As more physicians embrace concierge medicine, expansion of this service is inevitable. Giving them the ability to focus additional time and directed energy on their patients while also being financially more feasible and operationally easier to administer encourages an inviting transition to this model. Though one could say that their main reason is noble, I am not sure I completely agree.
From a service standpoint of seeing fewer patients, concierge medicine might deliver more focused care. However, according to the early research data, the model has not been shown to improve quality of care. Because of the fees charged and the potential of unneeded tests ordered, there is some concern the actual cost of care could be higher. Value is an equation where cost, quality and service are all variables. Concierge medicine could be lowering the overall value since the cost of care is greater without improved quality, even as service improves.
By implementing a membership fee that effectively limits participation based on ability to pay, we are segregating those we serve. As a profession, this is detrimental. Though we do it because we think we are delivering better care, we in fact are doing just the opposite, as we are serving fewer people in need. Instead of fixing the problems we have in healthcare by limiting who we see, let’s diligently work towards designing and implementing a system where we can serve more, not less.
Our profession requires us to look at the social good of our communities, just not the good of a few. As leaders in our field, how do we create a sustainable model where we have the ability to age, decrease our work load and stress levels yet still care for more people? Maybe our compensation models should allow for mentoring of newer physicians and care teams thereby delivering greater value to more people by sharing our experience and learnings. How do we design delivery systems that give enhanced service to more, not fewer? There are many such avenues available that do not require limiting the number of patients seen. Expanded care team models and services delivered by community resources with a physician involved as appropriate are just a couple examples.
If we want to hold true to our professional calling, we need to be more innovative in solving our issues. Solutions that might seem worthy, could, indeed, have unintended, deleterious consequences.