In their paper on consumer-directed health care and the courts (May/Jun 07), Peter Jacob-son and Michael Tunick explore questions about litigation and the legal standard of care that arise from the existence of health savings accounts and the care choices they present to patients. The existence of concierge medicine practices raises similar questions. Should differing legal standards of care apply to physicians providing concierge medical services (such as round-the-clock access to the patient’s personal physician, lengthy appointments, and unlimited medical procedures) than those that apply to physicians practicing “standard” medicine (with all of the constraints on physician time, access, and procedures inherent in today’s standard medical practices)?
One can envision a scenario where a concierge physician is able to diagnose and treat a serious medical condition because she spent additional time with the patient or saw the patient outside of regular office hours, in contrast to a situation where diagnosis and treatment are delayed because the physician was engaged in standard medical practice, would not see the patient outside of regular office hours, or was unable to spend the time needed with the patient to diagnose the condition. The issue is especially compelling for physicians who engage in both concierge and standard practices simultaneously.
Will this lead to the rise of a “gold” legal standard of care to accompany the alleged gold standard of practice evidenced by concierge medicine and a “regular” legal standard of care for everybody else? It seems only fair that physicians engaged in a gold standard of practice be held to a higher standard of care.