By Carol M. Ostrom, Seattle Times health reporter
For years, doctors who started so-called 'concierge' medical practices, offering personalized care in return for fixed retainer fees, have existed in legal limbo.
State regulators have argued that the arrangement is essentially medical insurance and should be subject to the same rules. Doctors and patients insist it's the antithesis of insurance: middleman-free deals between patients and doctors.
State lawmakers are now on the verge of finally ending the confusion and opening the door to more such practices. But the controversy is far from over.
A bill poised to land on the governor's desk this week proclaims concierge medicine an 'innovative, affordable option,' and directs the state insurance commissioner to keep track of the plans but not regulate them.
'We want to liberate primary care to do what it's really meant to do,' Seattle physician Erika Bliss urged a state Senate committee in February.
But opponents, including some of the state's largest insurers, called the measure a 'wolf in sheep's clothing' that would send the best medicine to wealthier, healthier patients while making it even harder for average families to get decent primary care.
Too many outstanding clinicians of my acquaintance are becoming increasingly alienated from the conditions of practice demanded by the new economic models that increasingly dominate "organized" medicine. They see their priorities as caring for patients (and having the time to do so properly), not as maximizing patient throughput (and accompanying income streams). Most of them are committed to taking care of patients of modest means, not just the affluent. Is there an answer for them, and for patients who desire that sort of attention and caring medicine? Comments?
1 comment:
A pessimistic view of this spontaneous market uprising labelled "concierge care" may see it as 1) a perverse escape from the mass market by those with money and/or narcicism, or 2) a badly-timed political distraction from another opportunity in American's long struggle to get it right, or 3)the beginning of the next solution, a formally tiered system of health care.
On the other hand, what if we saw it as a response of free market agents to a mutual search for "the best in contemporary health service". What if we called it "patient-centered care"? And what if we used it as an ideal-type to model our new universal plan? And what if it resulted in making "best results" into the ordinary and every-day?
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