Scott Schreve's post on concierge physicians is a pretty good analysis of the pros and cons of this kind of practice. I had not considered the potential for accusations of inappropriate behavior with doctors practicing on their own. I have practiced chaperon medicine since coming to the States, although in Canada, we never felt we needed someone in the room while performing a breast or pelvic exam.
Perhaps, more importantly, there is one important down-side he did not consider that I am thinking about more and more lately. If primary care is in such short supply, concierge physicians divert resources from populations who really need it. It has been difficult recruiting family docs for my community health center. How much more with Medicaid expansions, the potential of a national health plan and just the organic trends of increasing primary care use?