Beginning in 1996, the Seattle-based Virginia Mason Medical Center, a nonprofit hospital, was confronted with a growing competitive threat to its primary care practice. In the city's wealthy Eastside district, a number of doctors in private practice began launching "boutique" medical practices offering amenities such as 24-hour access to physicians, next-day appointments, and house calls in exchange for monthly retainer fees of as much as $1,000, sometimes on top of insurance premiums. "Our pati…

To read this article and start a full year of unlimited online access, subscribe now!

Already a subscriber?

Need to register for your premium online access,
which is included with your paid subscription?