Concierge Care

Doctor charges $1,500 annual fee to AIDS patients

Dr. Shannon Ray Schrader has been a visible and, at times, inspiring presence in the fight against AIDS in Houston. So why are a lot of AIDS patients pissed off at him now?

It's because they're feeling abandoned.

Schrader has notified his 1,500 or so AIDS patients that he's making a drastic change to his practice: If they want to remain patients, they'll have to pay $1,500 a year above any other costs. And only 600 will make the cut. And if you don't make the cut, you're out of luck in two months.

He's been informing patients as they visit. And shocking them. "I literally was thinking, 'What can I sell? Is there any jewelry I could sell? Is there something I can sell to pay the $1,500 that would at least give me one more year to come up with a solution rather than two months?'" says one patient.

This patient says he wasn't angered ("Anger's not healthy"), but others in the community are pissed.

Schrader's "a greedy jerk...You do the math: 600 x $1,500 = $900,000 for Schrader without even depressing one tongue," says one activist, who worries about whether Houston's AIDS-­treatment facilities can handle a sudden influx of patients.

What does Schrader have to say about all this? To us, nothing. He wouldn't return several calls seeking comment.

In a letter to patients, however, he urged them to attend one of two meetings at the Hilton Houston Post Oak to explain the change.

"This smaller practice setting will also provide you with same- or next-day appointments that start on time and last as long as needed," he wrote. "You will be able to reach me directly 24 hours a day, seven days a week."

(The two meetings were canceled: 600 people signed up well before the scheduled date.)

Schrader is working with a company called MD-VIP, a network that specializes in what's called "concierge care" for patients wealthy enough to pay premium prices for first-class service.

Even though Schrader won't speak on his own behalf, he has been known as a pretty tireless AIDS fighter, famous for ending every office visit with a hug.

That's partly why the patient who couldn't scrape up the $1,500 is somewhat understanding.

"He told me...basically he just couldn't handle the pace any longer. It was affecting his personal life, his relationship with his partner, with his family," the patient says. "[He] just had to make changes for his own well-being."

You can't blame him for that. We just hope the patients who can't afford first-class make out all right too.

Natty Dread

Alabama Governor George Wallace famously stood in a schoolhouse door to block desegregation. Annette Cluff, director of a Houston charter school, stood in a schoolhouse door to block something apparently just as insidious: dreadlocks.

Or maybe she didn't stand in the doorway; there are conflicting versions of events. But one man's fight for his four-year-old to wear dreads has definitely riled things at Varnett Charter School.

Anthony Frazier enrolled his son Prince at Varnett, but found out at parents' orientation night that dreads were not allowed under the school's dress code.

Cluff said officials informed Frazier that Prince could wear his hair in a ponytail during school. Frazier told them, she says, that "Varnett had an unfair dress-code policy because [it] would make his son look like a white child."

"I didn't want to listen to their bull­shit," Frazier says. "People in this day and age should learn to accept cultural ­differences."

Frazier, who's a bassist for the funk band Collective Hallucination, is very, very serious about dreads. "It's not a hairstyle, it's a way of life," he says. "Cutting my son's hair would be like cutting a lion's mane."

Frazier is not taking this lying down. He's called Rodney Ellis, Quanell X and the ACLU. "Not all black children want a shaved head," he says. "What if the kid has an Afro? Where does it end?"

His son will probably attend public school now, he says.

You know, we're somehow guessing that the folks at Varnett aren't all that sad about missing out on the Prince Frazier experience.

Oops

Our novice attempt at creating a crossword puzzle last week about the Texans went about as well as a David Carr ­comeback.

Well, it wasn't that bad, but we did make one mistake.

If you're still stumped, absolutely unable to complete the thing, we can offer help.

In the lower right-hand corner of the puzzle, there should be another clue. It would have been numbered "34 Down" and it would be "Sinecure for aging or clumsy baseball players."

Ah, fuck it. The answer's "DH."

Andy Kahan's Top 100 Hits

Andy Kahan is head of Mayor Bill White’s Crime Victims Office. That can be a pretty grim gig. Luckily, Kahan has what he admits is “a wacky sense of humor that keeps me going.” And part of that is keeping active track of all the idiotic “murderabilia” that has actually been sold or offered for sale somewhere. In case you don’t know, murderabilia is any item connected to a vicious, senseless killer or his crime. Here's his current top-hits list.
 
  • Sevoflurane 06/18/2008 11:25:00 PM

    I was recently abandoned by my physician of 15 years because the group he is with decided to switch over to this form of elitist healthcare. In this case, the greedy third party outsider that brought this all about is MDVIP. If I wanted to continue on with my physician, I would have to sign a contract and pay MDVIP $1,500.00 per year simply to have access to my doctor. My primary insurance company would still be forced to pay for all office visits, lab tests and any in-house procedures. In retrospect, I never needed a third party outsider to get quality care from my physician and I�m not about to line the pockets of some greed driven outsider who has absolutely no interest in my well being. This concept is very unethical and patients are the real losers under this particular business model. Medicare and all insurance companies should refuse reimbursing physicians who adopt this approach to patient care.

  • Steve 09/23/2007 9:44:00 PM

    Amen............Dr. Schrader is a very good doctor and he deserves much better than the article the Press has delivered about him. If they had only bothered to check their own archives, they would see they have used him as a source for stories for several years. The Houston Press has greatly disappointed me with this type of article...I always thought they were the good guys. In the very least, they owe Dr. Schrader a sincere apology and so does the nameless "activist" who called him such horrible names that have never fit this great man.

  • A Schrader patient 09/23/2007 10:34:00 AM

    This article falls way short of being able to be called responsible journalism. Anyone who has ever met Dr Schrader can attest to his absolute commitment to his patients and to HIV. It is that commitment that has led to having to make this decision. This man has literally devoted his life to taking care of his patients, and has come to the realization that he can not continue at the same pace. He has not abandoned his patients nor has he walked away from HIV. You failed to mention the countless hours he volunteers at Legacy, or all the hours he puts into research and clinical trials. I challenge any one reading to give their job a 12 hour workday, 5 days a week, be on call every night, every weekend, and allow yourself one week vacation a year at the very most. How long would you last at that pace? And I agree, the activist who called Dr Schrader "A greedy jerk" should be named. This article is little more than slander.

  • Patient X 09/18/2007 2:33:00 AM

    For the record, Dr. Schrader is a Family Practitioner � not an AIDS doctor, although he does provide services for individuals with the HIV virus. I have been a patient in his practice for over ten years and HIV-positive for the past five years. Due in large part to the excellent healthcare I have received from Dr. Schrader and his staff, the virus has not progressed to an AIDS diagnosis. In today�s society, it is crude to refer to him (or any other doctor) as an �AIDS doctor.� Concierge care may be a controversial movement in the American healthcare system; however, it is not exclusive to Dr. Schrader. Anybody shocked by transitions toward scaled-down practices has not been watching the news and is not worried about the doctor-in-a-box shops popping up at local pharmacies and grocery stores. Physicians converting to �concierge care� are simply opting to provide quality care; something many of us today are claiming is lacking in our healthcare system. The overall declining quality care provided by our healthcare system is what I find truly alarming, and Dr. Schrader�s genuine concern for providing personalized service has clearly bumped right into the reality that our system does not afford physicians a mechanism to do both quality and quantity of care. This, of course, is ultimately the greatest expense that we all bear as a society. It is regrettable that not everyone can afford to be included in these programs, but concierge care is something that we as a society have demanded so that we can become the benefactor of the care we pay for; this is not something Dr. Schrader has demanded of us. The thoughtless comments of the ill-informed or alarmists will not go far toward reconciling this systemic issue. To change this system we need to address our concerns toward the politicians and policy-makers that can represent our views; personally attacking such a respected and loved doctor is unjustifiable and deleterious. Compared to the other care available in today�s system for those of us with chronic lifetime illnesses, the cost of this program is negligible. The $1500/annual fee of this program is expensive but tax-deductible. As a part of this program, �same- or next-day appointments that start on time and last as long as needed� will be available; waiting a month for an appointment is not an option for some of us. It is worth considering that this fee (which equals $125 per month) costs less than many of us pay per month for medications, covers a comprehensive annual physical exam, can be paid for in four payments, and can be paid for out of a pre-tax Flexible Spending Account or through some other tax-efficient strategy. Far from being greedy, I think if you were to actually �do the math�, you would see that most doctors going into these programs will actually be taking an income reduction. Further, consider that this fee will not compensate for a significantly reduced caseload and the attendant billing; yet office rental, insurance, and staff costs must still be covered. This article has hurt him, it has hurt those of us who are privileged to know him and to have him as a doctor, and I believe he is owed an apology. This article does not speak for me. On the contrary, it angers me considerably.

  • Russ 09/15/2007 4:35:00 PM

    Anyone who has ever met Dr. Schrader would know he is not "greedy and unethical". I think most who have responded on here are people who don't know the whole story and are not his patients but reacting to a one sided article. He is not leaving anyone high and dry without a doctor. When announcing this change, he also announced a plan to transition patients not joining the VIP MD program to other doctors. Also, the $1500 annual is not cash into his pocket. The fee includes a very intensive physical and bloodwork/tests that no insurance would ever cover. I would imagine anything above that would be going to increase his staff and improve the services for these patients, including the more time with the doctor during a visit. If some after that is going to him to help cover the reduction of the number of his patients, then good for him! As hard as he has worked all these years, people should be happy for him. I don't see how he was able to have a life at all with over 1500 patients.(I don't see how a doc could juggle 600). I think this is much better than just retiring like some doctors would do.

  • Eric Fine 09/13/2007 11:54:00 PM

    So, Dr. Schrader's being available 24 hours a day won't kill him? While I'm sure Dr. S has been a supportive and empathic doctor who may very well be exhausted and tired, he sounds like an opportunist and a greedy one at that. I feel he can better handle this situation by closing his intakes, working with those he continues to see regularly and through attrition change to his knew policies and practices. Making such an abrupt change and basically giving what sounds like an ultimatum to his long term patients seem to not only be unethical but bad practice. Now his patients and future patients get to know the other side of this doctor and knowing this type of behavior only supports the fact he really doesn't care about you! It comes down to the money and yes, thats the American way. I'm sure there are other fine doctors in the area who will give you what you need.

  • Tex 09/13/2007 6:17:00 PM

    While I can understand his need to alter his practice for personal reasons, to do it on a $1500.00 premium basis is not an ethical solution. I find it outrageous that no one else here sees the outrage.With the state of US healthcare on the brink of disaster, it's only a matter of time before only the very wealthy can get any degree of reasonable healthcare. Er, no, wait....THAT has already happened! If he were my doctor, I'd tell him exactly where he could shove my $1500.00 "surcharge". This is no doctor...but a cold calculating profiteer. $900,000 can buy a whole lot of peace and tranquility I suppose.

  • Paul Simmons 09/13/2007 4:10:00 PM

    Why did Houston Press grant anonymity to the "activist" who called Dr. Schrader a "greedy jerk"? Activists don't usually hide their identities; besides, if you're bold enough to malign another man's integrity, you ought to be bold enough to put your name to it. I empathize with those who feel frustrated and disappointed by Dr. Schrader's decision to reduce the size of his practice. But like other HIV-treating physicians in our community, Dr. Schrader has long been an overworked specialist. Unless he and his colleagues get control of their schedules and their lives, the only alternative is for them to leave the field altogether. Is that what your nameless source wants? Or would he lay the burden for health care reform on one doctor? Paul Simmons, RN Co-Executive Director/Programs The Center for AIDS Information & Advocacy

  • bill 09/13/2007 12:11:00 PM

    I see comments where people are makeing excuses for the doctor, well he is a doctor and if he cant stay profesional, live up to the oath he swore when he became a doctor then he needs to go! boo f'in hoo if he is haveing comeing out issues take a f'in vacation and sort it out or go get s shrink dont screw over people liveing with a terminal illness. this isnt only an insult to doctors its also one to everyone who has a scientific mind we are people of logic if you want to be a doctor and have drama go star on one of them TV shows.

  • russell byrd 09/09/2007 10:31:00 PM

    Not all of Dr Schrader's patients are AIDS patients. He is also a great general family practitioner. In the early 1990's, I was having a rough time with a religious family and coming out issues my partner Steve told me there was a gay friendly doctor's office I could see for the stress I was going through. Although a lot of their patients were dealing with HIV issues, we chose them because it was nice to be able to see a doctor you could ask any question about gay issues. Dr Bockman was the first doctor I had there. I visited and told him about the family stress I was going through and his office also diagnosed me with chronic high blood pressure. He prescribed a blood pressure med and also a prescription for klonopin for the stress. After several years, Dr Bockman retired and my new doc was Dr. Shannon Schrader. Later the group became Schrader clinic. He has been a great doctor over the years and while my medical needs did not require me to join his 600 elite patients, I can certainly understand why he had to cut his practice and do this. I wish him the best and hope he has more time for his family after the changeover. I think we sometimes expect doctors to be superheroes and forget they are human and need a life too. Russ

  • John Termine 09/09/2007 9:38:00 PM

    I`m commenting on your artical on Dr. Schrader. I do understand why some people would be upset with Dr. Schrader`s decision to try and cut his work load down a bit. I`ve been a patient of his for over 10 years and he has taken me back from the brink of death, and I trust him very much. If he continues to work they way he does, we might not have him around for anyone. As a patient who has had health probems on and off for years, I have learned that if I`m not OK, then I am no good for others, and hopefully that is what he is doing for himself. If you get a little more info, you will find out that the annual fee he will be charging his patients is not going into his pocket, but it will help him run his office more effeinctly, without so much overhead. I`m also in a place in my life where I`m learning sometimes less is more. I think people need to give him a break. Word of advice, there are alot of good doctor`s out there, be educated about your own illness, and do not put your whole medical life into one persons hand. Rock on Dr. Schrader. John Termine

 

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