New York Times Examines Issues Surrounding Concierge Practices
The New York Times on Sunday examined "concierge practices," a "small but growing field" in which "doctors are shrinking their practices and asking patients to subsidize their decisions." As many as 250 physicians nationwide have concierge practices, under which patients sign contracts with physicians and agree to pay an annual fee of between $1,500 and $20,000 in exchange for extra services, such as longer appointments, shorter waiting times and the ability to call directly. Michael Blau, an attorney for McDermott Will & Emery and co-author of "Developing and Managing Physician Networks," said that many physicians have moved to concierge practices to help improve quality of care. However, some concierge practices "are facing regulatory hurdles and skepticism," the Times reports. Health insurers have reviewed the contracts in response to complaints about charges for services that patients thought were covered. According to health care experts, patients who sign contracts should "find out what the annual fee covers, what the contractual obligations are and what is covered by insurance," the Times reports.
Criticism
Barry Schwartz, vice president of network management for Blue Cross and Blue Shield of Florida, said, "You're not paying for better care. You're paying for better service." David Smith, a professor of health care management at Temple University, said that concierge practices are "totally unregulated with no oversight," adding, "You're putting up a fairly large sum of money" without "any assurance you are going to get your money's worth." According to Thomas Mayo, an associate professor of law at Southern Methodist University who writes about legal and ethical issues in medicine, concierge practices lead to "an explicitly tiered medical system based on ability to pay" (Zipkin, New York Times, 7/31).
