Concierge Medicine

Note: The Houston Chronicle tends to pull stories off the web quickly. Read this one sooner rather than later if it sounds interesting to you.

Thanks to the small sliver of the free market still left in medicine, we in Texas are finally seeing the return of something that sounds more like the subject of a Norman Rockwell painting than a viable business practice: the physician house call.

At the Sugar Land practice of Frank Mazza and Kirk Lee, the doctor is always in.

Patients enjoy same-day scheduling, routinely empty waiting rooms, appointments that linger as long as it takes to unhurriedly answer questions and access to doctors via phone and e-mail during non-office hours.

If the patient is unable to come in, Dr. Mazza or Dr. Lee even make house calls.

"It's wonderful," said Laura Konrad, a 73-year-old patient in last week to have some moles checked out. "It gives you such a sense of security, a feeling that you can always get to your doctor and talk to him. I can't say enough about it."

There is a catch: It costs $1,800 a year out of the patient's own pocket.

It is known as concierge medicine, a revolt against what many doctors consider the McDonaldsization of contemporary health care. The premise is simple: Fees collected from patients allow the doctors to slash their caseloads and spend more time on those who remain. It also allows them to increase their income.

So it's a "catch" to pay someone for services rendered? And we're blaming the declining amount of time physicians spend with patients on capitalism? On those counts, this article is both immoral and incorrect.

Our medical sector is anything but "McDonaldized". Rather, we can thank our federal government's hiding medical insurance costs through the tax code and outright subsidies for the fact that most people see paying for medical care as a "drawback" -- while cheerfully paying for other life necessities and even luxuries. In fact, I wouldn't be surprised to learn that most people spend far more than $1800 per annum on vacations and other forms of recreation each year.

Even the charge that physicians who opt for small practices like the ones described are de facto unavailable is seen to be bunk late in the article when it is mentioned that some physicians would rather abandon primary care altogether than practice in the mill-like environments that the prevalence of managed care -- for which we can also thank government meddling -- has helped to make so common.

Would I necessarily opt for concierge medicine? Probably not, but its existence both indicts our current government-micromanaged health care system and points the way towards a solution. The government helped create the need for such practices in the first place -- and doctors are free (so far) to fill that need. Unfortunately, with so many journalists and intellectuals damning the notion of payment for services as "elitism" (as we see in this article), Americans sound ready to stampede in the wrong direction, trampling the rights of physicians and patients alike in a new quest to extirpate what little capitalism is left in a vital industry.

If we want to continue to have access to the best medicine in the world, we should embrace what makes it possible: Capitalism.

-- CAV

Updates

9-3-07: Corrected a typo.