• Boutique Options Offer Greater Choice in Medical Care

    IMAGE Although technology and research success have enabled medical miracles that were unimaginable decades ago, many patients and doctors crave personal care that is more typical of yesteryear. Boutique or concierge medicine may be able to provide you with that option, but only if you can afford it.

    Practice Specifics

    Most boutique practices charge a high annual retainer that typically includes same-day appointments, short waits, and email or cell phone contact with the doctor. Some models include home visits and travel-medicine services. To provide this level of access, doctors accept a limited number of patients.
    There are three practice models:
    • Model one: The yearly $600–4,200 retainer fee covers some extra services. The physician bills for separate visits and some physicians accept insurance.
    • Model two: The yearly $1,500–5,400 retainer fee covers all the patient's costs and the physician doesn't bill insurance or Medicare.
    • Model three: Physicians offer a retainer option in their practice.

    Concierge Concerns

    Concierge practices have ignited controversy in the medical community. Some say these practices discriminate against those who cannot afford to participate. Some doctors fear that limited practice sizes could increase crowding at remaining offices.
    Another concern with these practices is that physicians in them do not treat a wide variety of patients. Exposing themselves to different types of patients with different conditions helps them build experience.

    Equal Care for All?

    Nearly everyone recognizes that those who have the financial means more often buy better cars, private schooling, and other services. Medicine, though, has prided itself on providing equal care to everyone, yet some differences have always existed.

    Do You Want to Make the Switch?

    Being well informed is essential. If you are considering changing to a boutique-style medical practice, take these steps:
    • Learn about the doctor’s experience and credentials.
    • Ask if the practice accepts your insurance plan and find out about their billing practices.
    • Be cautious of practices trying to have it both ways, with some patients receiving boutique access and others not.
    • Look for extra value, such as comprehensive exams and wellness plans.
    • Stay within your budget.
    While debate continues about the bigger issues, individuals that can afford it seem eager to embrace the added convenience.


    American Medical Association http://www.ama-assn.org

    United States Department of Health and Human Services http://www.hhs.gov


    The College of Family Physicians of Canada http://www.cfpc.ca//

    Health Canada http://www.hc-sc.gc.ca


    Conway C. Physician ownership of hospitals significantly impacted by health care reform legislation. University of Houston Law Center. http://www.law.uh.edu/healthlaw/perspectives/2010/%28CC%29%20Stark.pdf . Published April 2010. Accessed September 17, 2012.

    Franklin D. Morning rounds: boutique hospitals and health insurers. National Public Radio website. Available at: http://www.npr.org/blogs/health/2009/07/morning%5Frounds%5Fboutique%5Fhospit.html . Published July 13, 2010. Accessed September 17, 2012.

    Silva C. Concierge medicine a mere blip on Medicare radar. amednews.com. 2010 Sept 30. Available at: http://www.ama-assn.org/amednews/2010/09/27/gvse0930.htm. Accessed September 17, 2012.

    US ‘boutique medicine’ could threaten care for the majority. Br Med J . 2002 Jan 26;324.

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