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posted: 10/1/2012 6:00 AM

Concierge medicine has its pros and cons

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Would you pay an additional $1,000 or $2,000 per year to have unlimited access to your doctor, office visits that last over an hour and an individualized medical approach rather than simply treating symptoms as needed? If you would, you have entered the new world order of concierge medicine.

Concierge medicine is a business model where a limited number of patients pay a monthly or annual fee to belong to a medical practice. For that fee, a physician provides intensely personal medical care and services far beyond that of the normal medical practice (email, texting, phone access). Often included are same-day office visits that can last up to two hours. This gives the physician enough time to really get to know their patients on a very personal level and formulate more complete medical plans than is possible in a normal medical practice. This type of personal attention is possible because a concierge physician rarely has more than 100 patients. The average primary medical practice has more than 2,000 patients.

Despite the goal of laudable goal preventing illness for all patients, the traditional medical model really focuses on treating acute medical problems. Physicians see 20 to 30 patients per day and only spend about 10 minutes per patient. For the most part, this medical model works -- barely. However, it is impossible for any physician to be able to provide aia level of personalized medical care that all patients want.

The current medical model will fail -- not may fail -- will fail. Right now, we need an additional 62,000 more primary care physicians just to treat the current patient load. In several months, as a result of the new health legislation, an estimated 30 million deserving patients may swell the ranks. This means that patients will rarely see their primary care physician and most of their medical care will be from nurses, nurse practitioners and physician assistants. In many medical practices, it is happening already. No matter how qualified, they do not have the same level of training and experience as a physician.

Physicians choose the concierge model of practice for many reasons. They want to do more than simply plug the "holes" in their patient's health. They want their patients to have a lifetime of health and vitality. Also, physicians, on average, work almost 60 hours per week not including the responsibilities of running a complex business and keeping up with the newest advances in medicine. Continue that schedule for 40 or so years and that does not leave too much time for family and personal time. Physician burnout is quite high. Changing to the concierge medicine model can significantly reduce physician burnout.

The concierge medicine model means that many patients must find a new physician (increasingly difficult). Some claim that this type of medicine creates ethical problems and violates the Hippocratic oath by creating a new class system in medicine (true). In contrast, concierge physicians are often considered to be excellent and some patients believe that $150 per month is good value for unfettered access to personalized medical care.

Patrick B. Massey, M.D., Ph.D is medical director for complementary and alternative medicine for the Alexian Brothers Health System. His website is www.alt-med.org.

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