Concierge Medicine in Healthcare Delivery System Assessment Answer

Identified Issue

A type of healthcare delivery called concierge medicine has recently attracted debate and attention. In this strategy, patients pay a primary care doctor or other healthcare practitioner a membership fee or retainer for privileged access to customised care (Baum et al., 2023). I chose this subject because concierge medicine is a massive change in healthcare, with both possible advantages and drawbacks. It poses significant issues regarding primary care's future, equity in healthcare, and access to care. The ongoing development of concierge treatment also has wider implications for debates over insurance and healthcare reform. It opposes the conventional primary care approach, which frequently depends on fee-for-service compensation (Nemzer & Neymotin, 2020).

The industry may be pushed into alternate payment structures and a more thorough assessment of how healthcare is provided and paid for if concierge treatment continues to gain popularity (Leive et al., 2023). Given that this model is still developing and has the potential to impact the healthcare system, it is critical to comprehend and explore its consequences. The following paper aims to examine this matter and throw insight into the more considerable discussion concerning insurance and healthcare reform, mainly the function of primary care in the contemporary healthcare environment.

Pros and Cons

The promise and difficulties of concierge medicine, a healthcare approach that has attracted prominence recently, have spurred intense discussion among healthcare professionals and the general public. This strategy has several substantial benefits intended to promote patient satisfaction and general health outcomes, including improved access, personalised treatment, prolonged appointments, and an emphasis on preventative health services.

Concierge medicine's dedication to improved access is one of its most attractive characteristics. Patients who follow this model frequently have convenient same-day or next-day appointments and 24/7 access to their doctor. This quick and straightforward access can benefit people looking to build a solid doctor-patient connection or patients with chronic diseases who may need immediate care (Gavirneni & Kulkarni, 2018). According to a study by Serna (2019), patients in concierge practices expressed more satisfaction with appointment scheduling. This finding suggests that the long-standing problem of appointment wait times, a common cause of patient annoyance in conventional healthcare settings, is efficiently addressed by this model.

Another element of concierge medicine is individualised care. In this arrangement, doctors often have smaller patient panels, allowing them to spend more time with each patient. Since doctors may learn more about each patient's particular health needs, objectives, and preferences, they can spend more time with each patient, fostering a stronger doctor-patient relationship reportedly enables a more patient-centred approach, improving patient satisfaction and healthcare outcomes (Serna, 2019). This individualised treatment model contrasts with the hurried, assembly-line method sometimes used in traditional healthcare when doctors must see a lot of patients in a short time.

Prolonged office visits, a defining characteristic of concierge medicine, enhance the comprehensiveness of care. Every area of a patient's health is noticed because of these extended consultation times, which encourage more thorough discussions and examinations. This comprehensive strategy might result in earlier diagnosis, more accurate treatment, and improved health results (Breen, 2018). A study by Martin et al. (2022) found that spending more time with patients in concierge clinics enables the identification of many more health concerns, improving overall treatment.

Another benefit of concierge offices is their emphasis on preventive healthcare. To keep patients healthy and prevent the need for expensive procedures down the road, these clinics prioritise wellness initiatives and preventative measures (Serna, 2019). According to research by Marx & Kahn (2021), concierge medicine's emphasis on preventive treatment reduces hospitalisations and healthcare spending, which benefits patients and the healthcare system.

Concierge medicine does, however, come with some issues and difficulties apart from these advantages. The idea of exclusivity is one of the critical problems. The membership costs needed to access this model may restrict its appeal to a patient population with higher income levels, thus worsening healthcare disparities (Breen, 2018). This has sparked ethical debate over whether healthcare should be provided according to a person's capacity to pay for preferred access. According to a study by Charrow et al. (2021), the concierge approach may unintentionally worsen healthcare disparities by favouring those who can afford it.

Concierge medicine may also make the primary care crisis worse in some locations. The accessibility of primary care services for non-members may be reduced by restricting the number of patients a concierge physician sees, making it more difficult for some people to get primary healthcare (Frankel & Bourgeois, 2018). This was mentioned in a research study by Gavirneni & Kulkarni (2018), highlighting concern about how the primary care shortage in areas with many concierge services has affected healthcare in the US.

Another critical issue is if concierge services work with health insurance. Many of these clinics decline health insurance for standard care, so consumers must still have insurance for other medical charges, raising costs. This financial dichotomy raises concerns about whether customised medicine is accessible to the typical patient (Vogenberg & Santilli, 2018). Research by Selladurai et al. (2020) noted that the pricing of concierge medicine can cause problems for healthcare affordability.

The concierge medicine paradigm has also been the subject of ethical debate. Critics claim that because it can give priority to those who can afford to pay more for exclusive access, it undermines the conventional doctor-patient relationship. The conflict between the ideals of egalitarian healthcare access and the need for individualised, prompt care is highlighted by this ethical problem (Lemley, 2022). A survey on concierge medicine's ethical issues emphasised the necessity for a well-rounded strategy that considers the person's preferences and the broader societal implications.

The concierge concept is also raising concerns about physician burnout. Concierge doctors might be under less pressure to see as many patients, but there might be more significant standards for the calibre of their services. Physicians may experience burnout due to the extra time and care provided to each patient, which can be mentally and emotionally taxing (Patel et al., 2018). According to a study by Lloyd & McAchran (2022), concierge doctors frequently express more significant levels of professional satisfaction and emotional tiredness, highlighting the intricate nature of the physician experience under this approach.

Position on this issue and how I arrived at it

A multifaceted method involving research, analysis, ethical reflection, and value-based reflection has gone into helping me, as a student, create a position on the concierge medicine debate. First and foremost, my understanding is the result of my investigation. I looked into articles, academic papers, and professional perspectives to fully understand what concierge medicine implies. I discovered several of its substantial benefits, such as improved access, customised care, prolonged office visits, and an emphasis on preventative health services.

However, it was crucial to understand the issues and debates surrounding concierge medicine. Due to this model's exclusivity and the possibility that its membership costs catered to a more affluent audience, ethical concerns regarding equitable access to healthcare were raised. I was also concerned about how the primary care deficit would worsen and how much it might cost patients. I was aware of the need to consider how concierge medicine fits with my values and moral standards, such as my conviction that access to healthcare is a fundamental human right.

My ethical considerations further impacted my opinions. I questioned the morality of giving those who can afford it priority access while potentially marginalising others who cannot. It became clear that there was an ethical problem, and I found myself striving to strike a balance between these beliefs. It was crucial to comprehend concierge medicine in the larger framework of the healthcare system. I tried to understand how this paradigm related to the current healthcare reform, insurance systems, and the changing primary care role. I saw the more comprehensive picture and appreciated the potential impacts that concierge medicine could have on the healthcare system by seeing how intertwined these issues are.

Another essential aspect was participating in seminars, debates, and conversations with teachers and fellow students. Through sharing my views, engaging with opposing points of view, and learning from many viewpoints, these exchanges helped me build a broader perspective. Through these discussions, I clarified my stance and understood the intricacy of the problem. Lastly, I have learned how crucial it is to keep an open mind when researching new things. My position is not static and must alter as new information and adjustments to the healthcare environment become available.

Conclusion

Finally, concierge medicine offers an attractive yet intricate healthcare approach with advantages and disadvantages. For enhancing patient outcomes, improved access, personalised care, and preventive health services offer considerable potential. But legitimate worries about exclusivity, a lack of primary care providers, and moral problems over fair access exist. I take a cautiously optimistic stance. Although I recognise the possibilities of concierge medicine, it must exist alongside traditional primary care to achieve healthcare equity. It's crucial to balance individualised care and readily available, equitable healthcare. To navigate the constantly changing field of concierge medicine and its effects on the more extensive healthcare system, more investigation and open discussion are essential.

References

Baum, N., Kahn, M. J., & Daigrepont, J. (2023). Concierge Medicine. In The Business of Building and Managing a Healthcare Practice: Going Beyond the Basics (pp. 201-203). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-031-37623-8_30

Breen, J. O. (2018). Direct Primary Care and Concierge Practice. Chronic Illness Care: Principles and Practice , 391-400. https://doi.org/10.1007/978-3-319-71812-5_33

Charrow, A., Kwak, R., & Nambudiri, V. E. (2021). Dermatoethics: The ethics of concierge medicine. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology , 341-347. https://doi.org/10.1007/978-3-030-56861-0_33

Frankel, S. A., & Bourgeois, J. A. (2018). Primary care practice: The structures and methods associated with community-based primary practice. Integrated Care for Complex Patients: A Narrative Medicine Approach , 29-46. https://doi.org/10.1007/978-3-319-61214-0_5

Gavirneni, S., & Kulkarni, V. G. (2018). Concierge medicine. Handbook of Healthcare Analytics: Theoretical Minimum for Conducting 21st Century Research on Healthcare Operations , 287-318. https://books.google.co.in/books

Leive, A., David, G., & Candon, M. (2023). On resource allocation in health care: The case of concierge medicine. Journal of Health Economics , 90 , 102776. https://doi.org/10.1016/j.jhealeco.2023.102776

Lemley, D. E. (2022). “Too Conscientious”: Marketplace Realities Confront Medical Professionalism. In Too Conscientious: The Evolution of Ethical Challenges to Professionalism in the American Medical Marketplace (pp. 1-12). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-030-96859-5_1

Lloyd, G. L., & McAchran, S. E. (2022). Burnout, Happiness and Work-Life Harmony. In Navigating Organized Urology: A Practical Guide (pp. 171-182). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-031-05540-9_17

Martin, J. L., Lee, Y. M., Corbin, L. W., Colson, R., & Aquilante, C. L. (2022). Patients’ perspectives of a pharmacist-provided clinical pharmacogenomics service. Pharmacogenomics, 23 (8), 463-474. https://doi.org/10.2217/pgs-2022-0013

Marx, R., & Kahn, J. G. (2021). A narrative review of slow medicine outcomes. The Journal of the American Board of Family Medicine , 34 (6), 1249-1264. https://doi.org/10.3122/jabfm.2021.06.210137

Nemzer, L. R., & Neymotin, F. (2020). Concierge care and patient reviews. Health Economics , 29 (8), 913-922. https://doi.org/10.1002/hec.4028

Patel, R. S., Bachu, R., Adikey, A., Malik, M., & Shah, M. (2018). Factors Related to Physician Burnout and Its Consequences: A Review. Behavioral Sciences , 8 (11). https://doi.org/10.3390/bs8110098

Selladurai, R., Selladurai, R. I., & VandeWerken, G. (2020). Exploring innovative, alternative healthcare models in the US. In Evaluating Challenges and Opportunities for Healthcare Reform (pp. 21-42). IGI Global. https://doi.org/10.4018/978-1-7998-2949-2.ch002

Serna, D. C. (2019). Lifestyle medicine in a concierge practice: My journey. American Journal of Lifestyle Medicine , 13 (4), 367-370. https://doi.org/10.1177/1559827618821865

Vogenberg, F. R., & Santilli, J. (2018). Healthcare trends for 2018. American Health & Drug Benefits , 11 (1), 48-54.

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