CHEST Guidelines-Concierge-Pulmonary-Medicine

Concierge-Pulmonary-Medicine_chest

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The letter to the editor addresses a debate on the topic of concierge pulmonary medicine, discussing the pros and cons of this model as a response to a failing healthcare system. The authors, Dr. Saadah Alrajab and Dr. Askin Uysal, express support for Dr. Freedman’s arguments in favor of concierge medicine. They argue that the current healthcare system often results in fragmented care and weak doctor-patient relationships, with patients frequently not even knowing the name of their physician post-discharge. They suggest that concierge practices, which offer private pay services, can provide more time and accessibility to quality care, potentially at a lower cost than traditional insurance.<br /><br />Concierge medicine, typically more concentrated in large cities due to the volume of patients required for such practices, could ironically offer cheaper services compared to some insurance reimbursements. Clinics that bypass lengthy insurance processes with direct contracts for laboratory and radiology services could also save patients money. They propose a two-tier healthcare system with basic coverage for all, funded by tax system modifications, paired with a second tier offered by commercial insurances, to address the current healthcare crisis.<br /><br />In response, Drs. Marilyn G. Foreman and Eric L. Flenaugh express concerns about equity, fearing that concierge practices might create a two-tier system based on financial ability, which opposes health equity principles. They acknowledge ongoing progress in reducing health disparities but advocate for cautious implementation of concierge models due to potential inequality and resource distribution concerns. They also highlight the issue of administrative burdens in medicine contributing to professional burnout, suggesting that incentivizing rather than merely encouraging community clinics could ensure access to care in any new system.

Keywords

concierge medicine

healthcare system

doctor-patient relationships

fragmented care

private pay services

insurance reimbursements

health equity

two-tier system

administrative burdens

professional burnout