CONCIERGE MEDICINE: PAYING THE PRICE FOR QUALITY OF CARE
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BY LISA BRODY
ur lives are ruled by sets of transactions and the choices we make. When we want something to put on our feet, we can shop at Payless for passable black shoes. Or we can head on over to Neiman Marcus for a pair of Prada pumps or black loafers. In need of a cup of joe? There are lots of choices. You can make a quick cup of instant, or a steaming pot of your favorite brew. New single cup coffee brewers, such as Keurigs, are now part of the options. And then there are coffee shop selections, from Starbucks to Biggby to Tim Horton’s and Dunkin’ Donuts. In today’s world, health care is also ruled by sets of transactions, from eligibility to reimbursement of coverage. It has become a system often ruled by financial decisions, rather than medical considerations. Some physicians and patients are choosing to seize their health care back from insurers and the government through a series of independent transactions with doctors of their own choosing who offer personalized care. It’s called concierge medicine. Concierge medicine is a relationship between a patient and a primary care physician where the patient pays the doctor an annual fee or retainer in exchange for enhanced personal medical care, including 24/7 access to the doctor via cell phone and e-mail, no waiting for visits, electronic medical records, and even visits to the patient’s home or office. While patients who are electing this kind of care rave about the advantages, detractors warn about the dangers of a two-tiered health care system developing in the United States. Once upon a time, health care consisted of visiting your family doctor for everything from pediatrics to geriatrics, and just about everything in between. He delivered your baby, saw it through well visits and the croup, watched your kids grow up, and eased you through middle age and into your waning years. Like Marcus Welby MD, he (because there were few female physicians) was available when you and your family