Possible (or Legal) to Hire Your Own Doctor?

Let’s say I was filthy rich, and I didn’t want to get my medical care by waiting in a waiting room with all the plebians. I offer a physician a salary comparable to what he could make in his own practice, set him up with a fully-equipped office in my mansion, and make him my own private doctor. He spends his days researching, or doing whatever it is doctors do in their down time, but his only patients are me and my family, and any of us can see him whenever we please, no appointment.

Is such a thing even legal? Is it done today?

Doctors can work for whomever they please, as long as they’re licensed and not doing any illegal procedures or selling crack and whatnot.

It would be pretty unusual for a doctor to be hired to take care of one patient 100% of his time, though. Even the sickest people can have most of their needs met by nurses or other staff, with the doctor coming around once in a while.

So your hypothetical doc would probably get pretty bored, and start seeing patients in the nice office you built him anyway.

Here in Charlotte, and I imagine in any city of its size or larger, there are “concierge” medical practices which basically cater to the filthy rich. I would think that would be a much better way to spend your limitless wealth.

Sure, it’s legal. But in addition to the fact that it’s a huge waste of resources, you wouldn’t expect any really good doctors to be willing to take the job because it will result in a big hole on their resume when you kick off, so it’s going to be even more expensive.

–Cliffy

Yes, it’s legal, but I doubt it’s very common in real life. Both the movie Being There and Heinlein’s I Will Fear No Evil featured elderly, frail, filthy rich men who had a doctor in attendance fulltime, IIRC. Conan Doyle had his own interesting spin on the concept: http://en.wikipedia.org/wiki/The_Adventure_of_the_Resident_Patient

I’ve heard tales of Saudi princes hiring young American doctors for a “fellowship” that consists of treating the royal family for a year. No idea if there’s any truth to those stories.

It’s perfectly legal in the US; a physician here is under no obligation to work for anyone in particular. As mentioned above, concierge or boutique practices are also common. In such a model a patient pays a fee above and beyond other insurance to gain access to a particular practice. It’s more likely that the doctor’s office will be cleared out for the “rich people days” as opposed to setting up a clinic in someone’s house, but if you are Howard Hughes and you have the OCD thing with germs going, sure–the office could be in your mansion.

There are a couple considerations. A totally personal physician is, in effect, simply a hired consultant. If you get sick and the physician actually needs to extend care versus simply advise you, most significant care requires physical facilities and a whole team of caregivers–everything from nurses to a variety of specialists. In theory you could have your own entire (privately-funded) “clinic” as long as you weren’t in the business of taking care of anyone but your owner; once you are in the actual hospital business, so to speak, you are subject to a host of regulatory requirements. And a totally stand-alone clinic that just sits there waiting for the rich guy to need his procedure is going to kill him the first time they try to do anything–if they aren’t doing complicated procedures every day, they aren’t any good no matter how much they practice on mannikins. There are also regulatory considerations to consider: you might need a state license for setting up your own proton beam therapy, and they ain’t gonna give you that license just for your personal use.

There’s a second consideration: your own private physician is, by definition, a non-practicing clinician. She may have been the world’s expert when you hired her; three months later she’s already rusting. The thing that keeps us sharp is practicing and interacting every day. Book learning alone doesn’t cut it.

Finally, to be able to get you the best care a doctor has to have extensive relationships with rest of the medical world. This usually means being on staff somewhere and having some clout with that staff.

In the end, the model that’s usually followed by the well-heeled is the good old “connection” model. They do have physicians (and even hospitals) that tend to cater to them even if it’s not one-on-one. And when they actually get sick or need a procedure, those physicians know they right guy to get them the best care. And I’d be surprised if that’s any different than any other country in the world. The difference in the US, in my opinion, is that that right guy might be operating the next day on a pauper from Missouri.

Not that I’m trying to drag us from GQ to GD (this might be the first time I’ve ever even taken a thread close to the line :wink: ) but is there really such a big difference between Missouri paupers and those from Canada, Brazil, India, Israel, Germany, Wales, or Australia?

Which is to say, if you’re making the point that only in the US would the most distinguished and talented doctors be taking care of poor people, I don’t believe that you’ve got your facts straight.

When you go to a hospital and see that a wing is named after a major benefactor, it’s a safe bet that benefactor and his family get a little extra attention when they show up with a problem.

I suspect a privately employed physician would be watched closely by some government agency lest they become Dr. Feelgood.

Ah… It’s happened once before (a doctor becoming a full time “employee” of one patient).

The doc: Dr. George C. “Dr. Nick” Nichopoulos, from 1970 to 1977. The patient: Elvis Presley.

Dr. Nick’s career didn’t end well, but IIRC while he was Elvis’s full time physician the Tennessee medical authorities weren’t exactly breathing down his neck. It was only after Elvis was long dead (1995 or so) that the TN medical board got around to yanking his medical license, when they (finally) discovered that he’d been overprescribing for a number of patients. They did indict and try him in 1980 for overprescribing (mostly to Elvis and Jerry Lee Lewis), but Dr. Nick’s defense was that he was trying to wean Elvis off the painkillers, and the jury bought that defense and acquitted him.

Cheers,

bcg

Actually, Dr Nick went on to treat other stars and still remains a celebrity:

IANAD but I do computer work for a mobile doc. He works from home and has around 50 clients who pay him a monthly fee. If a client has a problem he goes to them, checks them out, writes scrips as needed, etc. He has a helper who runs samples to labs for testing and picks up/delivers scrips.

I didn’t ask how much he charges…I probably dont want to know.

The big shot, of whatever kind, could also have different doctors in different places. My GP in New York years ago was also personal physician to the Greek Orthodox Patriarch. But the Pa only spent part-time in NY, and was very old but not terribly sick, so my doc also had other patients.

Why on earth did you think it might be illegal?

They actually have similar physicans but most of these doctors are at or close to retirement and want something to do.

Research doctors will do this to, though as one poster mentioned they probably won’t make the best GPs because they are out of the mainstream and focused on research. But it could be an excellent gig for someone who was retired or about to.

Just put them in your will.

My dad is an orthopaedic surgeon and essentially spent ten years as the personal orthopaedic physician for the Omani royal family.

When they didn’t need him he worked in the Armed Forces hospital in Seeb, which is reserved for Omani servicemen and their families; when a royal needed medical attention, he was expected to hand off all his other patients to one of the junior consultants.

I feel it’s worth pointing out that the fees paid to “concierge” docs usually aren’t entirely outrageous. A typical “retainer” can run from $1-2,000/year per person or per family depending upon the size of the practice. Given that we spend, on average, ~$7,000 per person per annum in the United States on health care, if the ready availability of a primary care doc can avoid one-two unnecessary ER visits per year, “concierge” docs could even be cost effective. Many proposed primary-care centric models that have been proposed for the reform of the US healthcare system would pay a similar capitation per patient for primary care doctors that would ideally truly coordinate and lead the care of a particular patient.

Let’s not forget the house doctor in Hannibal.