Concierge doctor offers his patients a personal touch

Driving the streets of Manhattan is part of

Driving the streets of Manhattan is part of the daily routine for Dr Ronald A. Primas, one of the few doctors who make house calls. (Credit: Photo by Joe Epstein)

Special to Newsday

 

Ronald Primas doesn't play one on TV - he's a real doctor to the rich and famous, and he makes house calls!

Dr. Hank Lawson from the USA Network's summer hit "Royal Pains," may save lives performing tracheotomies in restaurants, but Primas, real-life "concierge" physician to the well-heeled, says the show does not quite capture what the practice is like.

"We're alike in personality. When Dr. Hank asks, 'Hey, what happened to your hand?' or 'What's going on with your eye?' - I do that all the time, it's like being a father."

Primas' office is in Manhattan, where he says he's always on call for world travelers or stars such as hip-hop recording artist Ludacris, and actors Richard Griffiths and Mickey Rooney. With his Marcus Welby bedside manner and black bag in hand, he dashes to movie sets, hotel rooms, private offices and homes to treat patients from 10 years old to 104.

As the two brothers in "Royal Pains" battle ethics, Dr. Hank Lawson, played by Mark Feuerstein (Josh in "Sex and the City" and Cliff in "The West Wing"), tempers Evan's (Paulo Costanzo) greedy motivations so that they are not just catering to the privileged.

"Dr. Hank's got heart. Sure, we take poetic license when he performs brain surgery with a ½-inch drill bit in a back bedroom on an obscure island," says Feuerstein, whose uncle, Dr. Bearish Strauch, is considered one of the founding fathers of microsurgery as the first doctor to transplant a toe in place of a missing thumb.

"Would our 12 episodes pass through the American Medical Association's standards? Probably not. But our writers, Andrew Lenchewski and executive producer Michael Rauch, navigate our incredible cast dramatically through the promised land of the Hamptons. There's an ER surgeon, Dr. Irving Danesh, on call to make sure we're accurate."

Primas gained some attention for diagnosing the bubonic plague for a New Mexican couple suffering with flulike symptoms in 2002.

Married 19 years with two children, Primas, 49, works hard to strike a balance in his own life, yet he's "always accessible to my patients.'' His availability is emphasized on his Web site, travelmd.com, which advertises "urgent medical care.''

"I don't know what to expect,'' he says. "I could be in a recording studio at 2 a.m. or waiting two hours for a princess of Saudi Arabia in a Manhattan hotel lobby." And, yes, he makes good money, has seen it all but is discreet about it - which is one of the reasons few of his patients are named here. One patient who had had sex with a masseuse "was well-informed enough to ask for Rocephin for gonorrhea, just in time for his wife's return from vacation the next day," Primas says.

Then there are the routine "emergency Viagra prescriptions" in the middle of the night.

 

Rich and famous royal pains

Being a doctor to the rich and famous has drawbacks.

"I can see what happened to Michael Jackson," Primas says, referring to Michael Jackson's sudden death in Los Angeles on June 25. The singer was under the care of live-in physician Conrad Murray, and authorities recently ruled his death a homicide, blaming the use of the anesthetic propofol and other sedatives given to him by his doctor.

"Everyone around him got caught up because he was a product. . . . The people I care for need to stay in top form to produce. But there are healthy ways," Primas says. "A doctor becomes an integral part of these celebrities' lives. . . .

"They live in Hollywood and are doing movies out here. They need a doctor. These celebrities are under extreme pressure. They work very hard. They will say, 'My back hurts,' 'Migraines are severe,' and are looking for the Oxycodone, Vicodin or Percocet, or claim they have ADD and want meds." Primas says, "I'm very blunt when that red flag goes up. If they don't go to a follow-up visit with the orthopedist/physical medicine specialist, can't put me in touch with their original doctor in L.A. or get the required MRIs, etc., I'm suspicious."

Primas recommends pain management specialists to patients seeking pain killers, or he'll discharge them from his practice. He says he's cut loose three major celebrities from his care for that reason.

Mostly, Primas' patients are businessmen and women, United Nations diplomats, even members of the Obama administration, and he continues to see long-term elderly patients on a pro-bono basis he had first treated at the Boriken Family Health Center in Harlem, much like HankMED services on "Royal Pains."

Seventeen years ago, he started his concierge, one-stop- shopping practice after a Nigerian man who feared he had malaria called Primas to a hotel room for after-hours care.

"He found me in the Yellow Pages and was staying in a hotel in New York City and begged me to come over. Back then, 1993, Kaufman's drugstore on 50th Street was open 24 hours and delivered anywhere in the city. It turned out he had strep." Primas has made house calls ever since.

 

The 'elitist' label

Primas is part of a crop of concierge or "boutique" physicians, opting for long-range health care practices based on quality time per patient instead of quantity of clients. Instead of packing in 2,500 patients, where all a doctor can do is treat, they keep it down to about 600.

Some call it elitist health care: Ana Christina McGannon, 47, a Syosset resident, isn't interested in being a patient of what she calls "elitist" medicine. "It's a business, and I think health care should be not-for-profit and not a moneymaking vehicle." But some patients, more informed through the Internet, say they'll pay for good care.

"He takes care of himself and practices what he preaches," says Susan Ziegler, a middle-aged Manhattan resident who weekends in the Hamptons and has been a patient of Primas for 12 years. "He cares about your overall well-being and doesn't just treat one problem. I was having difficulty with my stomach, and he helped me take a look at my whole health-care regime."

With personalized preventive care, members pay a membership fee for a doctor like one of the 319 physicians available through the Florida-based MDVIP network. There are eight member physicians on Long Island (28 states have network doctors). For the $1,500 membership fee, members get a Mayo Clinic-level physical and a CD-ROM of all EKGs, X-rays, medications and blood work. Members have their own Web sites, doctor's e-mail address and cell-phone number and year-round wellness care. MDVIP accepts assignment from insurance and Medicare.

"It's certainly not elitist health care at $4 a day," says Darin Engelhardt, president of MDVIP. "It's about choice and not one-size-fits-all health care. In these cost-conscious times, people are prioritizing their health." After nine years, MDVIP's patient renewal rates are still high at 90 percent with 120,000 patients nationally.

Not an MDVIP physician, Primas charges fees ranging from $95 for quick visit to get a simple medication refill, to $200 for a visit in which he handles common ailments, up to $800 for a full physical.

Lyndon Campbell, a media business executive in his late 30s who moved to Manhattan from Britain, chose Primas on the recommendation of friends eight years ago. "We summer out in East Hampton, and I have terrible allergies. The ragweed and dust makes it worse." Campbell says spending the extra on his health is no bother.

Primas says he's dedicated to helping his patients live every day healthy. He says the majority of his patients with any ailments, including diabetes, are off medications as a result of exercise and good care. "It's about longevity and prevention."

Meanwhile, according to Nielsen Media Research, "Royal Pains'' became the USA Network's most-watched first season of an original series ever and signed on for another season.

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