Concierge medicine has a cost for all patients

http://www.latimes.com/health/healthkey/newsletter/la-he-practice-concierge-medicine-20110627,0,7101789.story

By Steve Dudley, Special to the Los Angeles Times
June 27, 2011

I've begun seeing a new patient, a retired delivery driver named Donald. Nice guy, friendly and chatty, and a little mystified as he tries to navigate his way through the constantly changing world of healthcare. He had been my patient many years ago, but we parted ways when I left that office. Donald tracked me down because his former doctor had switched to a concierge-style practice.

Concierge medicine — you may have heard of it — is gaining in popularity. Patients pay a monthly fee directly to the doctor, on top of their regular health insurance premiums and co-pays, to secure better access to the physician. Donald told me that the service was promoted to him as an opportunity to improve the doctor-patient relationship. Instead of juggling more than 2,000 patients, the physician would be able to winnow that number to a very manageable 600, enabling him to devote more time to the select few who opted for premium service.

Being a naturally frugal sort, Donald didn't think such a monetary commitment was prudent, especially on his retiree income.

Even among concierge practices, there are different levels. Some doctors charge very high retainers that give their patients access to them 24/7. Physicians have even been known to vacation with their charges, just in case anything goes wrong.

This raises some interesting logistical problems. What if one millionaire is taking his family to Zermatt, Switzerland, and wants a tag-along doctor while at the same time another client has decided that this is the perfect time of year to see Zanzibar, Tanzania? Oh, the decisions! What does a poor concierge doctor do with such a dilemma?

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