TECHNOLOGY: How Ethical is your Concierge Medical System?

By Steve Nellon
June 24, 2013

For patients, the much-touted benefit of concierge medicine is that the doctor has more time and can provide them greater access. Email consultations, preventive tests and extensive exams are some of the additional services provided which otherwise are not covered by insurance. In the middle of all this, there are a lot of people questioning the credibility of this model. Infact many states are putting forth the question whether concierge medicine is not against the existing insurance laws. There are admonitions being sent out to the doctors that charging Medicare patients an ‘access fee’ is similar to double billing. In addition to this, it will also worsen the physician shortage system as there will be very few left to address the needs of non-concierge patients. Also, will this model be able to solve the healthcare issues at the national level is a big question mark. How many people will also be willing to pay an additional amount after paying the premium for health insurance ?

Medicare system, for whatever benefits it has to offer, is in financial trouble as it reduces payments to physicians, thus making patients covered under Medicare less desirable. The model is making the lives of physicians tougher not just financially but in an operational sense as well. Mounting paperwork and low rate of payment is making the whole system untenable. Thus for physicians the concierge model is not necessarily about less work. On the contrary, it makes it more satisfying for them as professionals and allows them to build a more profitable practice. Their income is based on contracts that they enter into with the patients and their satisfaction is derived from the amount of control that they have in running their medical setup. They are no more at the mercy of the insurance companies who otherwise pull the strings and decide the course of treatment in most cases. So overall they feel they are in more control of their destiny. The physicians who are actively advocating this new model are going to the extent of saying that its adoption will potentially solve the current problem of, which is expected to get worse in the future, shortage of Primary Care Physicians. The logic that they put across is that there has to be enough incentive in the field of medical science to draw bright and young people to take it up as a profession. They have to have a justification to make an investment in a career which looks promising.

Many are looking at Concierge Care as an effect of demand and supply. Physicians are considering this option only because they see a lot of willingness among patients to get the kind of access and services it offers. This model started about a decade ago and ended up being accessible only to the rich masses. However proponents of the model realized that for it to get a wider acceptance, variants had to be devised to include people who are not necessarily rich. There is a hybrid model which is being looked upon as well. In this, the physician continues to operate in the traditional way but shift a group of patients, who are willing to go ahead, to a concierge model and charge them an additional amount on a monthly basis to avail the additional benefits. They also have the prerogative to stop the payment if they are either unable to pay or don’t want the services. However critics of the hybrid model are not convinced if on a practical basis, physicians will actually be able to provide additional care and time to the upgraded patients when the number of patients mapped to them will not have gone down. In the meantime, there are reports of one concierge practice having gone bankrupt because of the physicians turned dissident and convinced a large number of patients to not renew their contract and instead pulled them along to another concern. Although the practice has sought legal help to resolve the issue, it kind of opens up possibilities of issues which practices adopting the new model are likely to face. Healthcare software development teams can help you build clinical and EHR/EMR software projects within allocated budgets and time schedules.

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Categories: Technology

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