Boutique care dangerous for US healthcare

Tufts-New England Medical Center (Tufts-NEMC) has entered highly contentious territory with its decision to offer boutique care services. In a boutique care system, patients willing to pay high retainer fees receive benefits that go "above and beyond basic healthcare." These "VIPs" get more access to doctors, more comfortable facilities, and longer appointments. Tufts-NEMC expects the income generated by retainer fees will finance the hospital's money-losing primary-care practice, which serves regular and low-income patients.

Critics have pointed out that the extra services provided by boutique medicine often leave physicians with less time to divide up among their non-elite patients. Tufts-NEMC has preemptively addressed the problem by setting up a system in which the primary care practice will only miss one of its 24 doctors at any given time due to retainer services. The fact that the physicians will not be pocketing the annual fees -- unlike at most boutique operations -- further demonstrates that Tufts-NEMC's decision to move to a retainer system is sincerely geared towards continuing to serve the community. Most other boutique care services are motivated by profit.

But relying on boutique care revenue to patch-up the shortfalls of the current healthcare system may be the beginning of a dangerous path. Dwindling resources for primary care patients may eventually force patients seeking decent coverage to pay for boutique care, while a greater number find that basic care is beyond their reach. The United States already spends more on healthcare than any other country, yet more than 40 million people in this country lack access to reliable care. While Tufts-NEMC's effort to solve the problems brought up by the conflict between health care access and cost is admirable, it is certainly not the ultimate solution so badly needed to America's health care crisis.