Amid the ongoing shortage of primary care physicians, physicians and patients alike are weighing the benefits and drawbacks of concierge medicine, an increasingly popular solution to the long wait times and insurance delays associated with traditional practice models.
In an April 16 report by KFF Health News, patients and physicians in Massachusetts shared their views on concierge medicine. Here are 10 takeaways from the report:
1. In September 2024, Florence, Mass.-based Pioneer Valley Internal Medicine shifted to a concierge membership model, much to the surprise of Michele Andrews, a longtime patient at the practice. The yearly membership fee at the practice was $1,000, out-of-pocket, for existing patients, in addition to her insurance premiums, according to a letter she received from the practice.
2. Critics of concierge medicine argue that it only helps patients who have extra money to pay for the service. They also say that it shrinks the supply of traditional primary care physicians, which can have a compounding effect in rural communities most acutely experiencing shortages.
3. Ms. Andrews and her husband told KFF that they opted to leave the practice rather than pay the fee. “I’m insulted and I’m offended,” Ms. Andrews said. “I would never, never expect to have to pay more out of my pocket to get the kind of care that I should be getting with my insurance premiums.”
4. Christine Baker, MD, told KFF that fewer than half of her patients opted to stay, cutting her patient load from 1,700 to 800. Dr. Baker said she felt so stressed prior to the switch that she considered retiring, and that the drop in patients gave her a more manageable workload.
“I knew some people would be very unhappy. I knew some would like it,” Dr. Baer said. “And a lot of people who didn’t sign up said, ‘I get why you’re doing it.'”
5. Another patient, Patty Healey, a retired nurse, did not consider leaving. “It might be to my benefit, because maybe I’ll get earlier appointments and maybe I’ll be able to spend a longer period of time talking about my concerns,” she told the publication.
6. Rebecca Starr, MD, a geriatrician in the same region, also recently started a concierge practice. She said that while she was torn about her options, as she knew it would mean taking on fewer patients and asking for payments in addition to insurance, she ultimately decided it was the best option for maintaining high-quality care at a small practice.
7. Shayne Taylor, MD, recently opened a direct primary care office in Northampton, Mass. This differs slightly from concierge medicine in that it charges a recurring fee to patients, but bypasses insurance altogether. Patients must have insurance for X-rays and medications, but she does not charge for services she renders, saving on administrative costs. She said that the traditional primary care model simply doesn’t work.
“We cannot spend so much time seeing so many patients and documenting in such a way to get an extra $17 from the insurance company,” she told KFF.
8. Paul Carlan, MD, a primary care physician who runs Valley Medical Group with multiple locations in western Massachusetts, said that his practice has been stretched very thin in recent years, in part due to absorbing patients from physicians who switched to concierge medicine.
9. “We all contribute through our tax dollars, which fund these training programs,” Dr. Carlan said.
“And so, to some degree, the folks who practice healthcare in our country are a public good,” he continued. “We should be worried when folks are making decisions about how to practice in ways that reduce their capacity to deliver that good back to the public.”
10. But Dr. Taylor said that individual physicians cannot be expected to resolve the issues caused by a “dysfunctional” healthcare system.