Concierge Medicine: Should Financial Considerations Prevail Over Ethical And Moral Concerns?
Authors: Lauer Fred , Neil Benjamin A. 
Published: February 2016

<p class="MsoNormal" style="text-align: justify; margin: 0in 0.5in 0pt; background: white;"><span style="color: black; font-size: 10pt;"><span style="font-family: Times New Roman;">Many primary care physicians are now considering changing <span style="letter-spacing: -0.1pt;">their practices to the new concierge medical practice. Also known as </span><span style="letter-spacing: -0.05pt;">boutique medicine, retainer or "highly attentive" medicine. This new </span><span style="letter-spacing: -0.2pt;">style practice offers access to a physician who has now limited the size of </span><span style="letter-spacing: -0.1pt;">his practice in exchange for an annual fee.<span style="mso-spacerun: yes;">&nbsp; </span></span>These practices are nearly all primary care, and usually vary in <span style="letter-spacing: -0.15pt;">size from 600 patients to 300 or less and carry a typical fee of $1,500.00 </span><span style="letter-spacing: -0.05pt;">a year. Although a recent phenomenon, boutique medicine remains a </span><span style="letter-spacing: -0.1pt;">small niche. But the number of practices continues to grow. Particularly on the East and West coasts where there are more wealthier people, who </span>expect more from their health care providers.<span style="mso-spacerun: yes;">&nbsp; </span><span style="letter-spacing: -0.1pt;">Benefits of this new practice include same-day or next-day </span>appointments not under time constraints, house calls, 24 hour a day <span style="letter-spacing: -0.2pt;">access by cell phone, annual wellness evaluations and highly appointed </span><span style="letter-spacing: -0.5pt;">offices.<span style="mso-spacerun: yes;">&nbsp; </span></span><span style="letter-spacing: -0.25pt;">One of the major criticisms of concierge medicine involves those </span><span style="letter-spacing: -0.05pt;">who do not participate in such a program. The practices also displace </span>patients to other medical providers. And as such, create problems of <span style="letter-spacing: -0.15pt;">excessive demand on the existing physicians who do not participate.<span style="mso-spacerun: yes;">&nbsp; </span></span><span style="letter-spacing: -0.05pt;">Generally speaking, the patients who elect to participate in concierge practices are healthier and require less intensive care than </span><span style="letter-spacing: -0.1pt;">those cared for in other settings. All this without consideration of the approximately 45 million Americans who live without health care insurance, which only serves to compound the existing problems.<span style="mso-spacerun: yes;">&nbsp; </span></span>There "VIP" medical services with their superior amenities and <span style="letter-spacing: -0.2pt;">convenience can be purchased by those with sufficient wealth. However, </span><span style="letter-spacing: -0.1pt;">the question should not turn on the quality of health care which depends on the amount of money an individual can spend on it. Many would </span><span style="letter-spacing: 0.05pt;">regard good health as a right rather than a privilege.<span style="mso-spacerun: yes;">&nbsp; </span></span><span style="letter-spacing: -0.05pt;">The final ethical question is to consider the thought that an </span><span style="letter-spacing: -0.1pt;">individual might experience more or less morbidity or mortality based on how much money they could devote to medical care. Health care </span><span style="letter-spacing: -0.05pt;">should not be discretionary, as everyone should be entitled to the </span>quality without regard to financial status.</span></span></p>