My cardiologist friend recently learned that his personal primary care doctor turned his practice into a concierge model by affiliating with MDVIP. My friend wasn’t crazy about paying $1,500 a year to stay in the practice, but after a scary bout with pneumonia, he is now singing the praises of having an internist who cares for him like he is “the only patient on the planet.”
While my friend insists that he doesn’t have a moral issue with embracing the world of two-tiered medicine, he compared it to buying a high-priced BMW M6.
“What is more important to me, access to a doctor or a fancy car?” he asked.
I wondered if he felt like he had to justify it to me, or to himself.
Would the same justification be needed if he were telling me about paying more to send his child to a private school, taking a long-awaited European vacation with his wife or even going to a hair stylist versus a barber?
In a capitalistic society, what could be more reasonable than deciding to pay more to receive a higher level of service and access from the person you rely on most for your healthcare?
Like education, I believe that everyone in our country has a right to receive good healthcare regardless of ability to pay. But, if I have the means and decide that it is important to me to have a comprehensive two-hour physical, 24/7 access and other perks from my doctor, then I should be able to buy it.
P&G, the consumer goods and services conglomerate that bought MDVIP last year, is banking that many people will feel the same way. It considers healthcare a key segment in its portfolio of businesses and MDVIP is the hottest company they have in that sector. It currently has 450 physicians serving 160,000 patients.
Piedmont Healthcare employs five primary care physicians who are part of MDVIP. While this is a small fraction of the 140 primary care doctors that Piedmont employs, it provides an important option for consumers wanting to pay more to have a doctor who limits his practice to 600 patients, compared to the average of 2,000 in a typical physician practice.
Because of this math, a concern about concierge medicine is that it will worsen the primary care physician shortage in the United States. But I wonder if more of our best and brightest might pursue a career in primary care if there are more market-based compensation options. After all, while they are worthy options, not every lawyer wants to spend his career as a public defender and not every engineer wants to work for the Army Corps of Engineers.
“Are physicians public servants or independent entrepreneurs?” my friend the cardiologist asked.
Won’t we all be better off if we leave that choice up to them?