'Concierge' Medical Care Unfair?

For Big Fee, Some MDs Give Patients More Time, But Critics Worry

(CBS)  "By making your life better, and taking fewer patients, it will make somebody else's life worse," asserts Dr. Richard Cooper of the Institute of Health and Economics at the University of Pennsylvania.

He observes that, though concierge medicine benefits individual patients, it leaves lower income people with fewer choices.

"If all the primary care doctors were to see half as many patients as they now see, so they can spend twice as much time, we'd essentially have half as many primary care doctors, and that wouldn't be enough for everybody," Cooper worries.

Wyner says: "I would love to practice this way for everybody. I'd love to do it for 2,500 patients. I just don't think it's possible."

Although concierge medicine is on the increase, Senay notes, it is still relegated to mostly urban areas. And, while experts on the healthcare industry disagree over whether it creates a multi-tiered system, it is one more example of a movement toward consumer-driven healthcare.

Some 300 doctors in the United States practice concierge medicine, Senay says, with an estimated 135,000 patients. So, though the number of such doctors is growing, it is still only practiced by a small number of physicians located mainly on the East and West Coasts.

As for insurance coverage, Senay reports it depends on the provider: Most insurance companies do cover the additional charges for extra procedures and tests. There are, however, some insurance companies that have dropped some concierge doctors from their networks due to contractual provisions. So, if someone is looking into this, they need to find out from that particular doctor what the initial fee covers, and what the insurance will cover.

If the doctor accepts Medicare, and about 76 percent of these practices do participate in Medicare, the membership fee must not result in additional charges for items or services that Medicare already reimburses, Senay adds.