By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    An Expert’s Guide To Building and Improving Endurance
    June 30, 2022
    medical assistants
    What Do Medical Assistants Do On a Day to Day Basis?
    April 5, 2022
    superfoods to help with prostate health
    10 Healthy Foods That Can Help Protect Your Prostate
    August 29, 2022
    Latest News
    5 Steps to a Promising Career as a Healthcare Administrator
    August 3, 2025
    Why Custom Telemedicine Apps Outperform Off‑the‑Shelf Solutions
    July 20, 2025
    How Probate Planning Shapes the Future of Your Estate and Family Care
    July 17, 2025
    Beyond Nutrition: Everyday Foods That Support Whole-Body Health
    June 15, 2025
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    healthcare cost crisis
    What If the Health Care Cost Crisis Solves Itself?
    May 11, 2013
    Do You Need Life Insurance? What Does It Cover?
    December 23, 2022
    HIE metal plans
    The Four “Metal Plans” of Health Insurance Exchanges
    May 28, 2013
    Latest News
    How IT and Marketing Teams Can Collaborate to Protect Patient Trust
    July 17, 2025
    How Health Choices and Legal Actions Intersect After an Injury
    July 17, 2025
    How communities and healthcare providers can address slip and fall injuries with legal awareness
    July 17, 2025
    Let Your Lawyer Handle the Work Before You Pay Medical Costs
    July 6, 2025
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: Ethicist’s Take on Concierge Medicine is a Misdiagnosis
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Business > Ethicist’s Take on Concierge Medicine is a Misdiagnosis
Business

Ethicist’s Take on Concierge Medicine is a Misdiagnosis

Thomas Pane
Thomas Pane
Share
5 Min Read
SHARE

Arthur Caplan, a leading bioethicist at the University of Pennsylvania, published a Medscape video editorial on August 4th discussing the ethics of concierge medicine.  Titled “Concierge Practice: Unjust for Patients and Doctors Alike”, this three minute, thirty-

Arthur Caplan, a leading bioethicist at the University of Pennsylvania, published a Medscape video editorial on August 4th discussing the ethics of concierge medicine.  Titled “Concierge Practice: Unjust for Patients and Doctors Alike”, this three minute, thirty-eight second editorial presented Professor Caplan’s view that concierge medical practice is unjust.

I think the first two minutes of the presentation were fine.   Dr. Caplan outlined the reasons why approximately 6,000 U.S. primary care physicians adopted a concierge model.  For more background on concierge medicine, see a prior post here.  The remainder of the piece presented two arguments against concierge medicine, underlined below and followed with my own respectful disagreement.

Argument 1:  When doctors enter concierge medicine, they remove themselves from the general pool of  primary care providers, leaving more work for the doctors left behind.

More Read

Why Physicians Are Afraid of Social Media and Why They Shouldn’t Be
HIPAA Compliance Breaches Higher Than Ever: What Are You Doing About It?
Stem Cell Therapy FDA Approved for Wrinkles
HealthCamp Boston 2012: Brainstorming the Future of Health Care
MGMA 2011 Conference in Las Vegas

I don’t agree, for several reasons.  Doctors have an individual responsibility to their patients, but they do not have (as yet) a system-wide obligation to suffer because of the current business model of private-practice medicine.  Most of those problems are not due to doctors or even insurance companies.  They result from the gradual intrusion of top-down government control over healthcare, beginning in 1965.  This control has now progressed to the point where instead of addressing market failures, government behavior has caused them.  Leaving more work for other physicians is not a valid argument against concierge medicine.

That line is more appropriately applied to resident physicians who slack off during training, leaving more work for their trainee-colleagues.  (This is a cardinal offense in the world of residency).  If doctors are operating private businesses on government-mandated pricing systems, they have little choice but to make other adjustments to keep their businesses viable, since they cannot raise prices.  If a business cannot raise prices when needed, its options to keep itself viable are limited.  One can assume that if market forces were allowed to operate, the value of primary-care office visits would float based upon service, clinical skill, reputation, and management skill (controlling overhead).  I don’t know what a typical primary care office visit should cost, but neither do government price-setters.

Argument 2:  Patients may end up with less quality care, since they will be seeing more physician extenders.

I disagree with this as well.  In many primary care practices, physician extenders have been required to maintain viability even in non-concierge practices.  Furthermore, non-concierge hospital primary care groups with employed physicians already make liberal use of physician extenders.  The “trend to extend” has been driven by many other forces, the least of which is the growth of concierge medicine, itself just now becoming a blip on the national radar.  In some rural areas, unsupervised physician extender primary care practices are already a reality.  Discussing the proper role of physician extenders and whether or not there is a quality difference is itself a large and distinct topic.  Extenders are here to stay, and patients will have less control over whether they see an extender or a physician, especially as health reform plays out.

Concierge medicine may not be perfect, but it represents market forces attempting to assert themselves, now that the centrally-planned model (administered prices) has been strained to its natural breaking point.  We don’t have these sorts of arguments on the price differentiation common in all other service-industries, such as consulting, law, accounting, etc.  Yet in medicine, we seem to feel that price differentiation is somehow inappropriate.  Prof. Caplan does acknowledge longstanding concierge-like models of care, such as executive physicals and specialty clinics.

Virtually all industries have participants targeting low, middle and high market segments. Medicine is not that different, and promoting wide access to good-quality care for all who require it can be done without more top-down control of the system.  If anything, it is that control which has exacerbated the healthcare system’s problems.

Related articles
  • ‘Concierge medicine’ a controversial trend in Canada (ctv.ca)
  • John Geyman: The Decline Of Primary Care: The Silent Crisis Undermining U.S. Health Care (huffingtonpost.com)

TAGGED:concierge medicinehealthcare business
Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

technology in medical research
The Tools Helping Medical Researchers See the Full Picture
News Technology
August 3, 2025
5 Steps to a Promising Career as a Healthcare Administrator
5 Steps to a Promising Career as a Healthcare Administrator
Health
July 31, 2025
holistic dental
Holistic Dentist Services Are Natural and Safe
Dental health Specialties
July 28, 2025
botox certification
Help Improve People’s Skin Health Via Botox Certification
Skin Specialties
July 22, 2025

You Might also Like

Nominate a Young Health Care Leader For a $40,000 Prize

June 2, 2012
Hospital Administration

Things To Consider Before Becoming A Locum Tenens Hospitalist

June 21, 2021

How Medicare Spends Its Drug Dollars

June 28, 2011
psychiatric drug development
BusinessFinanceSpecialties

Few Psych Meds Coming Our Way

June 18, 2013
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?