The Debate Over Concierge Care


In the last week, the Houston Chronicle and the Washington Post have both issued stories on the topic of concierge care from the perspective of patients and managed care companies. Meanwhile my esteemed colleague, Chip Hart, has been busy making the case by analyzing numbers specific to pediatrics.

By now, most of you know that primary care practices are the hardest hit in terms of reimbursement for services rendered and vaccines administrated. In order to alleviate the sheer volume of work faced by these practices in order to keep revenues up, some are beginning to offer their patients the option to pay a fee in order to receive less compressed care and better personal service. So what is all the fuss about?

In the case of insurers, some don’t want physicians to charge these fees to their members citing contract provisions excluding them from doing so, while others do not have a problem with it. However, many are concerned that about access to care issues, because by offering concierge care physicians naturally have to restrict the number of patients they are willing to see in order to make the time available to satisfy that offering.

Today we are beginning to see to the effects of lower reimbursement on the number of physicians entering primary care specialties, and realize that shortages are becoming a big problem. By setting up such offerings, this will restrict access to physicians even further, or so the argument goes.

But is that really the case? It might be, were it not for minute-clinics and other competitors moving in to the marketplace to help compensate for the volume spilling over from established practices. The reality is, many physician practices do not want to be clinics or mills. These doctors want to provide the best care they can, but current managed care policies do not allow for that.

So let the minute-clinics be the mills for strep tests and ear infections, if that’s what some consumers want. But let the physicians limit the number of patients that walk through their doors in order to regain some quality of care and put the sanity back into practicing medicine. In doing so, it might just help redress the imbalance that insurers have so successfully created.

For more information about concierge care, check out MDVIP.

3 thoughts on “The Debate Over Concierge Care

  1. Pingback: The Concierge Concept Continues to Spread | Confessions of a Pediatric Practice Consultant

  2. When you get a few minutes, could you post what you know about those insurers who allow their members some ability to work with the concierge model? I think that’s a huge hole in the dam through which primary care physicians ought to be driving (it’s late, I mix metaphors).

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  3. MDVIP’s CEO kindly returned my call and informed me that the answer varies state-to-state and month-to-month. Insurers that allow it today may change their policies in the future, and national companies that allow it in one state don’t necessarily allow it in another. MDVIP helps physicians to work with insurers though, and hlps make the case on their behalf.

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