Many physicians contemplating an alternative to the standard care delivery paradigm find retainer-based medicine to be an appealing possibility. The subscription-based, flat-rate payment system ensures consistent revenue based on member numbers and reduces the possible stress of a fee-for-service business.
Many doctors are being forced to rethink their approach to care delivery as the healthcare sector shifts away from fee-for-service payment models and toward value-based care. In light of this, most doctors mention enhanced doctor-patient interactions as their primary motivator for switching to concierge medicine.
Concierge care physicians may dedicate more time and attention to each patient since they see 20 or fewer patients per day and appointments run anywhere from thirty minutes to an hour, depending on the patient's requirements.
Furthermore, many practitioners believe they are able to provide a greater level of care than they would be able to in a fee-for-service practice, where they may be scheduled to see as many as 30 patients in a single day. Concierge physicians report feeling happier with their employment and therefore better able to deliver the best possible treatment to their patients without the performance expectations, scheduling conflicts, and administrative hassles of standard primary care practice.
However, doctors aren't the only ones who gain from this arrangement. Concierge medicine is especially well-suited to the demands of individuals living with chronic medical issues due to its flexible scheduling and unrestricted access to a physician who is intimately familiar with their patients' specific health histories.
While the flat-rate membership price does not cover specialist care services that some chronic disease patients may require, unrestricted physician access—both over the phone and in the doctor's office—provides these patients with the assistance they seek.
Below are some drawbacks with this business model:
Patients or customers are charged with subscription (or access) fees for medical and other health care services under concierge medicine, also known as retainer medicine. Frequently, physician entrepreneurs will use concierge medicine to build a high-end, primary care model, but they are ignorant of the legal difficulties that come with insurance, contracts, and other issues.
Concierge or boutique medical practices present legal concerns that need an understanding of insurance regulations, contract law, and ethical principles that apply to doctors and other clinicians. These difficulties can affect doctors working in both traditional care and complementary and alternative medicine or wellness.
The extent to which the access or retainer fee for the concierge medical practice includes services that are typically covered by insurance, such as physical exams, normal medical office visits, and routine diagnostic testing, is one of the significant legal problems.
Another issue is deciding how to discharge patients once a certain number of services have been performed. Patient abandonment is illegal under state law and ethical guidelines. Allow ample time for the patient to choose a new and suitable physician.
Concierge medical practices must also be aware of advertising laws that apply to physicians and non-physician providers (both allied health and complementary and alternative medicine practitioners), as well as refrain from making claims of efficacy, result, or cure that are impossible to achieve and will only increase the risk of liability. An expert attorney can analyze marketing materials to ensure that they are compliant with applicable laws and to assist reduce the risk of liability.
In general, a clear legal review by experienced health care and contracts attorney would benefit the concierge practice, as would having the lawyer draft a contract between the practice and the patient that clearly specifies the services to be covered by the access or subscription fee; the Medicare status of the physicians involved; whether those providers accept insurance; how billing will be done; and what will happen if the patient is terminated.