One of my colleagues will start our new retainer practice. UAB plans exclusive clinic access, for a price
“The health care is the same, but they will get amenities,” said Dr. Douglas Tilt, who will start and head the Camellia Medical Group Practice. “There’s a market for it.”
The concept of boutique medicine, a trend that has been confined mostly to private practices in the Northeast and Northwest, has attracted criticism over medical favoritism. At the UAB Health System, officials said no state money will be spent on the clinic, while the service will make a profit for the system.
National health authorities have been debating the ethical and legal complications of providing concierge care to patients who are willing to pay a hefty price. There’s concern about creating a medical system that caters to a small group of elite patients while most others wait in line to deal with harried doctors and nurses.
The American Medical Association in June gave a tepid approval to boutique medicine but warned that it could not be promoted as better care.
Dr. John Goodson, an internist at Massachusetts General Hospital and associate professor at Harvard School of Medicine, expressed concern about an academic medical center such as UAB going into boutique medicine.
Tufts-New England Medical Center recently became the first U.S. academic medical center to announce that it will provide boutique services to wealthier patients.
“These are really country clubs,” said Goodson, an outspoken critic of boutique medicine. “I think it’s very discriminatory.”
But Tilt described boutique medicine as a movement back to the old-fashioned, close relationship between doctors and patients. It is being fueled by widespread frustration over the assembly line quality of modern medicine.
For instance, Tilt, a doctor of internal medicine, said he normally would have up to 3,000 patients and would see about 25 a day.
His boutique practice will be limited to about 300 patients, and he expects to see five or six a day. For patients, that will mean short waits and long visits with the doctor.
“There’s not going to be a cadre of five or six people between you and the doctor,” Tilt said.
For Tilt, it will mean getting back to the basics of medicine – really knowing patients and their personal needs.
Sounds a lot like Marcus Welby. The “debate” is always interesting to me. We live in a capitalistic society. If you want to spend more on something, you often get more value. This is true for legal advice (perhaps), automobiles, houses, clothes, and the list goes on.
If a patient wants to spend money to ease access to care, to have the physician’s cell phone number, to receive house calls, why is that immoral? If one states that retainer medicine is immoral, then it follows that capitalism is immoral. Since I believe that capitalism is the fairest system (although one could certainly point out some flaws), then retainer medicine is fair.
Our hospital and clinic do much indigent care. We care for “all comers”. We want the clientele who would want and pay for retainer medicine. They already support the institution and I suspect that their involvement will enhance our charitable receipts.
But, what we are really talking about is how miserable our current system of care has become. Money has not caused this movement, the practice climate has.
If any reader would like to write a dissenting view, given coherence and logic, I will gladly publish that view as a rant (with the proviso that as always I get a rebuttal).
