RECIPE FOR SUCCESS:

Remember when the telephone company actually gave you phones for free? And when we didn’t pay for TV or for bringing luggage on an airplane?

Services we enjoyed for free less than 20 to 30 years ago are now being resold to us at a premium price.

But should this philosophy of paying for service apply with our family doctor?

Many are asking that question as “concierge medicine” becomes a growing trend in health care.

Physicians in these “concierge” or “Platinum Practices” cater to a wealthy clientele who are willing to pay an annual fee to have their doctor on retainer/on call 24 hours a day.

No more waiting weeks for an appointment, or a call back. You have the doctor’s cellphone number and e-mail address.

Some concierge doctors make house calls and accompany you to specialists. The doctor spends quality time with you during appointments instead of rushing you out in 15 minutes or less, but these services don’t come cheap.

Yearly fees can range from $1,000 to $20,000 and more depending on how many patients are in the practice. The fewer the patients, the higher the fees.

These types of practices are popping up in affluent communities across the country and of course right here in Newport Beach.

A Google search on concierge medicine turns up 123,000 sites.

Doctors in these types of practices justify the annual fees, saying times have changed. They’re faced with rising malpractice insurance rates, overloaded patient schedules, delayed payments and red tape from insurance companies; they need to pare down their practices to return to a level of patient care like the good old days of Marcus Welby, M.D. and yet make ends meet.

But is concierge medicine really a recipe for success for doctors at the expense of the patients?

If a doctor takes a practice of 3,000 patients and reduces that to 1,000 at an annual fee of $2,500 it equals $2.5 million annually — and that’s conservative.

The concierge business model offers doctors lucrative fees, less patient load and a crème de la crème clientele.

But how would you react receiving a letter from your longtime family physician saying the practice was going concierge? Would you pay? Many facing this dilemma say they have no choice but to pay if they want to keep their M.D. Changing doctors and developing a new medical relationship is a hassle.

Some established practices are blending patients retaining some who don’t pay a fee. It’s the difference between buying a first-class or coach airline ticket. You get to the same place, but the level of service depends on how much you’re willing to pay.

Is this elitist form of medicine taking advantage of those who can pay, and discouraging to those who can’t worsening the health care gap in this country?

There are also legal and ethical questions being raised by some states and insurance carriers.

My family doctor recently retired. Over the years he made many house calls. I had his private numbers. He accompanied me to specialists during some very dark times. We’ve laughed and cried together. He did those things not because I was paying him exorbitant fees, but because that’s just what doctors did.

BARBARA VENEZIA is the chairman of the Santa Ana Hts. Redevelopment Project Advisor Committee and was the co-creator of the cooking show “At Home on the Range” with John Crean.