Portman Robert M, Romanow Kate
Powers, Pyles, Sutter & Verville, PC in Washington, DC, USA.
J Health Life Sci Law. 2008 Apr;1(3):1, 3-38.
The practice of "concierge" or "retainer" medicine is growingly steadily due to economic and legal pressures on physicians. This practice model, which typically involves charging access or subscription fees to a limited pool of patients, raises legal hazards, contractual challenges, and ethical dilemmas for physicians interested in converting to concierge medicine, as well as important health policy questions. This article examines these legal and contractual issues, and discusses some of the ethical and policy implications of this relatively new form of medical practice. The authors conclude that this innovative practice form provides a beneficial alternative for patients seeking more personal, proactive, and/or intensive medical care. As concierge medicine proliferates, a wider range of practice models and fee structures should make this approach more affordable to lower and middle income patients--and help satisfy the need for greater access to preventive healthcare. Health policy makers should take steps to encourage this outcome.
由于医生面临的经济和法律压力，“礼宾式”或“预付费”医疗模式正稳步发展。这种医疗模式通常向有限的患者群体收取准入费或订阅费，对于有意转向礼宾式医疗的医生而言，会带来法律风险、合同挑战和伦理困境，同时也引发了重要的卫生政策问题。本文探讨了这些法律和合同问题，并讨论了这种相对新型医疗模式的一些伦理和政策影响。作者得出结论，这种创新的医疗模式为寻求更个性化、主动和/或密集医疗服务的患者提供了有益的选择。随着礼宾式医疗的普及，更广泛的医疗模式和收费结构应使这种方式对中低收入患者更具可承受性，并有助于满足人们对获得更多预防性医疗服务的需求。卫生政策制定者应采取措施鼓励这一结果。
