Concierge Medicine Today

LEGAL: Concierge Medicine – A New Frontier

Concierge Medicine – A New Frontier

[author – Philip Nimoityn, M.D.]

Concierge medicine is a relatively new, but rapidly growing and evolving supplement to traditional medical care. A concierge physician charges an annual retainer fee that provides the patient with additional services that are not covered by insurance, but which enhance accessibility, the amount of time spent with the physician, and hopefully a much more personalized and satisfying relationship. Enhanced accessibility usually includes 24/7 direct cellphone access to the physician, same day appointments with efforts made to minimize waiting, and meetings to develop a plan for preventive care. Individuals and families that have concierge physicians report significantly more satisfaction with their medical care and the state of their health.

Most of the early concierge physicians were primary care physicians, either internal medicine or family medicine physicians, but now specialists such as cardiologists and urologists have entered the field. Some concierge physicians limit their practice to only concierge patients, some act as the concierge physician in a larger practice with their non-concierge patients transferred to the care of other physicians in their practice, and some physicians maintain a hybrid model where they see both concierge and non-concierge patients. Many concierge practices only provide outpatient care, but some do continue to provide inpatient care as well.

Concierge practices potentially raise many legal issues, including for example, double billing and patient abandonment. Therefore, proper legal counsel is imperative when establishing and maintaining a concierge practice to ensure that it is compliant with federal and state laws and regulations, Medicare rules and regulations, and insurance contracts.  As the healthcare system continues its rapid evolution toward more restrictive policies, limited services, and decreased physician accessibility, the demand for concierge medicine is very likely to rapidly accelerate in the next few years.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.


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