits,” said Dr. Pantelakos, of the e-medicine services.

            Patients enjoy benefits such as e-consult and follow-up for both acute and chronic disease management, ability to review lab, x-ray and other test results, continuously updated medical records through a patient portal, expedited medication and appointment requests, no refill fees and the ability to complete and update insurance information out of the office.

Highland Medicine Direct Plus/Concierge

            In addition to the benefits associated with Medicine Direct, patients have “24/7 phone/text/email contact” with Dr. Pantelakos, including cell and home phone numbers. House calls are available, if necessary. Regarding the age of patients with whom the plan is popular, he said, “You’d really be surprised who signs up. While it tends to be an older group, it’s a mixed bag of all ages who really care about their health.”

            Equally surprising are the potential savings associated with the annual fee, which is based on age. “I really enjoy it because I can spend more time with each patient. We can accomplish more in one visit than we could normally accomplish in a series of visits,” said Dr. Pantelakos.

                With the constant availability of a physician comes a unique empowerment to discern the severity of illness. While a traditional patient might visit the emergency room for an acute illness after business hours, access to a physician can, possibly, thwart that need and expense. “These models are research-based. Concierge medicine can lower hospitalization rates 65-80%. In the end, it can save people time and money,” said Dr. Pantelakos. 

            Of course, situations arise when a physician is able to encourage a patient to seek treatment immediately, in which concierge patients experience the highest level of advocacy through enhanced physician-to-physician and physician-to-medical-center communication. “Having a physician as a partner and coach is an ideal doctor-patient relationship,” said Dr. Pantelakos.

            Enhanced contact might imply that a physician is never able to leave the office, or the virtual office. Dr. Pantelakos is quick to point out the contrary. “It’s the opposite of what you might believe. People do not want to bother you. They respect your time. Theoretically, you’re addressing problems in the office and you won’t have very many calls. I have to encourage people to call me, and when they do, I know there is a real issue. We emphasize optimal medical care through prevention and wellness.”

            Generally, concierge care, sometimes referred to as “boutique medicine” or “direct care,” is not covered by insurance, although there are some exceptions. “Depending on how a patient’s insurance is structured, they may be able to pay the annual fee through a health savings account,” said Dr. Pantelakos.

            By 2020, more than 30 million Americans will be insured and regularly seek primary care services. In response, nearly 10 percent of practice owners in the U.S. plan to convert to “cash-only” and concierge care in the next three years, according to the Physicians Foundation. Dr. Pantelakos’ vision for his practice parallels the predicted consumer demand for availability and convenience. “My plan is to transition to an even greater percentage of concierge patients in the next few years.”

            Patients interested in concierge care at Highland Family Practice can learn more at 910.323.0334.