Dr. Cyrus Peikari received his MD from Southwestern Medical School in Dallas, which included several prestigious externships abroad. He then completed his Internal Medicine training at Dallas Presbyterian Hospital. Dr. Peikari is a well-known physician and author who has written several books. His medical textbook is used by physicians across the country as a study guide for ABIM Internal Board Examination certification.

After 10 years in leadership positions at Baylor Medical Center and Presbyterian Hospital, Dr. Peikari decided to change course and opened a solo practice. Born and raised in Dallas, he has always felt a strong connection to the local community. A few years later, he turned to a concierge-style medical practice.

With a concierge-style practice (also commonly called boutique or retainer-based medicine), patients are charged a monthly or annual fee. Insurance is not accepted. This, according to Dr. Peikari, eliminates a host of problems that the typical doctor encounters. Dr. Peikari normally accepts no more than 200 patients in his practice and spends at least 30 minutes with each patient per visit. This allows for highly individualized care. Most doctors see 30 to 50 patients a day. Patient satisfaction in this type of setting is predictably higher.

Although this model tends to favor people with higher incomes and those with more complex medical conditions, the model has been successful in places like Seattle, where Quliance hasn’t accepted reimbursement insurance for more than 15 years. Patients pay a flat monthly fee for unlimited access to 13 doctors. This model has been extremely effective as typically 40-50% of the overhead in a medical office is spent on billing and collections. As Dr. Piekari states: “Everyone in health care is in transition, the market is eliminating traditional practices, which are going bankrupt. It’s becoming Concierge Care or Mass Medicine.”

We were lucky enough to take a few moments out of Dr. Piekari’s busy schedule and have him answer some of our questions about Concierge-style healthcare.

Kevin: Dr. Peikari, one of the main complaints from most patients is that they see an increase in waiting time and a decrease in individual attention from their doctor. Concierge care is a trend that is increasing in popularity. Could you explain the basic business model and why more doctors are choosing this type of practice?

Dr. Peikari: Concierge or “cash only” practices are changing health care back to the way Marcus Wellby practiced it on television. Until now, third parties such as insurance payers and the government have crowded into the exam room. Concierge care brings back that up close, private and personal attention. He has a trustworthy doctor again, like the one he had when he was a child.

Kevin: How can a patient expect to be treated any differently in this kind of setting?

Dr. Peikari: Concierge medicine allows enough time for a full discussion of your problems. Often I don’t find out what the real problem is until after 30 or 45 minutes of talking with a patient. It’s so refreshing to be able to get these important health advances. This is what you miss in a 3 minute visit.

Kevin: Do you think this will be a viable alternative to traditional insurance-based health care now that the Affordable Care Act is about to go into effect?

Dr. Peikari: It’s viable because in a cash-only practice, the market determines prices. Although the nature of our specific services places us at the higher end of the cost spectrum, you can now find concierge services at a great price…thanks to free market forces at work.

Kevin: Can you explain how this type of practice gives you the ability to spend more time with your patients?

Dr. Peikari: By eliminating third-party payments, our busy work time is reduced by 90%, allowing our face-to-face time with our patients to increase by 1,000%. So a rushed 3-minute visit automatically turns into a leisurely 30-minute visit.

Kevin: How can a patient get the individualized attention of Concierge and at the same time be prepared in the event of a catastrophic illness?

Dr. Peikari: We recommend catastrophic insurance with a higher deductible. In fact, this is what “insurance” was originally created for: to “insure” you against catastrophes.

Kevin: In closing, Dr. Peikari, what is the most important consideration to have when deciding what type of health care is best for your needs?

Dr. Peikari: Your personal point of view on healing is what is important. If you think a prescription and a 3-minute visit is all you need, then the current system works well for you. However, others believe that it is the relationship with the doctor, rather than just the drugs, that helps unlock her inner healing abilities.

Dr. Cyrus Piekari runs his Texas MD medical practice in Dallas, Texas. You can reach him at 214-739-6100. His business website is texasmd.com.

Kevin Nimmo is a writer and online media strategist. He interviews subject matter experts and educates his readers based on information provided by experts in their respective fields.