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Castle-Based Medicine

Castle and MoatI can sympathize with a doctor who yearns to spend more time with his or her patients, but is “concierge medicine” really the best alternative?

Patients pay concierge doctors upfront fees that can top $1,000 a month. In return, the doctors limit their practices to a fraction of their usual size and offer patients easy access, extended face time and other perks.

Meanwhile, for every doctor that goes into this, that’s one less doctor to handle everyone else, as has been noticed by some of his colleagues:

“We just don’t have enough primary-care physicians,” said Ted Epperly, chairman of the Leawood-based American Academy of Family Physicians.

“(Concierge medicine) will provide exceptionally good care for patients who qualify,” Epperly said. “That’s fine for those who can afford it. It’s not so fine for those who don’t have access.”

That poses an ethical problem, said Myra Christopher of the Center for Practical Bioethics in Kansas City.

“What we all yearn for is a relationship with a competent medical provider who can help us navigate through the system,” Christopher said.

“But when you’re buying a first-class seat or getting preferred access, I have questions about that. It does widen the disparities gap and makes us even more a nation of haves and have-nots.”

I have questions, too: does this concierge doctor do any pro bono work? Help out at a local free clinic? Donate some services to a local school? Do some work at the local nursing home?

I went looking, but couldn’t find anything. However, I did see that he does have a blog now: ExclusiveMD.

The name kind of says it all, doesn’t it? With a name like that, I’m guessing the answer to my questions is “no.” Otherwise, it wouldn’t be “exclusive.”

Forget calling it “concierge medicine” — it sounds like “castle-based medicine” to me. It’s great for the courtiers in the castle, but not so good for the serfs in the fields or the stranger lying in the ditch.

I wonder if his office has a moat?

Bodium Castle photograph courtesy of Joffley

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I'm an ordained Lutheran pastor with a passion for language, progressive politics, and the intersection of people's inner sets of ideals and beliefs (aka "faith" to many) and their political actions. I mostly comment around here, but offer a weekly post or two as well. With the role that conservative Christianity plays in the current Republican politics, I believe that progressives ignore the dynamics of religion, religious language, and religiously-inspired actions at our own peril. I am also incensed at what the TheoCons have done to the public impression of Christianity, and don't want their twisted version of it to go unchallenged in the wider world. I'm a midwesterner, now living in the Kansas City area, but also spent ten years living in the SF Bay area. I'm married to a wonderful microbiologist (she's wonderful all the way around, not just at science) and have a great little Kid, for whom I am the primary caretaker these days. I love the discussions around here, especially the combination of humor and seriousness that lets us take on incredibly tough stuff while keeping it all in perspective and treating one another with respect.

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