Concierge medicine: Good for doctors but questionable for patients

By Aine Cryts

Physicians who embrace the concierge medicine model say they're able to spend more time with fewer patients. Still, critics protest that the practice model makes physicians' lives easier, without regard for what's best for patients.

Rising overhead, flat reimbursement and increasing regulatory demands such as Meaningful Use led James Williams, M.D., a physician in the District of Columbia, to convert his practice, according a recent MedPage Today article. Whereas Williams once saw 4,000 patients, he now sees fewer than 400. In return for a $1,800 annual membership fee, his patients can call Williams' cell phone and expect a call back the same day--or even a home visit.

"We need to take time, talk with people, find out about their medications, their family and social history … When you're rushed, and stressed, you can miss the real picture," Frank Ditz, M.D., a family doctor in Cocoa Beach, Florida, told the news outlet.

Ditz converted his practice two years ago because he couldn't properly treat patients during visits that lasted about seven minutes. Today, Ditz has a 250-patient panel and schedules 45-minute appointments with each of them.

Still, concierge medicine has its detractors. Calling it an "immoral and unethical" practice, Paul Speckart, M.D., a San Diego physician and a former American College of Physicians (ACP) regent, told the publication he's particularly concerned that patients who can't afford annual membership fees will seek emergency room care.

All primary care physicians are frustrated with the demands on their time, added Speckart. "The answer is, you have to roll up your sleeves and go to work."

The ACP outlined a set of recommendations for concierge and other direct contracting practices late last year. While not denouncing the model outright, the group's position paper urges physicians to consider the impact a switch would have on their patients and communities, FiercePracticeManagement reported previously. 

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