Concierge care: Local pediatrician offers cutting edge approach to medicine

She's gone where no one has gone before -- at least in this part of the country.

When local pediatrician Dr. Jennifer Liles opened a new concierge pediatrics practice at 110 N. Water St. early this year, she did so knowing that no one else in this region of the United States had attempted such an endeavor.

While adult concierge medicine is better established, she said, "shockingly there are no national models for pediatric concierge practices ... We are on the cutting edge of that." 

So just what is concierge medicine?

"It's a paid monthly service for me to become their physician and provide 24-hour a day, seven-day a week, 365 days a year excellent care," Liles said. "I'm only taking 300 patients and I have about 150 patients right now. Concierge medicine is about getting to know a small group of patients. We are trying to take the best care of a smaller group of patients that we possibly can, providing world class care."

"In today's society, I think it's become about getting patients in and out, in and out. See more, see more, see more. So what we're finding, nationally, with adults and kids, is that a medical provider has about eight minutes to spend with each patient. Some things can be solved in eight minutes like strep throat or ear infections and pink eye. But there are a lot of things that can't be solved in eight minutes," Liles said.

"So I've branched off from the traditional way of practicing medicine -- get them in, get them out -- because I was finding that I wasn't being a very effective physician. I was seeing patients at Wal-Mart or out at the Riverwalk that I hadn't seen in a year or so and I'd say, 'That's such a great thing that you've been well.' They'd respond 'No, we've had eight ear infections but we can't ever get in to see you so we go to urgent care or to the MOM clinic. We are going elsewhere to seek care because the physicians are so busy.'"

Spending eight minutes with a patient, "it's not what patients want and it's definitely not what physicians want because we don't feel we know our patients. Concierge medicine is truly concierge, just like your concierge desk at a hotel. I'm here for my patients, 24 hours a day, seven days a week. And I know them better than any practitioner out there. When they do call me with a question or text me with a question, I know exactly who they are and their history. I have their electronic medical history at my fingertips. We have convenient appointments. We can get them in and I'm not sending them to urgent care, or we aren't making them wait two weeks until I can see them," Liles said.

"I provide anytime access, even in some cases, house calls. If there is a family of five and they all have the flu, I don't want that poor mama to have to get out and bring all five kids to the office. No. We'd make arrangements to meet them at their house," she said.

"I'm only taking 300 patients but when I worked with Methodist Pediatrics I was seeing 5,000 individual patients annually," she said.

"You really need to have the same doctor seeing you over and over again to put the trends together," Liles said, adding that the continuity minimizes the time it takes to get a diagnosis for an ongoing problem, versus seeing one doctor then a different one. "Seeing the same doctor also could cut down on health-care costs for things like chest X-rays and labs. Because if you only see a patient once, you don't want to miss anything" so a lot of tests are ordered.

"Keeping the numbers low, you get to know your patients really well," said Jamie Liles, who is Dr. Liles' sister as well as the office manager.

"Our patients become like friends and family," Dr. Liles said.

The monthly fee for one child is $55; two children it's $85; and three or more children it's $100. The fee is separate from costs associated with doctor's visits and those related medical situations which would have to be filed with insurance. Dr. Liles said her practice accepts all major private and commercial health insurance plans at this time. People can also pay with cash, check, debit or credit cards.

"Insurance doesn't pay the monthly fee yet, but if you do have a Health Savings Account, we can give you a receipt showing what the service gets you. You aren't just paying for access to a physician, we will also perform extra screenings during their wellness exams and extra testings that if it's not covered by insurance, then we don't charge," she said.

"I know people aren't used to paying a monthly fee in addition to insurance because we all have to have insurance and it's very expensive, but I try to keep my costs down. Adult concierge medicine is quite a bit more expensive. Just one adult is $1,250 a year. Some practices in Louisville charge around $4,000 per adult annually. I try to keep my prices down. We also do some special pricing if you want to pay for the entire year up front."

Union County resident Jessi Gibson is one of the parents that decided to give the pediatric concierge practice a try. Her 15-month-old J.B. is one of Dr. Liles' 150 current patients.

"We went to Dr. Liles when she was with Methodist and at that time we had trouble getting same-day appointments," Gibson said. "Because I'm a nurse, I don't take him to the doctor for everything, so when he does go to the doctor, he really needs it. When she opened her own practice, I felt it would be good for us to stay with her."

Having 24/7 access to J.B.'s physician, she said, "Is a huge relief. It's so nice to text her and be able to reach her even when the office isn't open. We love the convenience of it."

As for the monthly fee, Gibson said, "I feel that if I can pay that for my hair and to have my toenails and fingernails done then I can pay it for my child's health. Some people may be hesitant about a monthly fee, but let me give an example. One Saturday, J.B. woke up with a 104-degree temperature. I texted Jen. She called in medicine and he was better by the next day. When they are little, they can go down so fast. The same day appointments can make all the difference."

"We love our community," Jamie Liles said. "We love Methodist Hospital, but they recently closed their pediatric floor so knowing that her patients have access to her and to medical care without crossing the bridge or going to Owensboro" is a benefit and relief to them.

Henderson resident Leslie Burton also wanted to keep her children, Norah 4, and Emilia, 6 months, with Dr. Liles.

"We saw her at her previous practice," she said. "We wanted to go where she was."

Concierge medicine has worked well for their family, Burton said. 

"Knowing that any time I need a doctor, I can get in touch with her, and knowing that there is someone on the end of the line who truly cares about my kids makes all the difference," she said.

Burton said she and her husband had to think about and get used to the idea of a monthly fee.

"We decided to make the sacrifice up front to see if it was worth it," she said. "It's been well worth it."

"Her patients now have her personal cell phone number and they've been really respectful," Jamie Liles said. "They text, they call or they call the office. I think having that access has made the patients appreciate it and not take advantage of it."

"We've had some naysayers," Dr. Liles said. "I've been accused of being greedy, but actually I've taken a huge pay cut to start this business and I'm so much happier and my patients are so much happier."

Concierge medicine has a "back in the day" feeling when towns had one doctor who really got to know each patient, she said.

"We are taking it old school ... where the physician and the patient are a team ... but in a cool digital age."