My Boutique Medicine Visit

Update: After my second visit to Dr. Michael Mall, and a very  frustrating  phone call with MDVIP, I can honestly say that I would not recommend either.  I just spent hours in a doctors office, fighting with them to get the treatment I scheduled two weeks ago.  Here is a post about my follow up issues.

When I turned 35, it hit me that I was now in my thirties.   (I’m a little slow to get things some times)   So, I decided it was time to get a bit more serious about my health. Part of my plan was to schedule a comprehensive physical.   So I called around and found a doctor.   I made the appointment and went prepared for the uncomfortable expectations of a physical.  

I arrived at the doctors office, went into the cold room where they make you strip, and waited like a kidnapping victim for my doctor to arrive.   When he shows up, 20 minutes after I was forced to take of my clothes, he proceeded to look over my chart while he asked me questions that I had already answered in writing.  

He then asked me a sort of puzzling question, “what can I do for today?”.   I was a little confused because I had scheduled a physical when I made the appointment, but quickly replied that I was there today to get a physical.   “What’s the problem?” he responded.   I was a little lost.   Being a guy, I sort of having that feeling myself.   Why do I need a doctor when I feel fine?   So I told him that since I hadn’t been to see a doctor in over 5 years, I thought   it might be time to get a physical.   “What do you want me to check?” he asked.   “I don’t know.   I’m 35, what do you recommend?”, I responded.   The doctor let out a sort of annoyed laugh with an eye roll.  

At this point I wasn’t sure what to say.   I had thought I would walk into a doctors office, and that upon hearing my age, weight, family history, and the fact that I haven’t had a physical in nearly a decade, I would be immediately hooked up to complicated machines that would be sucking samples from every orifice.   But that wasn’t happening.

“Should I have my cholesterol checked?”, I asked.   “Sure, we can do that.” he replied.   “Okay, how about my blood pressure and and maybe a blood test for STD’s and stuff.” I added.

His face immediately changed.   “Do you think you have an STD?” he asked grimly.   “Well, no.   If   did I would have lead off with that upon meeting you.” I replied.   He looked at me confused.   “Is it possible you an STD?” he said in a very serious tone.   I had to think abut this a moment.   I don’t really think I have a high risk lifestyle, but I’m not a virgin.   “I guess it’s possible…. No, wait, it’s really not possible, at least it’s highly unlikely.   My life is not that exciting.” I admitted.   “Can you just tell me what test we should do?” I asked.

He looked down at his clipboard, which I could tell had nothing written on it.   “How about we just order this blood screening package?” he said as he pointed at the bottom of a form.   I guess it’s like picking my kids school picture package, so I agreed.   He started to get up.   “Wait, I have another issue I wanted to have looked at.” I said quickly.   The doctor froze and waited for a second, like I just called him a name.   He turned and looked me.   “What else?”.  

I told him that my hearing had become quite poor over the past few weeks, and that it felt like something was wrong.   “You’re getting older, and hearing goes with age.” he said in a tone of someone just asked what planet we were on.   “I’m 35!” I exclaimed.  

Now I was willing to deal with the fact that my teen years spent with Van Halen cranked up on my Walkman to 11, followed by some time in the Army enjoying the bangs and booms of gun and artillery fire (followed by that little moment of dead silence after) had in fact damaged my ears.   But this guy know nothing of my hard rocking youth or military background.   To him, I was a 35 year old guy who just said I’m going deaf, and all I got was a shrug.   I was starting to lose my patients.

“I would really like to look into what’s going on with my hearing” I said in a tone that was a little harsher than I had meant.   He threw the folder down and grabbed a stethoscope and stuck it in each ear.   “It looks fine” he said.   “But it’s not fine, I can’t hear very well” I replied.   Since he could tell that I wasn’t letting this go, he agree to give me a hearing test.   I was told to wait for the nurse.

About 10 minutes later, the nurse comes in with this huge cart carrying what appears to be the same machine I took my school hearing test back in 1976.   She hands me the cheap blue headphones with the rubber, air filled cushions and told me to put them on.   I adjusted them to my head and listened.   The beeps were slight, but I could hear them. I raised my had with each appropriate tone.   After a series of about a dozen, the nurse took the headsets and congratulated me on my perfect hearing.   At least I think that’s what she said.  

On my way out, a nurse gave me this form to take to take to a separate lab.   So I emerged from the doctors office without having a finger in anal region, or having my testicles fondled.   After all that preparation, my ears were the only orifice examined, and not even well.   A week later I got confirmation from the lab that I did not have any STD’s.   I also got some numbers about my cholesterol, but I had to look up what they meant online.   Overall, my cholesterol was high, my not high enough to be given anything stronger than a lecture about eating red meat.

Overall I was extremely disappointed.   How the physical I received was certainly not invasive, it also didn’t do anything to make me feel like I was being proactive about my health.

So when I got to Las Vegas, I decided to try out a local concierge medicine plan.   After asking someone to do some research, we discovered that the biggest player in the space was MDVIP, which, among other things, helps match up patients with doctors who maintain this type of practice.

I put a call into MDVIP and got ahold of a very nice, helpful guy there who offered to go down the list of doctors to see who would be the best fit.   We started talking about any special needs I had.   Other than wanting someone who would is a decent doctor, I wanted someone who could also treat my son.   My son is 14, and some doctors chose to not treat teens below 16.  

The good news was that my son would be covered under my annual fee, which ended up being $1,500.   That was very good news to me.   Knowing that the fee is providing my son with more comprehensive health care would make the check easier to write.

The MDVIP rep and I also spoke about what is included in my $1,500 free.   First off, I get an “Executive Physical”.   I immediately thought about the Mad Men episode where they pitch a bank on the idea of an “Executive Account”, and I immediately started picturing a doctors office with a martini bar and hot women.   But unfortunately the Executive Physical is just an overly compressive battery of test to find out how bad of shape I’m in.   Considering the current state of my body, I would say that it’s overkill.

On top of an Executive Physical, I get a semi-guarantee that I will get same day appointments, or at worst next day.   Having a child, that was nice to hear.   It’s a pretty lousy situation to have a sick kid and find out you can’t see a doctor for 2 weeks.   It makes you wonder the point of insurance if you can’t really use it when you need it.  

Of course the other big part of the plan is not what I get, but what the doctor doesn’t have.   And that is a whole lot of patients.   The average physician has a base of well over 1,000 patients.   My doctor would have less than 500, giving me a lot more free time and flexibility.

After screening out the doctors that would not treat my son, we ended up with 3 on the list.   The rep invited me to have a face-to-face with the doctors and see which one fit.   I decided to take him up on that and made arrangements to meet with Dr. Michael Mall.   The rep took my information and arranged for the doctors office to call to set up the time.  

The face-to-face idea made me a little happier.   It’s nice to be able to screen a doctor in person before you have to start letting them treat you.   Like George Carlin says, “Somewhere out there, there is the worst doctor in the world.   And someone has an appointment with him tomorrow.”

A day or so later I received the call to schedule the appointment.   I arrived a little early, figuring that I would have the usual paperwork to fill out.   I was promised by MDVIP that part of the program is that I don’t want more than 10 minutes for the doctor.   Another great little perk.  

I admit that I hate filling out this paperwork.   It seems so personal and invasive.   It’s not that I have anything to hide, and I’m certainly aware that this information is needed to treat a patient, but it just seems so rude to ask what my family died of.   Plus, I hate when they ask questions about who my current doctor is.   When I don’t have a name to enter, I feel like I just stated a low credit score or something.  

While I filled out the paperwork, I took in the surrounding office.   I’m not sure what I expected from a concierge, or boutique doctors office, but not this.   The walls were that dingy white, they had the same People and US magazines as all doctors offices.   (People who visit doctors often must know everything there is to know about Bradgelena)   I expected the office to be like a fancy doctors office that you see rich people having in movies; with wood paneling and fancy paintings.   This just had the usual cheap prints in frames, accompanied by the free promotional posters.  

I turned my paperwork in at the desk and sat in my uncomfortable seat waiting to be called.   This is now 3 minutes to my scheduled appointment.   A minute later a nurse came out and took me into the hallway.   She showed me another door that had a sign for MDVIP.   “From now on, when you visit Dr. Mall, you can just go in through this door.” she said.   She opened the door to a smaller waiting room.   The room, which is really more like a corner near a nurses station, had four bigger plush leather chairs, and magazines like The DuPont Registry and Luxury Las Vegas.   No fancy art work or wood paneling, but a step up.

A few minutes later I was brought into the examination room.   Because this was just a face-to-face, I could keep my close on.   This made me feel better.   It would be difficult to conduct what is basically an interview, in my underwear.   Not that   I don’t have nice underwear, I was wearing boxer briefs.   But to conduct an interview, one would really need to go with straight up boxers, preferably white with blue stripes.  

The doctor came in at 8 after, besting the guaranteed time by two minutes.   He introduced himself and took a look at my freshly created folder.   We started a brief conversation about how he works with people in the MDVIP plan.   He let me know that as a VIP patient I would have his mobile number and email, and that he actually likes texting.   He showed me his Blackberry.   I considered engaging in an iPhone vs. Blackberry debate, but I wasn’t sure if I was going to be personally charged for this session yet.  

He asked me if I was looking for anything specific.   I mentioned my desire for a true physical, and recounted (in shorter detail than above) my last encounter with a doctor for a physical.   He assured me that the Executive physical was not only very invasive, but time consuming.   I would be spending 45 minutes on the written portion of the exam alone.   Visions of SAT prep entered my head, and I was both excited and nervous.  

I mentioned that I had a problem with my hearing, and that it had been an increasing problem over the past couple years.   He moved forward and grabbed a stethoscope.   I told him the previous doctor said I was just getting old.   “You’re only 37.” he said.   God bless this man.   I now know how older women feel when someone says “only” in front of their age.   He took a look in my left ear, and then my right.   It’s the right one that is giving me the real issue.   “It’s all blocked up” he said as he put the stethoscope back.   “Really, the right one?” I asked.   “Yeah, with soft wax.   Do you use the phone a lot with that ear?”.   I told him I’m on a headset most of the day for phone calls.   He told me that wax builds up sometimes to protect the ear from damage.  

He decided that before we do the physical, which includes a hearing test, we should clean out the ear so that we don’t skew the results with a known issue.   He also recommended that after the cleaning, I turn down the headset a little to prevent reoccurrence.  

So far I was already ahead with this guy, and he didn’t even make me get naked for him yet!  

After a few more questions back and forth, we concluded what ended up being a thirty minute session.   I believe that’s the longest I have ever spent with a doctor that didn’t want to discuss my feelings about my mother.  

I headed to the nurses desk to make arrangements for my follow up ear washing.   I was actually walked over to the desk and streamlined through the process.  

Overall I was quite impressed with my boutique medicine visit.   I am of course comparing it to a really crap doctor in a small town, but I do feel the level of service was beyond what I have ever seen for a doctor.  

I just got the voicemail from MDVIP to follow up on my appointment last week.   I will likely be signing up with the plan by the end of the year.   I figure Michael and I can start the new year with physicals and enjoy a few months of knowing we’re not dying from anything, at least not quickly.  

I’ll do a follow up on this post after my physical to let everyone interested know what it entailed, and how it went.