The complexity and high costs of the U.S. health care system create significant challenges for many Americans. Even those with insurance often face substantial out-of-pocket expenses, leading some to seek more affordable options.
The current system benefits certain stakeholders, but it’s clear that a more sustainable and equitable solution is needed. In many cases, women and children with limited resources find navigating this system difficult. The shortage of primary care doctors is escalating and other disciplines in medical care are disappearing in many states.
Many primary care physicians are exhausted with paperwork involved with our current system of health care and a growing number are leaving traditional practices and opting for concierge medicine. According to one study, the U.S. Concierge Medicine Market was expected to grow by 10.4% between 2024 and 2030.
Concierge medicine is a model in which patients pay a membership fee for a more direct relationship with a primary care doctor, previously used to feel like a perk for the super wealthy.
But as fees have come down and people have gotten more frustrated with the state of traditional primary care, concierge services may not seem like such a pie-in-the-sky option. There’s less waiting, more access, longer visits and greater coordination of care. However, the fees can be high, and if you don’t have complex medical needs, it may not feel worth the expense.
Most primary care physicians desire to provide patient-centered medical care. Doctors want to provide care on the patients’ terms rather than deal with the barriers and constraints from insurance companies. In fact, the desire to provide patients with more attention has been considered the most essential factor for becoming a concierge physician.
Membership fees for concierge medicine vary widely. For one large concierge network with doctors in 44 states, the fee is typically between $1,800 and $2,200 per year — between $150 and $183 per month. Other practices can run much more. If you have a flexible spending or health savings account, you can use those toward your annual fee if it is a wellness benefit.
What are the advantages of concierge medicine? It is usually possible to get same-day or next-day appointments with your doctor and waiting times are minimal. In most cases you have access to your provider at all hours of the day and since the doctors have fewer patients, your doctor has more time to spend with you.
A concierge doctor who spends more time with you can focus on preventive care and potentially catch health issues early, and save you money in the long run. Advocates for concierge care feel patients are less anxious and more comfortable with their doctors during a visit and open up about their medical issues.
The disadvantages for most people is the cost. For people on a tight budget or those without substantial health care needs, concierge medicine could be very expensive without real benefits.
Besides the costs, the practical concerns are that concierge doctors comprise a small percentage of the medical field, thus your options for care could be limited. Primary care concierge medicine can handle your regular or perhaps chronic concerns; however, you will still pay for visits to hospital, emergency room, major surgeries and visits with specialists.
Concierge medicine could potentially lead to disproportionately wealthier people being able to pay for the scarce resource of physician time and pushing out people who have lower incomes and are sicker. Critics of the concierge medicine argue it threatens care for the poor and uninsured. Studies have shown that concierge practices see fewer African Americans, Hispanics and Medicaid/Medicare patients. Patients on Advantage plans may not be accepted because of doctors waiting to receive payment.
Patients who lose their doctors to the concierge system often give up on having an ongoing relationship with a primary care clinician. They may rely solely on a pharmacy-based clinic or urgent care center or even a hospital emergency department for primary care.
What can you do? Be vigilant, stay updated and talk to your health care provider.
Educate yourself on the changes in health care in your area. The National Institutes of Health is a great source of information.
Editor’s note: Women’s Watch is a cooperative writing effort of the local chapters of the American Association of University Women, the League of Women Voters and the National Organization for Women. This piece was authored by Diane Smith. Please send your comments to AzOpinions@iniusa.org. We are committed to publishing a wide variety of reader opinions, as long as they meet our Civility Guidelines.
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