DR. C’S JOURNAL: THE RISE OF ‘CONCIERGE MEDICINE’

I am a physician. I believe that the modern medical care system is broken. It used to be that the patient selected the doctor because of her reputation, and the doctor was motivated for excellence. Now the doctor is apportioned by the insurance system, and the doctor is motivated to be “efficient” (to see more people in less time). 

Coupled with electronics surveillance of doctors, requirement for electronic medical records, the expansion of patients in a doctors practice to quadruple the number it used to be, plus increasingly technological surgery ( I consider such doctors as technicians more than physicians ), a system of payment that favors such surgery,

With the “disease” model of medicine still dominant over the “health” model, it is difficult for the doctor to take patient’s phone calls, inform patients of their laboratory results, counsel them in nutrition,  exercise, sleep, and other health benefits, or even see them the same day as their illness. Thus “go to the emergency room“ is the default advice.

The concierge doctor attempts to remedy some or or most of these deficiencies, which characterize the usual modern medical practice. Concierge medicine  is so different from regular medicine as to draw the interest of Congress in preventing such discriminatory behavior.

Of course, the concierge doctor charges a periodic fee to deliver these services; there in lies it’s “unfairness”. I have even heard of super concierge doctors who meet your injured child at the emergency room with the chief of orthopedics , or fly with you to the Sloan Kettering Institute if you need consultation there. They, of course, charge tens of thousands of dollars annually for such service.

We already have multiple tier medical systems in America. The original concierge Idea modeled the care delivered to professional athletes, who must stay healthy in order to play.

Of course, there are still good doctors out there if you look hard enough and are lucky. Some family practitioners and internists still manage to practice quality medicine. Otherwise, my advice is to find a concierge doctor you can afford.

–Dr. C

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