Retainer Medicine: Ethical or Not?

Some might argue that these “highly ethical physicians” aren’t so highly ethical by practicing retainer medicine. One ethical framework would suggest if all physicians just practiced retainer medicine, there would not be nearly enough physicians to go around. In that framework, retainer medicine would be viewed as unethical.


If retainer physicians are unethical, then what about physicians who quit seeing patients entirely and enter medical administration. What about any variety of subspecialists?

Upon further reflection we should learn from this ongoing entrepreneurial experiment. Why are patients choosing to spend moneys on retainer medicine? I believe patients are smart. They are tired of the relative inattention that most physicians can provide.

Comments are moderated before they are published. Please read the comment policy.

  • Anonymous

    Why is one economic model of physician compensation ethical and another is not?

    Fee-for-service with insurance, or direct payment “insurance-free” practices”? An emloyed model? Staff model HMO? Retainer?

    Assuming the services paid for are actually delivered. Why is one ethical and another is not? In any model, there will be someone unwilling or unable to pay what is expected.

    Maybe the only “ethical” model of physician practice is to take an absolute vow of poverty. That way, there will be no one unable to access your services.

    Until you roll over dead, I suppose.

  • Anonymous

    The previous post reads in part: “Maybe the only ‘ethical’ model of physician practice is to take an absolute vow of poverty. That way, there will be no one unable to access your services.”

    The last sentence should be, “That way, there will be no one ABLE to access your services.”

    None of my staff are willing to work without pay. My rent is due each month. My malpractice carrier wants money. Staples wants to be paid for paper. My mortgage holder doesn’t care about the ethics of patient care…

  • Anonymous

    The only ethical model of practice in my point of view is strict market controlled fee for service payment in full at the time of service practice. A doctor with a decent revenue stream from such an obviously equitable arrangement will have no problem seeing the occassional gratis patient who couldn’t afford the market rate. Nowadays with even most insured and medicare patients reimbursing doctors less than their overhead for a visit, there is a strong negative incentive to be too altruistic to the needy. I would suggest taking a look back at at time when medicine was handled this way in the US, pre-medicare, pre HMO. Was it really so bad? Did we hear about medical bankruptcy constantly? Didn’t the doc operate on the appendix regardless of the patient’s ability to pay back then?
    From what I can see, the more government meddles in healthcare, the more fricked up it becomes. Lastly, what the hell is ethical about healthcare company CEOs getting BILLION dollar compensation plans while doctors stuggle to “spin their gerbil wheels faster” just to make ends meet. I doubt most Americans are smart enought to realize that in the long run, the cheapest best quality healthcare will come from a totally free market system and that there indeed is no system existing or fathomable that gives everything to everyone anytime they want with no one falling through the proverbial safety net. Such utopian socialist fantasies are a waste of time. And for people who think doctors will work for taxicab driver wages – think again. Most doctors are at least average intelligence, they should be able to make a living doing something else pretty handily. The previous poster is correct. Doctors have NOT taken a vow of poverty to become doctors. If that becomes a requirement, be prepared to simply have NO DOCTORS.

Most Popular