Boutique Medicine

Boutique medicine is a term that is used more often and coming into our popular lexicon. By most definitions boutique medicine is used to describe a type of physician practice which has a few distinguishing characteristics that separate it from conventional physician practices. Typically a boutique practice is set up to cater to a limited number of patients who pay a premium, often times, an up-front enrollment fee ranging from $1,500 to $20,000 a year, in exchange for unlimited and unfettered access to the practice’s physicians. A boutique practice is usually comprised of two or three physicians who limit the number of patients they each treat to approximately 600 – 800 patients. By limiting the number of patients under their care, the physicians are able to spend more time with their patients, offer same day appointments, and usually increase their net income in the process. From the patient perspective, the annual premium is money well spent in exchange for this personalized and prompt care. Taken at face value, the boutique concept of a physician practice is American capitalism at its very best, free enterprise at work. At its very worst, the boutique concept is an elitist, unethical, and immoral business practice, which further divides the rich from the poor. Imagine for a moment an economically depressed area with a desperately underserved patient population. Hundreds and thousands of patients, in fact, all needing a surgical intervention that would save them from a lifetime of blindness through a simple cataract procedure, yet none of these patients having the means to pay for such an operation. Now imagine in that same country the wealthiest of the wealthy being given red carpet treatment in the plushest of facilities for the very same cataract affliction using state of the art equipment, technology and methods, a boutique practice, if you will. The only thing separating these two groups of cataract patients is the ability to pay. Now imagine further a scenario whereby the profits from the boutique practiced were used to finance a second practice that provided the same service, same world-class technology and cutting edge methods, minus a few of the red carpet frills to the population of poor patients. The physicians operating the practice by all reports are well satisfied and well compensated. The patients pay a premium for their care and are well satisfied with the quality of their care. So what effects do well paid, well-satisfied doctors and well-satisfied patients have on their local community’s health and healthcare system? The next issue beyond simple dollars is to look at what is happening because of health care to this select part of the population, the boutique patients, here in the U.S. Satisfied patients enjoy better health and satisfied physicians practice better medicine, both of these positive affects contributing to the overall improved health of the community at large. Perhaps a practical example might further illustrate this important point. Because of a patient’s wealth, he is able to a obtain a necessary flu shot before winter sets in. Yet, it is understandable that our instincts tell us that it is precisely disparities such as these, are unfair. But the focus on the disparity itself is one that often times further confuses the issues. Taking away boutique medicine will do nothing to decrease disparities in a community’s health. While boutique medicine may admittedly have a distinctly bad taste for some people, it is nevertheless distinctly good medicine for some people.

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Health

 Generally, the context in which an individual lives is of great importance on health status and quality of life. It is increasingly recognized that health is maintained and improved through not only the advancement and application of health science, but also through the efforts and intelligent lifestyle choices of the individual and society. According to the World Health Organization, the main determinants of health include the social and economic environment, the physical environment, and the person's individual characteristics and behaviors. The maintenance and promotion of health is achieved through different combination of physical, mental, and social well-being, together sometimes referred to as the “health triangle”. Health Promotion furthered that health is not just a state, but also a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities. Systematic activities to prevent or cure health problems and promote good health in humans are delivered by health care providers. Applications with regard to animal health are covered by the veterinary sciences. The term healthy is also widely used in the context of many types of non-living organizations and their impacts for the benefit of humans, such as in the sense of healthy communities, healthy cities or healthy environments. In addition to health care interventions and a person's surroundings, a number of other factors are known to influence the health status of individuals, including their background, lifestyle, and economic and social conditions; these are referred to as determinants of health. Health science is the branch of science focused on health. There are two main approaches to health science: the study and research of the body and health-related issues to understand how humans (and animals) function; and the application of that knowledge to improve health and to prevent and cure diseases and other physical and mental impairments. The science builds on many sub fields, including biology, biochemistry, physics, epidemiology, pharmacology, medical sociology, and others. Applied health sciences endeavor to better understand and improve human health through applications in areas such as health education, biomedical engineering, biotechnology and public health. Organized interventions to improve health based on the principles and procedures developed through the health sciences are delivered among practitioners trained in medicine, nursing, nutrition, pharmacy, social work, psychology, physical therapy and other health care professions. Clinical practitioners focus mainly on the health of individuals, while public health practitioners consider the overall health of communities and populations. Workplace wellness programs are increasingly adopted by companies for their value in improving the health and well-being of their employees, as are school health services to improve the health and well-being of children. Personal health depends partially on the active, passive, and assisted cues people observe and adopt about their own health. These include personal actions for preventing or minimizing the effects of a disease, usually a chronic condition, through integrative care. They also include personal hygiene practices to prevent infection and illness, such as bathing and washing hands with soap; brushing and flossing teeth; storing, preparing and handling food safely; and many others.