When I train doctors to deliver ‘person-centered’ healthcare, concierge practices are not exactly what I had in mind. NBC’s article highlights potential disparities in resource allocation and access resulting from the use of boutique medicine. –

Concierge practice — also known as boutique medicine — is a new a model of medical service emphasizing easy access, long doctor visits, house calls and same-day appointments. And it is gaining popularity through the Bay Area, according to KNTV medical reporter Marianne Favro.

A mother of an 11-month-old said of the concierge practice: “It’s an amazing service — the ability to call and receive your doctor on the phone is unparalleled.

The service is expensive, ranging from $1,000-$10,000 annually, depending on the practice. Patient Jamis Macniven said the money is well spent, as the individualized care has helped him lose 40 pounds, lower his cholesterol and get off blood pressure medication since he became a patient.

“There’s only one big benefit. [A] proactive interest in my wellness as opposed to just responding to an illness — that’s everything,” Macniven said.

His doctor, Dr. Prerarna Sangani, benefits as well — she said that when she worked for a practice in San Francisco, she had about 2,500 patients. Now, she sees 250 patients without restrictions from insurance companies. “I’m happier, and I feel that I can practice the medicine the way that I want,” Sangani said.

As some 300 doctors and growing are practicing this model on both coasts, critics such as Santa Clara University’s director of health care ethics Dr. Margaret McLean are saying concierge practices worsen an already-beleaguered medical system. McLean said she’s concerned about the patients concierge care leaves behind.

“If you’ve got a practice of 2,000 patients, and you know a quarter of them go with you as you transition into boutique medicine, then what happens to those other 1,500 patients?”

Sangani said of the smaller patient lists: “I think we are still serving the community — yes, to a smaller group of patients — but we are still in the system whereas a lot of practitioners might have left the system altogether.”

McLean predicted if more doctors choose this model of medicine, it could impact the way business is done in the emergency room. “The more you squeeze the pipeline into primary care in the community, the more people then wind up being sicker and try to shove themselves into the pipeline of the emergency room,” McLean said.

McLean said she questions whether this model of medicine serves those in need, as a nationwide study of concierge practices found they treat fewer Hispanic and black patients than traditional practices.

Macniven, the portrait of a satisfied customer, said of boutique medicine: “It’s just doctors taking time and interest in each patient — if that ends up costing money it’s definitely worth it.” http://www.nbc11.com/mariannefavro/16125470/detail.html