If you’re unfamiliar with concierge medicine, it’s a bit like a gym membership, insofar as patients pay an annual fee to their private physician. In return, the physician will provide more tailored healthcare services, and assume a smaller population of patients. In this regard, patients will have exclusive access to their private physician, with whom they may enjoy longer office visits, such as a 1 hour long annual check-up, as opposed to the standard, 15 minute visit.
In theory, this sounds like a great idea; for both physicians and patients, it seems to be a win-win. Physicians will have fewer patients, who will presumably be more complaint with their care insofar as they are more invested in it, whereas patients will receive better, more personalized health care. As a patient, one will enjoy exclusive access to one’s physician, provided that one is willing and able to pay for such privilege.
And thus, we begin to appreciate the problem with concierge medicine; it reinforces the fact that access to quality healthcare is contingent upon financial resources. Let us not delude ourselves into thinking that those with more money are inherently more deserving of better healthcare. In reality, the only way to improve the quality of healthcare across the population is to reduce the patient burdens of primary care physicians; the only way to do that is to create more medical schools and produce more physicians in the first place, and to increase the compensation of primary care physicians relative to their specialist peers.
Nevertheless, more affordable alternatives to concierge medicine are popping up in places like the Bay Area. And to be honest, this has given me some pause, leading me to be very much on the fence about concierge medicine. As a patient, I think it sounds fantastic, and I would be willing to pay a 3-figure nominal fee to enjoy the privilege of a reliable physician. But as a prospective physician who seeks to serve an under-served population, I am wary of what this means for efforts to improve equity in healthcare.