Family Matters

House Calls: A New Pediatric Model?

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Inevitably, kids get sick at the most inconvenient times. It’s uncanny how they manage to spike a fever minutes after the pediatrician’s office has closed, or smack in the middle of a holiday weekend. Why don’t doctors make housecalls anymore, you groan. Ah, they do. Or at least one doc does, provided you live in New York City or nearby, in New Jersey or parts of Connecticut. (More on Kids Really Are More Allergic)

The Wall Street Journal profiled Edward Kulich recently, detailing his personalized service that involves everything from routine vaccines and sniffles to sleep consultations. He’s got a fancy title, “board-certified concierge pediatrician,” but really, Kulich explains, he’s just meeting a need.

“I can deliver better care than I did in an office setting,” Kulich, who used to have a private practice in Florida, told me en route to a Manhattan house call. “I’ve never been in-and-out in less than half an hour.” Half an hour? That would be considered a super-long pediatric appointment, by anyone’s standards. Yet for Kulich, 33, it’s the equivalent of a quick follow-up. (Related Links: 9 Ways to Stay Sniffle-Free)

His longest appointment lasted two hours, though that’s not the norm either. But here’s the point: each house call is open-ended and not limited to the specific reason you called in the first place. Your kid has an ear infection? No problem. But if you’re also concerned about his eating habits, there’s no need to wait for a well visit to bring that up.

“I take all the time a patient needs,” says Kulich.

But you gotta pay to play. Depending on how close you are to his Brooklyn home and when you call (inherent in the concierge definition is 24/7 availability, even on holidays), Kulich charges $300 to $500. Though he doesn’t accept insurance, he says patients whose parents file can get back up to 70% of his fee. (More on Photos: Dr. Mehmet Oz: Medicine Man)

As for criticisms that concierge medicine is elitist, Kulich has got a ready rebuttal/analogy: it’s no different than private schools. “It’s the same kind of thing,” he says. “You pay taxes for your public school, but you can choose to send your kids to private school. I haven’t heard private school teachers being referred to as concierge teachers.”

Still, he knows his model isn’t for everyone. It’s not for most people, in fact. He doubts he could have made it work in Florida, for example, where he saw up to 50 kids a day. “If people are already paying an astronomical amount for their health insurance, they’re going to want to use it,” he says. “The majority of my calls for inquiries don’t end up in house calls. I say you have to pay up front, and that’s the end of that.”

As a result, his workload varies enormously. A busy day might have him seeing seven kids. A slow day? None. Still, Kulich estimates he’s making about the same amount as he did in private practice — though there are obvious trade-offs. (More on Most Babies Sleep through the Night (But Not Mine))

Take vacation, for example. He’s chained to his coverage area. Earlier this month, for example, his wife and 4-year-old son were on a cruise without daddy. “My son had breakfast with Diego,” says Kulich, “and I am on my way to a house call.”

What do you think about Kulich’s business model? Parents, would you pay out-of-pocket for a pediatrician to be at your beck and call?

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