Concierge Medicine?!

I have been seeing an excellent internist as my primary care physician. Dr. Louis Malinow is a great physician. He is friendly and down to earth. Patients even call him Dr. Lou, instead of the more formal Dr. Malinow. He tries very hard to be on time for appointments and spends a reasonable amount of time with you when you come in for a visit.

His office staff is ok (which is far better than most doctors’ office staffs which are awful). While they are ok, ok is excellent in comparison to most doctor office staffs.

A few weeks ago, I received a letter advising that Dr. Malinow will be joining MDVIP. Essentially this means that Dr. Malinow will charge $1500 per year for the privilege of being his patient. This $1500 is of course in addition to any payments for services from the patient and the patient’s insurance company. You still need to pay for the services you get from Dr. Malinow, but you must pay $1500 per year for this privilege.

The patients who are willing to cough up the money do get a lot of nice benefits. Your yearly physical is far more comprehensive than a standard physical, appointments can be scheduled the same day or the next day, and the doc spends much more time with you when you visit.

I do understand why Dr. Lou is doing this. He is an excellent doc with an excellent reputation. He currently has approximately 4000 patients in his practice. He is pulled in a million directions. He works weekends and night catching up on paperwork and returning calls. I know because he calls me on weekends and at night to let me know the results of any tests or to respond to any questions I have.

So he is cutting down his practice to 600 patients who are willing to pay, and the other 3400 are out in the cold.

But Dr. Lou really needs to look at this from another perspective. It is unfair to require patients to pay $1500 a year, in addition to paying for services received. If one is old and the government pays for your health insurance than it is not a big deal to pay 1500 for the right to see your doc. But is you are a young/middle aged person with a family, and paying up to $10,000 a year for health insurance, and thousands in copays and deductibles, it is unfair to expect an additional 1500 on top of that. Basically, only old people and wealthy people can avail themselves of Dr. Lou now. If that is the king of practice that Dr. Lou wants than that is his prerogative. Sounds like a violation of the Hippocratic Oath that Dr. Lou took when he graduated medical school.