Paul David P, Skiba Michaeline
Author Affiliations: Monmouth University, New Jersey.
Health Care Manag (Frederick). 2016 Jan/Mar;35(1):3-8. doi: 10.1097/HCM.0000000000000088.
Concierge medicine is a medical management structure that has been in existence since the 1990s. Essentially, a typical concierge medical practice limits its number of patients and provides highly personalized attention that includes comprehensive annual physicals, same-day appointments, preventive and wellness care, and fast, 24/7 response time. Concierge medicine has become popular among both physicians and patients/consumers who are frustrated by the limitations imposed by managed care organizations. From many physicians' perspectives, concierge medicine offers greater autonomy, the opportunity to return to a more manageable patient load, and the chance to improve their incomes that have declined because of increasingly lowered reimbursements for their services. From many patients'/consumers' perspectives, concierge medicine provides more immediate, convenient, and caring access to their primary care physicians and, regardless of their physician's annual retainer fee, the elimination of third-party insurance coverage costs and hassles. The major criticisms of the concierge medicine model come from some health care policy makers and experts, who believe that concierge medicine is elitist and its widespread implementation will increase the shortage of primary care physicians, which is already projected to become worse because of the Affordable Care Act's individual mandate, which requires everyone to have health insurance.Utilizing these topics as its framework, this article explains why concierge medicine's form of medical management is gaining ground, cites its advantages and disadvantages for stakeholders, and examines some of the issues that will affect its growth.
礼宾医疗是一种自20世纪90年代就已存在的医疗管理模式。从本质上讲，典型的礼宾医疗业务会限制患者数量，并提供高度个性化的服务，包括全面的年度体检、当日预约、预防和健康护理，以及全天候快速响应服务。礼宾医疗在医生以及那些对管理式医疗组织所带来的限制感到不满的患者/消费者中都很受欢迎。从许多医生的角度来看，礼宾医疗提供了更大的自主权、回归到更易于管理的患者数量的机会，以及提高因服务报销费用不断降低而减少的收入的机会。从许多患者/消费者的角度来看，礼宾医疗能让他们更快捷、方便且贴心地接触到自己的初级保健医生，并且无论医生的年度预付费是多少，都能消除第三方保险覆盖成本和麻烦。对礼宾医疗模式的主要批评来自一些医疗保健政策制定者和专家，他们认为礼宾医疗是精英主义的，其广泛实施将加剧初级保健医生短缺的问题，由于《平价医疗法案》的个人强制参保要求每个人都要有医疗保险，预计这一短缺问题会变得更严重。本文以这些话题为框架，解释了礼宾医疗的管理模式为何正在兴起，列举了其对利益相关者的优缺点，并探讨了一些将影响其发展的问题。
