Concierge Medicine – A Further Divide

This morning, I skimmed my tweets to see what the tweeples are talking about.  One posting about concierge medicine really stood out.  Premium-based healthcare, as it is called, allows people to pay a fee in order to ensure quality healthcare.  Yep, that’s right.  In this scenario, quality healthcare is no longer a given (not that you can rely on it these days anyways)….you have to pay for it!

I think we can all agree on a few points.  First, doctors are underpaid (thanks to the greed of insurance companies) and the majority of them have overwhelming patient loads.  BUT, second, and most importantly, the patient ultimately pays for all of this.  Five minute office visits and a doctor who’d just as soon throw a prescription at you than take the time to find the root cause, have become the norm.

While establishing a concierge healthcare system compensates those doctors who chose to cater to the wealthy, what about the poor people who can’t afford the current healthcare system or the doctors who chose to provide services to them (wonder how many would jump ship if they knew they could significantly increase their income by charging the wealthy $4,000 a year in addition to regular costs)?

Establishing a premium-based healthcare system isn’t healthcare reform (I haven’t seen anyone call it healthcare reform, but I wanted to rule that out right away). True healthcare reform addresses the  quality of care and access to healthcare.  What’s reforming about telling people, “Okay, you can have quality healthcare and premium access (under the premium-based plan doctors will make housecalls) if, and only if, you can afford to pay for it.”?

This sounds like just another way to widen the gap between the haves and the have nots.

What do you think?  Share your thoughts.


3 Responses

  1. Well, you said a mouthful in this one. First I would like to thank you for acknowledging what a lot of people do not realize or choose to ignore: “First, doctors are underpaid (thanks to the greed of insurance companies) and the majority of them have overwhelming patient loads. BUT, second, and most importantly, the patient ultimately pays for all of this.” You are on the money on both of these statements. People think well a doctor makes between $50-$500 per hour, so what are they whining about? They don’t realize that by the time the doc pays business overhead, malpractice insurance, student loans, continuing medical education, licensing, etc., it has gotten to the point that many do not even have enough to pay themselves a salary. Most physicians can never retire…working until the day they die. So many physicians are struggling now that banks consider physicians high risk, because so many are declaring bankruptcy. Add to that the fact that in order to make that $50-$500 per hour, most are now seeing a backbreaking number of patients. Few physicians actually go into medicine for the money. Most really do want to help people, but the current system has made it impossible for any physician to survive without paying extremely close attention to the financial bottom line.

    Concierge medicine will not be the be all and end all answer to the problem, but it should not be the whipping boy to all that ails medicine either. I believe that it is a model that is the start of a revolution. It is bringing about change, but the model itself will not represent the final product. Sure, there will always be “haves” who can purchase the high end version of concierge medicine, but I believe that the preventive health based, medical home style will be a large part of what the future of medicine will have to look like. This modified model will be available to all.

  2. Great post Dr. Cheryl. This is an issue that is truly in the forefront as so many patients and doctors are looking for alternatives to this healthcare mess.

    I also appreciate you bringing up the fact that so many doctors truly don’t make enough money for their tireless work. And, too many patients are paying outrageous fees already for 5 minute appointments and misdiagnoses. Something definitely has to give, and I say that concierge medicine is a great bridge.

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