Developing a Concierge Orthopedic Practice: Q&A With Dr. William Leone of The Leone Center for Orthopaedic Care

Written by  Laura Dyrda | Friday, 14 January 2011 17:22
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William Leone, MD, an orthopedic surgeon at Holy Cross Hospital in Fort Lauderdale, Fla., recently opened The Leone Center for Orthopaedic Care, a concierge medicine center where patients pay a fee for surgery. The other costs associated with the surgery, including implants, hospitalizations, anesthesia, radiology, physical therapy and home health services, are still typically covered by Medicare. "I'm taking care of a lot of people who have Medicare insurance and they prioritize their health," says Dr. Leone. "They say they want to invest in their healthcare and it's worth paying the extra cost."

Dr. Leone discusses the creation of his concierge orthopedic practice and the advantages he sees for these types of practices in the future.

Q: What factors led to your decision to opt out of the Medicare program and create the concierge orthopedic practice?

Dr. William Leone: I decided that I didn't want to participate in the Medicare program anymore because, like a lot of physicians, I felt a sense of frustration. I was running faster and faster to see patients and what made medicine special to me was beginning to be lost. There was also a sense of frustration that reimbursement was based only on volume and not a lot of quality. In my 21 years of practice, every year I would do more cases (last year I did 700 joints) and it was taking 3-4 months for patients to get on the schedule. That's not how I wanted to go about it. The feel-good part of practicing medicine is getting to see the patients and I was getting to the point where I was losing that. I made the decision to practice medicine the way I wanted to practice it, emphasizing the highly personalized care and the patient/physician relationship.

I think in our current healthcare practice, which is really based on quantity, there are a lot of surgeons like myself who have high volumes, and more and more of them are going to limit access to Medicare patients. I think the whole vision of me trying to do this is that I wanted to say I am different.

Q: What are the elements of your practice that makes it different from other orthopedic practices around the countries?

It's a very different kind of office. There aren't many people in the waiting room, the appointments are on time and if the office is running late, the patient is communicated with. I partnered with a hospital, so I am able to have a quiet and respectful waiting area. Patients get tea and water while waiting for their appointments. There are also some private rooms and suites where the patient can get nicer meals and extra services after surgery. Patients can pay up front for a room in the hospital, a robe and nicer food. If that's not your priority, it's okay. We like to give options.

We don't really know what's happening in Washington, but we do know that the system is already extremely full and there's going to be a lot more people coming into the system. There will be longer lines and more waiting. Building the concierge service is just creating a greater distinction between most other practices and mine.

Q: Are you finding the concierge orthopedic practice sustainable?

Historically, my practice has been strictly driven by word-of-mouth marketing, and every year we got busier. Now we are doing something a little unique and scary. For the first time, I have been advertising with the hospital. I give talks at physician meetings to teach other physicians about concierge medicine. My practice is also growing now beyond my community. A lot of people are coming from the Northeast. When marketing the services, I emphasize the relationship and highly personalized care. I show that patients are treated with respect. The first year after the transition, I went from cranking out joint surgeries to spending more time with patients and I think that's good.

Q: How do you see your practice fitting into the current healthcare environment?

WL: I think having concierge medicine gives people choices. There will be people who can't afford it, but there are also going to be a lot of people who say, "No, I don't want to have what the government is offering. I want to have a nice place for my healthcare. This is my experience and where do I have the best chance for getting the best results? Where will I feel like I have been taken care of?" The practice isn't really elitist. It's going to keep other physicians practicing because there will still be many patients who won't go to concierge practices. That's really what it boils down to. In our country, there needs to be a lot of options and for people who want good treatment and care, this is a wonderful option. I think a lot of physicians are going to follow suit.

Learn more about The Leone Center for Orthopaedic Care.

Read other coverage on orthopedic and spine practices:

- 6 Techniques for Building a Successful Spine Practice

- 4 Tips for Tackling Challenges Facing Orthopedic Surgeons

- 4 Steps for Employing Quality Improvement Benchmarks at Orthopedic Practices
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