‘Medical homes’ may provide the same convenience benefits of concierge medicine

By Miriam Laugesen | January 24, 2013 — Yesterday I posted on concierge medicine. One reason people choose these arrangements is faster access to their doctor. The US consistently under-performs in terms of access to same-day or next-day appointments, according to Commonwealth Fund international surveys that measure access across countries. If people can’t get an appointment, they go to the ER or put off necessary care altogether, so it’s important. However, (perhaps in a small part a response to the shame brought by international comparisons), there is a new emphasis on addressing timely access to appointments. One approach is the development of the ‘medical home’ model. Many aspects of the medical home model stress the kind of personalized attention and responsiveness to patients (through continuity of care and knowledge of the patient, and phone/email access) found in the concierge model, although I am definitely not saying they are the same! But I do think it’s interesting that there are alternatives to the concierge model aimed at improving the patient experience that also make sense in terms of improving health. It’s not perfect, but it’s a start.

In addition, once you get there, concierge medicine supposedly minimizes the time spent in the waiting room. That could also reflect the healthier patient population. But on average, across all kinds of practices, people actually only wait 21 minutes.

That doesn’t seem like long to me, but it may feel like a long time in actuality—does the perception of time get warped in the waiting room? Perhaps it’s like the studies quoted in Daniel Kahneman’s book ‘Thinking, Fast and Slow’ on how time is experienced differently. I hate to wait too, but within limits, it’s usually not enough time—I sometimes feel like I’m being yanked from reading something extremely engaging–right at the moment when they call my name. I’d like to say, “can’t I just finish this terrific article?”


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