Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-21T11:43:49.781Z Has data issue: false hasContentIssue false
  • English
  • Français

Currents in Contemporary Ethics: Concierge Medicine: Legal and Ethical Issues

Published online by Cambridge University Press:  01 January 2021

Sandra J. Carnahan
Get access Rights & Permissions [Opens in a new window]

Abstract

An abstract is not available for this content so a preview has been provided. Please use the Get access link above for information on how to access this content.
Image of the first page of this content. For PDF version, please use the ‘Save PDF’ preceeding this image.'
Type
JLME Column
Information
Journal of Law, Medicine & Ethics , Volume 35 , Issue 1 , Spring 2007 , pp. 211 - 215
Copyright
Copyright © American Society of Law, Medicine and Ethics 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Mark A. Rothstein serves as the section editor for “Currents in Contemporary Ethics.” Professor Rothstein is the Herbert F. Boehl Chair of Law and Medicine and the Director of the Institute for Bioethics, Health Policy and Law at the University of Louisville School of Medicine in Kentucky. (mark.rothstein@louisville.edu)

References

U.S. Government Accountability Office, Physician Services: Concierge Care Characteristics and Considerations for Medicare, GAO-05-929 (2005) (prior to conversion, physicians averaged 2716 patients); Virginia Commonwealth University, Patient Load per Active Primary Care Physician in Virginia (2001) (reporting average primary care patient load from 1800 to 3900), available at <http://www.primcare.vcu.edu/manpower/sld004.htm> (last visited December 9, 2005).+(last+visited+December+9,+2005).>Google Scholar
Carter, J., What Makes a High-earning Family Physician? Family Practice Management (July-August 2005), available at <http://www.aafp.org/fmp/20050700/16what.html> (last visited December 20, 2006) reporting 2004 American Academy of Family Physicians Annual Practice Profile Survey illustrating steady yearly decrease in physician before-tax income from $161,000 in 1995 to$141,000 in 2003.Google ScholarPubMed
Glendinning, D., “Medicare Trustees: Gloomy Forecast for Physician Reimbursement Rates,” American Medical News (April 11, 2005), available at <http://www.ama-assn.org/amednews/2005/04/11/gvl10411.htm> (last visited December 3, 2005).Google Scholar
Concierge medicine is also known as concierge care, boutique medicine, premium practice, platinum practice, access fee practice, and retainer practice.Google Scholar
Alexander, G. C. et al., “Physicians in Retainer (‘Concierge’) Practice: A National Survey of Physician, Patient, and Practice Characteristics,” Journal of General Internal Medicine 20 (2005): 1079–1083, at 1080.CrossRefGoogle Scholar
OneMD, The Affordability of OneMD, available at <http://www.myonemd.com> (last visited December 13, 2006). (Charging $4000 annually, paid in monthly installments, with a four-month prepayment requirement).+(last+visited+December+13,+2006).+(Charging+$4000+annually,+paid+in+monthly+installments,+with+a+four-month+prepayment+requirement).>Google Scholar
Renaissance Health, Membership, available at <http://www.renhealth.net/modelpractice/membership.html> (last visited December 12, 2006).+(last+visited+December+12,+2006).>Google Scholar
Leidig, D., “Concierge Medicine: A New Specialty?” Texas Medical Liability Trust Reporter (March-April 2005), available at <http://www.tmlt.org/publications/resources/Reporter/MarchApril05.pdf> (last visited December 12, 2006).Google Scholar
See OneMD, supra note 6.Google Scholar
American College of Physicians, Access Fees Have Physicians Moving Cautiously (2004), available at <http://wwwacpon-line.org/journals/news/apr04/asccess.htm> (last visited December 13, 2006).+(last+visited+December+13,+2006).>Google Scholar
Washington State Medical Association, “Access Fee”/“Boutique”/“Concierge”/“Retainer” Practices Update 1 (2004), available at <http://www.wsma.org/mem-resources/PRC_AccessFees.pdf> (last visited December 12, 2006).+(last+visited+December+12,+2006).>Google Scholar
Washington Legislature, Senate Bill Report SHB 2404, “Senate Committee on Health & Long-term Care,” available at <http://www.leg.wa.gov/pub/billinfo/2005-06/Pdf/Bill%20Reports/Senate/2404-S.SBR.pdf> (last visited December 4, 2006).+(last+visited+December+4,+2006).>Google Scholar
N.J. Stat. Ann. § 17B:30–12(d) (West 2006)Google Scholar
Letter from New York Commissioner of Health to Health Insurance Industry CEO's (April 16, 2004), available at <http://www.wnj.com/marquis/NY_DeptofHealth.pdf> (last visited December 12, 2006). (last visited December 12, 2006).' href=https://scholar.google.com/scholar?q=Letter+from+New+York+Commissioner+of+Health+to+Health+Insurance+Industry+CEO's+(April+16,+2004),+available+at++(last+visited+December+12,+2006).>Google Scholar
See, e.g., Tex. Ins. Code Ann. § 843.361 (2006) (“A contract or other agreement between a health maintenance organization and a physician or provider must specify that the physician or provider will hold harmless for payment of the cost of covered health care services if the health maintenance organization does not pay the physician or provider for those services.”)Google Scholar
42 U.S.C.A. §1395u(b) (3) (B) (ii) (2005) (defining “participating physician” as one who accepts the Medicare allowable amount as the full charge for the service provided); 42 U.S.C.A. § 1395w-4(g) (2) (C) (defining “limiting charge” as “115 per cent of the recognized payment under this part for nonparticipating physicians…”).Google Scholar
Letter from Representatives Waxman, Henry A. et al., to Secretary Tommy G. Thompson (March 4, 2002), available at <http://www.wnj.com/RetainerMed/pdf/medi_030402_HHSletter.pdf> (last visited December 5, 2005).+(last+visited+December+5,+2005).>Google Scholar
Office of the Inspector General, OIG Alerts Physicians About Added Charges For Covered Services (2004), available at <http://www.oig.hhs.gov/fraud/docs/alertsandbulletins/2004/FA033104AssignViolationI.pdf> (last visited December 5, 2005).+(last+visited+December+5,+2005).>Google Scholar
Editorial, “Keeping it Ethical: Retainer Practices Have Rules and Restrictions,” American Medical News (May 3, 2004), available at <http://www.amaassn.org/amednews/2004/05/03/edsa0503.htm> (last visited January 3, 2007).+(last+visited+January+3,+2007).>Google Scholar
Office of the Inspector General, OIG Alerts Physicians about Added Charges for Covered Services (March 31, 2004), available at <http://www.oig.hhs.gov/fraud/docs/alertsandbulletins/2004FA033104AssignViolationI.pdf> (last visited December 5, 2005).+(last+visited+December+5,+2005).>Google Scholar
Social Security Act § 1128A(a) (5), 42 U.S.C.A. § 1320a-7a(a) (5) (2003).Google Scholar
Id.Google Scholar
Code of Medical Ethics, Termination of the Physician-Patient Relationship § 8.115 (Am. Med. Ass'n 2004)Google Scholar
Code of Medical Ethics, Retainer Practices § 8.055 (Am. Med. Ass'n 2004).Google Scholar
Id.Google Scholar
Principles of Medical Ethics VI (Am. Med. Ass'n 2004); Code of Medical Ethics, Free Choice § 9.06 (Am. Med. Ass'n 2004); American Medical Association House of Delegates Policy § 380.989H, Patient and Physician Right to Privately Contract for Health Care, available at <http://www.ama-assn.org/apps/pf_new/pf_online?f_n=browse&doc=policyfiles/HnE/H-380.989.HTML> (last visited December 12, 2006). (last visited December 12, 2006).' href=https://scholar.google.com/scholar?q=Principles+of+Medical+Ethics+VI+(Am.+Med.+Ass'n+2004);+Code+of+Medical+Ethics,+Free+Choice+§+9.06+(Am.+Med.+Ass'n+2004);+American+Medical+Association+House+of+Delegates+Policy+§+380.989H,+Patient+and+Physician+Right+to+Privately+Contract+for+Health+Care,+available+at++(last+visited+December+12,+2006).>Google Scholar
American Medical Association, Report of the Council on Ethical and Judicial Affairs, “Potential Patients: Ethical Considerations,” No. 4-A-00 (2000), available at <http://www.ama-assn.org/ama1/pub/upload/mm/369/ceja_4a00.pdf>(last visited December 12, 2006).(last+visited+December+12,+2006).>Google Scholar
Id.Google Scholar
Alexander, G. C. et al., “Physicians in Retainer (“Concierge”) Practice: A National Survey of Physician, Patient, and Practice Characteristics,” Journal of General Internal Medicine 20 (2005): 1079–1083, at 1080.CrossRefGoogle Scholar
See Code of Medical Ethics, Caring for the Poor § 9.065E (Am. Med. Ass'n 2004).Google Scholar
Code of Med. Ethics, Retainer Practices § 8.05E (Am. Med. Ass'n 2004).Google Scholar
Gusmano, M. and Schlesinger, M., “The Social Roles of Medicare: Assessing Medicare's Collateral Benefits,” Journal of Health Policy, Politics, and Law 26 (2000): 37–74, at 41.CrossRefGoogle Scholar
Association of American Medical Colleges, Help Wanted: More U.S. Doctors (2006), available at <http://www.aamc.org/workforce/helpwanted.pdf> (last visited December 1, 2006).+(last+visited+December+1,+2006).>Google Scholar
U.S. Department of Health and Human Services, Bureau of Health Professions, “Shortage Designation” (2006), available at <http://www.bhpr.hrsa.gov.shortage> (last visited December 12, 2006).+(last+visited+December+12,+2006).>Google Scholar
American Academy of Family Physicians, 2006 Match Summary and Analysis (2006), available at <http://www.aafp.org/match> (last visited December 1, 2006).+(last+visited+December+1,+2006).>Google Scholar
Association of American Medical Colleges, Help Wanted: More U.S. Doctors (2006), available at <http://www.aamc.org/workforce/helpwanted.pdf> (last visited December 1, 2006).+(last+visited+December+1,+2006).>Google Scholar
Id.Google Scholar
American Medical Association, “2004 Health Care Trends: An Environmental Analysis,” at 5 (2004), available at <http://www.ama-assn.org/ama1/pub/upload/mm/41/ea00.pdf> (last visited December 1, 2006).+(last+visited+December+1,+2006).>Google Scholar
Association of American Medical Colleges, Help Wanted: More U.S. Doctors (2006), available at <http://www.aamc.org/workforce/helpwanted.pdf> (last visited December 1, 2006).+(last+visited+December+1,+2006).>Google Scholar
The Boards of Trustees, Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds, “Annual Report” (2005), available at <http://www.cms.hhs.gov/ReportsTrustFunds/downloads/tr2005.pdf> (last visited December 1, 2006): 19.+(last+visited+December+1,+2006):+19.>Google Scholar
Center for Medicare and Medicaid Services, Medicare Announces Final Rule Setting Physician Payment Rates and Policies for 2007 (November 1, 2006), available at <http://www.cms.hhs/gov/apps/media/press_releases.asp> (last visited December 7, 2006).+(last+visited+December+7,+2006).>Google Scholar
Glendinning, D., “AMA Warns Medicare Payment Cuts Would Harm Patient Care and Access,” American Medical News, (April 25, 2005), available at <http://www.ama-assn.org/amednews/2005/04/25/gvl10425.htm> (last visited January 3, 2007).Google Scholar