Concierge medicine and patient-centered medical homes: How perception masks similar care goals

By Jill Gardner on November 11th, 2010

William Shakespeare wrote, “What's in a name? That which we call a rose by any other name would smell as sweet.” But healthcare PR and marketing experts know better.Take, for example, two current healthcare trends: the patient-centered medical home (PCMH) and concierge medicine. Their monikers help contribute to vastly different levels of appeal.The “patient-centered medical home” sounds great, doesn’t it? Invokes images of homemade chicken soup, mom and Marcus Welby all working to soothe your ills away. Who wouldn’t want that?

Now consider “concierge medicine,” or “boutique medicine,” as it’s also called. The term conjures thoughts of personal service, to be sure—but for a fee. With this phrase, the warm, fuzzy, down-home PCMH sentiment turns decidedly upscale, less accessible. Concierge doctors, many feel, are simply trying to gain more money by treating only well-to-do patients.The very labels used to describe these two models of care pit Hollywood against Main Street. Yet, if you set aside reimbursement differences, one could easily argue that both seek to provide patients with the same clinical goals: better, more personalized, wellness-focused primary care.The NCQA defines PCMH as a care model “…that seeks to strengthen the physician‐patient relationship by replacing episodic care based on illnesses and patient complaints with coordinated care and a long‐term healing relationship…each patient has an ongoing relationship with a personal physician who leads a team that takes collective responsibility for patient care.”That same personal relationship and focus on preventive medicine is precisely what attracts many physicians—and patients—to the concept of concierge medicine. One online article from earlier this year, for instance, highlights a Chicago internist who turned to concierge medicine after a watershed moment, when a longtime patient said she no longer wanted him as her doctor because he couldn’t devote the time and attention she wanted.We all want Marcus Welby, but he had the time to make house calls. PCMH and concierge medicine both are models of care that attempt to fight against the declining reimbursement and rising overhead costs that now are forcing physicians to see more and more patients just to stay afloat. The names of these care models, however, help influence our acceptance of them.A rose by any other name. Maybe, with the right emphasis, “concierge medicine” could smell just as sweet as “patient-centered” care.