The relationship and decision making process between patient and doctor has become increasingly disconnected. Pushing them further and further apart is a health insurance system that obfuscates prices, micromanages transactions, and limits choice, and a government set to control the entire industry through bureaucratic command and control polices. Left out of the equation is the doctor – a professional that pursued a career both to serve and make money – and the patient – a consumer who in almost every other aspect of life makes rationale purchase decisions. The problem is the current system does not enable the doctor and patient to interact in a normal fashion, and thus we have looming problems.

According to the Washington Post’s John C. Goodman demand for primary care physicians and routine visits will increase substantially:

“Here is the problem: The health-care system can’t possibly deliver on the huge increase in demand for primary-care services… Take preventive care. ObamaCare says that health insurance must cover the tests and procedures recommended by the U.S. Preventive Services Task Force. What would that involve? In the American Journal of Public Health (2003), scholars at Duke University calculated that arranging for and counseling patients about all those screenings would require 1,773 hours of the average primary-care physician’s time each year, or 7.4 hours per working day.”

At the same time for a variety of factors, the supply of primary care doctors is declining according to Anne Lowrey and Robert Pear writing for the New York Times:

“The Association of American Medical Colleges estimates that in 2015 the country will have 62,900 fewer doctors than needed. And that number will more than double by 2025, as the expansion of insurance coverage and the aging of baby boomers drive up demand for care…Physician compensation is also an issue. The proportion of medical students choosing to enter primary care has declined in the past 15 years, as average earnings for primary care doctors and specialists, like orthopedic surgeons and radiologists, have diverged.”

Under a free market system, high demand and low supply would mean more doctors flocking to serve more patients to make more money. But that’s not happening. Instead, patients are waiting longer and longer for service, and doctors are pursuing better ways to earn a living. One of those ways is leaving general practice altogether, but another is the concept of concierge medical care. In concierge medicine, you pay your doctor a yearly set fee in exchange for access and better service. This retainer fee can be as low as $1,500 per year. If a concierge doctor signs up 150 patients, his income is $225,000 per year. And because his income comes directly from his patients, he doesn’t have to spend time and resources billing, authorizing, and dealing with insurance carriers or government. The perks for the patient include more attention, house calls, mobile phone and email accessibility, and the ability to set a same day appointment.

Think of concierge medicine as a return to the family doctor of yesteryear. It requires you to change your perspective and pay out-of-pocket for service. But if health care is a priority and quality of service a factor – it may become the new realty for those who can afford it.