A former U.S. Navy officer, Daniel Carlin spent his early years as a physician in a refugee camp in Pakistan and an American hospital emergency room before developing the idea of providing telemedicine to ships. Then in November 1998, Carlin gained global acclaim after emailing lifesaving instructions to a solo yacht racer, enabling the patient to self-operate on an infected elbow 1,000 miles offshore.
“It was a seminal moment,” he said. “I used the internet to save a man’s life.”
As the founder and CEO of WorldClinic, a concierge telemedicine provider to family offices and other ultra-high-net-worth individuals, Carlin centered his practice on understanding that today’s fast-paced, mobile executives need health care that goes everywhere with them. “What they’re looking for is speed, convenience and accountability,” Carlin said.
While concierge health care has been around for decades, a new generation of providers has raised the bar for what’s available for family offices and ultra-high-net-worth individuals, thanks to cutting-edge technologies and approaches that enable a more holistic approach than ever.
It’s no longer just about having a doctor on call; it’s about preventive health care and managing outcomes.
“The life sciences revolution is changing the way we understand bodies in high-resolution detail,” said Jordan Shlain, M.D., founder and managing partner at Private Medical, a concierge health care practice with offices in San Francisco, Miami and New York.
Private Medical’s model focuses on preventive medicine and relies on its relationships with academic centers of excellence in the United States and doctors in 203 cities worldwide. Shlain said his firm is less concerned with technology than access and convenience. “For our families, we’re on speed dial,” he said.
COVID CHANGED EVERYTHING
Having such a service at a family’s disposal certainly comes at a price. Concierge health advisers typically charge an annual fee of between $25,000 and $80,000 per family member. Others sell their services like law firms, in hourly blocks. But in most cases, those fees are all-inclusive and cover a wide range of tests and services.
Many family offices decide that the benefits outweigh the costs. “For this particular slice of the economic pie, money is no longer the currency of their lives,” said Carlin of WorldClinic. “Time is the most precious commodity. And thankfully, that’s our sweet spot. That’s often why we get hired, because they’re so time-sensitive. They are aggressively opposed to ever wasting time.”
When the pandemic first hit in early 2020, the traditional, insurance-based health care system was caught off-guard. Many health care professionals were worn out by the traditional model of medicine. According to a recent study conducted by Brigham and Women’s Hospital, nearly 50% of a group including doctors, nurses and clinical staff reported burnout, with 28.7% expressing an intent to leave the profession.
Rather than quitting medicine, some have migrated over to concierge health care to practice their craft the old-fashioned way. In today’s world of concierge care, house calls, prescription deliveries and coordinated appointment schedules are all part of the package.
And while concierge services are used by a relatively small group of ultra-high-net-worth individuals and only employ a sliver of the medical community, their innovations may offer glimpses of a solution to the overall crisis in health care.
Derrick Miles knew from his background as a health care executive what worked and didn’t work. He started CourMed as a prescription transport service in 2018. During COVID, he was able to get monoclonal antibodies to an executive with the virus traveling in Mexico. In another case, a hedge fund manager in Miami Beach woke up on Saturday morning and discovered he needed to close a deal in another country but needed a PCR exam to get on the plane.
“We sent a nurse to him in 15 minutes to do the test,” said Miles.
Now CourMed provides on-call medical care to family offices as well as to banking firms and branded residences. CourMed works primarily outside of the health care insurance networks.
“Our clients pay cash,” said Miles. “We work with our attorneys so they can write it off on their taxes.”
Better Health Advisors founder and CEO John Samuels, another former hospital administrator, built his concierge firm around the idea that insurers don’t have patients’ well-being as a priority.
“Our service is separate from health insurance,” he said. “Your insurance pays for doctors' visits and hospital care. The work we do is to help coordinate the care, so we arrange appointments, talk to doctors in between appointments. We help people find the right doctors and the right facilities. We help support second opinions. We create a plan for our clients.”
GOOD HEALTH — AND A GREAT VALUE
It’s not hard to imagine a future where looking at a family’s big-picture health needs becomes more commonplace. Taking a familywide approach to health care has significant long-term benefits.
Private Medical builds a detailed medical annual report for each person and creates an iterative strategy throughout the year. If its medical staff uncovers a genetic predisposition toward, say, cancer or dementia, it will notify younger family members and conduct the appropriate screenings and adjust the strategy accordingly.
“A lot of people take comfort that we are managing ‘the medical spreadsheet of their life,’ ” said Private Medical’s Shlain.
Some concierge health care providers rely on technology for that high-touch experience.
“Yes, we have technology, and similar to Uber and Lyft, we have health care providers who use that app,” said Miles of CourMed. If a patient needs a blood sample analyzed before taking a certain medication, the need will be addressed in real time by a professional who can help immediately.
Other providers are more advisory and focused on on-call human interaction. Samuels of Better Health Advisors said his firm does everything from mapping out the costs of long-term assisted-living care for a senior family member to determining whether a family office has the right insurance plan.
“It’s not a family office’s job to solve the health care dilemmas of their family members,” he said.
Regardless of the solution, most concierge health care providers argue that their services are becoming more of a necessity than a desire.
“A lot of people don’t think of their health as an asset, they just take it for granted,” Shlain said. “But if you thought of your body as a portfolio risk, how do you invest in decreasing the risk? So that’s what we do. We use data-driven evidence and try to get you to understand what your state of health is and how do we improve it. How do you become healthier 10 years from now than you are today?”