With all the talk about health care reform and insurance on a national scale, I thought it would be interesting to look at the other end of the spectrum: a family doctor who makes house calls.

Yes, they still exist. In fact, since the late 1990s their ranks have been growing. Partly this is due to patients who want more individualized care than they feel they’re receiving at practices serving thousands of families. But it’s also due to physicians who are likewise dissatisfied.

That’s what happened to Dr. Elizabeth Laffey. Five years ago she left a traditional practice after telling her boss she wasn’t happy in it. Laffey recalled her boss “actually patted me on the head and told me I was happy.”

She’s now president of Gateway Physician in Kirkwood, a concierge practice where families pay a yearly fee. Laffey makes house calls, gives out her cell number and e-mail, and even attends specialists’ appointments with her patients when needed.

“A lot of patients just weren’t real content with the service they were getting,” she said. Parents in particular like the idea of spending more than 15 minutes talking about their child’s emotional and physical development. And, because “the last thing a sick kid wants to do is leave the house,” Laffey will come to the sick kid herself.

In case of serious illnesses, she can help patients make sense of what other doctors are saying. “Anybody who has something really severe may hear ‘blahblah, blahblah, blahblah, CANCER,’” she explained. She will accompany patients to appointments with specialists or to the hospital of their choice, including Des Peres Hospital, where she has admitting privileges.

Signing on with a concierge doctor is not a replacement for health insurance – Laffey said families still need insurance for costs like lab work, x-rays, specialists or emergency room visits. But going with a concierge doctor works well for families with high-deductible plans or health spending accounts. And the fee can be paid out of flexible spending accounts (employer-offered, tax-free accounts set up to reimburse for specific medical costs).

Her schedule is very flexible, a boon for both her patients and her family – she now gets to spend more time with her 10-year-old son. To preserve a high level of personalized care, Laffey will only accept up to 200 patients per year, a small practice by even concierge standards. To see a list of frequently asked questions or to contact her, visit the Gateway Physician homepage.