Concierge Medicine: Should Financial Considerations Prevail Over Ethical And Moral Concerns?

Abstract

Many primary care physicians are now considering changing their practices to the new concierge medical practice. Also known as boutique medicine, retainer or "highly attentive" medicine. This new style practice offers access to a physician who has now limited the size of his practice in exchange for an annual fee.  These practices are nearly all primary care, and usually vary in size from 600 patients to 300 or less and carry a typical fee of $1,500.00 a year. Although a recent phenomenon, boutique medicine remains a small niche. But the number of practices continues to grow. Particularly on the East and West coasts where there are more wealthier people, who expect more from their health care providers.  Benefits of this new practice include same-day or next-day appointments not under time constraints, house calls, 24 hour a day access by cell phone, annual wellness evaluations and highly appointed offices.  One of the major criticisms of concierge medicine involves those who do not participate in such a program. The practices also displace patients to other medical providers. And as such, create problems of excessive demand on the existing physicians who do not participate.  Generally speaking, the patients who elect to participate in concierge practices are healthier and require less intensive care than those cared for in other settings. All this without consideration of the approximately 45 million Americans who live without health care insurance, which only serves to compound the existing problems.  There "VIP" medical services with their superior amenities and convenience can be purchased by those with sufficient wealth. However, the question should not turn on the quality of health care which depends on the amount of money an individual can spend on it. Many would regard good health as a right rather than a privilege.  The final ethical question is to consider the thought that an individual might experience more or less morbidity or mortality based on how much money they could devote to medical care. Health care should not be discretionary, as everyone should be entitled to the quality without regard to financial status.