Dr. Pauline Chen, a super specialist, wrote an elaborate article in the NY Times on how primary care physicians at Tufts Medical Center are offering the patients the option of being part of either a traditional general medical practice or a retainer practice. They justify this by using the money made from retainer or concierge practice to cover the costs of the regular one. It's kind of like carbon offsets. It's not that I begrudge concierge medicine; I consider it an option for me someday. It just bothers me when anyone becomes judgmental about it. Primary care docs don't get paid nearly what their counterparts, like Dr. Chen, do. The fact that Tufts has to revenue share like MLB is proof of that. Anyway, the chief medical officer feels good about it because "using their retainer fees for this type of support helps them see that they are actually making a contribution to teaching and community service, which are the mission of this hospital.” I guess he is talking about teaching medical students. FYI, the cost for going to Tufts Medical School for four years equals about $360,000. And though the Dean may brag about how many medical students are going into primary care, most will specialize leaving on around 2% to do the job. My hunch is that this hybrid clinic isn't going to change many of their minds.