The tougher running a traditional medical practice becomes, the stronger the appeal of providing concierge or retainer-based medicine may be to some doctors. Setting aside recent criticisms of the model, be sure to address the following legal and ethical considerations before making this type of switch, according to Physician Trends:
- Write a letter to patients clearly explaining the changes underway at your practice, including how much you intend to charge for what services, the limitations of what the retainer fee covers, patients' options for continuing with or leaving your practice and whether you will continue to accept third-party payments.
- Use caution when terminating relationships with existing patients, especially those with "a continuing, intensive course of treatment." This means not only clearly outlining their options to stay with your practice or move on, but also to help transfer nonparticipating patients to new doctors at no charge. According to the American Medical Association's (AMA) ethical guidelines for concierge medicine, a doctor "may be ethically obligated to continue caring for such patients" if no alternate physician is available.
- Ensure that patients understand that the retainer model is not insurance and that they will be responsible for paying for or separately insuring services, such as hospitalizations, not covered by the agreement, according to KTVZ.com.
- Do not market your retainer practice as providing better diagnostic or therapeutic services than a traditional practice, as per the AMA guidelines.
- Keep abreast of and comply with any state laws regulating concierge medicine. A new law in Oregon, for example, requires practices using the retainer model to register with the Insurance Division, part of the Department of Consumer and Business Services, and disclose all details of their payment agreements with patients.