University of Michigan faculty criticize concierge medicine program for letting patients 'jump the line'

A concierge medicine pilot program that intends to enhance patient access to primary care physicians at Ann Arbor-based University of Michigan's Michigan Medicine is drawing criticism from university faculty, who claim the program is being used to "jump the line" and is discriminating against underserved patients, according to MLive.

The concierge medicine program, called Victors Care, is a direct primary care program that charges patients an annual membership fee to obtain more access and time with their primary care physician. The program is currently accepting enrollees.

Physicians in concierge medicine practices limit the number accepted patients to 20 percent of the number accepted in traditional primary care practices, according to Michigan Medicine. This limitation allows physicians to give more time and attention to each patient. 

Michigan Medicine faculty detailed concerns about the launch of Victors Care in a Jan. 29 letter to UM CEO and Executive Vice President for Medical Affairs Marschall Runge, MD, PhD, and Executive Vice Dean for Clinical Affairs David Spahlinger, MD. The letter asked to "stop recruiting our patients to this program and advertising it as providing much better care than all the rest of our primary care clinics." 

"As primary care physicians, we struggle on a daily basis to get our patients in to see specialists and to get critical testing," the letter reads. "Instead of addressing this critical barrier for all patients at Michigan Medicine, the implication is that Victors Care will now allow those who pay to jump the line. Some of our specialist colleagues have told us they fear being pressured to fit Victors Care patients ahead of others as they were not asked how they felt about having Victors Care." 

Faculty also expressed concern that the "quality care" label provided through Victors Care implies regular primary care physicians do not provide quality care, with "many" physicians noting Victors Care will "cherry-pick" patients more likely to be in good health. The faculty argued this could worsen quality measures for physicians outside of the Victors Care program by leaving them with more "sicker, poorer patients."

"Taking a physician from regular practice and reducing their patient load to 400 patients will mean that those other 1000-2000 patients will now be moved to the rest of us to assume their care, reducing access to care for all," the letter reads. 

Michigan Medicine Spokesperson Mary Masson acknowledged some faculty raised concerns about the program and said Michigan Medicine is working with this group on mutually satisfactory solutions that would benefit patients.

"We're committed to ethical, accessible care for all our patients and whatever programs we put in place should not diminish that in any way," Ms. Masson told MLive. "This will not adversely affect the access of other patients to our outstanding health care system." 

More articles on healthcare quality: 
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WSJ report spurs House oversight of hospital accreditation processes

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