Docs off the clocks. (Flip Side).

A pair of enterprising Beantown physicians recently announced plans to launch an exclusive medical practice that, according to The New York Times, "charges patients $4,000 a year on top of the medical costs covered by their health insurance." Subscribers to the service will receive "round-the-clock cell phone access to doctors, same-day appointments, nutrition and physiology exams at patients' homes or health clubs and doctors to accompany them to specialists," the article reports.

The Boston physicians are by no means the only professionals offering such upscale services. As the Times points out, several "concierge" practices charging between $1,500 and $6,000 per patient have sprung up in Florida and Arizona, while one Seattle-based practice charges a family rate of $20,000. The $20,000 fee not only covers medical expenses, but "heated towel racks, marble showers and personally monogrammed robes." Already, some physicians are opening "boutique" franchises in New York, California, Illinois, Texas, Maryland and Virginia. If the boutiques take off as expected, we will soon be treated to the sight of ornate signs all across America reading "Physicians without Inhibitions," "Docs off the Clock," and "Medicins Avec Frontieres."

Since imitation is the highest form of flattery, it is a virtual certainty that boutique medicine will expand into many other areas. I personally would welcome a dental boutique guaranteeing 24-hour access to surgeons specializing in abscesses and root canals, while offering within-the-hour appointments, weekly teeth cleanings and free toothbrushes for the family.

Brokerage firms could also profit from the concierge phenomenon. Surely, most well-heeled investors would be willing to pay a few thousand dollars a year to get their brokers to answer their calls, and face-to-face consultations in the wake of epochal dot-coin meltdowns would be an attractive innovation. Brokerage firms might also supply heated towel racks, marble showers, access to alcoholic beverages and onsite grief counseling for shareholders who did not dump Enron at $55.

The single greatest advantage of the boutique arrangement is that customers know that their doctors, brokers, lawyers and dentists will be available at any time of the day or night. This is why plumbers, electricians, carpenters and roofers might also consider setting up similar enterprises. Evasive craftsmen such as these have been known to disappear for years at a time, often in the midst of putting in a new kitchen, basement or roof. If paying a few thousand dollars a year to ensure their round-the-clock availability is what it takes to get them on the phone, the service is worth every penny.

Obviously, as boutique services expand throughout the economy, we will see likeminded enterprises springing up in far humbler sectors. Some of the more obvious areas include car repair, telephone service, computer diagnostics and transportation services. For example, many of us would happily pay a hefty premium for an airport transport service guaranteeing timely 24-hour pick-up and sober, non-smoking chauffeurs who can sometimes find their way to the airport without help from the customer.

Another effective use of the concierge system involves high school teachers. In return for a $1,500 annual fee, history teachers might be persuaded to show up prepared for classes and actually teach students about the French Revolution rather than allowing them to watch "A Tale of Two Cities" or "Les Miserables." Teachers would be available 24 hours a day to tutor particularly mutton-headed students and coach them as they prepare to take their college entrance exams.

Last but not least, politicians at the municipal, state and national levels are well advised to adopt the concierge system. In exchange for a $2,500 fee, politicians would make themselves available by phone to their constituents and would warn them months in advance of changes in the tax code, shifts in the Federal Reserve's monetary policy, impending interest-rate cuts, or foreign wars that might negatively affect their investment portfolios.

And then, of course, there are boutique funeral homes, offering the very finest in mortician services--hand-dug graves, freshly cut flowers, top-quality posthumous plastic surgery--but who really wants to get into that?

Joe Queenan ([e-mail]) is a regular columnist for CE.