Forum: Providing medical concierge services may not address patients' needs
A recent Opinion piece on healthcare costs (Some practical ways to rein in rising healthcare costs, premiums, May 21) mentioned how insurers can provide medical concierge services to direct patients to specialist doctors, based on their Integrated Shield Plans.
As a general practitioner (GP) since 1985, I have always referred my patients to specialists within their budget who I personally know have the skill sets that are relevant to their specific medical issues. For example, I would refer a young female patient with an enlarged thyroid gland to a surgeon I know is specially noted for neat, fine scars.
A young man likely to need prostate surgery for possible cancer would be sent to a urologist I know is exceptionally careful about conserving urinary continence and erectile function.
And I would send a patient with recurring bladder cancer to a hospital with a large multidisciplinary urology department – because I foresee that the patient will eventually need care available in an integrated group.
All this care in matching patients' needs with surgeons' skill sets can be wiped out by medical concierges referring patients to other specialists – with choices based on 'lower charges'.
Of course, it can be said that all general surgeons can do thyroid surgery competently, or all urologists can do a prostatectomy competently upon completing their specialist training.
But while all surgeons and all hospitals are competent, some are exceptional, and this matters in more complex cases. That is why many GPs try to match an individual patient's medical needs to doctors with specific skill sets.
In contrast, a medical concierge could simply locate another specialist who could be charging less and shunt the patient there, indifferent that the patient could have had a better outcome with the original specialist.
Is this acceptable?
Dr Lee Pheng Soon
Former president of the Singapore Medical Association
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