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.
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