By now you must know I married into a family of doctors. Bob’s father and his two uncles were doctors. He has a cousin on Long island who is an orthopedist, and one who was a practicing OB back in NJ. We have the MD gene and it runs deep. We would pack the kids up for the annual trip back to my MIL’s Seder each year, and one room was always devoted to a pick-up medical clinic – a Woody Allenesque review of sprained joints and aches and pains. So I’ve been hearing the disheartening rumbling with managed care for a long time now; but I’ve only recently heard about the Concierge or Boutique practice model.
Yesterday, a woman at the knitting circle mentioned her Cville doctor was turning his office into a Boutique practice and she was very willing to pay $1,600 a year for his time and attention. Now that’s just the fee to stay one of his patients, he’s whittling down the numbers from around 2,000 to only 500 patients. Some doctors will take medicare and insurance, others have given up completely and bill you, insisting the patient deal with the third party.This woman also said she thought that Proctor and Gamble owned the company that was going to run his new office. Look around, Family Practice and Internal Medicine docs are flocking to this model, officially called “retainer medicine.” This annual fee she felt would guarantee her access to the doctor, via email and phone, immediate appointments and even house calls!
I was surprised at my reaction. I said that’s too bad, because I see it as an ethical dilemma. In our great country, where the public option was taken off the table in the new Affordable Health Care reform act we barely managed to pass in order to appease insurance companies, a Concierge practice will only broaden the socio-economic gap between those who have so much, and those who are struggling to get by. The broad part of the middle class will become more fractured. I became slightly edgy, ranting about our fee-for-service medicine like I was some kind of, dare I say, socialist liberal. My knitting suffered. Intuitively, I just felt it was wrong. How can America be so alone in the world at not providing universal health care for its citizens? Here we are, with Africa…
Yet when I searched a popular physician website for “Concierge Medicine” there were 8,340 articles – all of them positive. They compared it to the choice of a private school over public, they said that while waiting for government to fix the system they decided to “…take matters into their own hands.” They reported about doctors going bankrupt! http://www.kevinmd.com/blog/2012/01/concierge-boutique-label-discredits-retainer-medicine.html They almost made me a believer. Almost. What do you think?
MountainMornings 