Response To Concierge Blog

I received a response to my blog dealing with Concierge Practice, from an unnamed physician. It is lengthy, but worth reading. The practice described is a limited sample.

"As an experienced family practice and ER physician who opted out of the traditional practice model, it always amazes me when colleagues attack the practice model. Granted, it is not a model that everyone should adapt or that everyone needs or even wants, but for those who do desire such a service or who may really have a need for such a service, it is a very reasonable healthcare model. There is always the argument that it steals providers away from the general population, but for some providers it keeps them in the game, when they would have otherwise finally opted out of medicine altogether. Additionally, many providers dream of doing benevolence work like Doctors Without Borders, or as in my case, seeing subsectors of disadvantaged patients like kids with disabilities. These kids take a long time to see in the office, sometimes an hour or more. Busy practices do not want to care for them, because they disrupt the flow...and the revenue stream. Since I provide services to a much smaller number of clients, I can take the time to patiently wait to gain the confidence of a flapping child with autism who is melting down in my office and then the extra time it takes to work with him or her just to get an appropriate assessment. Better yet, I can keep him or her in an environment where the child won't melt down, at home, where the child's routine is not so significantly disrupted. Yes, I do charge my clients a high dollar fee, but at the other end of the spectrum, that single mother of three, one of whom has severe disabilities, gets care for not only her children, but for herself, in spite of the fact that she has no ability to pay. I don't ask her to pay, because I don't have to do so. One of my high paying clients paid for convenience and in so doing allowed me the ability to take care of someone who was in a less fortunate economic condition without having to forego paying my own bills. There is a place for such practices. I provide a service that clients on both ends of the financial spectrum appreciate. Although on the surface it seems like an easy ride for lazy, greedy physicians to some, it will not threaten the current healthcare system, because when most physicians realize the real effort and commitment that it does take to do it well, they quickly head back to their own practices, saying, 'No Thank You! That is too much work! I'm not willing to give up that much of myself.' Concierge medicine is a wonderful practice model. I love what I do, but it does have its trade-offs. My patients are happy to pay for the extra "service," just as they are happy to pay for the extra services they get on first class plane flights or private jets and in six star hotels, as opposed to the Holiday Inn. You get a comfortable bed and a good nights sleep at both the Waldorf Astoria and the Holiday Inn, but you pay more at the Waldorf, not because of the bed, but because of the extra fancy little services. There is a place for both the Waldorf and the Holiday Inn. I don't believe either is threatened by the other. So should be the case with concierge medicine and other models. They are just different practice models serving different client populations with different wants and needs. There is no reason we should have any less flexibility in medicine. Additionally, just as the Waldorf makes contributions to the well-being of the community, concierge physicians give themselves the freedom to be benevolent, freeing themselves up to be able to do more. Call me naive, but I would like to believe that most physicians did go into medicine, because of their desire to help others, so I believe that most will give back to the communities that they serve in, if given the opportunity to do so. At least for me, concierge medicine provides me a viable opportunity to do so in a much larger, more sensible way. Besides, concierge medicine has always been there for those who could afford it. We have just formalized it, giving it a title and raising its visibility to the general public. People who have money at their disposal will always find ways to use it to get the extra personalized services that they desire and frequently need because of the lines of work they are in or the positions they hold in society. Many will find it because they have medical and/or social needs above and beyond what the standard system can accommodate. I see it as an adjunct to the traditional care models. I believe it can even serve to relieve the stress on overburdened practices, who can refer time-intensive patients over to concierge providers who can provide them with the extra time that they need, want, and absolutely require in order for them to get good quality care. It is one of many niches...and there is room for all."