Marketwatch: Boutique & Concierge Medicine

Boutique Medicine: Patients pay a flat annual fee to a primary-care doctor who caters to a smaller group of patients.

There has been a lot of media attention on the supposed rush into concierge medicine by unhappy docs. I haven't seen much of a rush. There are a few doctors I know that have discussed or investigated this as a possibility but I can't think of any that I know personally that have tried this.

From the article: Dr. William Plested, president of the American Medical Association and a thoracic and cardiovascular surgeon in Santa Monica, Calif., said doctors making the transition to a retainer practice are obligated to ensure the patients who don't join find a reasonable alternative. "The idea is certainly not to leave a patient in the lurch. The idea is to improve the type of service you're providing -- improve it for yourself and for your patients."

He and Caplan agree that boutique medicine is likely to stay a niche practice.

"It's a tiny drop in a huge ocean," Plested said. "The economic reality and demographic reality is there aren't that many areas that will support this type of practice."

Still, retainer practices point to an uncomfortable truth, Caplan said. "It undermines one of our favorite myths, which is same quality of health care for all. That's never been true, but this rubs our nose in it as a society."