Concierge practice article was too negative about a positive trend

LETTER — Posted Aug. 1, 2005

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Regarding "Cooling on concierge: Selling the service not so easy" (Article, June 6): I was disappointed to read such a pessimistic spin about retainer-based medicine when the actual cases cited in the article were success stories. If the worst that can be said about this new model is that it is growing slower than expected, then perhaps a warmer forecast is indicated.

There are certainly obstacles to success. Patients will eventually understand that using insurance for routine care makes as little sense as having home insurance cover periodic painting and lawn-mowing.

As health care savings accounts become more popular and remove the tax benefits of obtaining health care through a third party, patients and doctors will recreate the direct therapeutic and financial relationships they've wanted all along. Patients will figure out how much they want to pay, and doctors will practice the way they've been trained.

Physicians will eventually understand that the marketplace rewards quality and risk-taking, and that excellent medical training no longer ensures professional success. We have forsaken the business aspects of our profession, yielding to third-party payers and to government. We are learning now that our delinquency has harmed our patients and limited our options. The "concierge challenges" you list are the challenges any new small business faces.

I began enrolling patients in my retainer-based practice two months ago. I haven't cooled yet! Check in with me in a few years.

Albert Fuchs, MD, Beverly Hills, Calif.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2005/08/01/edlt0801.htm.

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