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Similar to PCS Business Plan (20)
PCS Business Plan
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TABLE&OF&CONTENTS&
Executive)Summary) 4!
Strategic)Planning) 6!
About)Premiere)Concierge)Services) 7!
Environmental)Analysis) 7!
Office)Layout) 11)
Marketing) 17!
Services)Offered) 18!
Distribution)of)Services) 21!
Promotion)of)Services) 22!
Differential)Statement) 24!
Geographic)and)Economic)Demographics) 24!
Organization)and)Design) 26!
Legal)Entity) 27!
Employment)Positions) 28!
Governance)of)Organization) 28!
Coordination)of)Work) 30!
Organizational)Chart) 32!
Staffing) 33!
Recruitment)and)Retaining) 35!
Contract)Work) 36!
Staffing)Issues) 39!
Performance)Evaluation) 40!
Member)Satisfaction) 41!
Benefits)Package) 42!
Disciplinary)Procedures) 42!
Termination) 42!
Regulatory)Compliance) 43!
HIPAA)Compliance) 44!
Drug)Testing)and)background)check)Policy) 45!
Regulatory)Compliance)Policies) 45!
Finance)and)Accounting) 46!
Initial)Funding) 47!
Financial)Statements)for)Fiscal)Years)1)and)2) 49!
Financial)Specifications) 51!
Technology) 53!
Desired)System)Functionality) 54!
Acceptable)Systems) 54!
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Staff)Training)Plan) 57!
Security)and)Data)Backup)Plan) 58!
Technology)and)Equipment) 59!
Works)Cited) 63!
Appendix)A:)Marketing) 67!
Explanation)of)services) 68!
Alabama)High)School)Athletic)Association)Physical)Evaluation)Form) 73!
Appendix)B:)Staffing) 75!
Staff)Member)Performance)Evaluation)Form) 80!
Premiere)Concierge)Services:)Member)Satisfaction) 83!
Staff)Member)Handbook) 85!
Appendix)C:)Regulatory)Compliance) 95!
HIPAA)Compliance)and)Confidentiality)Statement) 96!
Privacy)Policy) 97!
Employee)Drug)Testing)Policy) 100!
Employee)Random)Drug)Testing)Policy) 106!
Employee)Background)Check)Policy) 109!
Equal)Employment)Opportunity)and)Harassment)Policy) 111!
Occupational)Safety)and)Health)Program) 113!
ADA/ADAA)Policy) 118!
Appendix)D:)Finance)and)Accounting) 121!
Appendix)E:)Furniture)and)Fixtures) 129!
Appendix)F:)Technology)and)Equipment) 136!
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ABOUT&PREMIERE&CONCIERGE&SERVICES&
MISSION&STATEMENT&
We!strive!to!provide!our!members!with!more!than!just!healthcare.!Our!goal!is!to!modernize!the!traditional!
house!call!by!going!above!and!beyond!what!the!traditional!primary!care!practice!offers.!Our!holistic,!proactive!
approach!to!healthcare!addresses!your!physical,!mental!and!emotional!well:being!through!one:on:one!
counseling!and!comprehensive!diagnostic!testing.!!
MOTTO&
Providing!excellence!in!patient:centered!care,!built!on!a!foundation!of!knowledge,!innovation,!and!ethical!
values.!
STRATEGIC&GOALS&
!! To!create!a!service:based!company!whose!primary!goal!is!to!exceed!customers'!expectations.!
!! To!establish!a!partnership!between!PCS!and!at!least!two!of!the!top!10!local!companies!!
!! To!develop!a!sustainable!home!business,!surviving!off!of!its!own!cash!flow.!
!! To!become!the!concierge!practice!of!choice!for!Mobile!and!Baldwin!counties.!
!! To!have!a!prominent!and!positive!presence!in!the!local!community.!
ENVIRONMENTAL&ANALYSIS&
We!would!like!to!enter!a!target!market!of!upper!middle!class!residents!in!the!Mobile!and!Baldwin!counties,!
specifically!retirees!and!families!with!dependent!children.!The!average!household!income!in!both!Mobile!and!
Baldwin!counties!are!in!the!top!twenty!highest!incomes!in!the!state.!The!following!tables!display!the!population,!
median!household!income,!average!housing!value,!and!average!age!for!the!cities!in!which!we!believe!the!
majority!of!our!services!will!be!rendered:!
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The!Fairhope!area!is!notably!one!of!the!premiere!retirement!locations!in!the!state.!We!expect!that!a!large!
portion!of!our!patients!will!be!of!retirement!age,!so!the!retirement!population!in!the!Fairhope!area!would!be!
beneficial.!The!Fairhope!community!is!highly!family:oriented,!as!can!be!determined!by!the!vast!number!of!
quality!public!and!private!K:12!academic!institutions!in!the!area.!!There!is!market!share!to!be!gained!due!to!the!
fact!that!we!will!be!acquiring!the!only!exist!concierge!physician!in!the!area.!She!previously!performed!concierge!
medicine!in!addition!to!her!existing!primary!care!physician!role.!There!has!never!been!a!true!concierge!practice!
in!the!area.!The!sheer!lack!of!competition!would!warrant!an!easy!entry!into!the!market!as!there!are!currently!
few!barriers!to!entry.!!
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Daphne,!
23,633!
Fairhope,!
16,385!
Spanish!
Fort,!
7,629!
Mobile,!
194,899!
Population
$54,706
$71,899
$62,197
$36,150
$0
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
$70,000
$80,000
Daphne Fairhope Spanish!
Fort
Mobile
Median!Household!Income
$178,826
$197,099 $206,544
$119,300
$0
$50,000
$100,000
$150,000
$200,000
$250,000
Daphne Fairhope Spanish!
Fort
Mobile
Average!Housing!Value
37
44
40
36
0
10
20
30
40
50
Daphne Fairhope Spanish!Fort Mobile
Average!Age
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LOCATION&ADVANTAGES&&
•! We!will!be!acquiring!the!only!existing!concierge!physician!in!the!area,!eliminating!competition!!
•! Locating!the!office!in!Daphne!will!lower!property!price!compared!to!Fairhope!while!still!maintaining!
access!to!to!all!four!target!cities!
•! Can!service!the!Daphne,!Fairhope,!Spanish!Fort,!and!high:income!areas!of!Mobile!!
•! Physicians!already!have!privileges!at!the!Mobile!Infirmary!Health!Network!(Thomas!Hospital)!
LOCATION&DISADVANTAGES&
•! Entering!a!new!market,!which!adds!risk,!higher!marketing!costs,!and!other!challenges!
•! Acquiring!patients!who!have!preexisting!relationships!with!local!physicians!!
•! Lack!of!knowledge!of!concierge!medicine!as!a!practice!within!the!community!
•! Large!geographical!location!to!service!
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OFFICE&LAYOUT&
We!would!like!our!waiting!room!and!lobby!area!to!have!a!very!comfortable!and!warm!feel!to!it,!similar!to!a!living!
room.!Because!our!practice!specializes!in!home!visits,!we!want!our!members!to!feel!as!though!they!are!in!their!
own!home!when!they!enter!our!office.!!
Members!will!enter!the!waiting!room!and!lobby!area!where!they!will!be!greeted!by!our!receptionist.!In!the!
event!their!physician!is!not!immediately!available,!the!member!will!be!invited!to!wait!on!one!of!our!comfortable!
seating!options!and!offered!a!beverage!and!a!selection!of!magazines.!Our!beverage!station!will!consist!of!a!self:
service!Keurig!connected!to!a!water!line!so!that!we!do!not!have!to!worry!about!refilling!the!machine.!There!will!
be!a!selection!of!single:serve!coffee!pods.!There!will!also!be!carafes!of!chilled,!filtered!water!with!a!variety!of!
sliced!fruits.!We!will!offer!light!refreshments!at!the!beverage!station!such!as!fresh!fruit!and!small!whole!grain!
pastries.!We!will!have!gas:powered,!electric!fireplace!which!will!be!lit!during!the!colder!months!to!add!to!the!
homey!feel.!
Our!color!scheme!consists!of!light!blues,!greens,!and!greys,!which!we!have!found!to!be!inviting!and!not!
overwhelming.!Our!intention!is!for!the!space!to!feel!warm!and!inviting,!but!not!overly!bold!and!harsh.!
The!office!will!have!two!care!suites,!with!each!consisting!of!a!consultative!and!exam!room.!In!the!exam!room!
there!will!be!a!comfortable!exam!table,!physician’s!stool,!and!an!additional!chair!for!family!members.!On!the!
exam!side,!visual!information!display!and!storage!coexist,!making!the!most!of!space!and!encouraging!shared!
understanding!with!information!access.!The!consultative!room!will!have!a!couch!for!the!member!and!a!swivel!
seating!for!the!doctors,!to!be!able!to!maintain!eye!contact.!There!will!be!a!two:monitor!visual!display!to!increase!
the!ability!for!the!patient!and!doctor!to!understand!the!full!picture!of!the!health!context.!Both!sides!of!the!care!
suite!will!include!room!for!families!to!participate!in!learning!and!decision!making.!!
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SERVICES&OFFERED&
OUR&UNIQUE&SERVICES&
Comprehensive)Physicals)
Upon!a!member’s!first!visit!to!the!office!their!personal!physician!will!meet!with!the!new!member!for!an!hour!
and!a!half!in!order!to!provide!them!with!a!comprehensive!physical.!Unlike!a!traditional!primary!care!practice,!
the!physician!will!take!the!extra!time!to!get!to!know!the!member,!their!lifestyle!and!their!current!health.!Each!
physician!will!go!through!the!member’s!medical!history,!check!their!vital!signs,!perform!a!heart!exam,!lung!
exam,!head!and!neck!exam,!abdominal!exam,!and!neurological!exam!(see!Appendix!A!for!descriptions).!Through!
the!comprehensive!physical!we!hope!to!gain!an!in:depth!knowledge!of!each!member’s!medical!history!and!their!
chronic!medical!needs,!if!any!exist.!Additionally,!testing!may!include:!a!complete!blood!count,!urine!analysis,!
body!composition!test,!nutritional!assessment,!exercise!counseling,!heart!screening,!and!stroke!screening!(see!
Appendix!A!for!descriptions).!Our!practice!aims!to!know!members!as!a!whole!person,!rather!than!as!a!faceless!
name!on!a!chart.!
Wellness)Plan)
Each!member’s!physician!will!develop!a!wellness!plan!tailored!to!their!unique!health!goals!and!lifestyle!based!on!
their!comprehensive!physical.!The!physician!will!support!their!patient!along!the!way!to!living!a!healthier!and!
more!vibrant!life.!Some!of!our!areas!of!focus!include,!heart!health,!diabetes!prevention,!sleep,!emotional!well:
being,!sexual!health,!and!weight!management.!!
Personalized)Grocery)Shopping)
A!service!we!will!provide!to!our!most!committed!members!is!personalized!grocery!shopping!trips.!One!of!our!
Registered!Nurses!will!go!with!members!to!the!grocery!store!in!order!to!help!them!select!healthier!foods!to!
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Vaccinations)
Some!of!the!most!common!types!of!vaccination!we!plan!to!provide!to!our!members!are:!
•! Influenza!
•! Measles,!Mumps,!Rubella!(MMR)!
•! Measles,!Mumps,!Rubella,!Varicella!
(MMRV)!
•! Meningococcal!
•! Pneumococcal!
•! Varicella!(Chickenpox)!
•! And!Zoster!(Shingles)!
School)Physicals)
The!school!physical!helps!determine!whether!it!is!safe!for!a!member!to!participate!in!a!particular!sport.!The!
Alabama!High!School!Athletic!Association!requires!the!physical!prior!to!the!beginning!of!the!season!and!has!
specific!requirements!(see!Appendix!A!for!requirements).!The!medical!history!portion!can!be!filled!out!by!a!
parent!but!should!be!reviewed!by!a!medical!professional.!The!pre:participation!physical!evaluation!portion!of!
the!physical!is!fairly!standard!and!in!line!with!the!exams!described!in!the!comprehensive!physical.!!
PRICING&OF&SERVICES&
The!pricing!of!all!services!that!a!member!may!need!will!be!included!in!the!annual!membership!fee!they!pay!to!
our!practice.!There!are!three!levels!of!membership!that!new!members!can!buy!into.!The!top!level!of!
membership!for!our!most!committed!members!is!the!platinum!level,!this!includes!all!of!our!unique!services!such!
as,!the!comprehensive!physical,!wellness!plan,!personalized!grocery!shopping,!and!house!calls.!Additionally,!
platinum!members!will!have!access!to!a!spa!and!fitness!center!in!Daphne.!We!will!partner!with!the!spa!and!
fitness!center!in!order!to!receive!discounted!services!for!our!members.!The!annual!price!for!our!platinum!level!
membership!is!$1,750.!Our!second!level!of!membership,!the!gold!level!includes!the!comprehensive!physical,!
wellness!plan,!and!house!calls.!The!annual!price!for!our!gold!level!membership!is!$1,500.!Our!third!level!of!
membership,!the!silver!level!includes!the!comprehensive!physical!and!wellness!plan.!The!annual!price!for!our!
silver!level!membership!is!$1,200.!Additionally,!all!members!at!every!membership!level!will!have!access!to!their!
physician’s!cell!phone!numbers!to!easily!text!or!call!them!with!their!medical!concerns.!!
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Our!practice!understands!the!bulk!of!our!clientele!will!come!from!two!groups,!affluent!individuals!who!do!not!
want!to!bother!with!their!limiting!insurance,!who!want!the!extra!attention,!and!personalized!services!our!
practice!can!offer.!Additionally,!the!other!group!we!plan!to!serve,!the!chronically!sick!who!realize!our!services!
can!be!less!expensive,!comparatively,!for!how!often!they!must!come!in!contact!with!the!health!care!system.!Our!
goal!is!to!balance!these!two!groups!so!our!practice!is!still!profitable.!We!recommend!that!all!of!our!new!
members!wait!until!their!insurance!runs!out!and!instead!purchase!a!high:deductible!health!plan!(HDHP),!which!
can!be!used!in!the!case!of!catastrophic!emergencies.!!!!
DISTRIBUTION&OF&SERVICES&
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Our!practice’s!distribution!of!services!has!been!broken!up!per!physician.!In!our!first!year!we!plan!to!have!400!
members!per!physician.!Annually!we!plan!to!see!each!member!for!their!comprehensive!physical!and!wellness!
plan.!Our!most!common!service,!the!office!visit!is!based!upon!how!many!patients!the!non:concierge!primary!
care!physician!would!see!annually,!however,!we!will!see!less!than!a!quarter!of!the!typical!PCP.!The!distribution!
of!house!calls,!one!of!our!unique!services,!is!based!off!the!office!visits!as!it!will!be!used!in!substitution!of!the!
office!visit!for!some!of!our!members.!Vaccinations!and!school!physicals!are!also!based!off!the!distribution!of!
office!visits!for!the!typical!PCP.!!!
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Service Per(day Per(week Per(month Per(year
Comprehensive,Physicals 1 7 28 400
Wellness,Plans 1 7 28 400
House,Calls 2 14 56 672
Office,Visits 5 27 108 1,296
Vaccinations 5 35 140 1,680
School,Physicals 5 20 20,,,,,,,,,,,,,,,,
Distribution(of(Services(per(Physician
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PROMOTION&OF&SERVICES&
REFERRALS&
Our!practice!sees!referrals!from!existing!members!as!a!crucial!means!for!attracting!new!members.!In!order!to!
keep!word:of:mouth!consistently!positive,!we!will!make!sure!each!member!receives!care!personalized!to!their!
needs!and!wants.!If!a!member!does!not!feel!their!needs!and!wants!have!been!met,!our!practice!will!reach!out!to!
the!member!to!make!sure!any!problems!are!resolved.!!!
MARKETING&
For!our!internet!marketing!needs!our!practice!will!be!outsourcing,!the!company!we!will!outsource!to!is!A:Factor!
Marketing.!They!will!meet!with!us!about!our!practice’s!vision!for!the!website!and!Facebook!page,!strategize!
what!will!be!best!for!our!practice,!then!they!will!create!and!execute!our!website!and!Facebook!page.!They!also!
will!be!available!to!help!maintain!the!website!and!Facebook!page,!and!make!changes!whenever!needed.!
Additionally,!for!our!Facebook!page,!A:Factor!will!post!meaningful!articles!and!health!facts!to!increase!page!
views.!A:Factor!Marketing!will!charge!$4,000!in!the!first!year!and!$2,000!in!subsequent!years!for!the!making!and!
maintaining!of!our!website!and!Facebook!page,!when!we!plan!to!make!the!website!active.!!
ADVERTISING&
Brochures)
Our!practice!plans!to!consistently!print!and!distribute!brochures!advertising!our!practice,!some!of!our!unique!
services,!our!office!hours!and!location,!links!to!our!website!and!Facebook!page,!and!our!office!phone!number.!
We!will!strategically!distribute!our!brochures!at!local!churches,!schools,!health!food!stores,!upscale!gyms,!and!
country!clubs.!By!distributing!to!these!specific!locations!we!hope!to!make!contact!with!the!specific!clientele!that!
desire!our!practice’s!personalized!care.!!
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School)Athletics)Sponsorship)
Our!practice!is!donating!$1,000!to!each!of!the!following!schools:!Daphne!High!School!athletics,!Fairhope!High!
School!athletics,!Spanish!Fort!High!School!athletics,!McGill:Toolen!Catholic!High!School!athletics,!and!St.!Paul’s!
Episcopal!High!School!athletics.!Each!of!these!schools!made!our!practice!“Preferred!Sponsors”!for!their!booster!
club.!For!our!donations!these!schools!will!put!up!banners!displaying!the!Premiere!Concierge!Services’!logo!and!
contact!information!on!their!football!field,!baseball!field,!softball!field,!and!in!their!basketball!gym.!The!baseball,!
softball,!and!basketball!advertisements!will!begin!in!the!spring!of!2016!and!football!will!begin!in!the!fall!of!2016.!!
Club)Soccer)Sponsorships)
Our!practice!is!donating!$2,500!to!the!US!Youth!Soccer!program.!We!plan!to!sponsor!one!boy’s!team!and!one!
girl’s!team!in!Daphne,!Fairhope,!Spanish!Fort,!in!addition!to,!two!boy’s!teams!and!two!girl’s!teams!in!Mobile.!
Each!team!will!receive!a!donation!of!$250.!For!our!donations!these!teams!will!wear!the!Premiere!Concierge!
Services’!logo!on!their!jerseys.!!
!
Type Cost Frequency/per/Year Total/Expense
Brochures 2,000.00$.. 4 8,000.00$.....
School.Athletics.Sponsorship 5,000.00$.. 1 5,000.00$.....
Club.Soccer.Sponsorship 2,500.00$.. 1 2,500.00$.....
Total 15,500.00$///
Advertising/Budget
For/Year/Ending/December/31,/2016
Type Cost Frequency/per/Year Total/Expense
Brochures 1,000.00$.. 4 4,000.00$.....
School.Athletics.Sponsorship 5,000.00$.. 1 5,000.00$.....
Club.Soccer.Sponsorship 2,500.00$.. 1 2,500.00$.....
Total 11,500.00$//
Advertising/Budget
For/Year/Ending/December/31,/2017
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DIFFERENTIAL&STATEMENT&
Our!practice!can!not!be!compared!to!others!in!the!area.!While!we!offer!similar!services!to!a!primary!care!
provider,!our!goal!is!to!go!above!and!beyond!our!member’s!expectations.!Our!holistic,!proactive!approach!to!
healthcare!addresses!our!member’s!physical,!mental!and!emotional!well:being!through!one:on:one!counseling!
and!comprehensive!diagnostic!testing.!
Unlike!the!traditional!primary!care!provider!who!sees!2,000!patients!or!more,!our!practice!purposefully!limits!
our!physician’s!patient!load!to!600!in!order!to!better!serve!and!personalize!each!member’s!care.!In!the!first!year!
we!hope!to!keep!our!practice!relatively!small!at!400!patients!per!physician!and!growing!to!about!500!in!the!
second!year.!.!In!addition,!by!limiting!the!number!of!patients!our!physicians!see,!better!quality!of!care!and!a!
more!productive!work!environment!will!be!focused!towards!our!members.!
As!mentioned!in!our!pricing!of!services,!our!practice!includes!all!services!provided!in!the!annual!membership!fee!
so!our!members!and!physicians!will!not!have!to!deal!with!the!hassle!of!their!insurance!or!Medicare.!Our!practice!
will!be!all!self:pay!in!order!to!ensure!that!our!member’s!have!the!freedom!to!see!their!physician!as!frequently!as!
they!desire.!!!!!!
GEOGRAPHIC&AND&ECONOMIC&DEMOGRAPHICS&
Our!physicians!will!cover!Mobile!and!Baldwin!counties!specifically!Daphne,!Fairhope,!Spanish!Fort,!and!Mobile.!
We!hope!to!service!most!of!Mobile,!even!if!our!members!live!further!from!our!office!we!have!the!flexibility!to!
travel!to!them!in!order!to!provide!care.!Our!physicians!have!admitting!privileges!at!Thomas!Hospital,!which!is!
most!convenient!for!the!bulk!of!our!members,!as!well!as,!the!closest!to!our!office.!!
The!average!age!for!Daphne,!Fairhope,!Spanish!Fort,!and!Mobile!are!37,!44,!40,!and!36!respectively.!As!well,!the!
Fairhope!area!is!known!as!one!of!the!premiere!retirement!locations!in!the!state.!This!age!is!ideal!for!our!
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services,!we!are!targeting!older!adults!and!families!who!have!the!income!for!our!services!which!consist!of!out:
of:pocket!payments.!Also,!older!adults!and!retirees!need!more!access!to!their!physician!and!our!concierge!
practice!aims!to!be!with!our!members!as!much!as!they!need.!!
The!Average!Household!Income!for!Daphne,!Fairhope,!Spanish!Fort,!and!Mobile!is!$178,826,!$197,099,!
$206,544,!and!$119,300!respectively.!Our!members!are!required!to!pay!a!yearly!membership!fee!for!our!
services!to!ensure!adequate!time!and!availability!for!each!patient.!Due!to!the!yearly!membership!fee!we!expect!
most!of!our!patients!to!have!a!higher!income,!which!the!area!in!where!we!plan!to!enter!can!support!based!on!
the!data!previously!mentioned.!
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EMPLOYMENT&POSITIONS&
Premiere!Concierge!Services’!staff!will!include!two!physicians,!two!Registered!Nurses,!and!a!Practice!Manager.!
The!physicians!are!full:time!and!will!practice!within!our!office!as!well!as!our!members’!homes!for!house!calls.!
Both!physicians!will!be!owners!of!PCS.!One!physician!will!be!appointed!as!the!Director!of!Medicine,!serving!as!
the!lead!for!the!organization.!The!Registered!Nurses!will!work!part:time!during!the!weekdays,!switching!
between!Monday/Wednesday/Friday!and!Tuesday/Thursday!shifts.!The!weekends!will!be!determined!according!
to!appointment!times!and!availability.!The!Practice!Manager!will!work!full:time!within!our!office.!The!Practice!
Manager!will!be!responsible!for!all!bookkeeping!and!reception!duties!including!but!not!limited!to:!management,!
marketing,!finance,!taking!phone!calls,!and!checking!members!in!at!the!office.!!
GOVERNANCE&OF&ORGANIZATION&&
GOVERNING&STRUCTURE&
Premiere!Concierge!Services!will!be!governed!exclusively!in:house.!The!Director!of!Medicine!will!serve!as!the!
ultimate!decision:maker!when!a!collective!decision!cannot!be!made.!The!second!physician!at!the!practice!and!
the!Practice!Manager!will!answer!to!the!Director!of!Medicine.!However,!the!Director!of!Medicine,!Practice!
Manager,!and!physician!will!work!together!to!make!decisions!that!are!best!for!our!members!and!practice.!The!
Director!of!Medicine!and!the!other!physician!will!both!be!owners!of!Premiere!Concierge!Medicine,!so!it!is!
important!that!their!inputs!are!integrated!into!the!practice.!The!Practice!Manager!will!serve!as!the!champion!for!
the!business!aspects!of!the!practice!such!as!management,!finance,!and!other!administrative!duties.!The!Director!
of!Medicine!will!work!closely!with!our!Practice!Manager!to!bridge!the!gap!between!clinical!and!clerical!
operations.!While!the!Director!of!Medicine!is!the!main!leader!for!Premiere!Concierge!Medicine,!it!is!important!
that!our!Practice!Manager,!who!is!highly!involved!in!the!day:to:day!business!operations,!be!in!contact!to!ensure!
the!practice!is!running!smoothly!as!a!whole.!The!Practice!Manager!will!deal!directly!with!employee!conduct!
- 34. &
& 34&
At!Premiere!Concierge!Services!having!a!staff!that!portrays!great!work!ethic,!respect,!honestly,!positive!attitude!
and!integrity!is!significant.!A!top!priority!for!our!staff!is!for!them!to!appreciate!the!way!a!concierge!practice!
functions.!We!want!our!staff!to!be!dedicated!to!create!a!relationship!with!the!members,!while!giving!them!the!
top!care!needed.!Premiere!Concierge!Services!plans!to!have!staff!positions!of!a!Director!of!Medicine,!physician,!
two!Registered!Nurses,!and!a!Practice!Manager.!!See!Appendix!B!for!the!job!descriptions!in!detail.!The!staff!
positions!are!described!below:!
•! Director)of)Medicine:!a!physician!who!will!be!responsible!for!the!roles!of!the!physician!position,!and!will!
serve!as!a!leader!to!the!medical!aspects!of!Premiere!Concierge!Services!
•! Physician:!responsible!for!spending!time!with!the!members!to!develop!a!relationship!with!them!and!
treat!them!with!top!care,!while!providing!house!calls!to!members!and!working!at!the!office.!!!!
•! Registered)Nurse:!responsible!for!escorting!members!to!room,!recording!members’!history,!taking!vitals!
and!assisting!medical!staff!members!when!needed!
•! Practice)Manager:!responsible!for!information!management,!project!management,!human!resources!
roles,!marketing!roles,!answering!phone!calls!and!all!operations!of!the!organization!
These!positions!will!have!various!responsibilities!explained!in!the!job!descriptions!with!different!work!schedules.!
The!Director!of!Medicine!and!physician!will!be!working!all!operation!hours!on!Monday!through!Friday,!with!
appointments!on!Saturday!and!Sunday!and!be!available!at!all!times!to!their!members!on!a!daily!basis.!The!
Registered!Nurses!will!work!part:time!during!the!weekdays,!switching!between!Monday/Wednesday/Friday!and!
Tuesday/Thursday!shifts.!The!weekends!will!be!determined!according!to!appointment!times!and!availability.!The!
Practice!Manager!will!only!be!working!Monday!through!Friday.!!See!the!following!table!for!staffing!salaries.!!
- 35. &
& 35&
&
Because!we!are!operating!under!the!assumption!that!it!will!take!60!days!to!begin!bringing!in!patient!revenue,!
the!Director!of!Medicine!and!physician!will!not!be!earning!a!salary!during!that!60:day!period.!Their!salary!will!
begin!in!March!2016.!The!Practice!Manager!will!be!salaried!starting!in!January!2016!as!he!or!she!will!not!be!a!
part!owner!and!will!be!integral!in!the!practices!formative!months.!The!Registered!Nurses!will!begin!working!for!
PCS!in!March!2016!and!will!begin!receiving!salary!in!that!month.!!
RECRUITMENT&AND&RETAINING&&
At!Premiere!Concierge!Service!we!will!strive!to!recruit!the!most!qualified!staff!members.!To!be!able!to!recruit!
the!top!staff!members,!we!plan!to!market!to!professionals!who!desire!to!be!apart!of!a!concierge!practice.!The!
concierge!service!has!many!benefits!to!the!staff!members,!and!we!believe!this!is!an!advantage!to!us!to!recruit!
the!top!staff!members.!For!the!medical!staff!members,!the!biggest!asset!is!that!he!or!she!is!able!to!practice!
traditional!medicine!again,!and!is!able!to!build!relationships!with!their!members.!We!plan!to!strictly!use!our!
minimum!requirements!of!each!position!to!hire!our!staff,!and!seek!candidates!with!experience!in!their!position.!
Our!practice!wants!to!recruit!staff!members!who!exhibit!traits!of!a!positive!attitude,!strong!work!ethic!and!
professionalism.!Premiere!Concierge!Services!will!also!select!staff!members!who!will!represent!and!up!hold!our!
Position #(Required Salary Total(Salaries Employment(Expense((30%) Total(Expense
Director(of(Medicine 1 180,000$((((((((((((( 118,000$(((((((((((((((( 35,400$(((((((((((((((((((((((((((((((((((( 153,400$((((((((((((((((
Physician 1 170,000$((((((((((((( 108,000$(((((((((((((((( 32,400$(((((((((((((((((((((((((((((((((((( 140,400$((((((((((((((((
Registered(Nurse 2 60,000$(((((((((((((((( 120,000$(((((((((((((((( 36,000$(((((((((((((((((((((((((((((((((((( 156,000$((((((((((((((((
Practice(Manager 1 75,000$(((((((((((((((( 75,000$(((((((((((((((((( 22,500$(((((((((((((((((((((((((((((((((((( 97,500$((((((((((((((((((
Totals( 5 485,000$((((((((((((( 421,000$(((((((((((((((( 126,300$(((((((((((((((((((((((((((((((( 547,300$((((((((((((((((
Per(Month(Expense: 45,608.33$((((((((((((
Per(Week(Expense:( 10,525.00$((((((((((((
Year(1(Salaries 472,333$((((((((((((((((
Year(2(Salaries 547,300$((((((((((((((((
Salaries(Budget
- 36. &
& 36&
mission.!We!plan!to!recruit!our!staff!members!through!referrals!and!an!application!process!done!by!the!Director!
of!Medicine!and!Practice!Manager.!!
At!Premiere!Concierge!Services!we!plan!on!retaining!our!high!quality!staff!members!through!bonuses!when!we!
see!a!staff!member!needs!to!be!rewarded!for!their!work,!and!through!our!comprehensive!benefits!packages!
which!will!be!explained!later.!!We!want!our!staff!to!know!they!are!appreciated!at!our!practice!and!we!want!to!
help!them!realize!this!by!rewarding!them!frequently!for!their!dedication!to!our!practice.!It!is!important!to!keep!
our!staff!because!of!the!relationships!he!or!she!has!formed!with!their!members.!With!having!a!small!practice,!
and!not!many!staff!members!we!hope!the!relationships!will!help!retain!the!staff.!We!plan!to!promote!monthly!
contests!that!will!help!better!our!practice,!motivate!our!staff,!and!reward!our!staff!that!achieves!great!results!of!
the!contest.!Premiere&Concierge!Services!plans!to!make!a!significant!investment!in!our!staff!members!and!we!
hope!our!staff!members!don’t!see!their!salary!as!their!only!compensation,!but!all!of!their!benefits!to!work!at!a!
concierge!practice!also.!!
CONTRACT&WORK&&
Premiere!Concierge!Services!plans!to!be!a!small!organization,!as!we!will!only!have!five!salaried!staff!members.!
Rather!than!hiring!additional!staff!members,!we!have!decided!to!outsource!cleaning!services,!grounds!keeping,!
lab!services,!shredding!service!and!website!developer.!!!
CLEANING&SERVICES&
We!will!be!contracting!cleaning!services!out!to!Office!Pride!Mobile,!who!will!come!once!every!weekend!to!clean!
the!office.!They!will!come!after!office!hours!to!avoid!distractions!to!staff!members!and!members.!Registered!
Nurses!will!be!in!charge!of!keeping!exam!rooms!sanitized!and!clean!on!daily!basis,!as!Office!Pride!Mobile!will!
only!come!once!per!week.!!
- 37. &
& 37&
Office)Pride)Mobile)
9340!Sevenhills!Curve!
Mobile,!AL!36695!
(251)!473:9244!
$350!per!month!
GROUNDS&KEEPING&
Although!we!are!leasing!our!space,!Premiere!Concierge!Services!is!responsible!for!grounds!keeping!issues.!
Maximum!Landscape,!Inc.!will!come!once!per!week!to!do!maintenance!to!our!small!yard.!In!the!winter!months!
(October!–!March)!they!will!come!every!other!week.!The!yard!maintenance!that!Southern!Pride!Lawn!Care!will!
provide!is:!mowing,!clearing!leaves,!planting!and!maintaining!flowers,!and!trimming!bushes.!!
Maximum)Landscape,)INC.)
P.O.!Box!850754!
Mobile,!AL!36685!
(251)!633:6657!
$300!per!month!
LAB&SERVICES&
We!plan!to!outsource!all!of!our!lab!work.!However,!our!EHR!system!we!have!chosen!eMedicalFusion’s!software!
allows!for!bi:directional!lab!integration.!The!lab!integration!feature!is!compatible!with!Quest!and!Labcorp!labs.!
Premiere!Concierge!Services!will!use!Solstas!/!Quest!Diagnostics!in!Fairhope,!Alabama!for!lab!needs.!!
Solstas)/)Quest)Diagnostics))
811A!Fairhope!Ave.!
Fairhope,!Al!36532!
!(251)!990:2011!
- 38. &
& 38&
SHREDDING&SERVICE&
Our!practice!will!be!use!a!shredding!service!to!comply!with!HIPAA!and!maintain!patient!confidentiality.!Mobile!
Shredding!Service!will!come!to!our!practice!on!a!biweekly!basis!to!collect!documents!that!need!to!be!shredded.!
They!will!be!taken!to!a!shredding!facility!and!our!practice!will!be!presented!with!a!certificate!of!destruction!for!
compliance!records.!This!outsourcing!service!will!cost!$120!per!month.!!
Mobile)Shredding)Service)
107!Saint!Francis!St.!
Mobile,!AL!36602!
(251)!345:6250!
$120!per!month!
WEBSITE&DEVELOPER&&
Because!we!do!not!have!designated!Information!Technology!or!social!media!staff!members,!we!plan!to!contract!
with!a!website!developer.!A:Factor!Marketing!will!meet!with!the!Practice!Manager!about!our!organization’s!
vision!for!the!website,!strategize!what!will!be!best!for!our!organization,!create!our!website,!and!execute!it.!They!
will!be!available!to!help!maintain!the!website!and!make!changes!whenever!needed.!A:Factor!Marketing!will!also!
provide!our!Internet!marketing,!including!maintaining!our!Facebook!page!with!a!combined!fee.!A:Factor!
Marketing!will!charge!$4,000!in!January!2016!to!start!up!the!website,!and!$2,000!each!subsequent!year!for!
maintenance!and!Internet!marketing!fees.!!
A]Factor)Marketing)
4318!Downtowner!Loop!N.!Building!D.!
Mobile,!Al!36609!
(251)!285:1576!
&
- 39. &
& 39&
STAFFING&ISSUES&
THEFT&&
Theft!of!any!sort!will!not!be!tolerated!and!can!lead!to!immediate!termination!of!a!staff!member.!Theft!includes,!
but!is!not!limited!to,!office!supplies,!money,!medicines,!phone!service,!time,!inappropriate!use!of!the!computer,!
and!stealing!from!co:workers.!Theft!will!not!be!tolerated!at!Premiere!Concierge!Services.!If!this!is!problem!at!our!
practice,!the!Practice!Manager!has!the!right!to!terminate!the!staff!member!immediately.!!
SHIFT&TRADING&
The!only!staff!members!who!may!trade!shifts!are!the!two!Registered!Nurse!positions.!All!other!positions!may!
not!trade!shifts,!due!to!having!only!one!staff!member!to!fill!their!position.!A!shift!trade!request!must!be!done!
one!week!in!advance!and!be!approved!and!signed!by!both!staff!members!and!the!Director!of!Medicine.!The!
Practice!Manager!will!document!all!requests!and!approved!requests!for!shift!trading.!If!a!staff!member!becomes!
ill!suddenly,!the!Practice!Manager!is!in!charge!of!finding!a!replacement!or!fulfilling!the!staff!member’s!duties!
during!his!or!her!illness.!Shift!trading!and!time:off!request!procedures!are!explained!in!the!staff!member!
handbook!in!Appendix!B.!!
TARDINESS&
Tardiness!is!not!acceptable!at!Premiere!Concierge!Services!and!could!be!considered!grounds!for!termination.!!In!
order!for!our!practice!to!run!smoothly,!it!is!essential!that!staff!members!are!on!time!and!maintain!regular!
attendance.!Staff!members!are!expected!to!be!in!the!office!and!settled!before!the!practice!opens.!If!a!staff!
member!must!be!late,!they!should!inform!the!Practice!Manager!as!soon!as!possible.!At!the!end!of!each!
workweek,!all!late!arrivals!and!early!departures!will!be!totaled.!For!each!accumulated!six!minutes!that!the!staff!
member!is!late,!or!leaves!early,!he!or!she!loses!one:tenth!of!an!hour!of!pay.!!
- 47. &
& 47&
INITIAL&FUNDING&
!
Jan Feb Total
Sources0of0Cash
Loan%Proceeds
BBVA 106,250%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 106,250000000000000000000
Wells%Fargo 41,626%%%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 41,62600000000000000000000
Contributed%Capital 148,078%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 148,078000000000000000000
Total0Sources0of0Cash 295,954$%%%%%%%%%%%% 5$%%%%%%%%%%%%%%%%%%%% 295,954$000000000000000
Uses0of0Cash
Leasehold%Improvements 125,000%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 125,000000000000000000000
Furniture%&%Fixtures 13,424%%%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 13,42400000000000000000000
Technology%&%Equipment 35,549%%%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 35,54900000000000000000000
Operating0Expenses
Advertising 2,000%%%%%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 2,0000000000000000000000000
Building%Lease 2,640%%%%%%%%%%%%%%%%%% 2,640%%%%%%%%%%%%%%%%%% 5,2800000000000000000000000
Cable,%Phone,%Internet 1,028%%%%%%%%%%%%%%%%%% 428%%%%%%%%%%%%%%%%%%%%%% 1,4560000000000000000000000
Cleaning%Service 350%%%%%%%%%%%%%%%%%%%%%% 350%%%%%%%%%%%%%%%%%%%%%% 7000000000000000000000000000
Grounds%Keeping 300%%%%%%%%%%%%%%%%%%%%%% 300%%%%%%%%%%%%%%%%%%%%%% 6000000000000000000000000000
Shredding 120%%%%%%%%%%%%%%%%%%%%% 120%%%%%%%%%%%%%%%%%%%%%% 2400000000000000000000000000
Insurance%5%Facility%and%Umbrella 250%%%%%%%%%%%%%%%%%%%%%% 250%%%%%%%%%%%%%%%%%%%%%% 5000000000000000000000000000
Insurance%5%Malpractice 1,500%%%%%%%%%%%%%%%%%% 1,500%%%%%%%%%%%%%%%%%% 3,0000000000000000000000000
Interest 456%%%%%%%%%%%%%%%%%%%%% 456%%%%%%%%%%%%%%%%%%%%%% 9110000000000000000000000000
Medical%Supplies 2,500%%%%%%%%%%%%%%%%%% 2,500%%%%%%%%%%%%%%%%%% 5,0000000000000000000000000
Office%Supplies 1,000%%%%%%%%%%%%%%%%%% 1,000%%%%%%%%%%%%%%%%%% 2,0000000000000000000000000
Practice%Management%System 667%%%%%%%%%%%%%%%%%%%%%% 667%%%%%%%%%%%%%%%%%%%%%% 1,3330000000000000000000000
Professional%Services 20,300%%%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 20,30000000000000000000000
Salaries%and%Benefits 8,125%%%%%%%%%%%%%%%%%% 8,125%%%%%%%%%%%%%%%%%% 16,25000000000000000000000
Security%System 240%%%%%%%%%%%%%%%%%%%%%% 40%%%%%%%%%%%%%%%%%%%%%%%% 2800000000000000000000000000
Utilities%5%Water%and%Electronic% 1,000%%%%%%%%%%%%%%%%%% 1,000%%%%%%%%%%%%%%%%%% 2,0000000000000000000000000
Website%Development 4,000%%%%%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 4,0000000000000000000000000
Total0Uses0of0Cash 220,447$%%%%%%%%%%%% 19,375$%%%%%%%%%%%%%% 239,823$000000000000000
Net%Cash%Inflows%(Outflows) 75,507$%%%%%%%%%%%%%% 19,3755$%%%%%%%%%%%%%% 56,131$000000000000000000
Premiere0Concierge0Services
Sources0and0Uses0of0Cash0Projection
To0Start0of0Operations0
- 48. &
& 48&
Under!the!assumption!that!PCS!will!not!begin!generating!revenue!for!the!first!60!days!of!operation,!our!
calculated!start:up!costs!(uses!of!cash)!are!$239,823.!We!would!like!to!generate!enough!sources!of!cash!that!will!
allow!for!net!cash!to!be!10%!greater!than!break:even.!To!do!so,!our!sources!of!cash!must!equal!$295,954.!We!
will!finance!this!amount!through!the!following:!!
!
Because!we!will!not!be!generating!revenue!in!our!first!60!days,!principal!payments!on!both!the!BBVA!and!Wells!
Fargo!loans!will!not!begin!until!March!2016.!Only!interest!will!be!charged!in!the!first!60!days.!BBVA!charges!
3.50%!interest!over!the!5:year!loan!term.!Wells!Fargo!charges!4.20%!interest!over!the!7:year!lease!term.!
Because!the!Director!of!Medicine!will!be!earning!approximately!10%!more!salary,!he!or!she!must!buy:in!for!a!
greater!percentage!than!the!physician.!The!remaining!needed!contributed!capital!after!loan!proceeds!of!
$148,078!will!be!financed!55%!by!the!Director!of!Medicine!($81,443)!and!45%!by!the!physician!($66,635).!
!PCS!does!not!submit!claims!to!insurance!companies.!All!of!our!revenue!is!generated!through!the!$1,200,!$1,500,!
and!$1,750!annual!membership!fees,!billed!monthly!and!due!at!the!first!of!each!month.! !
Leasehold)Improvements)
(BBVA) 125,000.00$(
Loan(Proceeds 85% 106,250.00$((
Contributed(Capital 15% 18,750.00$((((
Furniture,)Fixtures,)Tech.,)&)Equipment)
(Wells)Fargo) 48,972.23$((((
Loan(Proceeds 85% 41,626.40$((((
Contributed(Capital 15% 7,345.83$((((((
Operating)Costs 121,981.81$(
Contributed(Capital 100% 121,981.81$((
Total)Initial)Funding 295,954.04$(
Initial)Funding
- 49. &
& 49&
FINANCIAL&STATEMENTS&FOR&FISCAL&YEARS&1&AND&2&
&
& &
2016%Total 2017%Total
Revenue
Membership*Fee*Revenue 991,667$********** 1,487,500$*******
Expenses
Advertising 15,500$************* 11,500$*************
Building*Lease 31,680$************* 31,680$*************
Cable,*Phone,*Internet 5,736$*************** 5,136$***************
Cleaning*Service 4,200$*************** 4,200$***************
Depreciation 30,945$************* 30,945$*************
Grounds*Keeping 3,600$*************** 3,600$***************
Shredding 1,440$*************** 1,440$***************
Insurance*M*Facility*and*Umbrella 3,000$*************** 3,000$***************
Insurance*M*Malpractice 18,000$************* 18,000$*************
Interest 5,174$*************** 4,239$***************
Medical*Supplies 30,000$************* 30,000$*************
Office*Supplies 12,000$************* 12,000$*************
Practice*Management*System 8,000$*************** 8,000$***************
Professional*Services 20,300$************* M$*******************
Salaries*and*Benefits 472,333$********** 547,300$**********
Security*System 680$****************** 480$******************
Utilities*M*Water*and*Electronic* 12,000$************* 12,000$*************
Website*Development 4,000$*************** 2,000$***************
Total*Expenses 678,588$********** 725,520$**********
Net%Income%(Loss) 313,079$********** 761,980$**********
Premiere%Concierge%Services
Projected%Income%Statement
For%Year%Ending%December%31,%2016%and%December%31,%2017
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& 50&
& &
2016
Assets
Current'Assets
Cash 444,481$**************
Total-Current-Assets 444,481****************
Property,'Plant,'&'Equipment,'at'cost
*********Leasehold*Improvements 125,000****************
Furniture*&*Fixtures 13,424*******************
Technology*&*Equipment 35,549*******************
Total*Property,*Plant,*&*Equipment,*at*cost 173,972****************
Less:*Accumulated*Depreciation 30,945*******************
Total-Property,-Plant,-&-Equipment,-net 143,028****************
Total-Assets 587,509$**************
Liabilities-&-Shareholder's-Equity
Current'Liabilities
BBVA 21,142$****************
Wells*Fargo 5,564$*******************
Total-Current-Liabilities 26,705******************
Long:Term'Debt
BBVA 68,046******************
Wells*Fargo 31,601*******************
Total-LongBTerm-Debt 99,647******************
Total-Liabilities 126,353****************
Equity
Contributed*Capital 148,078****************
Retained*Earnings 313,079****************
Total-Equity 461,156****************
Total-Liabilities-&-Equity 587,509$**************
Premiere-Concierge-Services
Balance-Sheet
December-31,-2016
- 52. &
& 52&
•! Our!interior!designer,!Sarah!Wallstedt,!will!handle!all!design:related!tasks!including!selecting!furniture!
and!décor.!Her!fee!is!$5,000!and!is!recorded!as!a!professional!service!expense.!
•! PCS!will!use!Verizon!Wireless’s!small!business!resources!for!our!mobile!device,!landline,!internet,!and!
cable!needs.!These!needs!are!discussed!in!the!subsequent!Technology!portion!of!the!business!plan.!
These!costs!reported!as!“Cable,!Phone,!and!Internet”!expenses!as!well!as!in!our!technology!budget.!
•! We!have!a!contract!with!A:Factor!Marketing,!a!web!developer,!to!construct!our!website.!A:Factor!will!
also!manage!our!internet!presence!through!managing!the!website!in!addition!to!a!Facebook!page.!This!
information!is!included!in!the!Marketing!section.!There!is!a!first!year!fee!of!$4,000!and!$2,000!in!each!
subsequent!year.!
•! We!will!carry!malpractice!insurance!on!each!of!our!physicians.!The!premium!is!$9,000!per!physician.!
•! Our!facility!will!be!covered!by!at!Business!Owner’s!policy!from!Geico!at!$3,000!per!year!to!protect!PCS!
against!accidents,!lawsuits,!etc.!
•! ADT!will!provide!us!with!a!small!business!security!system!at!a!fee!of!$200!for!the!system!and!installation!
in!addition!to!$40!per!month.!Specifics!about!the!system!can!be!found!in!the!Technology!section.!
&
&
&
&
&
&
- 54. &
& 54&
DESIRED&SYSTEM&FUNCTIONALITY&
Premiere!Concierge!Services!is!looking!to!acquire!a!practice!management!system!and!an!electronic!medical!
record!system.!Ideally,!we!will!invest!in!a!system!that!is!best:of:suite.!A!best:of:suite!solution!will!ensure!
simplicity!and!superior!interoperability!–!two!aspects!that!are!pivotal!to!a!small!practice.!Furthermore,!our!
needs!as!a!concierge!and!membership!payment!model!differ!from!those!of!a!typical!private!practice.!We!desire!
to!invest!in!a!software!solution!that!will!tailor!to!our!unique!needs!as!a!concierge!practice.!!
There!are!a!number!of!functions!that!the!solution!Premiere!Concierge!Services!acquires!must!contain.!All!of!the!
functions!must!have!the!personalized!patient!experience!at!their!forefront.!The!system!must!include!the!
following:!scheduling,!membership!account!management,!mobile!device!access,!ePrescribing,!personalized!
patient!communication,!simple!clinical!note!taking!abilities,!the!ability!to!track!patient!metrics!over!time,!and!an!
emphasis!on!security.!The!software!solution!that!is!chosen!must!tailor!to!the!needs!of!our!small!staff!size.!It!
needs!to!have!a!user!friendly!interface!for!our!clinicians,!support!staff,!and!members.!All!of!these!features!will!
enable!Premiere!Concierge!Services!to!place!personalized!patient!care!at!the!forefront!of!our!practice.!!
ACCEPTABLE&SYSTEMS&
After!vetting!numerous!systems!Premiere!Concierge!Services!has!identified!two!systems!that!are!considered!to!
be!acceptable.!The!first,!eMedicalFusion,!is!a!practice!management!and!EHR!bundled!software!solution.!The!
second,!McKesson’s!Medisoft!Clinical!v20,!is!also!a!software!solution!that!encompasses!practice!management!
software!with!an!EHR.!!
MEDISOFT&&
McKesson’s!Medisoft!Clinical!v20!has!several!key!features!that!would!benefit!Premiere!Concierge!Services.!
McKesson’s!solution!is!a!best:of:suite!solution!which!will!aid!in!interoperability!and!simplicity.!In!addition,!the!
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clinicians!will!be!able!to!see!who!is!scheduled!for!a!certain!time!period!and!what!his!or!her!medical!need!
concerns.!!
In!the!21st
!century!mobile!access!to!information!is!vital!to!provide!a!member!with!patient!centered!care.!The!
eMedicalFusion!software!is!accessible!from!Apple,!Android,!and!Surface!tablets!as!well!as!Apple,!Android,!and!
Microsoft!smartphones.!We!have!chosen!to!equip!employees!with!Apple!iPads!and!Apple!iPhones!so!that!they!
may!access!the!software!when!they!are!out!of!the!office.!In!addition,!the!wide!range!of!compatibility!will!allow!
our!members!to!access!the!patient!portal!aspect!of!the!software!on!the!go.!The!cornerstone!of!mobile!access!for!
our!members!is!the!HIPAA!compliant!two:way!communication!between!a!physician!and!a!member.!Members!
are!able!to!send!text!and!picture!data!to!a!physician!via!the!patient!portal.!Physicians!can,!in!turn,!respond!to!a!
member’s!message!using!his!or!her!mobile!device!or!standard!computer.!This!will!allow!members!to!get!results!
to!questions!and!concerns!in!a!timely!manner.!!
The!eMedicalFusion!practice!management!and!EHR!software!is!completely!cloud!based.!Premiere!Medical!
Services!does!not!need!to!invest!in!any!system!specific!hardware.!The!only!equipment!needed!to!access!and!use!
the!software!are!desktop!computers!and!mobile!devices.!A!MAGTEK!Mini!Magnetic!Strip!Reader!will!be!included!
in!the!software!purchase!so!that!credit!and!debit!cards!can!be!charged!and!put!on!file!in!the!event!that!a!
member!does!not!wish!to!add!the!information!using!the!patient!portal.!The!cloud!based!software!also!includes!
free!updates!and!is!billed!on!a!monthly!basis.!!
Electronic!prescribing,!commonly!referred!to!as!ePrescribing,!is!a!feature!that!is!included!in!this!software!
solution.!A!physician!has!the!ability!to!select!a!pharmacy,!select!a!medication!from!the!selected!pharmacies!
formulary,!select!the!dosage,!and!add!instructions.!All!of!these!features!can!be!done!from!a!computer!or!a!
mobile!device.!In!addition,!patients!can!schedule!refills!if!the!physician!allows!the!medication!to!be!refilled.!The!
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physicians!and!other!employees!each!complete!a!three:hour!session!on!the!first!and!second!day.!Upon!
completion!of!the!training!program!all!employees!will!be!competent!in!using!the!system.!Furthermore,!
eMedicalFusion!support!staff!is!available!Monday!:!Friday!from!9:00!AM!–!8:00!PM!EST!via!email,!telephone,!and!
video!chat!communication.!Finally,!when!updates!to!the!software!are!released!an!online!tutorial!is!published!to!
the!website!so!that!users!can!become!familiar!with!the!new!features.!!
SECURITY&AND&DATA&BACKUP&PLAN&
eMedicalFusion’s!software!is!cloud!based,!which!includes!all!of!the!data!housed!in!the!system.!However,!to!
ensure!that!all!programs,!files,!and!information!that!the!office!uses!that!is!not!stored!in!the!cloud!will!be!secure!
the!office!will!receive!an!external!hard!drive!from!eMedicalFusion.!The!hard!drive!will!back!up!all!of!the!desktop!
computers!and!mobile!devices.!The!computers!and!mobile!devices!will!be!backed!up!every!Friday.!This!ensures!
that!no!hardware!malfunction!will!disrupt!the!work!flow!of!the!practice.!In!addition,!the!external!hard!drive!is!a!
solid!state!hard!drive.!This!makes!the!external!hard!drive!used!to!house!the!back!up!data!significantly!more!
durable!than!traditional!hard!drives.!The!external!hard!drive!will!have!the!capabilities!to!store!up!to!one!
terabyte!of!data.!Because!of!the!large!amount!of!storage!multiple!copies!of!backed!up!data!can!be!stored!at!one!
point.!Each!back!up!data!file!will!be!labeled!according!to!the!date!of!the!back!up,!the!device’s!name,!and!the!
user.!The!eMedicalFusion!software!has!HIPAA!compliant!security!measures!built!in.!In!addition,!the!HP!
computers!and!the!mobile!devices!will!be!updated!on!a!weekly!basis!to!ensure!that!the!software!used!in!each!is!
up!to!date!with!the!latest!manufacturer!intended!security!measures.!!
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TECHNOLOGY&AND&EQUIPMENT&
&
MEDICAL&EQUIPMENT&
Our!medical!equipment!requirements!are!as!follows!(see!Appendix!F!for!images!of!medical!equipment):!
•! Body!composition!scanner!from!Seca,!which!achieves!the!following,!to!be!located!in!a!central!location!
for!all!comprehensive!physicals!and!routine!exams:!
o! Measures!intra/extracellular!water,!body!fat,!skeletal!muscle!mass!
o! Clinically!validated!accuracy!compares!to!scientific!gold!standards!used!in!clinical!studies!
o! Reproducible!measurements!ensure!accuracy!
o! Hand:held!electrodes!mounted!in!standing!aid!for!enhanced!stability!
Device Price Quantity Total1Expense1per1Device1
Apple%iPad%Pro 1,079.00$%%%%%% 3 3,237.00$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
Apple%Pencil 99.00$%%%%%%%%%%%% 3 297.00$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
iPad%Case 60.00$%%%%%%%%%%%% 3 180.00$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
Computer%Tower 1,529.00$%%%%%% 6 9,174.00$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
Computer%Monitor 139.99$%%%%%%%%% 10 1,399.90$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
Personal%Printer 179.99$%%%%%%%%% 3 539.97$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
Office%Printer 1,999.99$%%%%%% 1 1,999.99$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
Apple%iPhone%16GB 199.99$%%%%%%%%% 3 599.97$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
Body%Composition%Scanner 12,298.00$%%%% 1 12,298.00$%%%%%%%%%%%%%%%%%%%%%%%%%%
Biohazard%Receptacles% 13.99$%%%%%%%%%%%% 4 55.96$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
InMOffice%Defibrillator 1,231.00$%%%%%% 1 1,231.00$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
Travel%Defibrillator 959.99$%%%%%%%%% 2 1,919.98$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
WallMMounted%Height%Rod 96.00$%%%%%%%%%%%% 1 96.00$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
Stethoscope 43.99$%%%%%%%%%%%% 5 219.95$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
Diagnostic%Carry%Kit 60.00$%%%%%%%%%%%% 2 120.00$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
WallMMounted%Diagnostic%Set 1,089.95$%%%%%% 2 2,179.90$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
Total1Expense 35,548.62$1111111111111111111111111
Technology1&1Equipment1Budget
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o! Provides!measurements!in!20!seconds!or!less!
o! mBCA!utilizes!four!comparative!methods!to!achieve!precise!results!
o! 8.4!inch!touch!screen!display!for!convenient!use!with!wireless!360!software!
o! mBCA!514!is!equipped!with!Seca!wireless!360!for!EMR!transmission!
o! Touch!screen!display!may!be!rotated!360!degrees!for!physician!to!patient!sharing!and!discussion!
o! Weight!capacity!of!660!lbs.!(300!kg)!
o! Large,!easy!access!weighing!platform!constructed!of!safety!glass!for!easy!cleaning!
o! Automatic!electrode!detection!!
o! Includes!Seca!Analytics!115!software!for!transmission!of!data!from!mBCA!to!PC!
•! Wall:mounted!height!rod!to!be!located!in!a!central!location!to!measure!patients'!height!during!
comprehensive!physicals!and!routine!exams!
•! Sharps!and!biohazard!disposal!container!to!be!located!in:!
o! Exam!rooms!
o! Laboratory!
o! Central!location!for!any!additional!disposal!needs!
•! Automated!external!defibrillators!(AED):!
o! One!AED!located!in!a!central!office!location!for!emergencies!
o! Two!travel:compatible!AEDs!for!each!physician!for!house!call!emergencies!
•! Stethoscopes!for!each!physician,!nurse,!and!nurse!practitioner!in!Caribbean!blue!to!match!our!color!
scheme!
•! Diagnostic!kits:!
o! Wall:mounted!diagnostic!set!to!be!located!in!each!exam!room.!Contains:!
!! Digital!thermometer!
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!! Coaxial!ophthalmoscope!(eye,!nasal,!and!throat!examination!tool)!
!! Otoscope!(ear!examination!tool)!
!! Aneroid!and!sphygmomanometer!(blood!pressure!measurement!tools)!
!! Specula!dispenser!(disposable!covers!for!ophthalmoscope!and!otoscope)!
!! Wall!mounting!board!!
o! Diagnostic!carry!kit!for!each!physician!for!house!call!visits.!Contains:!
!! Automatic!sphygmomanometer!!
!! Thermometer!
!! Blood!glucose!meter!
NONZMEDICAL&OFFICE&TECHNOLOGY&AND&EQUIPMENT&
Premiere!Concierge!Services’!office!space!will!be!equipped!with!adequate!electronic!equipment!to!better!allow!
our!staff!to!perform!their!day:to:day!tasks.!See!Appendix!F!for!images!of!non:medical!office!technology!and!
equipment.!The!backbone!of!the!office’s!electronic!technology!will!be!the!HP!Z440!Workstation!desktop!tower!
computer.!The!HP!Z440!carries!8GB!of!RAM!which!will!allow!for!faster!processing!and!multitasking.!It!comes!
equipped!with!Windows!8.1!Pro,!which!is!compatible!with!the!eMedicalFusion!software.!There!will!be!a!HP!Z440!
in!the!physician!offices,!Practice!Manager!office,!reception!area,!and!in!each!of!the!exam!and!consultation!
rooms.!!The!HP!Pavilion!23:Inch!IPS!LED!backlit!monitor!will!be!the!monitor!model!in!use!in!the!office.!The!
Practice!Manager,!physicians,!and!reception!desk!will!all!be!equipped!with!dual!monitors!to!increase!
productivity!and!multitasking.!The!exam!and!consultation!rooms!will!be!equipped!with!only!a!single!monitor!
because!multitasking!in!those!areas!will!be!far!less!common.!The!physicians’!offices!and!the!Practice!Manager’s!
office!will!each!have!a!personal!printer!in!them.!The!HP!Officejet!Pro!will!be!the!printer!model!in!use.!It!provides!
the!ability!to!print,!scan,!and!copy!documents.!Furthermore,!the!office!will!be!equipped!with!an!HP!Officejet!
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WORKS&CITED&
ACIP!Vaccine!Recommendations.!(2015,!March!27).!Retrieved!November!11,!2015,!from!
http://www.cdc.gov/vaccines/hcp/acip:recs/index.html!!
Annual!Physical!Exams:!What!to!Expect.!(n.d.).!Retrieved!November!12,!2015,!from!http://www.webmd.com/a:
to:z:guides/annual:physical:examinations?page=2!!
Best!Doctors.!(2015,!November!1).!Privacy(Policy.!Retrieved!November!6,!2015,!from!Best!Doctors:!
www.bestdoctors.com/privacy:policy!
Body!Composition!Analyzer!|!Professional!Medical!Scale!|!Seca!mBCA!514.!(n.d.).!Retrieved!November!4,!2015,!
from!http://www.quickmedical.com/seca:medical:body:composition:analyzer:scale:mbca514.html!!
Body!Composition!Tests.!(n.d.).!Retrieved!November!11,!2015,!from!
http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/Body:Composition:
Tests_UCM_305883_Article.jsp#.VjkTAaI2k7A!!
Brochure!Printing.!(n.d.).!Retrieved!November!10,!2015,!from!http://www.fedex.com/us/office/brochure:
printing.html!!
Cleaning!Quote.!(n.d.).!Retrieved!October!10,!2015,!fromhttp://officepride.com/mobile/commercial:cleaning:
quote/!
Coding!“Routine”!Office!Visits:!99213!or!99214?!(n.d.).!Retrieved!November!10,!2015,!from!
http://www.aafp.org/fpm/2005/0900/p52.html!!
Complete!Blood!Count!(CBC).!(n.d.).!Retrieved!November!10,!2015,!from!http://www.webmd.com/a:to:z:
guides/complete:blood:count:cbc!!
Comprehensive!Health!Evaluation!Program.!(n.d.).!Retrieved!November!10,!2015,!from!
http://www.hopkinsmedicine.org/usa/patient_information/appointments/comprehensive_health_evaluations.
html!!
EMedicalFusion!Concierge!Medicine!EHR!Review.!(n.d.).!Retrieved!November!11,!2015,!from!
http://www.ctsguides.com/medical/emedicalfusion/!!
EMedicalFusion!Practice!Management!Software!Suite!for!Direct!Pay!Health!Practitioners!and!Concierge!
Medicine!Debuts!Version!6.0!with!Electronic!Health!Records!Today!in!Las!Vegas.!(n.d.).!Retrieved!November!11,!
2015,!from!http://www.prnewswire.com/news:releases/emedicalfusion:practice:management:software:suite:
for:direct:pay:health:practitioners:and:concierge:medicine:debuts:version:60:with:electronic:health:records:
today:in:las:vegas:235713471.html!!
Employe!Handbook.!(n.d.).!Retrieved!October!10,!2015,!from!
http://familyhealthcareclinic.com/media/Personnel$20Policies$2CNovember$202009.pdf!
- 64. &
& 64&
Employee!Performance!Review.!(n.d.).!Retrieved!November!10,!2015,!from!
http://cf.ltkcdn.net/business/files/874:Employee:Performance:Review.pdf!
Features!&!Functions!:!!eMedicalFusion!eMedicalFusion.!(n.d.).!Retrieved!November!11,!2015,!from!
http://www.emedicalfusion.com/features:functions!!
Gavin,!M.!(2013,!August!1).!Sports!Physicals.!Retrieved!November!11,!2015,!from!
http://kidshealth.org/teen/food_fitness/exercise/sports_physicals.html!!
GC!Medicine!:!Home!Page.!(2014).!Retrieved!October!6,!2015,!fromhttp://gcmedicine.com/Default.aspx!
Heart:Health!Screenings.!(n.d.).!Retrieved!November!1,!2015,!from!
http://www.heart.org/HEARTORG/Conditions/Heart:Health:Screenings_UCM_428687_Article.jsp#.VjkFiqI2k7A!!
High!Deductible!Health!Plan!(HDHP).!(n.d.).!Retrieved!November!10,!2015,!from!
https://www.healthcare.gov/glossary/high:deductible:health:plan/!!
How!Will!These!Animals!Help!Your!Buisness!Build!Better!Marketing!Solutions?!(n.d.).!Retrieved!November!4,!
2015,!from!http://www.afactormarketing.com!
HP!OfficeJet!Business!Printers.!(n.d.).!Retrieved!November!4,!2015,!from!
http://www8.hp.com/us/en/ads/officejet:pro:printers/officejet:pro:6800:series.html!
HP!Officejet!Enterprise!Color!MFP!X585dn!|!HP®!Official!Store.!(n.d.).!Retrieved!November!4,!2015,!from!
http://store.hp.com/us/en/pdp/printers/hp:officejet:enterprise:color:x585dn:multifunction:
printer?jumpid=ps_gymaw6xezr&aoid=109887&003=51733796!!
HP!Pavilion!23xw!23:inch!IPS!LED!Backlit!Monitor!|!HP®!Official!Store.!(n.d.).!Retrieved!November!4,!2015,!from!
http://store.hp.com/us/en/pdp/hp:pavilion:23xw:23:inch:ips:led:backlit!!
HP!Z440!Workstation!(ENERGY!STAR)!|!HP®!Official!Store.!(n.d.).!Retrieved!November!4,!2015,!from!
http://store.hp.com/us/en/pdp/business:solutions/hp:z440:workstation:(energy:star):p:f1m41ut:aba::1!!
IPhone!6s!:!Apple.!(n.d.).!Retrieved!November!10,!2015,!from!http://www.apple.com/iphone:6s/!
IPad!Pro!:!Apple!Pencil!:!Apple.!(n.d.).!Retrieved!November!4,!2015,!from!http://www.apple.com/apple:
pencil/?cid=wwa:us:kwm:ipad!!
IPad!Pro!:!Apple.!(n.d.).!Retrieved!November!4,!2015,!from!http://www.apple.com/ipad:pro/!!
Leonard,!D.!(2012,!November!29).!Is!Concierge!Medicine!the!Future!of!Health!Care?!Retrieved!September!13,!
2015,!from!http://www.bloomberg.com/bw/articles/2012:11:29/is:concierge:medicine:the:future:of:health:
care#p2!
Mackey,!C.,!Dwyer,!J.,!&!Truesdell,!D.!(2004).!Nutritional!Assessment.!Retrieved!November!10,!2015,!from!
http://www.encyclopedia.com/topic/Nutritional_assessment.aspx!!
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& 65&
MAGTEK®!Mini!Magnetic!Stripe!Reader,!USB!2.0!|!Staples®.!(n.d.).!Retrieved!November!11,!2015,!from!
http://www.staples.com/MAGTEK:Mini:Magnetic:Stripe:Reader:USB:2:0/product_IM1E45877!!
Maximum!Landscape,!Inc.,!'Maximum!Service.!Maximum!Quality'!–!Mobile,!AL!–!Home.!(n.d.).!Retrieved!October!
10,!2015,!from!http://maximumlandscapeinc.com!
Mobile!Shredding!Service.!(n.d.).!Retrieved!October!16,!2015,!fromhttp://www.mobileshreddingservice.us!
Occupational!Safety!and!Health!Administration.!(n.d.).!Sample(Safety(and(Health(Program(for(Small(Business.!
Retrieved!October!12,!2015,!from!OSHA:!
https://www.osha.gov/SLTC/etools/safetyhealth/mod2_sample_sh_program.html!!
Perman,!C.!(2011,!January!19).!These!Doctors!Make!House!Calls—And!Love!It.!Retrieved!September!12,!
2015,!from!http://www.cnbc.com/id/41157342&
Physical!Activity!Counseling.!(n.d.).!Retrieved!November!10,!2015,!from!
http://www.aafp.org/afp/2008/0415/p1129.html!!
Pulmonary!Function!Tests.!(n.d.).!Retrieved!November!11,!2015,!from!
http://www.hopkinsmedicine.org/healthlibrary/test_procedures/pulmonary/pulmonary_function_tests_92,p07
759/!!
Rabinowitz,!E.!(2015,!February!12).!Doctors!Recapture!Humanity!through!Concierge!Medicine.!Retrieved!
September!12,!2015,!from!http://www.hcplive.com/journals/md_magazine/2015/vol7:issue1/doctors:
recapture:humanity:through:concierge:medicine!
Samsung!:!T1!1TB!External!Serial!ATA!Portable!Solid!State!Drive!:!Black.!(n.d.).!Retrieved!November!11,!
2015,!from!http://www.bestbuy.com/site/samsung:t1:1tb:external:serial:ata:portable:solid:state:
drive:black/4225008.p?id=1219621585087&skuId=4225008!!
Society!for!Human!Resource!Management.!(2014,!July!3).!ADA/ADAA(Policy.(Retrieved!November!6,!2015,!from!
SHRM:!http://www.shrm.org/templatestools/samples/policies/pages/adaadaaapolicy.aspx!!
Shilton,!A.!(2015,!May!4).!Concierge!Medicine!Means!Only!the!Ridiculously!Rich!Can!Find!a!Doctor.!
Retrieved!September!13,!2015,!
fromhttp://www.slate.com/articles/health_and_science/medical_examiner/2015/05/&
Society!for!Human!Resource!Management.!(2014,!March!20).!Background(and(Reference(Check(Policy.!Retrieved!
November!15,!2015,!from!SHRM:!
http://www.shrm.org/templatestools/samples/policies/pages/cms_005370.aspx!
Society!for!Human!Resource!Management.!(2014,!June!17).!Drug(and(Alcohol(Policy.!Retrieved!November!15,!
2015,!from!SHRM:!http://www.shrm.org/templatestools/samples/policies/pages/cms_019908.aspx!
Society!for!Human!Resource!Management.!(2014,!March!20).!Equal(Employment(Opportunity(and(Harassment(
Policy.!Retrieved!October!12,!2015,!from!SHRM:!
http://www.shrm.org/templatestools/samples/policies/pages/cms_007618.aspx!!
- 66. &
& 66&
Society!for!Human!Resource!Management.!(2014,!June!17).!Random(Drug(Testing(Policy.!Retrieved!November!
15,!2015,!from!SHRM:!http://www.shrm.org/templatestools/samples/policies/pages/cms_021943.aspx!
Staff!Member:!Handbook.!(n.d.).!Retrieved!October!20,!2015,!from!
https://www.classicconcierge.com/classicteam/wp:content/uploads/2014/07/Staff!member:Handbook.pdf!
Stroke:!Screening!and!Tests.!(n.d.).!Retrieved!November!10,!2015,!from!
https://www.floridahospital.com/stroke/screening:and:tests!!
Support!eMedicalFusion.!(n.d.).!Retrieved!November!11,!2015,!from!http://www.emedicalfusion.com/technical:
support#/SupportServicesandHours!!
Three!Must:Have!EHR!Features!for!Membership!Medicine.!(2015,!March!4).!Retrieved!November!11,!2015,!from!
http://conciergemedicinetoday.org/2015/03/04/three:must:have:ehr:features:for:membership:medicine/!!
Urine!Test.!(n.d.).!Retrieved!November!11,!2015,!from!http://www.webmd.com/a:to:z:guides/urine:test!!
Wieczner,!J.!(2013,!November!10).!Pros!and!Cons!of!Concierge!Medicine.!Retrieved!September!13,!2015,!
from!http://www.wsj.com/articles/SB10001424052702303471004579165470633112630?alg=y&
!
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EXPLANATION&OF&SERVICES&
MEDICAL&HISTORY&
During!the!medical!history!potion!of!the!comprehensive!physical!this!will!be!the!time!for!members!to!discuss!
any!present!complaints!or!concerns.!Additionally,!the!member’s!physician!will!discuss!their!lifestyle!behaviors!
like!smoking,!excessive!alcohol!use,!sexual!health,!diet,!and!exercise.!The!doctor!will!also!check!on!the!member’s!
vaccination!status!and!update!their!personal!and!family!medical!history.!
VITAL&SIGNS&
Vital!signs!that!the!physician!will!check!to!make!sure!are!normal!include,!blood!pressure,!heart!rate,!respiration!
rate,!and!temperature.!
HEART&EXAM&
By!listening!to!the!heart!with!a!stethoscope,!a!physician!might!detect!an!irregular!heartbeat,!a!heart!murmur,!or!
other!clues!to!heart!disease!which!can!be!monitored!further!and/or!require!a!referral!to!a!specialist.!
LUNG&EXAM&
By!using!a!stethoscope,!our!physicians!will!listen!for!crackles,!wheezes,!or!decreased!breath!sounds.!These!and!
other!sounds!are!clues!to!the!presence!of!heart!or!lung!disease.!Our!physicians!will!refer!the!member!to!a!
specialist!if!necessary.!
HEAD&AND&NECK&EXAM&
The!physician!will!exam!the!throat!and!tonsils.!As!well,!the!ears,!nose,!sinuses,!eyes,!lymph!nodes,!thyroid,!and!
carotid!arteries!will!be!examined.!!
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ABDOMINAL&EXAM&
The!physician!may!use!a!range!of!examination!techniques!including!tapping!your!abdomen!to!detect!liver!size!
and!presence!of!abdominal!fluid,!listening!for!bowel!sounds!with!a!stethoscope,!and!palpating!for!tenderness.!
NEUROLOGICAL&EXAM&
The!physician!will!assess!nerves,!muscle!strength,!reflexes,!balance,!and!mental!state.!
COMPLETE&BLOOD&COUNT&
A!complete!blood!count!(CBC)!gives!the!physician!information!about!the!kinds!and!numbers!of!cells!in!the!blood,!
especially!red!blood!cells,!white!blood!cells,!and!platelets.!A!CBC!helps!the!member’s!physician!check!any!
symptoms,!such!as!weakness,!fatigue,!or!bruising,!the!member!may!have.!A!CBC!also!helps!the!physician!
diagnose!conditions,!such!as!anemia,!infection,!and!many!other!disorders.!
URINE&ANALYSIS&
A!urine!test!checks!different!components!of!urine,!a!waste!product!made!by!the!kidneys.!The!test!can!give!
information!about!the!member’s!health!and!problems!they!may!have.!The!kidneys!take!out!waste!material,!
minerals,!fluids,!and!other!substances!from!the!blood!to!be!passed!in!the!urine.!Urine!has!hundreds!of!different!
body!wastes.!What!a!member!eats!and!drinks,!how!much!the!member!exercises,!and!how!well!their!kidneys!
work!can!affect!what!is!in!their!urine.!More!than!100!different!tests!can!be!done!on!urine.!
BODY&COMPOSITION&ANALYSIS
Body!composition!is!used!to!describe!the!percentages!of!fat,!bone,!water!and!muscle!in!human!bodies.!Because!
muscular!tissue!takes!up!less!space!in!our!body!than!fat!tissue,!our!body!composition,!as!well!as!our!weight,!
determines!leanness.!If!a!member!has!too!much!fat,!especially!if!a!lot!of!it!is!at!member’s!waist,!they're!at!higher!
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risk!for!such!health!problems!as!high!blood!pressure,!high!blood!cholesterol!and!diabetes.!Which,!increases!
member’s!risk!for!heart!disease!and!stroke.!
NUTRITIONAL&ASSESSMENT&
A!nutritional)assessment!is!an!in:depth!evaluation!data!related!to!a!member’s!food!and!nutrient)intake,!
lifestyle,!and!medical!history.!Once!the!data!on!the!member!is!collected!and!organized,!our!physicians!can!
assess!and!evaluate!the!nutritional!status!of!that!member.!The!nutritional!assessment!can!aid!in!the!
development!of!the!member’s!wellness!plan.!!
EXERCISE&COUNSELING&
Exercise!counseling!consists!of!assessing!the!member’s!current!physical!activity!(type,!frequency,!intensity,!and!
duration)!and!providing!them!with!an!individually!tailored!recommendation.!The!physician’s!recommendation!
concerning!physical!activity!should!be!supported!by!a!discussion!with!the!member!about,!what!steps!to!action!
they!will!take,!their!plan,!and!their!intended!start!date.!Additionally,!the!physician!should!consistently!follow!up!
in!order!to!hold!member’s!accountable.!!
HEART&SCREENING&
The!key!to!preventing!cardiovascular!disease,!also!called!coronary!artery!disease!(CAD),!is!managing!the!risk!
factors,!such!as!high!blood!pressure,!high!total!cholesterol!or!high!blood!glucose.!The!best!way!to!know!which!
risk!factors!our!members!have!is!through!screening!tests!during!their!comprehensive!physical.)The!following!
are!the!key!screening!tests!recommended!for!optimal!cardiovascular!health:!
Blood)Pressure))
Blood!pressure!is!one!of!the!most!important!screenings!because!high!blood!pressure!usually!has!no!symptoms!
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so!it!can’t!be!detected!without!being!measured.!High!blood!pressure!greatly!increases!the!risk!of!heart!disease!
and!stroke.!If!blood!pressure!is!below!120/80!mm!Hg,!be!sure!to!get!it!checked!at!least!once!every!two!years,!
starting!at!age!20.!If!blood!pressure!is!higher,!our!physicians!may!want!to!check!it!more!often.!!
Fasting)Lipoprotein)Profile)(cholesterol)and)triglycerides))
Members!should!have!a!fasting!lipoprotein!profile!taken!every!four!to!six!years,!starting!at!age!20.!This!is!a!blood!
test!that!measures!total!cholesterol,!LDL!(bad)!cholesterol,!HDL!(good)!cholesterol!and!triglycerides.!A!member!
may!need!to!be!tested!more!frequently!if!the!member’s!physician!determines!that!they’re!at!an!increased!risk!
for!heart!disease!or!stroke.!
Body)Weight))
Starting!around!20!years!old,!a!member’s!physician!may!ask!for!their!waist!circumference!or!use!the!member’s!
body!weight!to!calculate!their!body!mass!index!(BMI)!during!the!comprehensive!physical.!These!measurements!
allow!the!member’s!physician!to!know!whether!that!member!is!at!a!healthy!body!weight!and!composition.!!
Blood)Glucose)
Starting!at!age!45,!members!should!have!their!blood!glucose!level!checked!at!least!every!three!years.!High!blood!
glucose!levels!put!a!member!at!greater!risk!of!developing!insulin!resistance,!prediabetes!and!type!2!diabetes.!
Untreated!diabetes!can!lead!to!many!serious!medical!problems!including!heart!disease!and!stroke.!If!a!member!
is!overweight!and!has!at!least!one!additional!cardiovascular!risk!factor,!that!member’s!physician!may!
recommend!a!blood!glucose!test!even!if!the!member!is!not!yet!45,!or!more!frequently!than!every!3!years.!
Discuss)smoking,)physical)activity,)diet)
Smoking!is!the!most!important!preventable!cause!of!premature!death!in!the!United!States.!If!a!member!smokes,!
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their!physician!can!suggest!approaches!to!help!quit.!Additionally,!a!discussion!of!each!member’s!diet!and!
physical!activity!habits!is!crucial,!this!will!also!help!the!physician!develop!the!member’s!wellness!plan.!
STROKE&SCREENING&
Screening!for!stroke!will!begin!with!a!physical!exam!and!the!physician!asking!the!member!about!risk!factors!for!
stroke,!including!smoking,!heart!disease!and!family!history,!along!with!information!about!when!the!symptoms!
began!(if!relevant).!During!the!physical!exam,!the!physician!will!check!the!member’s!mental!alertness,!
coordination!and!balance,!and!look!for!numbness!in!the!face,!arms!or!legs,!confusion,!and!trouble!with!vision!or!
speaking.!In!addition,!the!physician!will!look!for!signs!of!carotid!artery!disease,!which!is!a!common!cause!of!
ischemic!stroke,!by!listening!to!the!patient’s!carotid!arteries!with!a!stethoscope.!
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