Concierge Medicine Movement Enhances Consumer Choice

Published March 1, 2009

Dr. Marcy Zwelling has built her medical practice around what she views as a sacred relationship: that of patient and physician.

Zwelling runs a new style of medical practice known as a “concierge” practice. She began it in July 2004 after deciding to “speak out against the broken health care system.”

Focus on the Relationship

Concierge medicine is fairly new, according to Greg Scandlen, director of Consumers for Health Care Choices at The Heartland Institute. “It has only been around for six to eight years,” he said. “It started in Seattle, Washington with sports medicine doctors providing this kind of service to professional athletes with sports-related injuries.”

Now, Scandlen said, “most concierge physicians are in the primary care field.”

Zwelling favors the concierge approach because of its focus on the relationship between patient and physician. “The patient needs to be at the center of the decision-making,” she said.

“The quality of health care suffers in a system that transforms patients into numbers and the doctor’s office into a production line where HMOs and Medicare make all the rules,” Zwelling said.

A Benefit for Consumers

“Currently, if you go to see a doctor, you are part of a huge caseload of 6,000 to 8,000 patients,” said Scandlen. “Doctors are spending six to seven minutes with a patient. That is simply not enough time, in my opinion. They look at the problem and write a prescription, or tell you what to do.

“As a result, patients feel like they are being shortchanged,” Scandlen said.

Doctors in concierge medicine practices can cut their caseloads down to the hundreds. Patients pay an annual retainer, in monthly increments of $75 to $150, for 24-hour access to their physician. With the smaller caseloads, doctors know their patients extremely well and are able to act as intermediaries for their patients in case of any hospital visits, Scandlen explained.

“This,” Scandlen said, “is the consumer benefit of concierge medicine. You need someone to be your agent, to have an advocate, and with concierge doctors, they are able to provide that.”

A Matter of Choice

“This model of medicine will save health care,” said Zwelling, not only because of the cost savings but also thanks to “the core tenets of concierge medicine: the sanctity of professionalism, the patient-physician relationship, and the assurance that all medical decisions are in the hands of the patient and physician.”

The distinction between concierge medicine and institutionalized medicine, the current doctor-insurer-patient system, Zwelling said, is choice.

“Choice doesn’t work in institutionalized medicine, because patients are bound to certain hospitals by their insurance company or by their need for certain medical equipment.” Zwelling said.

“People choose which hairdresser they go to,” said Zwelling. In medicine, she continued, it’s even more important “to have those choices so the patient feels like their life is [at] their own discretion.”

Elisha Maldonado ([email protected]) writes from California.