The health-care industry is changing. In a couple of years, U.S. health care may be troubled by overcrowded emergency rooms, overbooked primary care offices, lengthy waits for appointments and overreliance on imaging and lab technologies rather than critical thinking.
Advances in telemedicine and the growth of concierge health-care services, however, provide wealthy families with more options when it comes to getting quality medical care.
Concierge medicine should at the least provide clients with rapid access
to their local physician's office. It should also include two key-and
often lifesaving-resources for client families:
Immediate diagnosis and treatment: In an emergency, no matter the time or place, a doctor must be available to diagnose, initiate and guide medical care.
Longevity planning: A formal strategy must be designed and monitored by a physician to achieve maximal health.
To meet these fundamental requirements, caregivers have two options: A physician and support staff that can handle clients around the clock or, more practically, telemedicine.
Telemedicine, it should be noted, has advanced substantially in recent years. Emergency treatment and diagnosis, as well as substantial primary care, can now be delivered over large distances, on demand. Telemedicine is also effective for managing chronic conditions.
Telemedicine often includes provisioning clients' homes with the equipment and medications they need for remote care. Databases of pre-qualified doctors and hospitals around the world and electronic medical records are also among the components of a quality telemedicine platform.
The Case For Immediate Telediagnosis And Treatment
A 52-year-old CEO was on a trip to Dongguan, China, to close a partnership with an electronics manufacturer. He contracted a cold ten days earlier in Jakarta, Indonesia, but had recovered. That Saturday morning, however, he awoke at his hotel with paralysis on the left side of his face, a sign that he may have been having a stroke.
For this CEO, or anybody above the age of 40, the greatest risk in a medical emergency lies in what physicians call the "golden hour"- the window of time after a traumatic injury when intervention has the greatest chance of saving the patient's life.
Concierge medical services with telemedicine capabilities offer the immediate response that is required in such situations. Moreover, the concierge provider can develop a local hospitalization contingency plan as part of a client's trip preparations, including plans for medical jet evacuations.
In this case, the CEO called our firm and was immediately connected with a doctor through a video connection on his iPhone. The transmitted picture was literally worth a thousand words. The left side of his face was indeed paralyzed, but he was able to wrinkle the left side of his forehead. This subtle detail told the entire story. Rather than a stroke, this was a classic case of Bell's Palsy: a temporary paralysis of the facial nerve.
Using the travel medical kit we put together for him before his trip,
the CEO followed the instructions of the physician and medicated
himself. He then made an appointment with a pre-screened,
British-trained neurologist at a hospital in Hong Kong for the following
day. His primary care provider in New York was notified and we
continued to track his progress closely. Three weeks later, the CEO was
The Case For Long-Term Telemedical Care
An older high-net-worth couple and their adult daughter built a successful company selling baby products. One side of the family had a history of breast cancer and dementia. Both parents were intermittent lifelong smokers and were eager to improve things.
The couple managed the company, which they founded. Their 36-year-old daughter was on track to take a leadership role, but was not yet ready to assume those duties.
The family had done virtually no health-care planning, but it was clear they needed a business-like strategy for achieving personal health goals. Our challenge was to create a detailed, actionable and trackable platform designed to maximize their health and possibly lengthen their lives.
The process we use for creating such a plan has several components:
Medical records: We gather all the client's medical records and organize the core data, including active medical conditions, allergies, medications, genetics and lifestyle. A best-practices checklist is applied to all the information.
Physical exam: Using the medical records, we develop a detailed list of exams and lab work that will be used for a customized, baseline physical exam.
Plan creation: A long-term action plan is created based on any conditions or risks identified in the baseline physical. The patient's administrative staff is made aware of any appointments. We monitor the patient to ensure the plan is acted upon.
Keeping score: We use a 100-point scoring system based on lifestyle, clinical health and compliance with the plan. Part of the score, for example, is based on the client's diet and smoking or drinking habits. Clients were skeptical of the system at first, but they are now keenly aware of their scores.
For our executive couple and their daughter, the father's family history of breast cancer led us to include genetic testing in the daughter's baseline executive physical. Her test was positive for the BRCA gene, putting her at a heightened risk for developing breast cancer. We changed her personal longevity plan to include more frequent breast exams and mammograms.