The New York Times recently ran an article about extremely high-end concierge practices. These elite programs charge patients upwards of $20,000 per year for membership—a figure that is obviously way out of reach for most Americans.
The truth is, most Americans don't need anywhere near $20,000 per year of medical attention—they just need a relationship with a physician they trust. That relationship is what is slowly being eroded in today's healthcare marketplace.
Concierge medicine answers that need—and certainly at price points far below what the New York Times reported. Most concierge programs cost around $150 per month, making it something many Americans, particularly those with health needs, can prioritize.
But for many physicians, charging patients a membership fee feels wrong. They worry about the moral implications of treating only those who can afford to pay them directly. Even the high-cost physicians in the New York Times article expressed concerns about developing concierge programs for such an exclusive clientele and what it could mean for the future of medical care.
Having worked in the healthcare marketplace for more than 20 years, these ethical concerns are no surprise. Most of the physicians I've worked with love their patients and the communities they support and want to do right by everyone. They don't want to stop seeing patients at a time where there are reports of physician shortages, nor do they want to contribute to a two-tiered healthcare system.
But what happens when an older, respected physician is becoming burned out due to the pressure of volume care and new mandates he's never had to deal with before? Oftentimes, he retires sooner than he ever expected to. He closes his practice and stops seeing all of his patients. With decreasing reimbursements and increasing overhead, it doesn't make sense to stay in business.
What about the busy group practice with several physicians and lower level providers? They work hard to care for and accommodate as many patients each day as they can. Often, that means that someone with an acute problem has to see whatever provider is available at the time they need care. Or, for less acute issues, they may have to wait weeks for an appointment with the physician of their choice. For some of these patients, in particular those with complicated health histories, this doesn't feel right either. The chosen provider wants to have time to manage that particular patient, but case load and schedules simply cannot guarantee it.