Dr. Connie Mariano wonders everyday what our health care system would look like if doctors treated every patient like they were the President of the United States. She tuned in to the quality-of-care differences between presidential care and the average person’s care and setup a service to bridge the gap. In the process, she created a simple but powerful idea in which to center her practice.
Mariano knows first hand about caring for US Presidents. While serving as a general internist in the United States Navy, she was selected to serve as the head of the White House medical unit, a position she held through three administrations. As the primary care physician for presidents George H.W. Bush, Bill Clinton, and George W. Bush, Mariano oversaw all aspects of the president’s care. This included everything from yearly physicals (and the briefing of the world press on their results) to routine check-ins and check-ups to the mobilization of specialists as needed (such as those she assembled on 24 hours notice to travel with then President Bill Clinton to Helsinki for a summit with Boris Yeltsin less than two weeks after an operation to repair damage to his knee).
After leaving the White House for the Mayo Clinic, Mariano experienced a small dose of the other side of patient care. Despite working at one of the best facilities in the country, she found herself administering medical services as part of a machine that had standardized care. Doctors like Mariano could see dozens of patients a day but the interactions were brief, impersonal and largely limited to packaged set of
services that delivered the bell curve of care. While at Mayo, she began a study of physician practices, meeting with hundreds of patients to tune in to their needs and preferences. Four and a half years later, she broke away from the Mayo Clinic to create her own practice around the premise of providing the same kind of care the President receives using the same kind of resources that a clinic like Mayo can mobilize. Some key aspects that she built into her practice include:
· No waiting – the president’s time is valuable and he/she never waits. Walk into Dr. Mariano’s Center for Executive Medicine, patients are greeted at the door, offered a cup of coffee and escorted immediately to the doctor who is waiting for the patient.
· No paperwork – the president doesn’t have time for it and certainly shouldn’t have to go through the excruciating re-entry of data for each visit. Mariano’s practice is fully automated and paperless. Patients never have to stop for payment nor have to provide written updates. Their credit cards are retained on file and charged for services provided at the time of the visit.
· Always respectful – the president expects to be treated as important and Mariano ensures that she and her staff are always on and always attentive to their patients. They know them by name, they know their histories, and their families.
· Pleasant experience – the president can pick any doctor he or she elects. Mariano knows the quality of the experience is a key determining factor. She mixes diagnostic questions with questions like ‘what would make your life better’ and ‘how can we help you achieve that goal’.
· Flexible service – when the president wants a doctor they are on call 24x7. Dr. Mariano is as well, only a cell phone call away whether you are local, on the road or overseas.
· Establish a relationship – the president expects to talk to one and only one person on their issues. Mariano enables the same for her patients, working as the quarterback of a distributed medical team that might include hospitals, specialists and even pharmacies. Patients make one call, Mariano takes care of the rest.
Mariano's practice is now one of 250 in the United States offering a concierge service where patients pay as little as $5-$10 a day to have a doctor on call to support their needs. With more than 310 patients, she has built one of the fastest growing, most profitable practices in the Phoenix metropolitan area.