Urgent care operators considering adding a concierge medicine component to their business may find rationale to do so—or not to do so—in a new position paper published in the November 10 issue of Annals of Internal Medicine. The paper declines to give either a thumbs-up or a thumbs-down to direct patient contracting practices (DPCPs)—aka “concierge medicine”—but does offer perspective on the pros and cons relative to medical quality, cost, access, and other factors. On the plus side, according to ACP, a DPCP model allows physicians to spend more time with patients; patients can also see physicians any time they like, and physicians wind up “more satisfied.” However, that model could make it harder for low-income patients who may not be able to pay the fees up front—possibly a medical ethical issue. The paper notes, however, that clinicians concerned with reduced access can always waive the concierge fee, or structure fees on a sliding scale. One Rhode Island practice charges $35/month after an $80 enrollment fee; patients then pay $10 per visit. Urgent care operators could largely ignore one caveat in the paper—namely, that clinicians be mindful of patient abandonment law requirements, such as adequate notice, when a physician terminates a relationship with a patient.

ACP’s take on concierge medicine
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