Two doors, two classes of service at clinic

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

Two doors represent two different tiers of service in one New York City clinic, according to MSNBC.com reporter Bill Dedman. MSNBC.com sent two producers to see how meaningful the differences in the two tiers prove to be.

One side of the clinic, Lenox Hill Radiology, takes insurance but patients wait longer for appointments, experience a crowded waiting room, might see only a technician and must wait days for their results.

two-doorsJust around the corner, patients who pay cash up front enter through a door to New York Private Medical Imaging that leads to the same changing rooms and scanning equipment. Those patients get appointments more quickly, wait in a private reception area, get perks like spa robes and see a doctor who immediately gives them results of their scan.

Dedman writes about the “subtle” differences in which the two patients/producers were treated and a bioethicist weighs in on “boutique” or “concierge” health care, in which patients pay up front and the clinics do not take insurance. The bioethicist did not see the differences as subtle.

The owner of the clinics says she knows of other doctors in the city that run similar clinics with two doors. Employees are forbidden from talking about the system to avoid allegations of fraud. “Steering of patients to a more profitable service would violate the clinic’s contracts with insurance companies.”

AHCJ member JoNel Aleccia’s companion story looks at the growth of “concierge” practices and their effect on the growing “chasm between the haves and the have-nots.”

The move to smaller, premium practices will worsen an already dire shortage of primary care doctors, creating an elite group of well-compensated physicians who see fewer and fewer upscale patients, dumping the rest on their increasingly harried colleagues, critics contend.

Aleccia’s story includes information from doctors who have made the switch to concierge practices about how the finances break down and what motivated them to make the change, as well as their patients.

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