When Lindsey experienced a violent allergic reaction to a sulfa drug prescribed after cosmetic surgery, her husband got on the phone with Dr. Tung shortly before midnight. By the time Lindsey, now in a coma, reached the hospital by ambulance, Dr. Tung had already had her records delivered there, which was hugely helpful to the attending physician. Lindsey feels that this kind of possibly lifesaving assistance is worth the cost. “If you break down the fee,” she told me after her recovery, “it comes to about $125 a month. We all have choices about how we spend money, and this is mine.” Choices, of course, assumes discretionary income, a luxury not every American enjoys.
My first visit with Dr. Fong occurred on March 15, barely half a year ago. To get a sense of how the relationship has unfolded, I counted the e-mails we’d exchanged. There were 75. After a few months with her, I realized I was solving problems without racking up extra doctors’ bills. I was no longer racing to the acupuncturist out of frustration over not being able to get to see my primary care doctor about my bronchitis. I did not need to visit the allergist for hay fever or the dermatologist for a rash, because these are things that a primary care physician is perfectly capable of handling. (See “How Much Does It Really Cost?,” for my conclusion about the net effect of concierge medicine on my bank balance.)
When I had a problem, I e-mailed Dr. Fong—actually, Mei-Ling and I were on a first-name basis—and she’d tell me what to do. For example, I was concerned about what seemed like a never-ending menstrual cycle. At one point, Dr. Fong sent me several well-crafted paragraphs describing how a deeply confused menopausal uterus and ovaries might behave and what she thought we might do about mine. After a very expensive pelvic ultrasound that showed nothing worrisome, she referred me to a gynecologist in San Francisco who focuses on menopause management and also takes my Blue Cross PPO. Dr. Fong made the appointment for me and sent the specialist a detailed chronology of my reproductive issues.
He suggested I try a CombiPatch, a transdermal hormone-therapy patch that contains both estrogen and progestin, which are continually released into the skin and the bloodstream. The next day, Dr. Fong and I talked it over. Because I had no risk factors—no breast cancer or heart disease—she thought I should give it a try.
Two days later, Dr. Fong texted me to see how I was faring. I was happy to tell her that at least for the moment, my female troubles were entirely resolved.
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CATHRYN JAKOBSON RAMIN’s next book, out in 2013, is The Fragile Column: How to Beat the Back Pain Industry at Its Own Game.