Critics of concierge medicine argue it's worsening physician shortages and expanding inequity

Primary care doctors are converting into membership-based concierge practices

Subscription-based practices sometimes don't accept insurance and they also require annual membership fees which can add up to thousands of dollars per year. In return, patients are promised more personalized care and round-the-clock access to medical providers. As doctors transition to concierge care, this retainer-based medicine model is forcing people to choose between searching for new primary care providers or paying hefty fees.

Doctors report wanting more time to plan, provide care for patients

Many physicians experience aspects of burnout, and concierge medicine provides a slower, more relational approach to medicine, including consistent follow-up care for a smaller pool of patients. A concierge medicine clinician may talk with each patient frequently, perhaps every few weeks, instead of just once a year.

By 2036, the US may face tens of thousands of primary care physician shortages

That's the estimate of the Association of American Medical Colleges, which contends that whenever physicians switch to concierge medical practices it exacerbates this projected shortage since each of those clinicians will see fewer patients and those patients must be able to afford that pricey care.

Roughly 45% of clinicians in 2023 reported at least one symptom of burnout

With that kind of statistic as a backdrop, proponents of concierge medicine practices argue that concierge services could help keep doctors in medicine and thus help to address physician shortages.

Concierge care may account for more than 10% of primary care physicians

That's the rough estimate from Zirui Song, a Harvard Medical School professor who focuses on health care policy and studies the growth of concierge medicine. He and other researchers found that between 2018 and 2023 the number of concierge and direct primary care practices (concierge care without accepting insurance) grew by 83% and the number of clinicians in those practices increased by 78%.

Concierge medicine practices typically have hundreds of patients, instead of thousands

A clinician describes how he's "one call away" from his patients in the concierge medicine system. His patients pay about $150 per month to be members in his practice on top of normal care visit costs. Doctors like him may only have hundreds of patients in their practice—instead of thousands.

Concierge medicine offerings are growing on college campuses, catering to students

Parents are interested in concierge and direct primary care services for their kids, including offerings with dorm visits, guaranteed same-day appointments, and medication access, so new practices have sprung up catering to college settings. (Some users may encounter a paywall.)

Virtual care—telehealth—is a significant component of concierge medicine

Telehealth—a central plank of concierge medicine—can widen the gap between the rich and the poor since lower-resource individuals may have less access to technology and encounter other access issues.

Concierge medicine officially began in 1996, with the first concierge practice

MD2 International, a concierge medical office that opened in Seattle, Washington, was founded based on the idea of unrushed, no-wait-time visits and personalized care offerings with strong relationships between patients and their providers.

Older, medically complex patients are a high proportion of concierge practices

These concierge medicine practices tend to have a high proportion of people ages 50 and older and are particularly concentrated in states with older populations, especially California and Florida.

The Government Accountability Office in 2005 concluded concierge medicine didn't threaten Medicare

This congressionally mandated analysis concluded that the number of concierge physicians nationwide was too small for concierge practices to undermine Medicare patients' access to affordable health care and it was "unlikely that the approach has contributed to widespread access problems." Medicare is the federal health insurance program for the aged and some disabled individuals.

Urgent care is one step up from primary care

If a patient needs to see a provider today, urgent care can be a good solution. It has shorter wait times and a more affordable price tag than heading to the emergency room. Typically, an emergency department will have more specialists available for a serious and complicated issue, as well as advanced testing capabilities.

Private equity's expansion into healthcare has been criticized for raising patient medical costs

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Men are flocking to hundreds of new online testosterone clinics for low T prescriptions

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The lack of diversity in clinical trials is undermining the future of precision medicine

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White patients waited 374 days for a kidney—Black patients waited 727 days

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The 15-minute city lets residents meet their daily needs within 15 minutes on foot

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Watch these Canadian doctors critique medical accuracy on television shows

Drs. Paul Zalzal and Brad Weening are orthopedic surgeons and members of the Royal College of Physicians and Surgeons of Canada. In this episode, they discuss which television shows they think are the most medically accurate. "Grey's Anatomy" did not fare well in their review.

Insurance denials prevent lifesaving care for patients with eating disorders

A patient living with anorexia nervosa was told by her insurance company that she wasn't sick enough to receive needed care. Her experience highlights how some insurers across Washington state focus on less useful metrics like body mass index and weight to gauge sickness instead of psychiatric symptoms that may better illustrate the urgency of receiving care.

Delivery apps have realigned the restaurant industry

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Visualizing the global supply chain of medicine

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Christos Makridis, a labor economist at Arizona State University, argues that the public has an appetite for the art form, but that the industry's business model is dated, relying too heavily on philanthropy and aging season ticket holders rather than embracing innovation.

Some argue that credit reporting promotes economic inequality in the US

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The coronavirus pandemic sparked theories about the dangers of 5G

COVID-19 spreading around the same time as the rollout of 5G sparked conspiracy theories and outrage that the new wireless technology was harming people and the environment. (Some users may experience a paywall.)

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