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Concierge Medicine--Premier Medical Service for a Price

With patients demanding a greater level of customer service during office visits and physicians receiving reduced amounts of income through standard insurance reimbursements, a growing trend in the healthcare profession is the practice of "concierge medicine." However, there are important ethical and legal questions that surround this controversial approach to patient care, as discussed in a special report in the most recent edition of the Jackson & Coker Industry Report entitled "Concierge Medicine--A Growing Trend?"

Alpharetta, GA (PRWEB) August 13, 2008 -- With patients demanding a greater level of customer service during office visits and physicians receiving reduced amounts of income through standard insurance reimbursements, a growing trend in the healthcare profession is the practice of "concierge medicine." The premise behind this concept is that some patients are willing to open their wallets wider to pay for a "premier" level of medical service and personal attention.

However, there are important ethical and legal questions that surround this controversial approach to patient care, as discussed in a special report in the most recent edition of the [Jackson & Coker Industry Report entitled "Concierge Medicine--A Growing Trend?"]

"Admittedly, concierge medicine is making some significant inroads into the healthcare community, but there are important questions that need to be addressed concerning this innovative practice model," mentions Sandra Garrett, president of Jackson & Coker.

Understanding the Concept:
Often referred to as "boutique medicine," "direct practice," "retainer practice," or "innovative practice design," concierge medicine is not a brand-new concept. For the last dozen years, a growing number of physician practices in the United States have experimented with the concept of offering a more personalized approach to treating patients who are willing to pay more out-of-pocket fees for shorter wait times during office visits, lengthier consultations, 24/7 access to their primary care physician via cell phone, and, in some instances, house calls by someone on the medical staff.

All of this is for a price. Often times, concierge practices offer a tiered-approach to fees for service. On top of customary insurance billing, the practice may charge patients annual fees ranging from $1,000 per person or upwards of $15,000 to $20,000 per family.

Thomas W. LaGrelius, MD, FAAFP, president of the Society for Innovative Medical Practice Design (SIMPD) [], addresses the matter of cost: "The range of fees goes down to as low as $39 per month for full care concierge services" in some practices. "The national average is less than $150 per month and membership levels as low as 50 patients. The average practice has about 600 patients as its cap. Keep in mind, the most expensive concierge doctor with the fewest patients is the White House doctor."

Some critics of concierge medicine raise this important question: How can healthcare practitioners justify concierge medicine on the upper end of the tier, given the fact that an estimated 40+ million of U.S. residents lack any insurance coverage at all? Furthermore, by making medical treatment even more costly, doesn't this widen the current disparity in healthcare delivery that is of concern to many segments of society?

"Such critics are short-sighted. Insurance is the problem, not the solution," mentions Dr. LaGrelius. "Most primary care doctors today run from room to room with seven-minute visits accomplishing next to nothing in the pursuit of generating enough CPT codes to keep the office solvent. Half the money paid to health plans and government for health care is wasted."

"Concierge doctors have been shown to cut high tech and hospital costs by as much as 60-85%. Insurance is not a useful tool in the delivery of primary care. Such care should be purchased directly, thus eliminating the costly, meddlesome middle man," he points out.

In fact, proponents of concierge medicine stipulate that for a modest $100 - $200 monthly retainer, along with higher deductibles to cover serious emergencies, providing patients significantly greater personalized medical attention is actually cheaper than traditional insurance-based healthcare models.

Direct practice proponents would further argue that this approach to patient treatment is intended to bridge the gap between theory and practice concerning consumer-driven medicine, and as such might serve as a viable model for reformed healthcare care in America.

Lingering Questions:
No matter which side of the argument one supports, there are lingering questions that concern all sectors of the healthcare community, as the JCIR special report notes. For instance, the American Medical Association (AMA) emphasizes that licensed physicians are obligated to provide the same level of care to all patients treated, regardless of their economic status. (Direct practitioners would emphasis that they also abide by this ethical standard.)

With respect to consumer satisfaction, patients who pay out-of-pocket $10,000 or more for family medical care certainly expect a different level of service than they have previously received.

Quality of care is judged by recipients of medical treatment, regardless of the cost, explains Dr. LaGrelius: "Keep in mind, the average concierge fee today is less than $150 per month. Most Americans pay more for cable, cell phone bills and cigarettes. Concierge medicine costs, like cell phones, are going down and such care is being used by more and more average Americans. That trend will continue. Most innovations start with wealthier people and then become generalized."

Furthermore, there are ethical and legal matters concerning when and how to inform current patients when a medical practice transitions to a retainer-based model. Patients who cannot afford concierge-level medical care must be given the opportunity to continue seeing competent physicians whose services are more affordable.

Concierge physicians have no problem with this stipulation, but point out that their approach to primary care medicine is to rule in, not rule out, persons who can benefit from access to "direct practice medical homes," much like the Dr. Welby-type practices of yester-year. Or at least that's their visionary goal.

As healthcare costs and delivery models are hotly debated in this political season, a fresh spotlight shines on innovative practice design, which will undoubtedly gain much more attention in the foreseeable future.

Ms. Garrett comments: "Our special report on concierge medicine raises concerns for all segments of the healthcare community. Though an interesting concept, it remains to be seen how widespread concierge medicine will be adopted by patients and practitioners who generally agree that improving customer service is a priority in our consumer-driven society."
About [Jackson & Coker]:
Begun in 1978, Jackson & Coker is a prominent physician recruitment firm headquartered in Alpharetta, Georgia. The firm places physicians in over 40 medical specialties as well as advanced practitioners (such as CRNAs) in temporary (locum tenens) assignments and permanent placement opportunities.

Jackson & Coker is a member of a "family of companies" known as Jackson Healthcare (JH). The corporation provides information technology and human resources solutions to hospitals and healthcare organizations across the country. Jackson Healthcare has the distinction of being voted among "Atlanta's Top 10 Fastest Growing Companies" and designated by Inc. Magazine as among "The Fastest growing U.S. private companies."

More information concerning [Jackson & Coker]--along with the monthly Jackson & Coker Industry Report--can be found at


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