Rising costs and patient loads push some primary care MDs to concierge practices

Aug 25 2009

Some primary care doctors are changing their practices, The Philadelphia Inquirer reports: "Faced with rising costs and patient loads, a small but growing number of primary-care doctors are sharply reducing their practice sizes and charging each patient annual fees of about $2,000 in exchange for personalized care. At least 20 such 'concierge' practices have sprung up in the Philadelphia area since 2002, mainly in affluent suburbs.... Nationwide, more than 800 doctors -- the vast majority of them family practitioners and general internists -- use some form of concierge practice, says health consultant Scott MacStravic, who has written about the topic. That number has more than doubled since 2005, he said."

"(The) charge -- which neither insurance nor Medicare reimburses -- typically covers such amenities as annual physicals lasting an hour or more, 24/7 access to the doctor via phone and e-mail, same-day or next-day appointments, a CD or flash drive containing personal medical records, little or no wait time, unlimited doctor visits, extensive preventive care, house calls, and hospital or nursing home visits" (Knee, 8/22).

WHYY (Philadelphia): "The patient experience is something akin to old-fashioned approach to medicine, where doctors did not feel compelled to cut you off and give you just a few minutes and only deal with the problem du jour. Critics think concierge medicine leaves poor people with even less access to care. Curbing that trend is another reason policy makers want to boost primary-care salaries. But that could mean reduced pay for some specialists" (English, 8/24).