Currents in contemporary ethics: Concierge medicine: Legal and ethical issues

Journal of Law, Medicine and Ethics

Volumn 35, Issue 1, 2007, Pages 211-215

  Carnahan, Sandra J ^a  

^a South Texas College of Law   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CLINICAL PRACTICE; ECONOMICS; ETHICS; HUMAN; LEGAL ASPECT; MEDICAL ETHICS; MEDICAL FEE; ORGANIZATION AND MANAGEMENT; REVIEW; UNITED STATES;

ETHICS, MEDICAL; FEES, MEDICAL; HUMANS; PHYSICIAN'S PRACTICE PATTERNS; UNITED STATES;

EID: 33847353472     PISSN: 10731105     EISSN: 1748720X     Source Type: Journal    
DOI: 10.1111/j.1748-720X.2007.00125.x     Document Type: Review

References (43)

1. 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);
2. 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).
3. J. Carter, 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.
4. D. Glendinning, "Medicare Trustees: Gloomy Forecast for Physician Reimbursement Rates," American Medical News (April 11, 2005), available at 〈http://www.amaassn.org/amednews/2005/04/11/gvl10411. htm〉 (last visited December 3, 2005).
5. Concierge medicine is also known as concierge care, boutique medicine, premium practice, platinum practice, access fee practice, and retainer practice.
6. G. C. Alexander 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.
7. OneMD, The Affordability of OneMD, available at 〈htp://www.myonemd.com〉 (last visited December 13, 2006). (Charging $4000 annually, paid in monthly installments, with a four-month prepayment requirement).
8. Renaissance Health, Membership, available at 〈http://www. renhealth.net/modelpractice/membership.html〉 (last visited December 12, 2006).
9. D. Leidig, "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).
10. See OneMD, supra note 6.
11. American College of Physicians, Access Fees Have Physicians Moving Cautiously (2004), available at 〈http://wwwacponline.org/ journals/news/apr04/asccess.htm〉 (last visited December 13, 2006).
12. Washington State Medical Association, "Access Fee"/"Boutique"/"Concierge"/ "Retainer" Practices Update 1 (2004), available at 〈http://www.wsma.org/memresources/PRC_AccessFees.pdf〉 (last visited December 12, 2006).
13. 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).
14. N.J. Stat. Ann. § 17B:30-12(d) (West 2006)
15. 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).
16. 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.")
17. 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...").
18. Letter from Representatives Henry A. Waxman 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).
19. 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).
20. 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).
21. 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).
22. Social Security Act § 1128A(a) (5), 42 U.S.C.A. § 1320a-7a(a) (5) (2003).
23. Id.
24. Code of Medical Ethics, Termination of the Physician-Patient Relationship § 8.115 (Am. Med. Ass'n 2004)
25. Code of Medical Ethics, Retainer Practices § 8.055 (Am. Med. Ass'n 2004).
26. Id.
27. 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).
28. 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).
29. Id.
30. G. C. Alexander 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.
31. See Code of Medical Ethics, Caring for the Poor § 9.065E (Am. Med. Ass'n 2004).
32. Code of Med. Ethics, Retainer Practices § 8.05E (Am. Med. Ass'n 2004).
33. M. Gusmano and M. Schlesinger, "The Social Roles of Medicare: Assessing Medicare's Collateral Benefits," Journal of Health Policy, Politics, and Law 26 (2001): 37-74, at 41.
34. 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).
35. 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).
36. American Academy of Family Physicians, 2006 Match Summary and Analysis (2006), available at 〉http://www.aafp.org/match〉 (last visited December 1, 2006).
37. 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).
38. Id.
39. 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).
40. 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).
41. 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.
42. 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).
43. D. Glendinning, "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).