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    View from a Boutique

    Dermatologist charts her own course by creating unique practice for patients seeking personalized service

    Kitha Griffin, M.D., is a woman who knows her own mind. She can't remember a time when she didn't want to be a doctor and, by high school, her interests had zeroed in on skincare. She set her sights early on Georgetown University for medical school, then quizzed admissions personnel to learn what they looked for in candidates so she could plan her undergraduate work accordingly.

    By the time the now-32-year-old dermatologist reached Georgetown, she already was planning her residency and looking ahead to her long-dreamed-of solo practice. Leveraging her residency to quiz experienced physicians in preparation for setting up practice followed a lifelong pattern.

    Spending Quality Time

    In addition to the expected words of wisdom, however, Dr. Griffin got a good dose of reality. "I reached the conclusion that everyone is frustrated," she says. "Patients are frustrated because they feel like they're on a conveyer belt with only two to three minutes with the doctor. Doctors are upset with dismal insurance reimbursements. I had to think about what to do because I wanted my own practice, but I didn't want to be unhappy."

    An article on a nascent trend called boutique medicine caught her interest. Fewer patients, longer appointments, personalized attention -- all aspects appealed to the Southern values of the Cleveland, Miss., native.

    "I grew up in the South," Dr. Griffin says. "I know that I can't be an effective physician seeing 50 patients a day. I believe that quality time with patients is crucial."

    As a specialist, Dr. Griffin eschewed the retainer model of boutique medicine in favor of a fee-for-service structure. Patients pay out-of-pocket at the time services are rendered, which she says keeps overhead to a minimum while allowing for high service levels. The valet parking and lushly appointed offices (accented with marble and furnished with antiques) follow through on the promise of the practice's name, Dermatology Boutique. As does Dr. Griffin, who schedules a minimum of 30 minutes for each patient, seeing no more than 16 patients a day. Within just a few days of the appointment, each patient receives a comprehensive letter that details the history, diagnosis, and treatment plan discussed.

    Insurance Not Accepted

    Dr. Griffin cuts straight to what she sees as the heart of the issue. "I have several colleagues who are completely miserable as pediatricians and internists," she says. "They didn't think this is what they'd get after 12 years of training."

    To those who criticize boutique medicine as elitist, Griffin responds, "This is America. I'm anti-HMO. Prior to managed care, this is what healthcare was about -- being able to go to any doctor you wanted." She also points out that she's received only positive feedback from her peers and her patients.

    Dr. Griffin estimates that as many as 90 percent of her patients have insurance benefits, although some knowingly relinquish HMO benefits. She leaves filling out and filing the paperwork to the patients, who pay at the time services are rendered. She admits her office visits are higher than average for her area but insists that clients perceive value. "I don't take insurance, but I do what I can to keep you out of the office," she tells patients.

    Personalized Attention

    Recently she consulted with a patient who had twice seen another dermatologist. "The first time she had a five-minute visit and the second time she saw the physician's assistant," Dr. Griffin relates. Dissatisfaction turned to doubt in her diagnosis, and the patient visited Dr. Griffin for a second opinion.

    While she declined to reveal whether the patient's condition actually had been misdiagnosed, Dr. Griffin noted that the client expressed full confidence in Dr. Griffin's opinion and went home confident in her treatment plan. Every patient enjoys the same personalized attention. After personally greeting the patient in the waiting area, Dr. Griffin escorts him or her to the doctor's office. She spends at least 15 minutes just consulting with the patient, reviewing his or her history and the reason for the visit.

    Only then does the patient move to the exam room, where Dr. Griffin fills the role of medical assistant, lab tech, nurse, and doctor. There is, after all, no one else to do those duties. Besides a front-desk receptionist to greet patients and process payments, Dr. Griffin handles every aspect of patient care.

    She credits the lengthy appointments with allowing her to give each patient her full attention. "It's great, because I can get a complicated patient and know I have the time to research a condition and investigate new treatments," she says.

    It's Not a Spa

    Don't confuse boutique medicine with a medical spa, she adds. "Seventy percent of my practice is general dermatology," Dr. Griffin asserts.

    She cites new treatments, such as immunomodulators for psoriasis, as one example of how patients receive tangible value from the extra attention. "These are very time-consuming treatments because you have to do thorough education of the patient," she says. "There's a full page of side effects alone that they need to understand."

    Just seven months after setting out her shingle, Dr. Griffin's practice is about 60 percent full. But with 100 percent patient retention -- which she proudly claims -- she doesn't anticipate it will take long to fill the remaining slots. She doesn't get referrals from other physicians in her Midtown medical building because all participate in managed care.

    Most new patients find Dermatology Boutique through an article (the practice has been written up in Atlanta magazine, the Atlanta Journal-Constitution, and USA Today) or through a personal referral. Dr. Griffin says she's also worked with Atlanta-based CNN and women's magazines nationwide.

    "I think 80 percent of the market will remain in managed care," Dr. Griffin said. "I'm going for the 20 percent who want a better office visit and a better relationship."

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