February, 2007 Archive

February 27, 2007, 11:41 am

The Emergiblog Review: MDVIP – Beyond Concierge Medicine

mdvipI have been asked to review the website MDVIP/Beyond Concierge Medical Care/Preventative VIP Medicine.

I have received compensation for this review from MDVIP. They do not, however, know the contents of this review. They are seeing it for the first time, just as you are now.


An MDVIP physician is one who has chosen to limit their practice to no more than 600 patients in order to provide personalized service to each individual (a normal practice may have up to 2000).

They offer 24/7 access, often via private phone numbers, hospital care, same day or next day appointments, unhurried visits and some will even do house calls.

The focus is on preventative medicine and health, which according the website results in fewer hospital admissions.

It seems not every doctor who applies can become an MDVIP, only the best are chosen. And, if you are a physician with the usual 2000 patient practice, you must decrease your number to no more than 600 and MDVIP helps you find care for your patients with other local doctors.

Basically, by helping doctors practice medicine the way they’ve always wanted, they enjoy their private practice and are able to have a life outside of medicine. Surprisingly, they get very few after-hours calls from their patients!


Patients receive personalized care, including a comprehensive yearly physical,

  • a personalized wellness plan,
  • a mini-CD with all their medical information on it (including EKG) that is playable on any CD (except vertical),
  • a personalized MDVIP website,
  • Travel Advantage (if you get sick while traveling and you are near an MDVIP doctor, you get the same personalized care),
  • the Medical Centers of Excellence program (in other words, they are hooked up with major medical facilities across the country and will assist you in obtaining appointments – your own insurance kicks in here and if it doesn’t cover, the patient is responsible for the charges), and
  • assistance with any insurance or prescription questions

Since the focus is on preventative care and healthy behaviors, the patients are assumed to be motivated and interested in living a healthy lifestyle based on their personal wellness plan.


Now, MDVIP is not insurance. It is also not a free service. Patients pay a membership fee of $1500 – $1800 dollars a year (average) for access to the advantages of an MDVIP doctor.

Patients still need insurance – the membership fee covers the preventative tests that most insurances will not cover in a physical and it also pays for the increased access and time the MDVIP doctor is able to give their patients. The MDVIP plans work with most insurances and with Medicare.


The site is one big advertisement, which isn’t necessarily a negative. One section is for physicians, the other for patients and still yet another for business executives (Executive Health Plus).

But it was very hard to find out the cost – I had to drop all the way to the bottom of the site and click on the “Press Room” link, then click the “About MDVIP” link on the left sidebar, then click on the “Corporate Fact Sheet” and then scroll down to “Patient Services” for the cost.

I would suggest putting the cost right up front after all the explanation of benefits in the “Patient” section.

Patients want to know. They don’t want to (1) have to send in for information or (2) download the brochure which said all the same things and never mentioned the cost!

In my own personal opinion, the cost is not excessive so there is no reason to make it so hard to find. By doing so, the site came across as a sort of “baiting” sales pitch and that left an initial negative first impression on me.

MDVIP needs to put ALL their information right up front on the pages their potential patients will see and that includes the cost of membership.


So, would I sign up?

Heck yeah!

Except that I am extremely pleased with the physician I see now (who happens to be within walking distance from one of the MDVIP doctors, a local MD with a wonderful reputation, by the way).

If my primary ever goes the MDVIP route, I’ll pay. If he retires or closes his practice, I’ll see if the local MDVIP wants to take on a very opinionated ER nurse/patient!

Just get that cost up front on the website! It will change the look of the site from one of a sales pitch to an informative look at an alternative to primary care. First impressions are important. Don’t bait the readers – inform the readers.

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9:05 am

Musings of a Grand Rounds Nature


My thanks to #1Dinosaur for hosting this week’s Grand Rounds at Musings of a Dinosaur for two reasons:

  • The entry from Emergiblog was included and for that I am very appreciative
  • I will use any, and I mean ANY excuse to use a photo of Jeff Goldblum on this blog.

Mr. T. Rex looks like he is ready to devour Mr. Goldblum in this photo.

I can relate.



Since the name came up, you might be interested to know that as of March 15th, on Fridays from 2100-2200, I will accept no calls, take no shifts and intend to buy a second television because my husband is stingy with the remote.

For the first time in decades, Jeff will be the star of a new TV series called “Raines”, in which he plays an LAPD detective who solves murders – with the help of the victims themselves!

(Cue “Twilight Zone” theme!)

So what has this got to do with emergency nursing, you ask? (And I know you are!)

Well, there is a great propensity for extreme tachycardia, possible hypertension and profuse euphoria while this show is on.

At least in this house.

I wonder if I should have a portable defibrillator handy?


Now back to the serious business of medicine!

Radiology Grand Rounds are up at Cochinblogs – very educational, at least for me.

There is a great picture following the the history of a male patient in sudden, acute excruciating pain with board-rigid abdomen.

Can you make the diagnosis before you see the photo?


Change of Shift submissions are already filling my mailbox for the next edition on March 8th. Please send me your nursing stories – the only requirement is that the stories are nurse related, and anyone is welcome to submit!.

As always, you can use the contact button at the top of this page or the ever popular and efficient Blog Carnival (you’ll find the widget in the middle bar on the left).


The deadline for submissions for the Nursing Jobs.org scholarship is rapidly approaching! There is good money available for the best essays on “Why I Chose Nursing”. Visit Nursing Jobs. org and the information is right there on the left!

By the way, it’s a great new look for the site!

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February 24, 2007, 9:47 am

Save Me From the Nothing I’ve Become



I suppose that if you are standing underneath this guy, you would want him to have access to prompt diarrhea control.

It’s got antibiotics, soothing, detoxifying properties and it tastes like fruit.

And those are just the major advantages!

I guess the minor ones include clean underwear and a fresh smelling derriere.

I guess anything is better than having the “urge” to go when you are thirty feet in the air….


She bolted upright from a sound sleep at 0400.

Something was wrong. She heard voices in the hallway.

She got up. No one in the hallway.

She decided to go to the bathroom and then check on her adult son sleeping across the hall. “Mothers”, she thought. “No matter how old they are, they’re still kids.”

Even in the darkness she could see.

Her scream pierced the silence.


He was the color of paste, his lips cyanotic.

She thought he was dead.

He was damn close.

Her husband heard her screaming and ran into the room. Luckily, Joe was a trauma nurse.

Agonal, gurgling respirations. Pulse of twenty and thready.

Joe threw his son off the bed and onto the ground. He positioned the airway, clearing vomitus from the mouth and beginning rescue breaths he ordered his wife to call 911 and his other teen-aged son to start chest compressions.

It seemed like hours before the firefighters and the medics arrived, Joe kept rescue breathing and trying to deal with the continual emesis impeding his efforts. When the medics arrived, Joe ran into the bathroom because he was throwing up.

The patient responded to Narcan. His breathing became less erratic, and an oral airway with bag assisted ventilation was stopped. His behavior bordered on combative as he was placed in the ambulance with his mother in the front passenger seat.

The patient was no stranger to drug use, but the overdose was accidental.

That family came this close to losing a son.

And I came very close to losing a nephew.


You can imagine my interest when I was contacted by Adam Isserlis from HBO. Here is what he had to announce:

“Beginning March 15, HBO debuts a 14-part documentary series on addiction that redefines drug and alcohol addiction.

THE ADDICTION PROJECT reveals new medical information about addiction; startling statistics; issues that face 1 in 4 Americans affected by a primary family member struggling with drug and alcohol related problems; and innovative new treatments that are changing the dialogue about an illness that is now considered to be a brain disease that is a treatable chronic condition as manageable as diabetes; hypertension or asthma.”

As a nurse, I find trying to help my addicted patients difficult at best. The manipulation, the lying and the general behavior that the addiction perpetuates can be emotionally exhausting, often leaving the health care giver frustrated at the ebb and flow of recovery or in the short-term acute situation, angry at feeling manipulated or duped into giving the patient what they are really asking for: a fix.

This makes those patients with legitimate chronic pain issues feel as though they are treated with suspicion when they seek help for breakthrough pain in the ER. They aren’t imagining it.

As a family member, I’m sick for my nephew, know he’s a good kid underneath it all and want to see him succeed in his recovery.

“Directed by 20 accomplished documentary filmmakers, THE ADDICTION PROJECT presents gripping stories of addiction and recovery from emergency rooms to the work place.”

The documentary also presents the nation’s leading experts and organizations in the forefront of the effort to understand and help 1 in 10 Americans over the age of 12 who are suffering from substance abuse or dependence.”

I never expected to get such an in depth inservice from a cable TV station. I will be watching every episode, hoping to learn both professionally and personally new information on addiction that will help me understand it as a disease and not a character flaw.

I hope you will join me in this endeavor.


Here are some statistics from HBO that you may find astounding:

  • Nearly 1 in 10 Americans over the age of 12 are classified with substance abuse or dependence.
  • Over 18 million adults suffer from alcohol use disorders.
  • Alcohol and drug abuse costs the American economy an estimated $366 billion per year in lost productivity, health care expenditures and crime.
  • Of the 22.2 million Americans who needed treatment for illicit drugs or alcohol, only 3.9 million received it.
  • Among those who felt they needed treatment but did not receive it, 44% attributed it to cost or insurance barriers.
  • 95 percent of all adults dependent on or abusing alcohol started drinking before age 21.
  • If you are not addicted by the age of 25, it is less likely that you will become addicted to alcohol or illicit drugs.
  • More than half of all adults have a family history of alcoholism or problem drinking.
  • One-fourth of all persons admitted to general hospitals are admitted for problems related to alcohol.
  • More than 100,000 deaths in the United States each year are attributable to excessive alcohol consumption.

If you know someone suffering from addiction, check out AddictionAction.org and find out how you can help.

If you don’t believe you know anyone suffering from addiction, look again.

You may find it in your own backyard.

I did.

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About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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