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?
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Why do you assume that that the population they serve need it less than some other group who cannot afford that type practice? Does the fact that someone cannot afford concierge medicine somehow mean that they need medical care more?
Good point. I guess it depends on the definition of 'need.'
From the perspective of potentially improving someone's quality of life, I would have to say yes. Wealthier people generally have the ability and power to protect their health interests. People on the margin need advocates.
Concierge service is an exercise in convenience and may have some economic benefit if it means a high-income earner can return to work sooner.
I doubt that anyone can even develop a framework for economic analysis of various kinds of health services without the pitfalls of politics, race and class.
You know, I always find myself in an awkward position, being a high income earner relative to the patients I try to help. I have interests in common with both groups. Your question really challenges our assumptions. Thanks you.
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