America's concierge medicine boom

Medical history

Would you pay a doctor a monthly membership fee or retainer to have access to them anytime? This direct pay for service model of medicine, dubbed concierge medicine, is a growing niche in U.S. health care where proponents praise the more personal doctor-patient relationships.

Critics worry it sets up a two-tier class health care system or displaces patients.

BusinessWeek recently wrote about the growing trend:

There are 4,400 concierge doctors in the U.S., 30 percent more than there were last year, according to the American Academy of Private Physicians, their professional association. "This is all doctors want to talk about," says Jeff Goldsmith, a health-care industry analyst and trend spotter. "'I want to go off the grid. I'm done billing Blue Cross. I can't deal with this anymore. It's destroying my life and my relationship with my patients.'"

Some health policymakers are encouraged by this trend. They think an increase of direct-pay doctors--especially affordable ones--could lead to better health care in the U.S., which has the highest costs and some of the worst outcomes of any wealthy nation. "I think it's great," says Kevin Schulman, a professor of medicine and business administration at Duke University. "We're rediscovering that if we just ask people to pay for services, we could provide them with better value. Primary care is affordable."

Mark Pauly, professor of health care management at Wharton School, will join The Daily Circuit Wednesday to look at concierge medicine.

Dr. Doug Nunamaker, co-founder of AtlasMD, will also join the discussion. AtlasMD is a direct-pay doctor model, which requires patients to pay $50 a month to get unlimited visits and easy ways to contact their doctor directly by phone or email.

Some of the questions we will explore: What is involved in this model of care? Why do doctors choose to transition to it and what are the implications if this practice grows?


ER concierge services at hospitals boost bottom lines (Bloomberg)

Concierge medicine: Greater access for a fee (PBS NewsHour)

American Academy of Private Physicians

What to consider before switching to concierge medicine (American Medical News)