High-end, high-cost concierge medicine for America’s wealthiest widens healthcare divide

As millions of Americans struggle to pay their medical bills and worry that they may lose insurance coverage if the Affordable Care Act is repealed, many of the wealthiest in the nation receive five-star treatment from doctors and hospitals if they are willing to fork over a five-figure annual fee. And apparently, they are more than willing. Ultra-elite concierge practices say business is booming.

Unlike the standard concierge model, The New York Times reports that these boutique practices charge as much as $80,000 per family per year. Those fees provide personal care of a physician, who is willing to make house calls or meet clients at work or an airport. These well-connected physicians can also provide their patients with immediate access to the country’s finest specialists and hospitals, unlike most average Americans who have to wait as long as 29 days for an appointment, according to the article.

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Jordan Shlain, M.D., founder of the San Francisco-based Private Medical group, told the publication he doesn’t use the term concierge care to describe his practice. Instead he calls himself an “asset manager” for a patient. Just like financial analysts will manage their fortune, his team will coordinate care for the entire family—young children, teenagers, even grandparents in a nursing home—with some of the best doctors and hospitals in the country.

High-end concierge practices are able to get the quick appointments because of their relationships with these top physicians.

“If you need to go to Mass General, we can get you in,” Harlan Matles, M.D., a physician at the MD Squared concierge pratice, told the NYT. “We are connected. I don’t know if I can get you to the front of the line, but I can make it smoother. Doctors like to help other doctors.”

Hospitals are also trying to meet the needs of these wealthy patients. For example, the NYT reports that Lenox Hill Hospital in New York is working with a designer so VIP patients will think they are in a luxury hotel instead of a hospital. A suite in the maternity ward with a separate sitting room for family and kitchenette may cost these patients $2,400 a night.

Although some of the physicians interviewed by the publication admit to struggling with ethical issues over the five-star treatment for wealthy patients, hospital executives said that the VIP care actually helps them provide charity care to other patients as reimbursement from Medicare, Medicaid and private insurers continues to decline.

Related: VIPs: Hospital clinicians feel the pressure when elite patients demand special attention, care

But some clinicians who provide care to these VIP patients in hospitals claim they often feel pressured to provide unnecessary care. Indeed, a study earlier this year found that a majority of hospitalists at eight different hospitals said they had ordered extra tests and treatments that they thought were medical unnecessary because of the demands of the patients and family members. A third said they were pressured by hospital administration to give in to the demands.