Concierge medicine

From Wikipedia, the free encyclopedia

Concierge medicine is a term used to describe a relationship with a primary care physician, where an annual retainer is paid in addition to any normal charges. In exchange for the retainer, doctors provide enhanced care. Many in the business consider the term a misnomer, preferring others like boutique medicine, retainer-based medicine, and "innovative medical practice design".

Concierge physicians care for fewer patients than in a conventional practice, ranging from 100 patients per doctor to 1,000, instead of the 3,000 to 4,000 that the average physician now sees every year. All generally claim to be accessible via cell phone or email at any time of day or night. The annual fees vary widely, from $60 to $15,000 per year for an individual, with some practices that do not accept insurance of any kind.[1]

Mostly concentrated on the East and West Coasts, in 2004 the Government Accountability Office counted 146 such practices. The American Medical Association does not track the number of concierge practices because the concept is still so new.[2]

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[edit] History

Dr. Howard Maron, the founder of MD2 International (pronounced MD Squared) and pioneer of concierge medicine, has said of the term: "...I only came up with the concept—not the term 'concierge medicine.' I know what a concierge is, but to describe what I do as simply opening doors and directing people.... I prefer 'highly attentive medicine.'"[3]

The origins of concierge medicine are often traced to MD2, which was launched in 1996 in Seattle by Dr. Howard Maron. Others include MDVIP and numerous individual concierge physician practices across the United States.

[edit] Controversy

The concept of concierge medicine has been accused of promoting a two-tiered health system that favors the wealthy,[4] limits the number of physicians to care for those who cannot afford it, and burdens the middle and lower class with a higher cost of insurance. Detractors contend that this while approach is more lucrative for some physicians and makes care more convenient for their patients, it makes care less accessible for other patients who cannot afford (or choose not) to pay the required membership fees.[5]

One physician in a CNN.com article noted that he might not be treating patients at all if he hadn’t made the switch to concierge medicine: "…many doctors are becoming so disillusioned with primary care that they are quitting altogether."

Proponents of concierge feel that it meets consumer demand, allows physicians to provide the treatment they deem necessary, and improves quality of care by increasing the amount of time that can be spent on preventative medicine.[6] Preventative care such as lifestyle advice, and follow-up phone calls and emails are not usually reimbursed by insurance. Physicians significantly reduce the number of patients they see in a day, which allows them to spend extra time and attention with each patient. It has also been noted that while some concierge medicine practices do not accept insurance, all of their patients are encouraged to carry health insurance for services utilized outside of the practice.

Some say that concierge medicine is not the solution to the healthcare system’s woes, but is a symptom of "too much emphasis being placed on cost control and too little emphasis on the patient."[4]

In early 2008 it was reported that one health insurer was dropping some physicians who charge an annual fee from their provider networks. Another insurer also expressed opposition to annual fees. Other insurers do not oppose concierge medicine as long as patients are clearly informed that the fees will not be reimbursed by their health plan.[7]

[edit] References

  1. ^ United States Government Accountability Office, Report to Congressional Committees, "Physician Services: Concierge Care and Characteristics and Considerations for Medicare," August 2005.
  2. ^ "Boutique Medicine: When wealth buys health," CNN.com, October 19th, 2006.
  3. ^ "The Highly Attentive Approach," Worth magazine, July 2005.
  4. ^ a b "Your Own Private Doctor," by Mary Duenwald, Departures magazine, November/December 2004.
  5. ^ Unites States Government Accountability Office, Report to Congressional Committees, "Physician Services: Concierge Care and Characteristics and Considerations for Medicare," August 2005.
  6. ^ John Abramson, Overdosed America, MD, pgs. 169-194
  7. ^ Lynn Cook, "Insurers, doctors at odds over `concierge' care," Houston Chronicle, March 13, 2008

[edit] External links