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Health & Medicine

Concierge Medicine: Pros and Cons of the Rising Health Care Trend

— December 4, 2019

Individuals who have the means to pay the retainer fees for concierge doctors would certainly be happier with this kind of care.

If you’ve had to see a specialist or even your family doctor recently, take a minute to think about your health care experience. Did you have to wait several days, weeks, or months to get in? How much time did your doctor spend assessing your symptoms and health goals? Did they take the time to discuss a wellness plan for your future? Or, did you spend extra time in the waiting room to only be seen for a few minutes?

A recent survey conducted earlier this year reported than Americans wait, on average, 24 days to see a new doctor. (I personally tested this myself – I called five primary care doctors in my area to see when I could be seen as a new patient. The earliest anyone could get me in? Three months from now!) Similarly, many Americans are fed up with the less than ideal experiences while at a doctor’s office. As a result, it comes as no surprise that personalized medical services are becoming a rising trend. Sometimes, these services are called retainer, boutique, or concierge medicine. Regardless of the name, patients pay a fee upfront to secure and guarantee services and access to a physician. 

Of course, having 24/7 access to someone who knows and thoroughly understands your medical history, provides you with same-day appointments and even video chats or text message updates sounds good to most people. This direct primary care or concierge medicine is highly appealing to many – but it comes at a cost. Let’s look deeper into the pros and cons of this up-and-coming healthcare trend.

Black and white analog egg timer; image by Marcelo Leal, via
Black and white analog egg timer; image by Marcelo Leal, via

The Pros

One of the more obvious upsides of concierge medicine is that patients get to bypass wait times and have access to a physician the moment they need access. No more late appointments or germ-ridden waiting rooms! In addition, patients will have unlimited access to their doctor without additional costs. Many concierge doctors also offer visual visits and 24/7 phone access. Let’s face it – who doesn’t want everything handed to them on a silver platter, when they want it, how they want it?

A report by the University of Wisconsin found that typical primary care providers spend only 15 minutes with their patients with one to two visits per year. By contrast, direct primary care providers spend an average of 35 minutes per visit with four visits per year. This is due to the fact that primary care providers have thousands of patients, while concierge doctors have far fewer patients and eliminate the administrative costs of dealing with insurance companies. In addition, a study conducted in 2014 found that 90% of patients with concierge doctors were satisfied with their care compared to 67% of patients with a traditional healthcare provider.

Advocates and renowned facilities in concierge medicine explain that “smaller patient panels…make for better health outcomes and lower risk of chronic disease.” They explain that when physicians spend more time with patients understanding and assessing their health goals and concerns, doctors can focus on proactive and preventative medicine rather than symptom management. After all, most people go to the doctor after their symptoms begin. However, staying in constant contact with a physician can help individuals prevent chronic diseases before they begin.

The Cons

When people switch to concierge medicine, they will rightfully have higher expectations. With all of the wonderful promises made, who wouldn’t? However, despite more satisfied patients, reputable research has yet to demonstrate that people who have direct primary care have better health outcomes. 

Furthermore, insurance companies aren’t obligated to pay the retainer costs of concierge medicine. Instead, that high-cost retainer fee you will pay comes strictly out-of-pocket. While it’s easy to imagine why patients who aren’t worried about healthcare costs would apt for direct primary care, this can lead to ethical issues regarding healthcare becoming exclusionary, preventing people who are under economic pressure from getting the same level of care that their well-off counterparts do. Meanwhile, there are already 40% fewer primary care providers in the U.S. compared to fifty years ago, as more physicians are turning to specialty care. 

For some providers, concierge medicine can be a great way to increase profits and improve patient satisfaction. For others, it could mean loss of patients due to costs. For patients, however, concierge medicine could introduce a divided healthcare system, blocking low-income families from having access to the quality healthcare they deserve. Many people are already frustrated with the harrowing issues surrounding the healthcare system, due to rising costs, long wait times, and political insurance battles, so concierge medicine could make healthcare better for some, but worse for others.

Who is Concierge Medicine Good For?

Individuals who have chronic health problems, such as heart disease or diabetes, usually have to visit their doctor more frequently. These costs can add up. As a result, individuals with chronic conditions can benefit from having a concierge doctor. Having fast access to test results and labs are an added bonus for individuals with serious health conditions. For others who have less serious needs, the accessibility to a physician and promise of rapid lab results may not be worth the retainer fee.

Individuals who have the means to pay the retainer fees for concierge doctors would certainly be happier with this kind of care. In the end, it is down to each individual to decide which kind of healthcare best meets their needs. For those who can’t afford the cost and don’t have time to wait to be seen, there is good news as well – virtual doctors’ visits are on the rise, but that’s a story for another day.

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