Steve Schwartz: Hello, and welcome to the Concierge Medical Marketing podcast. I’m your host, Steve Schwartz, and it’s my privilege and honor to have you with us today. Today, my guest is Doctor Paul Paterson. Paul has been a physician for many years, and he is a specialist in hand and upper extremity. Paul, did I say that right?
Dr. Paul Paterson: You said it perfectly.
Steve Schwartz: Good, good. And, he is a physician with Vero Orthopedic here in Vero Beach, Florida. Great guy. Paul, thank you for being here with us today.
Dr. Paul Paterson: Thank you for having me. I appreciate it.
Steve Schwartz: Certainly. Well, as you know, this is the concierge medical marketing podcast and we like to talk about different topics that are relevant to physicians who either are in concierge medicine with their practice or perhaps they’re thinking of transitioning from traditional model to a concierge practice, or perhaps even, people who are in med school who are thinking if they want to have a concierge practice when they finish their med school and residency and whatnot. So, we have lots of different guests that we’re gonna have on this podcast and we wanna bring different points of view, different experience. Obviously, you’ve been a physician for a long time. Do me a favor, Paul. Please share with our audience kind of a quick background or snapshot on you and your schooling and your specialties. Give us some background, please.
Dr. Paul Paterson: So I’m born and raised from Buffalo, New York, the Miami of the North. I went to school at the University of Buffalo, and from there, went on to graduate school at the University of Michigan. Then I worked as a sales rep for three years selling research chemicals to biochemistry and molecular biology research laboratories. One of the most educational parts of my entire life, actually. Then I went back to school at the University of Buffalo for medicine, did my residency in orthopedics there. Then I did a fellowship at Harvard in hand and upper extremity surgery, came back to Buffalo to practice, was there for till two years ago. And then a combination of better weather, lower taxes, and vaccine mandates found me looking for a job in Florida, and I was blessed beyond belief to find Vero Beach, the jewel of the treasure coast.
Steve Schwartz: It really is a beautiful town and an amazing area, isn’t it?
Dr. Paul Paterson: It’s incredible. The winters are a little bit more manageable than Buffalo.
Steve Schwartz: I’m just guessing.
Dr. Paul Paterson: Pretty much so. There really isn’t a winter here.
Steve Schwartz: Exactly. Last year, it got down to, like, sixty, sixty-five once or twice. You know? My wife laughs at me because she’ll actually see me wearing, like, a stocking cap and gloves when I’m taking the dog out. She just shakes her head like she can’t believe I’m doing it, but I do sometimes.
Dr. Paul Paterson: Exactly. We here in Vero Beach like to, I wanna say rub it in to our northern friends, but it does happen sometimes. It was a couple of years ago when upstate New York and other areas were literally just under what feet and feet of snow and closing the football arenas and all that because of ten feet of snow. And we’re like, yeah, I swam in the pool today in the backyard. Sorry, guys.
Steve Schwartz: Right? I was one of those buried under six feet of snow.
Dr. Paul Paterson: Yes.
Steve Schwartz: And we were buried under six feet of sand and sunshine. I know. So, well, we’re very glad you and your wife are here. We met at church several months ago, and it’s really my pleasure to meet you and your sweet family.
Dr. Paul Paterson: Thank you.
Steve Schwartz: Totally. Well, let’s do this. Let’s talk a little bit about concierge medicine. Concierge medicine and concierge practices, I found, means a little bit something different to everybody. There are different opinions and different ideas of what concierge medicine means. From your point of view, what does concierge medical practice mean to you?
Dr. Paul Paterson: It means incredible service, incredible access compared to what you’re gonna find in traditional medical models. It’s perhaps access that is one of the most important parts for patients. Unfortunately, the way medicine works nowadays, there’s a lot of pressure for physician providers or mid-levels to see a certain number of patients to generate enough revenue to keep the lights on. That often results in people being overworked, short-staffed, and cranky. As a result, if you’re a patient trying to get into the practice and get calls answered or messages back, it can be pretty frustrating. What the concierge model did was say, okay. Well, we’re gonna slow all this down. It costs a little extra money to do that, but we’re gonna slow it down to make sure that everybody gets the service they really want. You call into the office, you’re gonna get a response within an hour or so. You’re not gonna wait one or two or three days. You’re gonna develop messaging systems that will allow you to rapidly contact a provider and receive some of that information back. It’s just that little extra care, especially when you don’t feel well and you’re struggling, that can be vitally important. But in today’s traditional medical model, economically speaking, it can be pretty difficult to provide that level of care.
Steve Schwartz: I had a discussion with another physician who was with a big hospital system that they were literally given ten minutes per patient, and that’s it. Excuse me. Ten minutes per patient. That had to include not just seeing the patient but also entering notes into the chart or using their little recording to dictate the message. Is that for real? Is it really ten minutes per patient, and that’s it? You gotta get into the next room?
Dr. Paul Paterson: Not for me, but in special hospital settings, yeah. That is the case. It’s all productivity based. Most doctors really did get into this to take care of people. When you realize in that model that’s a difficult, if not impossible, goal to attain, you probably don’t stay there very long, leading to high turnover rates. That happened to my father-in-law recently. The cardiologist he was seeing just wasn’t there anymore. And while he was scheduled for an appointment, now there’s a new cardiologist, and he’s booked out, like, three months. He has issues that need to be addressed, but there’s no access. That’s one of the biggest problems: just the access.
Steve Schwartz: One of our clients is a cardiologist here in Vero Beach, Florida. I can give you his name and information if you want to put your father-in-law in touch with him. He’s moving his practice into a hybrid model, retaining his traditional clients and the concierge model for those who wish to have more direct access to him. So if you want, I’m happy to put you two together.
Dr. Paul Paterson: I’d appreciate that and also talking to him about the hybrid model because I think that’s a fascinating possibility.
Steve Schwartz: Exactly. The way he sees it is not all of his patients want that extra level of access or if they’re willing to pay for it. But if some are willing to spend a couple thousand dollars a year for the concierge membership, they’re paying for the extra access. I’m grateful he’s here in town and happy to put him in touch with you.
Dr. Paul Paterson: That’d be great. Wonderful.
Steve Schwartz: Let me ask you this. I know that Vero Orthopedic is a traditional model type of business. Tell me, is there interest there in perhaps adding concierge medicine to what they’re already doing?
Dr. Paul Paterson: We’ve had very basic preliminary discussions between some of the administrative staff and some of the physicians. Economics is constantly changing. The fee increases for providers don’t come close to the fee increases that our insurance companies are getting. They are keeping most of that money for themselves. We are constantly reinventing and considering new ways to maintain revenue while costs rise. As you mentioned, interest in a hybrid model is very much something we’ve talked about.
Steve Schwartz: I am available if you and your leadership team at Vero Orthopedic would like me to join a meeting. I’d be grateful for the opportunity to help them make a decision. As we talked about earlier, your position is in the traditional physician space. Have you ever considered becoming a concierge physician? If so, what was your thought process?
Dr. Paul Paterson: I have not considered it because I’m not aware of many opportunities in orthopedics. It would be something I would consider, maybe as a hybrid. Service has always been important to me. I don’t know that I could exclude patients entirely from my practice. I’d be more likely to consider concierge as an adjunct.
Steve Schwartz: I’ve spoken to several physicians, and the hybrid model sounds attractive for that reason. It’s the idea of providing a premium level of care while continuing to serve those who need me. For example, mission trips to Africa, doing surgeries. How does that kind of grab you?
Dr. Paul Paterson: Very much. We are trying to come up with solutions that allow us to keep up with rising costs and decreasing reimbursements. This is definitely part of that plan and strategy.
Steve Schwartz: In my research, I found concierge medicine is a six billion dollar industry in the U.S., forecasted to grow. Where do you see concierge medicine as an industry in the next five to ten years?
Dr. Paul Paterson: I expect it to grow. A lot depends on the economy and government policies. If the corporatization of medicine remains, as long as the economy doesn’t crash, concierge medicine will grow. People will reject lesser care if they can afford it.
Steve Schwartz: Medicine is a business with expenses. Rising malpractice insurance, buildings, staff, equipment. A procedure involves many expenses. How do you see this going forward?
Dr. Paul Paterson: The staff is the largest cost. Rising living costs mean staff need higher wages. You have to maintain revenue to keep staff employed and provide care.
Steve Schwartz: Exactly. People work hard to care for their families. It’s an interesting time, considering high gas prices and cost of living.
Dr. Paul Paterson: Let’s change direction. You’re a specialist in upper extremity and hand. Can you share about a procedure you’re performing with great results?
Dr. Paul Paterson: Carpal tunnel syndrome is common. In the past, treatments were ineffective, and recovery was long. In 2017, I learned an ultrasound-guided carpal tunnel release technique. It involves a small incision and a quick recovery. Over ninety percent resume normal activities in two to four days. The procedure is under strict local anaesthetic like a dentist visit. The initial jab is the only discomfort.
Steve Schwartz: What anaesthetic do you use?
Dr. Paul Paterson: Lidocaine, neutralized with sodium bicarbonate to reduce pH and discomfort.
Dr. Paul Paterson: So when I sit down to do an anesthetic on a patient, it’s not just a pinch and a burn. We take the lidocaine and buffer it with sodium bicarbonate. The result is that the acidity is neutralized, which dramatically reduces the discomfort when the anesthetic is administered. Patients typically report feeling very minimal to no discomfort because of this approach.
Steve Schwartz: That’s fascinating. So with this technique for carpal tunnel release, you’re telling me people are coming out of the procedure feeling significantly better almost immediately?
Dr. Paul Paterson: Yes, that’s right. The procedure itself only takes about three to five minutes to perform. Once completed, patients can use their hand almost right away, which is far different from the traditional open surgery where recovery could take three to six months. Patients will experience some mild soreness for a few weeks, but compared to traditional methods, the recovery is substantially quicker, and most people are thrilled with the result.
Steve Schwartz: That’s incredible. Just thinking about how transformative that must be for your patients compared to traditional methods. You know, we’ve talked quite a bit about the changes and advancements in medicine. I appreciate you sharing such innovative practices with our audience. Is there anything else you’d like to add or any other exciting developments on the horizon for you professionally?
Dr. Paul Paterson: Well, this procedure continues to be one of the highlights of my practice. I’m continually seeking ways to enhance patient care while minimizing downtime and discomfort. Whether it’s through technological advances like the ultrasound-guided carpal tunnel release or exploring new patient care models such as concierge medicine, the goal is always to put patient care first while adapting to the ever-changing landscape of medical practice.
Steve Schwartz: That’s great to hear, Paul. Thank you once again for joining us today on the Concierge Medical Marketing podcast. It’s been really insightful learning about your background, your contributions to the medical field, and your thoughts on the future of concierge medicine.
Dr. Paul Paterson: Thank you, Steve. It’s been a pleasure talking with you, and I look forward to seeing how medicine progresses in the years to come. It’s an exciting time to be part of this industry.
Steve Schwartz: Absolutely. And thank you to our listeners for tuning in. Be sure to join us next time as we continue to explore different topics and perspectives within the field of concierge medicine. Until then, take care and stay healthy.