Concierge medicine
From Wikipedia, the free encyclopedia
Concierge medicine is a term used to describe a relationship with a primary care physician in which the patient pays an annual fee or retainer. This may or may not be in addition to other charges. In exchange for the retainer, doctors provide enhanced care. Other terms in use include 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 the lower annual fees being in addition to the usual fees for each service and the higher annual fees including most services. Some concierge practices do not accept insurance of any kind.[1] It should be noted that this annual fee is not a substitute for medical insurance, and generally does not cover consultations outside the practice, laboratory procedures, medicines, hospitalizations or emergency care from other providers.
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.
Since 2003 there has existed a professional society of concierge and other direct practice doctors known as the Society for Innovative Medical Practice Design or SIMPD. As of mid 2008 this organization had about 200 members and by late 2008 was growing at the rate of a member a day. SIMPD offers many member benefits including national care networks, discounts for direct practice doctors on mal practice insurance, annual meetings and many more. Patients looking for concierge doctors and other direct practice doctors can visit the "find a physician" link on the SIMPD web site at http://www.simpd.org to find such a physician in their community.
[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 while this 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 claim 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] See also
[edit] External links
[edit] References
- ^ United States Government Accountability Office, Report to Congressional Committees, "Physician Services: Concierge Care and Characteristics and Considerations for Medicare," August 2005.
- ^ "Boutique Medicine: When wealth buys health," CNN.com, October 19th, 2006.
- ^ "The Highly Attentive Approach," Worth magazine, July 2005.
- ^ a b "Your Own Private Doctor," by Mary Duenwald, Departures magazine, November/December 2004.
- ^ Unites States Government Accountability Office, Report to Congressional Committees, "Physician Services: Concierge Care and Characteristics and Considerations for Medicare," August 2005.
- ^ John Abramson, Overdosed America, MD, pgs. 169-194
- ^ Lynn Cook, "Insurers, doctors at odds over `concierge' care," Houston Chronicle, March 13, 2008
