Would you pay $600.00 for same day access to your doctor that included phone conversations, secure emails, and possibly housecalls? Some people spend more money on that in a year on lattes. But others could never scrape it together.

Email me. sstricklen@kgw.com I'll share some of your thoughts leaving out your names and email addresses. ((Update as of 5:20pm.. WOW they rolled in fast!! See responses below.))

This is a huge debate, with significant ethical concerns. Dr. Biemer is not the first, nor will he be the last doctor in the metro area to switch to this kind of healthcare.

We first wanted to air this story last week, but made a last minute decision to hold it so the doctor could get the last round of his letters out to his patients. Imagine finding out about this on the evening news as opposed to from your doctor! I also wanted to talk to ethicists directly to refresh my memory on the issues surrounding this debate and could not for the life of me line up a local ethicist who would talk.

I did find one out-of-state. Dr. Arthur Caplan at the University of Pennsylvania Center for Bioethics sees several ethical issues:

Concierge medicine creates a two-tiered system of healthcare that excludes those who can't afford it.

Concierge medicine forces people to pay for services that should be routine in our healthcare system. He sees this as a flaw in the system-- not with individual doctors.

And, he asks, where does the money go? Statistics show concierge doctors make more money on average than their conventional counterparts.

Concierge doctors will tell you the money isn't always better, especially if too few people enroll. They will express thier dissatisfaction with cramming too many patients into a day-- allowing 15 minutes each. They will complain about reimbursement rates that are so low they can't adequately cover the cost of providing care, let alone provide for thier families.

Here are some really excellent links that I looked over in working on this story.

This is an AARP bulletin on the topic:
http://www.aarp.org/bulletin/yourmoney/a2004-11-11-boutique.html

And here is a GAO report that is long, but there is a synopsis at the front:
http://www.gao.gov/new.items/d05929.pdf

This is written by a concierge physician:
http://www.physiciansnews.com/business/204.kalogredis.html

This is written by a group representing doctors:
http://www.kgw.com/news/pdf/ImpendingCollapse.pdf.pdf

And this is from another group representing doctors... the American Medical Association. Click here for the AMA position

Viewer responses:

J writes:

A year ago, due to my former primary care physician's retirement, I was looking for a new physician. In my pursuit the idea of concierge physicians was considered. However, even though I had the means to pay the annual fee, I did not feel the benefits were worth it. I continued my search and found a physician who is not a concierge physician, but one who spends an enormous amount of time with each patient, both in the office and over the phone when necessary. He limits his practice to a finite number of patients in order to keep the quality of care high. I feel very fortunate to have found the physician without having to pay any annual fee and I don't think I would be too anxious to pay such a fee in the future if there were any other choice.

Thank you for doing this story. It is certainly an interesting concept.

A writes:

I would absolutely pay my Doctor for more time and personal attention! I think $600.00 is a smart investment for email access, same day appt.'s , and even house calls!! Wow! I would know that when I called he would know me by name and face and be there in any emergency! If it were my children's Pediatrician I would do it too!!

R writes:

I think that we pay more than adequately for our health insurance as well as our deductibles when we go to an appointment.

That's all... again, feel free to email me: sstricklen@kgw.com