13 Concierge Medicine

Srinagesh Gavirneni1 and Vidyadhar G. Kulkarni2

1 Cornell University

2 University of North Carolina at Chapel Hill

13.1 Introduction

Primary care physician service in the US is in a state of crisis because of the significant shortage of physicians working in this specialty, the aging patient population, the projected increase in the number of office visits following implementation of the Affordable Care Act, and increased patient expectations (Petterson et al., 2012). Under these circumstances, it is not surprising to hear about patients taking six to nine months to find a new primary care physician, or up to two weeks to get an appointment with their current primary care physician. At the same time, these healthcare providers are feeling overworked, unappreciated, and professionally unsatisfied with the incomplete care they provide (Murray et al., 2003). In the third‐party payment system prevalent in the US healthcare system, easy access to a primary care physician is an important and necessary first step and must be managed carefully (Forrest, 2003).

Recognizing these inadequacies (Bodenheimer and Pham, 2010) in the current primary healthcare delivery system, some physicians have started offering concierge medicine—a system of fee‐based priority access—to better serve the patients who are willing to pay extra for faster appointment scheduling ( Alexander et al., 2005). The patients who are unwilling or unable to pay these additional fees (often ...

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