Keeping candles lit: The role of concierge medicine in the future of primary care.

Universal coverage and financial sustainability are two competing aims in primary care. Patient empowerment and patient engagement have been suggested as essential ingredients of the recipe for innovative primary care models aimed at sustaining universal coverage. Concierge medicine is achieving a growing popularity among both scholars and practitioners as a direct primary care practice which allows to bridge the gap between patient empowerment and patient engagement. However, ethical and legal concerns hinder the diffusion of concierge models in the current primary care practices. This manuscript is aimed at providing an evidence synthesis of extant contributions in the field of concierge medicine in order to discuss its attributes and to examine its expected effects on universal coverage and sustainability. For this purpose, a systematic literature review involving 29 manuscripts was performed. The findings of this study pointed out that concierge models could play a significant role in enhancing the access to primary care and in improving the sustainability of the healthcare service system. However, the existing institutional arrangements which regulate the access to primary care should be revised to allow more spaces for the implementation of concierge practices.