POINT: Is It Time for Pulmonary Concierge Practices? Yes

Response

“…We thank Drs Alrajab and Uysal for their interest in our commentary. 1 We are pleased that their two-tiered recommendation for solving the current health-care crisis includes provision of basic coverage for all, suggesting that they agree that the solution should not result in two standards of care created by ability to pay. However, "encouragement" of community and charity clinics, rather than incentivization, is insufficient to guarantee access to the second tier.…”

Concierge Medicine Is Here and Growing!!

“…To maintain income, many primary care physicians are seeing more patients and spending less time with them. 2,3 This has led to the "burn out" of some primary care physicians. 4 The primary advantage of a concierge practice is that the panel of patients is smaller, ranging from 400 to 600, 2 compared with a panel size of 2000 to 3000 in a typical primary care practice.…”

“…2,3 This has led to the "burn out" of some primary care physicians. 4 The primary advantage of a concierge practice is that the panel of patients is smaller, ranging from 400 to 600, 2 compared with a panel size of 2000 to 3000 in a typical primary care practice. 5 As a result of the smaller panel size, a concierge physician sees 6 to 8 patients per day compared with 20 to 24 patients for the typical primary care physician.…”

“…5 By 2014, the number had increased to 12,000. 2 The increase in concierge practices is due in part to the emergence of organizations that recruit concierge physicians and manage concierge practices. One of the largest, MDVIP, was founded in 2000 and was bought by Proctor & Gamble in 2009.…”

“…6 This could lead to a 2-tier health care system: healthy wealthy patients versus chronically ill poor patients. 2,3,5,6 However, most concierge physicians also care for charity patients. 6 A second criticism relates to when a primary care practice is downsized to a concierge practice.…”