Dr. Edward J. Balbona

It's nearly noon, and Ed Balbona is just hitting stride.He's already visited 10 patients, but 20 more wait before the physician's rounds are done.

"Most days I come in at 7 and leave at 8 or 9 at night," said Balbona, describing a typical hectic day for a doctor in the era of managed care.

Managed care has created what the hospital physician calls episodic treatment.Patients fight for appointments.Doctors with practices of 3,000 to 4,000 patients whiz in and out of exam rooms.Neither develops a meaningful relationship.

Balbona said he wants to change that.

The internal medicine specialist is planning to open Jacksonville's first practice that will cut the typical patient load in half, make house calls, give out the doctor's cellular telephone number and offer other perks.

Known elsewhere as "concierge" care, Balbona and perhaps other associates intend to make up for the cost of running this old-fashioned-style practice by charging a monthly or annual fee to patients not covered by insurance.

Also called "boutique" or "executive" care, practices like the one Balbona is planning have attracted critics who say charging fees -- up to $20,000 in some places -- circumvents insurance and Medicare rules, creates an elitist tier of care and could push skyrocketing health costs higher.

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Balbona said his practice will be elective, not elitist.He intends to charge $50 to $100 per month, which he compared to the price of a cell phone -- something nearly everyone can afford.

"It's crazy that people can't decide to have better care," Balbona said."You should be able to have a choice and say, 'I want better access to health care.'"

Sure, fee payers would receive same-day house calls, personalized wellness plans, artful waiting rooms with medical library, but Balbona said he also would continue seeing patients who don't pay the fee.

Fewer patients would allow him to practice medicine with all his patients the way it should be: with time and care.

"To have an experienced physician who spends time with you is a thing of the past," he said."I'm trying to bring it back."

Medicare in jeopardy

Balbona had practiced both ways, working in the Office of Attending Physician at the Capitol in Washington and in a private practice with Baptist Medical Center in Jacksonville.He is not a hospital doctor at the center.

Among Balbona's small and exclusive clientele in Washington were members of Congress.His patient load increased dramatically after he moved to Jacksonville.

Recently, he saw people willing to pay extra for health care as medical director at HealthScreen America, a company that provides medical screenings for well people.Although the company is not meeting business projections, 12,000 clients have paid up to $1,200 for screenings since 2000.

Balbona said he believes there is a market for concierge care in Jacksonville, a smaller but similar market to a company called MDVIP running in South Florida.

Concierge care began on the West Coast in the mid-1990s and found critics when it moved East.Some questioned MDVIP's ethics and its legality -- similar questions that face Balbona's decision in Jacksonville.

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"It's a fee for specialized services," Torres said, a conclusion that Balbona supports.
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"It's like a cell phone or a cable service," Balbona said."People pay what they can afford for the extra convenience and service."

For clients who pay the fee, Balbona will set aside blocks of time each day to treat patients who want to see him quickly.Those clients also will receive annual physicals, reminders of when prescriptions are expiring, and extra studies, scans or diagnostic screenings.

The American Medical Association has not taken an official position.Members have expressed differing views.

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Balbona said he believes his practice will attract people with busy lives and demanding jobs, those with chronic conditions and those requiring frequent or immediate care.

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It's worth the money to know Balbona will treat him, his wife and children at the office or at home on short notice.

He also feels as though the practice would allow time for more personal care and attention.

Delaney will be joining the ranks of several seasoned healthcare executives including Chris Fey , founder and former CEO of HealthCare USA , Fred Fey , former CEO and president of the University of Chicago Family First Health Plan , and Dr. Edward Balbona , a doctor of Internal Medicine and a former naval officer , who served as a U.S. Capitol Physician providing healthcare to members of Congress and the Supreme Court.
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According to HealthScreen America's Medical Director , Dr. Edward Balbona , The tests are non-intrusive , involve little or no discomfort , usually can be done in less than 60 minutes , and employ the latest in high tech diagnostic equipment and procedures..

A clicks and mortar healthcare company , Admiral Delaney will also oversee the development of the world's largest database of presymptomatic persons.Screening results and individual records can be placed into the secure , encrypted personal health records available at www.HealthScreenAmerica.com.

Contacts :

Delaney will be joining the ranks of several seasoned healthcare executives including Chris Fey, founder and former CEO of HealthCare USA, Fred Fey, former CEO and president of the University of Chicago Family First Health Plan, and Dr. Edward Balbona, a doctor of Internal Medicine and a former naval officer, who served as a U.S. Capitol Physician providing healthcare to members of Congress and the Supreme Court.
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According to HealthScreen America's Medical Director, Dr. Edward Balbona, "The tests are non-intrusive, involve little or no discomfort, usually can be done in less than 60 minutes, and employ the latest in high tech diagnostic equipment and procedures."

A clicks and mortar healthcare company, Admiral Delaney will also oversee the development of the world's largest database of presymptomatic persons.Screening results and individual records can be placed into the secure, encrypted personal health records available at www.HealthScreenAmerica.com.

Contacts:

Edward J. Balbona, MDMedical Director, HealthScreen AmericaDr. Balbona received his MD from the medical college of Georgia and completed his specialty training in Internal Medicine at the National Naval Medical Center in Bethesda, Maryland.As a Navy Physician, Dr. Balbona has treated members of the U.S. Congress and Supreme Court.He has practiced for a decade at Jacksonville's Baptist Medical Center, specializing in cardiovascular disease and women's health issues.He is a strong advocate for evidence-based medicine with an emphasis on disease prevention and health maintenance through education.

Edward J. Balbona, MD General Physician and former Attending Physician, Office of the Attending Physician to Congress

Dr. Balbona received his MD from the Medical College of Georgia and completed his specialty training in Internal Medicine at the National Naval Medical Center in Bethesda, Maryland.As a Navy Physician, Dr. Balbona has treated members of the U.S. Congress and Supreme Court.He has practiced for a decade at Jacksonville's Baptist Medical Center, specializing in cardiovascular disease and women's health issues.He is a strong advocate for evidence-based medicine with an emphasis on disease prevention and health maintenance through education.