CHEST Guidelines-Rebuttal-From-Dr-Freedman_2017

Rebuttal-From-Dr-Freedman_2017_chest

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The document discusses the ongoing debate surrounding concierge medicine—an evolving healthcare model where patients pay retainer fees for enhanced access to physicians—and its impact on healthcare disparities. Dr. Neil Freedman acknowledges arguments by others, notably Foreman et al., about the potential negative classist implications of concierge medicine, which ties financial ability directly to quality care access. Nonetheless, Freedman points out that current and upcoming changes in healthcare reimbursement models inevitably make traditional practices challenging, compelling physicians to adopt models like concierge medicine to maintain financial viability. This model provides benefits like improved patient-physician interaction and satisfaction, both of which could enhance the quality of care.<br /><br />However, Foreman, Lopez, and Flenaugh counter that while modern constraints have shifted many physicians from private practices to employed positions, the benefits of concierge care, specifically in improving patient outcomes or decreasing costs, remain largely unproven. They assert that this model could exacerbate existing inequities unless carefully managed and studied for its long-term impact on health disparities. They highlight that current economic pressures, like those from the Medicare Access and CHIP Reauthorization Act of 2015, push physicians towards seeing more patients per day, potentially compromising care quality.<br /><br />Ultimately, there is consensus on the importance of ensuring no patient is left behind as healthcare systems evolve. Both sides recognize the growing economic and administrative pressures in medicine but differ over whether concierge medicine is a viable solution to the challenges or a potential contributor to systemic inequities.

Keywords

concierge medicine

healthcare disparities

retainer fees

physician access

healthcare model

financial viability

patient-physician interaction

care quality

health inequities

economic pressures