First-Class Health Care -- for a Price

Sept. 14, 2007— -- Although most of us balk at the idea of paying even higher rates for health care, a growing number of people choose to shell out hundreds more -- and actually like the idea.

Retainer practices, also referred to as "concierge medicine" or "boutique health care," offer patients a wide range of services, including longer appointments, no wait time and 24/7 access to their physician.

All this comes attached to a hefty price tag -- a yearly fee of up to $1,500 or more.

Despite a report this week in the journal Health Affairs that insurance premiums are rising faster than inflation and wages, many are willing to pay these extra fees. This testifies to how far those who can afford such services are willing to go to avoid frustrating waits and receive first-class care.

But therein lies the controversy.

"This is clearly an example of two-tiered medical practice -- one tier for the wealthy and another for the less financially able," says Dr. Curtis Stine, professor and associate chair of family medicine at the Florida State University College of Medicine in Tallahassee.

Dr. David A. Goldstein, co-director of the Pacific Center for Health Policy and Ethics at the University of Southern California, says that this type of practice "further marginalizes the care that is given to patients who cannot afford it; it risks reducing the available pool of physicians to care for the populace."

However, others say that this model of care allows them to devote more time to their patients.

Dr. Stephen Glasser, an internist in Baltimore, is affiliated with MDVIP, a company that specializes in personalized preventive care. He switched to this model when his former practice became overwhelming.

"We [started] to be in a mode of seeing more and more patients to keep up with the overhead and demands of the practice," he says. "I would see 30 patients a day. I was unable to carry out what I consider to be appropriate care for every patient."

Dr. David DeAtkine Jr., an MDVIP-affiliated internist and endocrinologist in Birmingham, Ala., has also seen an easing of his patient burden in his new practice.