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Gott'Concierge doctoring' wave of the future?
By Peter H. Gott, M.D.

DEAR DR. GOTT: I am writing about your recent response about "concierge doctoring." In your response, you suggested that limiting the number of patients seen and charging those patients a fixed fee is driven by the desire of some doctors for greater reimbursement to compensate them for interference in their profession.

My neighbor recently signed up for just such an arrangement, enthusiastically. She had found, as have lots of other patients, that many doctors today are doing just the opposite of concierge doctoring. To satisfy their compensation requirements (or perhaps to meet some quota imposed on them by HMOs or PPOs), they are cramming as many patients as possible into their schedules. This results in rushed visits, limited time for patient questions (let alone in-depth discussion), delays in being seen and so on.

The current process leaves many patients (and their doctors) frustrated. Concierge doctoring offers a solution for both doctors and patients. It provides the luxury of time, accessibility and thoroughness. The doctor does not necessarily make more money than if he or she were seeing many more patients in the same amount of time but can practice medicine at a less frantic pace. The patient does incur additional costs, because he or she pays a fixed fee plus the normal charges for specific services provided. However, patients who elect for this medical relationship believe they get better "doctoring" and are willing to pay for it.

Based on my limited experience, I see concierge doctoring as patient-driven as much as it is doctor-driven.