Health & Healthcare
Concierge Medicine - The Future or the Past?
The current US healthcare system is broken. Few would argue this point. Rising costs, decreasing reimbursements, more lawsuits, insurance hikes, and an aging population are just some of the difficulties that face both physicians and patients today, and the situation doesn’t seem to be improving.
One of the other major problems is the shortage of time. In order to make ends meet, doctors are being forced to see more and more patients in the same amount of time. For many physicians, what used to be an hour for new patients and half hour for established patients has been shrunk down to 20 minutes for a new patient and 10 minutes for an established one.
How could quality care possibly be carried out in such little time?
The recent advancements in medical technology and preventative medicine alone would take hours to adequately explain to a patient. Needless to say, accomplishing this feat is essentially impossible.
As a solution to this problem, an increasing number of physicians are turning to something known as “concierge medicine,” or “boutique medicine.” Under this system, patients are required to pay a yearly fee to the physician above and beyond the cost of their healthcare, which can range from $1,000 to $20,000. In return for this fee, they are granted a much higher level of access to their physician than one would expect. Doctors who participate in concierge medicine spend an hour with their patients on visits. They give out their personal cell phone numbers to be reached at all times. Many make house calls at no additional fee. Physicians guarantee that if you are sick and need to be seen, you can do so within 2 hours. Those long waits in the doctor’s office? Gone. Concierge physicians guarantee no wait in the waiting room.
Does this arrangement sound enticing to you? What would you do if you could spend an hour with your doctor on a visit, going through each of your problems in detail and really discussing the issues surrounding it? What if your doctor took the time to get a complete family history and perform all the latest cutting edge screening tools to assess your future risk for disease? Quality of care under this system would almost necessarily improve.
Of course, controversy stems from the fact that patients with lower income would likely not be able to afford these services. Also, if doctors are seeing fewer patients then we would need more of them to meet the demand. The system isn’t perfect by any means, but it’s a start in the right direction while we wait patiently for tangible universal healthcare. What do you think?
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3 Comments
It is an interesting alternative or supplement to the idea of universal health care. I think that this is a logical extension of market segmentation, but I think when applied to health-care (and not airline tickets) it could be viewed as elitist. It’s an interesting idea, though, and worth a shot.
I use concierge medicine, as I have a quite rare, complex genetic condition. I’ve found that it is an invaluable investment for my situation.
I think the elitist criticism is a real, serious concern. I would love to see some of the management companies taking the initiative to do their part to mitigate this issue. For instance, my doctor has limited his practice to 600 patients. I’d be willing to consider switching companies if there was one that limited the practice to 500 concierge patients and 100 patients who were unable to afford the service.
Additionally, I believe that whatever the ultimate outcome, the emphasis being put on healthcare and the growing issues involved will have a positive impact on the current circumstances.
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Dr. Surve is correct about the benefits of concierge medicine - benefits experienced by both the patient and the doctor. I opened one of the first concierge practices in this country 8 years ago. I’ve just written the first book to be published on the subject, “Concierge Medicine, A New System to Get the Best Healthcare” (Greenwood/Praeger, May 2008). Though there are controversies, concierge medicine is now available for the middle class and is quite affordable in many areas. Most of the arguments against concierge medicine fall apart under scrutiny. I have an entire chapter in my book devoted to this issue.
Concierge medicine is driven by patient dissatisfaction over our present fast-food medical model of HMOs, PPOs and a failing Medicare system. Patients love the time they have with their concierge doctors. Doctors love having the time to do what they were trained to do. Unless primary care medicine becomes more attractive to young doctors, by implementing models such as concierge medicine, no one will opt for a career in internal medicine, family practice or pediatrics and the shortage of primary care doctors will only worsen.
Steven D. Knope, M.D.