Can Concierge Medicine Help the Poor?

When I look at the word “concierge,” I think about luxury apartment complexes / homes, upscale hotels, fancy restaurants, mega yachts, and private jets. Our culture almost exclusively reserves this word for the wealthier portion of the population — or should I say, the wealthiest portion, or the so-called 1%. Now, even the field of medicine, something that has been built to deliver indiscriminate care, has its own concierge version.

Wikipedia defines concierge medicine as,

“the relationship between a patient and a primary care physician, in which the patient pays an annual fee or retainer, while the physician provides enhanced care in exchange.”

In other words, patients pay an annual premium out-of-pocket, and get to see their physicians any time they like. By all means, the concept sounds like something that promotes a two-tiered healthcare system favoring the wealthy, limits the number of physicians available for the less advantaged socioeconomic groups, and burdens the middle and lower class with an even higher cost of healthcare insurance. It just seems like another privilege of the rich, but is it really?

Before jumping to any conclusion, let’s evaluate concierge medicine from the perspective of primary care practitioners. To be honest, primary care is not the most lucrative specialty in medicine. The idea of concierge model certainly would be very appealing to those PCPs that are drooling over their plastic surgeon friend’s fine automobile, and the amount of time they get to drive it. (Sorry for the mental image, but you know what I meant lol.) Not to mention that, anecdotally, many primary care physicians are very frustrated that they don’t get to spend enough time with their patients, either to obtain a more detailed past medical history, or to establish that deep patient-physician relationship. Nonetheless, by allowing the practitioners to work more flexible hours with much better pay, concierge medicine could easily resolve these problems.

So the point of concierge medicine is to privilege the rich and free primary care practitioners from long hours and terrible pay? Well, there’s more to it. First of all, with the small number of patients the practitioner has to see, they are now able to spend much more time with each patient. This means much better communication, and more established patient-physician relationship. More importantly, no one likes to work like a machine. The personal contact also greatly improves job satisfaction for the physicians. The patient of Dr. Steven Knope, a board-certified internist and sports medicine expert who started his concierge practices in late 2000, once said,

“Dr. Knope spends time with us, as much time as we need. We certainly receive much better care and service.”

What’s more, the more flexible hours make it possible for physicians like Dr. Knope to take pro-bono cases in their free time, which may benefit the less advantaged socioeconomic class, and ultimately contribute to the reduction of the ever-widening gap between the wealthy and the poor.

That said, according to the estimates of previous research, only about 800 to 5,000 physicians are practicing concierge medicine in the United States, while the Association of American Medical Colleges has predicted a shortage of as many as 45,000 primary care practitioners by 2020. Although it might sounds like a very capitalistic idea, I do think concierge medicine could help reduce physician shortage, improve work satisfaction of the less desirable medical specialties, and ultimately benefit the society as a whole.