I belong to
the American Academy of Family Physicians (AAFP), the
leading organization for family doctors with about 100,000 members. My physician
brother, more activist than I, belongs to more liberal physician
organizations which are much smaller.
I bought a
lifetime membership years ago, so I’m stuck with it, but its heart is in the
right place. The AAFP wants members to practice high quality, compassionate
medicine and requires that they stay educated and pass a test every seven
years. It expresses deep concern with Americans who can’t afford medical care but
refrains from urging doctors to greatly inconvenience themselves to remedy this.
Most doctors are conservative; the AAFP’s leadership is more politically
sophisticated than its members, but, in the end, it reflects their interests.
That brings
me to today’s subject. I was perusing the AAFP’s weekly news bulletin. One
article cheerfully announced that direct primary care was piquing everyone’s curiosity
and that two physician-entrepreneurs would provide the “inside scoop” in a web
workshop free to AAFP members.
I was
preparing to move on when, with a shock, I realized that direct primary care is
a euphemism for concierge medicine. The AAFP was plugging concierge medicine!!!
That’s like promoting Mexican cancer clinics!
If you’ve
followed this blog you know my low opinion of concierge doctors. They don’t
accept insurance. Patients usually pay a monthly or yearly retainer in addition
to the usual fees; in exchange, they receive quick access, longer appointments,
and, if necessary, housecalls. This money pays for the doctor but nothing else.
Tests, X-says, therapy, specialists, and hospitalization cost extra. It’s a luxury
service.
When
concierge doctors address the public they extol the superior care they deliver
to a grateful clientele. Around the lunch table with only doctors present, they
extol the pleasures of a cash-only practice. I've never met a concierge doctor
I could respect.
Finishing
the article, I hit the “comment” button and forgot my rule about not responding
in the heat of emotion. The satisfaction of delivering my opinion which
included the adjective “sleazy” evaporated when I read the avalanche of abuse
that followed.
Later that
day an E-mail from an AAFP official explained that readers were complaining at
the lack of respect shown in my response, so it was being deleted. It vanished,
but the angry responses remained. You can read them at http://www.aafp.org/news-now/practice-professional-issues/20130508directwebinar.html.
If that’s too much of a mouthful, google “inside scoop on running a direct
primary care practice” and it will turn up.
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