Concierge-model practices may deliver better care while cutting costs

LETTER — Posted June 7, 2004

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I have no interest in starting a concierge practice. However, I would like to point out that the concierge model might often save health care dollars, improve patient satisfaction, and improve the quality of care.

In my area if one calls their doctor, they often get an electronic answering machine that directs them to call 911 if there is an emergency. If the problem is not an emergency, they then get to push up to six more buttons, and are told to hang up and they may get called back later.

Take the case of the patient who does not understand the instructions for his new insulin therapy: Under the current model he would often become frustrated and end up in the emergency department.

Under the concierge model, he would get a real human, feel much better about his care, be more compliant, and save health care dollars presently and in the future.

If a patient calls late in the afternoon about a symptomatic UTI, under the current model, they are often directed to the emergency department in the area hospital. Under the concierge model, the patient would be treated in the physician's office or even over the phone!

I agree that patients are treated under either model but only a hospital administrator or a $30-million-a-year insurance company CEO could feel that the current model is better, cheaper, or more efficient than a concierge model.

After all, the concierge model is not much different than the way we used to treat patients. Maybe we, the members of the AMA, need to reconsider the benefits a concierge model of care would offer to society.

Peter W. Rufleth, MD, Hyannis, Mass.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2004/06/07/edlt0607.htm.

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