CHEST Guidelines-Rebuttal-From-Drs-Foreman,-Lopez,-and-Flenaugh

Rebuttal-From-Drs-Foreman,-Lopez,-and-Flenaugh_201

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The healthcare system is undergoing significant economic changes that will impact physicians' practice decisions, regardless of employment models. The Medicare Access and CHIP Reauthorization Act of 2015, set to take effect in 2019, will impose financial penalties on many physicians involved with Medicare, which may lead them to limit the number of Medicare patients they accept. Maintaining practice viability while facing rising operational costs could result in physicians seeing more patients, leading to lower job satisfaction and increased burnout. This might also affect the quality of patient care, as physicians may have less time with each patient.<br /><br />Concierge practices, which offer a potential solution to these issues, involve patients paying a premium for more personalized care and could increase both patient and physician satisfaction. However, transitioning to such a model may be unfeasible for all physicians and patients. There is a concern over creating a multi-tiered healthcare system, wherein access and quality of care could be dependent on geography and income level.<br /><br />A rebuttal from Drs. Foreman, Lopez, and Flenaugh acknowledges these pressures and agrees that traditional private practices are becoming obsolete. Increasingly, physicians are employees rather than independent practitioners, affecting career choices among medical students who prioritize lifestyle impacts. Concerns about the overall impact of concierge practices remain unresolved, as their efficacy in reducing costs and improving health outcomes is yet unproven.<br /><br />While caution is advised against broadly adopting concierge models, there is a call for innovative approaches to enhance global respiratory health. Objective, unbiased research is essential to assess the implications of concierge medicine on public health and to guide informed decision-making.

Keywords

healthcare system

economic changes

Medicare Access

CHIP Reauthorization Act

physician burnout

concierge practices

multi-tiered healthcare

private practices

medical students

respiratory health