Retainer Medicine Stats
I’d like to rudely insert myself back into the Retainer Medicine foray that Dr. Centor and Bad Medicine have kept up and offer a bit of… data.
There’s a good survey/article published from the JGIM: Physicians in Retainer (“Concierge”) Practices (also has a fantastic references section on the topic) which offers a bit of information on the practice size and demographics of retainer practices (for those who responded to the survey, obviously):
As you can see, retainer practices are likely to be MUCH smaller, and have wealthier, healthier patients.
And now two bits that certainly support retainer medicine that I hadn’t considered:
- SteveSC’s comment about a physician’s duty to his current patients , which I agree with, but doubt that all physicians would truly close their censuses.
-
Uwe Reinhardt (renowned Princeton economist and health policy wonk)’s piece in the BMJ
with this damning bit (the whole thing is only a page and worth the read):
I consider boutique medicine for the upper income classes a harmless, almost playful fringe phenomenon. It is practiced by a handful of physicians who, I believe, do hide behind the shield of “quality” to protect their income. Let them. Not much harm done. The boutique medicine implicit in the Medicaid program strikes me as far more harmful and, indeed, inherently fraudulent. It strikes me as fraud when federal and state legislators pay physicians and hospitals a pittance for hard work under the Medicaid program and then pretend to God and country that they have looked after the poor. After all, what is a state legislator really saying to a pediatrician when, through the legislator’s own insurance, he or she is willing to pay the physician $80 for a patient visit, all the while paying the physician only $20-$30 for the same visit accorded the child of a poor family? Economists believe that the relative prices buyers offer signal relative values. The state legislators’ relative valuation of the treatment of their own children and that of poor children is crystal clear.