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Concierge Medicine: Differentiated Healthcare for the Rich

This article was written by in Health. 16 comments.


Earning or having more money might not universally increase happiness or health. Wealthy people can be sad or sick just like those who are less financially fortunate. More money does provide more access to “stuff,” though, and people often like that “stuff.” Businesses that cater to the rich with services for which they might be willing to pay extra often thrive. In economic downturns, rich consumers often stay rich and save more of their money, but they’ll likely return to their luxury items.

One of these services is medicine. Concierge doctors, doctor to whom you can pay a retainer to ensure personal attention at any time, have increased in number over the past few years. Not all of the popularity increase can be attributed to the entertaining television program Royal Pains, in which a doctor whose career abruptly ends due to his positive ethics that conflicted with the medical establishment moves to the Hamptons to seek out a wealthy clientele while also treating the residential underclass for free. More doctors are turning to this style of business because medical school was expensive, they have bills to pay, general practice doesn’t provide great salaries, and the thought of higher income beckons.

This doesn’t necessarily mean that the wealthier one is, the greater the quality of medical care one might receive. Doctors are ethically bound to treat everyone to the best of their ability, regardless of financial situation. Paying for membership to a private doctor might increase availability for appointments but won’t increase the quality of your medicine or advice. It can, however, provide the feeling that one is well cared for and reduce the anticipation of stress during a hypothetical emergency. If one has little faith in the healthcare system — a system that works well for the most part — concierge medicine provides an alternative option if you have $1,500 to $25,000 to spend per month (according to the New York Times).

Even if the only benefits were easier access and less stress, is it fair that only those who can afford sizable monthly fees can take advantage of these services? The medical industry will continue to mutate as market forces pull it one way or another. The concept of the health maintenance organization (HMO) began around one hundred years ago when society faced the same question: how to bring quality medical care to more people. While the HMO may now be a symbol for bureaucracy and inefficiency, the system has helped keep society healthier. If traditional medicine eventually falls by the wayside in favor of more lucrative business plans, the system will continue to change to accommodate the needs of the many.

Do you think concierge medicine will help or hurt the medical industry? Is it a problem that a certain selection of medical professionals want to cater only to the rich?

Published or updated May 2, 2011. If you enjoyed this article, subscribe to the RSS feed or receive daily emails. Follow @ConsumerismComm on Twitter and visit our Facebook page for more updates.

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About the author

Luke Landes, also known as Flexo, is the founder of Consumerism Commentary. He has been blogging and writing for the internet since 1995 and has been building online communities since 1991. Find out more about him and follow Luke Landes on Twitter. View all articles by .

{ 16 comments… read them below or add one }

avatar Krantcents

This is a reaction to the health insurance companies cutting doctor’s fees. It circumvents the cost cutting administered by the insurance companies. So far it is a tiny part of medicine, it has no material effect. Very few of us can afford to pay for concierge medicine, so I do not see it becoming popular.

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avatar Ceecee ♦796 (Dime)

You are correct—-this doesn’t guarantee a better doctor. I might rather have a doctor who earns a wealth of knowledge from treating more patients than one who caters to fewer patients with TLC and bedside manner. I think a better alternative may be to educate yourself and be a partner with your doctor—most of the healthy habits and healing are done when the doctor is not around. Also, these doctors aren’t specialists so you’ll still need other doctors and a plan that will cover their fees.

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avatar shellye ♦107 (Cent)

This is already being practiced in some areas at a lower level. Basically you buy a ‘membership’ to a physician’s practice, and, for a monthly fee, you can get your basic healthcare covered. It’s almost like insurance, only you pay it to the doctor directly instead of the insurance company. In North Texas you can pay $49 per month and have access to a doctor who will care for your common colds, ear infections, backaches, whatever. Kind of like an urgent care facility but it’s with a private physician in his office. I can see concierge medicine working for wealthy people who want their aches and pains treated privately and at their convenience rather than the doctor’s.

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avatar Pat S

I think the more critical issue is the lack of primary care physicians available for the current US population. The problem will likely only get worse with universal health care making insurance available to all Americans. The system will have to adapt, or will likely crumble under the weight of more demand for services.

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avatar wylerassociate ♦906 (Dime)

the system has to adapt with the passage of health care reform, I think a great thing would be for the american medical association to lift the quota on number of doctors who graduate from overseas medical schools.

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avatar Bobka ♦13 (Newbie)

It will be interesting to see where this leads. Just yesterday my wife’s dermatologist’s office called and said they were no longer accepting our insurance for her appointment scheduled for today. And also yesterday I visited my primary care doctor who now has posted on his door that as of May 1, he was no longer accepting certain brands of insurance altogether, and others, including mine, for existing patients only. I suspect this is in reaction to the ever smaller reimbursements that the doctors receive from the insurance companies. Are we headed back to the olden days of fee-for-service in medicine?

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avatar Wayne Lipton

It’s time to quit positioning all concierge medicine as an option that pits those with against those without. New concierge models – especially hybrid concierge programs – are about providing alternatives that provide viable solutions to physicians and real choices to patients. Most primary care doctor simply can’t sustain a practice in today’s healthcare environment – costs are too high –reimbursement too uncertain. Providing a private source of non-taxpayer supported revenue – for just those few patients that want concierge – gives good physicians the incentive to stay in practice caring for all patients – those with private insurance and even those on Medicare. (Also, to clarify, most concierge programs average $1,200 to $3,000 per year – the upper level of $25K is extremely rare.) We all want to have access to the best doctor and the best healthcare. Reasonable options that allow for market solutions ultimately are our best answer.
Wayne Lipton
Founder
Concierge Choice Physicians

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avatar ConciergeMD

Great comment, Wayne. To support your point about the cost benefits of concierge medicine, we’ve surveyed physicians and concierge patients across the U.S. and found that over 63% of concierge programs cost less than $135 per month, per individual. Some plans are as low as $10 per person.

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avatar Dr. Mark Nelson

Hi Wayne
Hybrid practices have great potential, all the more so when family physicians who are struggling can generate significant additional revenue helping their patients get healthy, generating health for their patients and for their practice. The average family physicians has 5,000 patients. If 2% of them are on our Optimal Health Program, that physician could generate approximately $7,000 or more in additional cash income per month. The revenue is independent of managed care and there is no inventory. I would welcome the opportunity to share Our Optimal Health Program with you and your colleagues.

In Health,
Dr. Mark Nelson MD, FACC, MPH
cell: 518 573-0608

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avatar Lorie

“Is it a problem that a certain selection of medical professionals want to cater only to the rich?”

The whole lack of primary care physicians, the healthcare reform debacle and the exorbitant costs of healthcare aside, I have a problem with this question in general. When did it become wrong to become and/or enjoy the perks of being wealthy in this country? The American Dream used to be about raising your standard of living, being successful and providing a nice home and accoutrements for your family. Now, it seems there is a pervasive “rich people are evil” mentality in this country. I think if you have the means to pay for extra services such as this one, good for you.

America is not a commune. We don’t have to (and shouldn’t) guarantee that everyone gets the same perks regardless of whether you are financially successful or not. Otherwise, why do we try to achieve financial success at all, if we know we will be given the same whether we work for it or not? Not a politically correct viewpoint, I am sure, but, there you have it, lol.

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avatar Luke Landes ♦127,380 (Platinum)

The question is whether “public health” is a perk of being wealthy. As an individual, I want the people I interact with on a daily basis to be as healthy as possible for my own safety. Public health benefits all citizens of this country — and of the world, now that global travel is much more common. It’s better for a society to have a healthy populous… therefore, health is a social (societal) concern, and the question is legitimate.

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avatar Michael Tetrault

Here’s the current downside in concierge medicine: We’ve recently been studying the demand for concierge, direct care, cash only and retainer-based medical models by consumers. We’re finding that the number of patients who are seeking concierge medical care is far greater than the actual number of primary care and family practice doctors available to serve them. It’s extremely difficult to find a physician for those seeking concierge physician services in very rural areas like Idaho, North and South Dakota, Louisiana, Mississippi and others. Often times, we have found that there are less than half-a-dozen practitioners to serve an entire state.

But, there are currently four states that have a huge lead in the amount of active concierge physicians in practice and consumers seeking their care. Florida, California, Pennsylvania and Virginia each have a significant number of people (most over age 50) seeking out concierge doctors and there is, fortunately, a sizeable number of concierge physicians to serve them.

While the number of physicians entering concierge medical practices needs to increase, more transparent pricing among doctors is also needed. Unfortunately, our nation’s new health care reform law does little in this respect.

Michael Tetrault
Executive Director, Founder
Concierge Medicine Today

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avatar skylog ♦368 (Nickel)

thank you michael for the detailed response. i was wondering if you could explain “why those four states?”demographics? was it a case demand and supply filled those areas? something else?

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avatar lynn ♦155 (Cent)

I like this idea if the monthly charges are a great savings from insurance premiums. And the medical records do not have to be placed in a medical records electronic system. The patient could keep their records rather than the MD.

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avatar Ted Foster

I think Concierge Medicine is the future. I agree with both Michael & Wayne.

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avatar qixx ♦1,819 (Half-Dollar)

I love this system. While i don’t have the funds for this system i think i will (or maybe already do) benefit. Supply/Demand and Trickle-down economics suggest that these services will eventually reduce the demand at the top causing the top tier doctors that lose patients to seek to grow down. This in turn causes the next level to grow down. Eventually this will reduce demand at my doctor’s office.

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