Part of being a private concierge doctor means you have to be prepared for any possibility – no two days are ever the same, keeping the work diverse, fascinating and interesting.
Whilst typing up the consultation notes from my last patient in Harley Street, I receive a phone call from a sixty-year-old gentleman, on business in the UK from the USA for two days. He’s staying at arguably the most luxurious hotel in the capital and has been vomiting the moment he disembarked from his private jet the previous day. It sounded like a case of gastroenteritis but you can never be sure until you examine. I offered to visit him in his suite and he just didn’t look right. After years of being in medicine, you develop a sixth sense of being able to recognise an acutely unwell patient just by standing at the end of the bed. His pain was out of keeping with a simple gastroenteritis.
He needed urgent blood tests and a scan. One phone call to a highly skilled surgical colleague and he was admitted to one of the finest private hospitals in the country. Luckily it saved his life – his bowel had twisted on itself and he needed an urgent operation to correct it and relieve the obstruction. Five days later he was out of the hospital, annoyed that he missed all his business meetings but happy to be pain-free (and alive)!
Consultations can vary from simple colds, lost medication and itchy rashes to potentially life threatening conditions requiring admission such as chest pain, pneumonia and acute appendicitis. One minute I can be sharing a couple’s excitement about a positive IVF pregnancy and the next patient could be a high flying CEO suffering from acute anxiety exacerbated by alcohol and substance misuse.
Then there will always be the truly memorable cases. Helping one of the world’s most prominent music artists in a hotel room just hours before a sell-out performance with an acute attack of anxiety. I was asked to be present backstage just in case the symptoms recurred – thankfully the concert passed without incident and it’s always a bonus have a front row seat!
Some cases, however, although memorable, I would rather forget! Seeing a gentleman in his seventies with symptoms of fever. He opened the door to his St Johns Wood townhouse completely naked and utterly unaware of the fact. His high temperature had resulted in a delirious state and he needed admitting to hospital for treatment of a urinary tract infection. As I mentioned, unpredictability and concierge medicine go hand in hand, you have to be prepared for any eventuality!
Unfortunately, the scenario of mental health issues and substance misuse is something I am seeing more frequently in our HNW patients. The underlying issues can often be complex and longstanding. Gaining trust by forging relationships over time and continuity of care is essential to unravel the myriad of factors underlying the condition and treating such patients holistically. These are exactly the type of cases where I would also involve colleagues to offer in depth tailored management. This could include psychiatrists, psychologists, dieticians, personal trainers and life coaches all working collectively.
Being a doctor to HNW individuals and families requires flexibility, many of our patients have hectic schedules and travelling frequently. Being able to see them at short notice and around their diary is key. In addition to seeing patients in my clinic, the visiting service clocks up countless miles driving within the capital – whether it’s attending a hotel suite or penthouse apartment overlooking London’s skyline, to being chauffeured to a country estate, or seeing an actor in a film set trailer – it’s all part of the concierge service. Seeing musicians back stage is a relatively common request and on a couple of occasions this has even resulted in last minute gig cancellations, never an easy decision to make, especially when facing resistance from artist and management!
Adaptability is hugely important. Seeing patients from all over the world requires being sensitive to various customs and cultures. Establishing a good rapport quickly is vital to any doctor – patient relationship.
Over the past few years, there has been a drive towards personal fitness and healthy eating – partly driven by increased presence of these topics on social media. This trend has been noticed and in some cases even pioneered by London’s elite. Encouragingly there has been a more proactive approach to wellness and maintaining optimum health.
Many of our patients are savvy and intelligent financial and property investors. They are now recognising that being proactive with their health is the single most valuable investment they can make, being healthy for as long as possible so they can enjoy their empire.
One of the most popular services is health screening and preventative medicine. Most of our patients would come in for an annual check and tailored health screen, highly personalised to their individual risk factors, lifestyle and family history. In addition to comprehensive blood tests and an ECG, the bespoke screen can include ultrasounds, echocardiograms, CT, MRI, DEXA and endoscopies.
Health screening is an area I’m hugely passionate about and it’s incredibly useful in identifying disease early or preventing it from occurring in the first place. There have been numerous cases of cancers, cardiac disease, diabetes, hypertension, thyroid disease and many other conditions that have been picked up early, which then gives you the best chance to manage and in some cases potentially cure the condition.
Recent advances have meant we can now offer more sophisticated testing as part of a health screen. Many of our patients opt for a one off genetic test which looks at your genetic risk of acquiring certain diseases, such as Alzheimer’s, coronary heart disease and various cancers. In cases where high risk has been identified, we can target other modifiable risk factors more aggressively – this may include starting medication or lifestyle changes and working with an individual’s dietician and personal trainer. Furthermore, testing also exists to predict how effective certain medications would be based on your individual genes- this is truly the benchmark of personalised medicine.
Biological ageing tests have also become increasingly more popular. By looking at the genetic structures we are now able to ascertain how well a person is ageing and compare their real age to their biological age. The elite are now using this as a monitoring tool to see if their lifestyle changes are actually slowing down the ageing process, enabling them to live longer and healthier lives.
Providing an elite service is evolving – it’s not only about being accessible to a patient when they are feeling unwell or getting them admitted into the best private hospital under a leading consultant. There is now a shift of focus towards prevention and slowing down the ageing process. Using modern technology and innovative testing we now strive to reduce the chance of illness and ensure optimal health for years to come.
Amarjit Raindi is an experienced Private GP & Concierge Doctor, practising bespoke medicine, with a focus on holistic and preventative healthcare. www.thegpcliniclondon.com