Physician Case Studies


SignatureMD-affiliated physicians share their stories.


Dr. Christina Skale, MD

Internal Medicine

Chesterfield, MO

Dr. Skale was ready to switch careers. She saw 27 patients a day, and typically ran more than an hour behind. Her patients were often irritated, and Dr. Skale felt frustrated by the lack of quality time with both patients and her family. She revealed her distress to her father, Bill Benedict, MD, with whom she shares a practice.

“I told him, ‘I can’t sustain a practice like this for another 25 or 30 years,’” she remembers. “It was so unsatisfying. We weren’t able to address the complexity of people’s problems.”

Drs. Skale and Benedict ultimately landed on concierge medicine as a better option. After interviewing several concierge medicine companies, they found that SignatureMD’s dynamic model best met their needs.

Dr. Skale now hears gratitude from her patients about their on-time, unhurried appointments. With expanded testing, she can catch conditions such as metabolic syndrome and prediabetes at an early stage, and can educate patients about staying healthy. “It’s a great way to practice medicine,” she says. “It opens so many doors in terms of how you can improve patient care. It’s a breath of fresh air … and gratifying in so many ways.”


Dr. Bill Benedict, MD

Internal Medicine

Chesterfield, MO

Dr. Benedict longed for the days of quality patient interaction. He and his daughter, Christina Skale, MD, spent long, punishing days in their joint practice, racing from patient to patient, limited by insurance dictates and a time-consuming electronic health record system. Dr. Benedict worried that his daughter was burning out.

Converting to a concierge model with the help of SignatureMD changed everything. They see a fraction of the patients they once did, and spend more time listening, educating patients, and focusing on preventive care. “We can talk about important problems that we could only glance over before because we didn’t have time,” Dr. Benedict says. “This is the way medicine should be practiced.”

The new model has personal pay-offs. “It’s a better lifestyle day-to-day. You’re more relaxed, and you’re not rushing around from sun up to sun down,” Dr. Benedict says. And he spends more time with his 10 active grandchildren: “I now go to a lot of their games.”


Dr. Cathy Grellet, MD

Internal Medicine

Los Gatos, CA

After her breast cancer diagnosis, Dr. Grellet realized she couldn’t continue the same grueling pace, seeing 26 to 30 patients a day. She began considering concierge medicine, and was drawn to the flexible SignatureMD model.

“No one was dictating to me how to practice medicine,” Dr. Grellet says. She prides herself on providing thoughtful comprehensive care, and didn’t want a third party mandating that she conduct specific tests during annual physicals, for example. “I want the freedom to use my judgment to personalize care for the person in front of me,” she says.

Since becoming a SignatureMD affiliate, she sees 9 to 12 patients a day. “I don’t bring work home at night, I don’t work on weekends anymore, I do things with friends and work out regularly with a trainer,” Dr. Grellet says. “Life is so much better.”


Dr. Jim Williams, MD

Internal Medicine

Washington, DC

Jim Williams feels as though he has a calling to provide thoughtful care to his patients, most of whom are senior citizens. “It’s very worthwhile work,” he says. “Older individuals are the ones who need us the most.”

Dr. Williams began his career in practice with his father, also an internist. But as Medicare reimbursement rates were slashed, and his father prepared to retire, Dr. Williams sold his practice to a hospital system. It was clearly not a good fit; he desperately missed his independence, and hated the rushed 12-minute patient visits.

Based on the recommendation of a physician friend, Dr. Williams began talking with SignatureMD, and chose to convert with the company to concierge practice.

“I’m providing much better, much more attentive, much more detail-oriented care to a fraction of the typical number of patients,” he says. “You can get to know patients, their spouses, and their children.” He calls his patients’ oncologists on a regular basis.

He also has time to make house calls for patients who are home bound or recovering from surgery. “It’s an important part of good health care for people who really need it,” Dr. Williams says. “Concierge care makes it possible.”

This is the health care Dr. Williams envisioned when he became a doctor. “The hard work is so much more rewarding, so much more effective and thorough, and so much more appreciated,” he says.


Dr. Bob Saltman, MD

Internal Medicine and Endocrinology

St. Louis, MO

Bob Saltman and his colleague Dan Gaitan, MD, began to consider concierge medicine, but they disliked the “cookie cutter corporate model” used by most concierge companies. That approach didn’t mesh with their unusual medical practice; they are board certified in both internal medicine and endocrinology and wanted to treat a combination of concierge and traditional patients.
SignatureMD stood out for offering a flexible option.

“We just loved SignatureMD’s approach, which is to individualize to the needs of a practice,” Dr. Saltman says. “CEO Matt Jacobson said ‘Let’s talk about what would be good for your practice.’ We respected his input, and his model worked. We’re very pleased to be part of the SignatureMD family. It’s been an enjoyable, successful four years.”

Dr. Saltman and his colleagues hired a new physician to see the patients who chose not to convert to concierge care. “This has allowed me to have a much better lifestyle,” Dr. Saltman says. “My evenings are much more relaxed because I don’t bring home the two hours of work that I used to, and I have peace of mind that I didn’t leave any loose ends.”

While SignatureMD provides invaluable help with logistical issues such as billing for membership fees, Dr. Saltman likes that the company “doesn’t get involved in what we do for patients.” Other companies dictate which tests physicians must conduct in a patient’s annual physical. Not SignatureMD. “They respect us and know we’re going to do a thorough and comprehensive job. They take care of the logistical end so that we can practice medicine.”


Dr. John Verheul, MD

Family Medicine

Midlothian, VA

The harried pace of traditional medicine left John Verheul deflated. “I spent all this time behind the computer and wasn’t able to look my patients in the eye,” he says.

He began researching concierge medicine, but disliked that most concierge companies required him to dismiss his nurse practitioners. “SignatureMD was the only company that embraced the idea of my nurse practitioners staying on board,” Dr. Verheul says. Patients who didn’t want to switch to concierge service remained with the nurse practitioners. That patient pool has become a “constant renewable source of program members for me,” he says.

The concierge schedule gives Dr. Verheul time to provide stellar patient service. Roughly 75 percent of his patients are seniors on Medicare, and he knows many crave social interaction. He began hosting activities for patients, including dances led by a dance instructor.

He devotes Friday mornings to home visits. He and a nurse stop in to see three or four different homebound patients each week, taking blood samples and observing the patient’s home environment. “While we’re there, for example, we can open the refrigerator and see what they’re eating,” he says.

“Throughout the day there is such a reduction of stress,” he adds. “My staff has time to laugh.” And colleagues who once doubted the concierge model “are now seeing how wonderful my life sounds compared to theirs,” Dr. Verheul says. They’re starting to think about possibly switching to concierge practice themselves.


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  • My patients say, “If I had known it would be this good, I would have helped you set up this practice years ago!”
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    SignatureMD Physician | Dr. Jim Williams, MD
  • I’m finishing my fourth year with SignatureMD. Everybody’s happy. My staff is happy. All of my patients are happy. I’m happy.
    Read More

    SignatureMD Physician | Dr. Cathy Grellet, MD
  • With concierge medicine, you get to practice medicine the way it was meant to be practiced.
    Read More

    SignatureMD Physician | Dr. Bob Saltman, MD
  • Everything that’s frustrating about traditonal medicine ceases to exist.
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    SignatureMD Physician | Dr. Christina Skale, MD
  • This is the way medicine should be practiced. It’s a better lifestyle day-to-day.
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    SignatureMD Physician | Dr. Bill Benedict, MD
  • I did not enter concierge medicine for the money. I did it to save my soul as a physician. I wanted to bring back some joy in my practice. That is exactly what SignatureMD has given me.
    Read More

    SignatureMD Physician | Dr. John Verheul, MD

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