Concierge medicine: a "regular" physician's perspective.

Concierge medical practices, which advertise expanded access to care and individualized attention, collect charges both from insurance companies and directly from their patients. Some bill hundreds of dollars for one-time "executive" physicals, whereas others have patients pay annual retainer fees. Yet, virtually no data are available about these "luxury" practices. It is not known how many physicians have "turned concierge," whether they have altered their testing and prescribing patterns, or whether their clinical outcomes are superior to those of their colleagues in traditional practices. Although some have voiced concern that concierge physicians create a 2-tiered system and may contribute to the difficulty that many patients have with access to care, the medical community has largely remained silent on the matter. The mere existence of concierge medicine may reflect our need as physicians to do better by our patients. Yet our responsibility as a professional community is to engage in--not run from--that monumental challenge.