A hospital emergency room, with its attendant chaos and wait times, is not where anyone sick truly wants to be. But for many years it has been the only place to go. These days, however, a doctor can come to you.

An increasing number of physicians are, for a substantial annual fee, converting their businesses to concierge practices, offering patients primary care with fast appointments with no waiting time, and the ability to contact their physician 24 hours a day. Many others have gone beyond that, offering house calls and medical care on demand.

In San Francisco, SF On Call Medical Group, founded by Jordan Shlain, M.D. in 1997, offers medical care throughout the Bay Area and a guarantee that you will talk with a doctor within 10 minutes. The six-doctor practice includes internal, naturopathic, pediatric and emergency medicine delivered through its signature house call in the convenience of your own home. In addition, the practice provides a full-service medical clinic for wellness plan exams.

“There was a need for doctors to get their sanity back, and by distancing ourselves from the insurance cartel, we were able to take the concept of service-oriented healthcare to a five star level,” says Shlain. Shlain says word-of-mouth has doubled his six-doctor practice in the last three years. “The luxury market is always in search of high quality services and we tapped into this latent desire for always-available medicine,” he says.

The average price of a visit is $350, although middle-of-the-night emergency visits can be from $100 to $200 more. The group doesn’t accept insurance, but provides a form to submit to health plans to seek reimbursement. Shlain says many providers like PPOs do pay at least 50 percent of the fees.

John Horning, M.D., a board certified emergency physician, began his Urgent Med Housecalls in San Francisco’s Pacific Heights area as an alternative to facility-based medical care. Horning, who currently works solo, visits patients in their homes, businesses and hotels, bringing with him medications, IV fluids, items for wound repair, tetanus shots, splints, catheters, lab testing and many other services including X-rays. (The bulk of his business comes from international and business travelers who call him from their San Francisco hotels.) EKG and cardiac monitoring are also provided, and patients can receive medication without a trip to the pharmacy. He does not provide ongoing primary care.

“My practice policy is that the doctor should always be available to patients,” says Horning, who answers his phone 24 hours a day and stays in touch with patients after treatment.

Basic house calls during regular business hours start at $240.

SFOnCall.com, 415-732-7029
Urgentmedhousecalls.com, 800-767-4058

[Photos from a.drian via Flickr]