Bernard Lo, MD
Disclaimer: The views expressed in this article are solely the responsibility of the authors and do not necessarily represent the official view of the National Institutes of Health.
Acknowledgment: The author thanks Laurie Dornbrand, MD, for providing insightful comments and helpful feedback on drafts of this article.
Grant Support: By the Greenwall Foundation and by National Institutes of Health grant MH062246. The funders played no role in the design and writing of this article.
Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-2120.
Requests for Single Reprints: Bernard Lo, MD, University of California, San Francisco, Suite C-126, San Francisco, CA 94143; e-mail, email@example.com.
Lo B.; Retainer Medicine: Why Not for All?. Ann Intern Med. 2011;155:641-642. doi: 10.7326/0003-4819-155-9-201111010-00016
Download citation file:
Published: Ann Intern Med. 2011;155(9):641-642.
What's not to like about retainer medicine? Patients and physicians both want unhurried visits, improved access, and better continuity and coordination of care. Physicians also welcome less stress and higher income per hour of clinical practice. In contemporary business parlance, retainer medicine is a win–win situation—as long as you're part of the “in” group.
Critics charge that retainer medicine is unethical because it increases disparities and poor access to primary care. Furthermore, now that Medicare covers an annual wellness visit, retainer fees that cover an executive physical examination may run afoul of Medicare bans on double-billing (1). In defense of retainer medicine, Huddle and Centor (2) argue that individual physicians, including those practicing retainer medicine, have no ethical obligation to supply any particular amount of primary care. Physicians fulfill their ethical duties simply by providing competent and ethical care within the framework set by society. Access is society's problem to be solved by someone else, such as by legislators, government officials, and insurers. All citizens have some responsibility on societal issues, but physicians have no more than others. Huddle and Centor further argue that attempts to ban retainer medicine or to prescribe a minimum patient panel size will be misguided, unsuccessful, or even counterproductive.
to gain full access to the content and tools.
Learn more about subscription options.
Register Now for a free account.
Ethics, Healthcare Delivery and Policy.
Results provided by:
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only