Concierge Medicine

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As health-care costs continue to rise in the United States, some doctors are adopting a payment model that makes costs even higher for their patients — and many of those patients willingly and even enthusiastically participate.

In what has come to be called concierge medicine, primary-care doctors charge their patients an up-front annual fee for what they promise will be an exceptional level of personal attention. Privileges of membership may include guaranteed same-day appointments, house calls, and visits by the primary-care doctor in the emergency room if such a situation arises. The doctors also emphasize that due to the membership fee, they can shrink the number of patients they see and spend more time with each patient. They also note that with fewer patients to keep track of, coordination of care with specialists and paying close attention to lab results and other data becomes much easier.

In a recent segment on PBS Newshour, correspondent Betty Ann Bowser interviews two doctors with concierge practices in the Houston, Texas, area. Both are members of a nationwide network called MDVIP, which helps doctors convert their existing practices to a concierge format. Practices affiliated with MDVIP charge around $150 per month for membership, and they are allowed to have no more than 600 patients. One of the doctors interviewed noted that before he joined MDVIP, his practice saw about 3,000 primary-care patients; it now sees about 400. MDVIP claims that its format boosts preventive care and helps reduce hospitalization rates by more than 70%. One critic, however — a professor at the University of Texas School of Public Health — suggests that serving affluent patients who care about their health in the first place is the most likely reason for MDVIP’s lower hospitalization rate.

And while individual patients may benefit from membership in a concierge-style practice, whether they get their money’s worth is an open, and subjective, question. What is not in question, however, is that concierge medicine offers few answers to problems that vex the greater health-care system, such as high costs and a shortage of primary-care doctors.

What do you think — does the idea of concierge medicine appeal to you personally? Do you feel that your current primary-care experience is too rushed and impersonal, and could benefit from more time dedicated to each patient? How much would you be willing to pay for membership in a concierge practice? Are you comfortable with the idea of doctors limiting their practices to well-paying clients? Leave a comment below!

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