Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Concierge medicine sucks for specialists. Here’s why.

Anonymous
Physician
February 3, 2018
Share
Tweet
Share

As a private practice specialist in an affluent metropolitan area, I am often inundated with requests for consultation by local residents and primary physicians. That’s fine — it’s what I do, and it’s what I enjoy doing. Hey, it pays the bills, and I won’t complain about that.

Concierge medicine has taken a foothold locally, and this means more referrals directly from doctors who insist we take care of their patients immediately. We all understand how this works. The physician takes a fee to make sure that their patient is navigated through the health care system expeditiously and hopefully appropriately. This obviously benefits the patient and certainly benefits the referring concierge practitioner. Does it benefit society as a whole? Probably not: Because if someone’s getting squeezed in, someone else is getting the short shrift.

One assumption that’s worth discussing is that it benefits the specialist as well. There seems to be a common misperception amongst my peers that these referrals directly from concierge practitioners means increased business for me and increased revenue as a result. “Oh, you get so-and-so’s patients? He does really well. Good for you!” But what is really happening here?

I make my living taking care of a large number of patients who have routine medical needs, my specialty’s chronic conditions, as well as some who are ill and need more acute care. When I get a call to move someone to the head of the line from a concierge practitioner, it is generally not someone who is acutely ill. Instead, it is usually someone who is a VIP, has met their deductible and needs a procedure before the end of the year, or I should see as a “favor” for the referring doctor who has bothered to call me personally. The vast majority of calls I get are for people for whom there is little yield in tests and are demanding and difficult, or who need special “handholding” about unrealistic health care concerns.

So to my referring concierge practitioners, I say this: Someone’s underlying anxiety disorder and chronic compulsion about their internal health do not make a medical emergency requiring me to squeeze them in before the end of the day. A 99-year-old lady with 25 years of symptoms does not need an urgent procedure just because her two sons are lawyers. A learning disabled student does not deserve an appointment sooner than all my other patients just because of her social situation and the heightened expectations of her parents.

I am happy that my concierge colleagues have done so well in a difficult fiscal environment. But let’s be clear — the money they get for expediting these patients through to me does not trickle down to me in any way. A marginal increase in patient volume does not translate to significant increased revenue on my part. I’m not charging these patients extra like the concierge practitioner — I take whatever their insurance pays, like most practitioners of a traditional variety. So what I get out of it is a few extra patients who take considerably more time, are more demanding, have ruined my schedule and have unrealistic expectations because their concierge physician connected them to me.

I’m happy to take care of anyone who is sick, even the difficult patients or the ones who just need some hand-holding. But I’m a little offended at being pushed into taking care of the concierge practitioners’ stable patients on an urgent basis just because they are being paid to do the pushing.

The author is an anonymous physician.

Image credit: Shutterstock.com

Prev

One house, one spouse, one job. How did this physician do?

February 3, 2018 Kevin 1
…
Next

Here's how poetry saved my life in medical school

February 3, 2018 Kevin 8
…

Tagged as: Primary Care

Post navigation

< Previous Post
One house, one spouse, one job. How did this physician do?
Next Post >
Here's how poetry saved my life in medical school

ADVERTISEMENT

More by Anonymous

  • When the white coats become gatekeepers: How a quiet cartel strangles America’s health

    Anonymous
  • Graduating from medical school without family: a story of strength and survival

    Anonymous
  • Why young doctors in South Korea feel broken before they even begin

    Anonymous

Related Posts

  • How social media can advance humanism in medicine

    Pooja Lakshmin, MD
  • The expanding role of specialists in value-based care

    Martin Lustick, MD
  • Why academic medicine needs to value physician contributions to online platforms

    Ariela L. Marshall, MD
  • The difference between learning medicine and doing medicine

    Steven Zhang, MD
  • KevinMD at the Richmond Academy of Medicine

    Kevin Pho, MD
  • Street medicine: You don’t know about it, but you don’t care to

    Ti Hoang

More in Physician

  • The shocking risk every smart student faces when applying to medical school

    Curtis G. Graham, MD
  • The physician who turned burnout into a mission for change

    Jessie Mahoney, MD
  • Time theft: the unseen harm of abusive oversight

    Kayvan Haddadan, MD
  • Why more doctors are leaving clinical practice and how it helps health care

    Arlen Meyers, MD, MBA
  • Harassment and overreach are driving physicians to quit

    Olumuyiwa Bamgbade, MD
  • Why starting with why can transform your medical practice

    Neil Baum, MD
  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 43 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Concierge medicine sucks for specialists. Here’s why.
43 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...