Concierge model criticized for worsening doc shortage

Tools

The number of retainer-based physicians in the United States has doubled over the past two years, according to the American Academy of Private Physicians. And even though that currently adds up to only a few thousand "concierge," "boutique," or "personalized" physicians in total, the trend is expected to continue nationwide, CNN reports.

But the novelty of the VIP physician hasn't been embraced as warmly in some parts of the country as in others. Most recently, health officials in Vermont (one of a couple states with single-payer care in the works) have criticized the model for exacerbating the problem of physician shortages, the Burlington Free Press reports.

Profiled in the article is Rutland primary care physician Dr. Seth Coombs, one of the first doctors in the state to adopt the controversial model. Similar to the stories of many physicians who've switched from a traditional to some form of a retainer model, Coombs reportedly was frustrated by working harder than ever yet unable to truly give his patients or family his best. But since informing his patients of his new $1,200 to $1,600 retainer fee in July and transitioning his practice to become "a microcosm" of what it once was, Coombs is feeling substantially better about his practice, according to the article.

Although patients interviewed by the newspaper praised the new offering as "a good solution" for those who can afford it, thousands of other patients are no longer under Coombs' care.

"We already have a lack, relatively speaking, of primary care physicians," Dr. Robert Macauley, the medical director of clinical ethics for Vermont's largest hospital, Burlington's Fletcher Allen Health Care, told the newspaper. "So the reason that people are dissatisfied is there are too many patients and not enough doctors."

Therefore, for every doctor who reduces his or her practice, the tougher it becomes for the remaining traditional physicians to provide access to greater numbers of patients, Macauley argued.

Nonetheless, some consumer experts told CNN that better service--not necessarily provided by a retainer model--can drive better health. "A happy patient is more likely to adhere to the doctor's recommendations," said Dr. Ashish Jha, an associate professor of health policy at Harvard.

To learn more:
- read the article in the Burlington Free Press
- read the article from CNN

Related Articles:
Concierge practices multiply as more docs drop Medicare
MDs building concierge, cash businesses with patient-friendly promises
Legality of concierge practice questioned in Canada
Vermont pursues single-payer system