Thursday, March 16, 2006

Concierge medical practices

I don't know what the solution to our healthcare crisis is, but I know that banning concierge medical practices is not part of the answer.

Frank Pasquale on Concurring Opinions comes down heavily against practices that charge patients a retainer for what essentially amounts to better healthcare than that tolerated and encouraged by managed care.

My response:

The rise of concierge medical practices is a direct result of the managed care revolution. A significant amount of healthcare dollars have been transferred from providers to administrators. The administrators have produced no improvement in the cost or delivery of healthcare.

In the meantime, doctors have been forced to see more patients in less time than ever before, in order to maintain an income level comensurate with their level of education. You can debate all you want about the appropriate income level for a physician, but the fact is that physicians are going to expect to make the same amount of money as their law school and business school educated peers. Anything else will simply cause the best physicians to leave the practice of medicine (which is already happening).

The managed care revolution encouraged doctors to behave like business people, and so they have. The obvious business solution for a doctor is to escape the bondage of self-enriching insurance companies and strike out on their own. At the same time, they can give their patients the time and attention that patients expect and deserve.

To claim that doctors not be allowed to open concierge practices is tantamount to saying that doctors must remain in thrall to insurance companies, institutions that do not have anyone's health at heart.

If you want to obviate the need for concierge practices, restore doctor's compensation for visits and procedures to previous levels (corrected for inflation). Both doctors and patients will be happier. The cost of healthcare won't need to rise to compensate, because the money can be taken directly from the administrators who add no value and suck up cash.


Blogger The MSILF said...

for those of us outside the US, can you explain what Concierge payments are? I've never heard this one.

3:25 AM  
Blogger Amy Tuteur, MD said...

The term "concierge medicine" refers to a private practice that does not accept insurance. In exchange for a registration fee, the limited number of patients in the practice are guaranteed same day appointments and other services like the doctor coming with them to specialist appointments.

8:18 PM  

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