The growth of concierge medical practices could “potentially exacerbate racial, ethnic, and socioeconomic disparities in health care,” the American College of Physicians warns in a new policy position paper.
Direct patient-contracting practices (DPCPs) also could impose “too high a cost burden on some lower-income patients,” ACP stated in the paper, published Nov. 9 in Annals of Internal Medicine.
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The college said it supports physician and patient choice of practices that are “accessible, viable, and ethical,” but asserts that physicians who choose concierge practices “must ensure they are meeting their obligations to serve patients of all types, especially the poor and other vulnerable patients.”
In particular, “physicians in all types of practices should strive to take care of patients enrolled in Medicaid,” according to the policy.
ACP also is calling for more research on DPCPs, including determining the number of physicians in such practices; the factors that are leading physicians to work in DPCPs; the effects of these practices on the physician workforce; the effects on out-of-pocket costs, quality of care, and outcomes; and the effect of physicians not participating in national quality measures and programs such as interoperable electronic health records, and the associated effect on quality and outcomes (Ann Intern Med. 2015 Nov 9. doi:10.7326/M15-0366).
Tom Blue, chief strategy officer of the American Academy of Private Physicians, a group that represents physicians in direct patient-contracting practices, suggested that concierge medicine is not out of reach, even for lower-income populations.
“Most people think of them as luxury medicine, but the average price nationwide is probably now at about no higher than $135 a month and the fastest growing segment of private physician population is under $100 a month,” Mr. Blue said in an interview.
Private physicians “as a group, because of the way that their schedules work and the control that they have over them, I have found they are far more prone to reaching out to the underserved through free clinics or through what they call ‘scholarship programs’ in their own practices” where monthly membership fees are adjusted for those in need, Mr. Blue said.