NCPA - National Center for Policy Analysis


January 19, 2010

Concierge medical practices take many forms and go by different names, such as direct practice physicians.  They all strive to make medical care more accessible and convenient to patients by rebundling and repricing medical services in ways that are not possible under third-party insurance.  The result is innovations that raise quality and improve patient care coordination, says Devon Herrick, a Senior Fellow with the National Center for Policy Analysis (NCPA). 

A few health insurers recognize the value of these services and reimburse enrollees for them, but concierge practices usually cater to cash-paying customers.  Thus, they may be especially useful to patients who have a consumer-driven health account -- such as a Health Savings Account (HSA), a Flexible Spending Account (FSA) or a Health Reimbursement Arrangement (HRA) -- and to the uninsured, explains Herrick. 

Many patients experience difficulty reaching a physician by telephone or e-mail, or after office hours.  Fewer than one-in-four doctors communicates with patients electronically.  A routine prescription or answer to a simple medical question usually requires an office visit.  The reason is simple: Most insurers generally do not reimburse physicians for phone or e-mail consultations. 

Patients perceive that this lack of communication results in lower quality care.  For instance, according to a survey reported in the New England Journal of Medicine: 

  • More than two-thirds of the public (72 percent) think "insufficient time spent by doctors with patients" is one cause of preventable medical errors.
  • Three-fourths (78 percent) think medical errors could be avoided if physicians spent more time with patients.  

Many patients have difficulty finding a physician, obtaining an appointment and taking time from work for a traditional office visit.  Often, the only way to reach a physician after hours is in a hospital emergency room -- which is both costly and time consuming, says Herrick.  

A study of medical access between 1997 and 2001 found that seeing a doctor has become increasingly difficult:

  • The proportion of people reporting problems seeing their primary care physician rose from less than one-quarter (23 percent) to one-third over the four-year period.
  • Nearly one-quarter reported problems taking time from work to see a physician. 

Source: Devon Herrick, "Concierge Medicine: Convenient and Affordable Care," National Center for Policy Analysis, Brief Analysis No. 687, January 19, 2010. 

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