Concierge medicine could make primary care shortage worse

A recent article in the Los Angeles Times highlighted the trend of frustrated California primary care physicians making the switch to concierge medicine. Concierge medicine is a simple model where patients pay a doctor an annual fee rather than pay for each visit. The model allows doctors to take on fewer patients and give them more personal attention. One doctor profiled in the article said he cut his patient load from 2,000 to 400 when he switched to concierge medicine. The smaller load allows patients the ability to make same-day or next-day appointments and doctors the ability to double time spent with patients during appointments. It also provides physicians relief from the aggravation associated with decreased insurance reimbursement and increased overhead costs. Although the model allows 400 patients better access to their doctor, it leaves 1,600 patients suddenly without a primary care provider. Experts already predict a shortage of 60,000 primary care physicians by 2020. If more primary care doctors choose to practice private, concierge medicine, the shortage may become even more severe. Still some of the physicians profiled say that switching to concierge medicine was the only way they could continue working as physicians without becoming resentful. Even the president of the American Academy of Family Physicians, Glen Stream, acknowledged that physicians who choose concierge medicine are adapting toa dysfunctional health care environment.