We recently overheard a conversation about “boutique medicine” and whether that term applies to the Boothbay Region Health Center. The term “boutique medicine” does NOT apply to community health centers. Actually, quite the opposite is true.
A “boutique” is defined as a small, retail store, especially a fashionable, specialty store marketing to a small, particular (elite) clientele.
As some (many?) doctors are getting fed-up with the way the practice of medicine is going, they are establishing “boutique” practices. These practices usually cater to a small, select patient panel – typically well-insured or able to afford “boutique” fees to get “special” attention. The so-called Direct Primary Care model that is gaining popularity among some discouraged physicians might be one example of “boutique medicine”.
What we are talking about for the Boothbay Region Health Center is quite the opposite. We propose a “comprehensive primary care” practice — not a “specialty” practice. And we are targeting the entire community population — not a “small” select group. In particular, we aim to serve the community of patients who may not currently be well-served by existing primary care services due to any of several reasons. We aim to serve any who need primary care and medical service — conveniently, effectively, efficiently, affordably, and with compassion in a committed relationship between patients and providers.
“Boutique” medical practices typically exclude patients who are uninsured or who are covered by Medicare or Medicaid for whom reimbursement is “limited” and usually requires a markdown or contractual adjustment from the normal fee schedule charge. That is not at all what we propose.
We have discussed the idea of offering a “cottage membership” to part-time seasonal residents who have a primary care provider “back home”. These folks may have one or more chronic conditions for which they need attention while they are here. We understand that it is often difficult or impossible for these folks to get in to see one of the local doctors who already have full practices. These patients then often end up going to Urgent Care or to the Emergency Department for episodic, expensive care of their problem. We might offer a “capitation fee” arrangement to these folks whereby they pay a monthly fee while they are here, we provide their primary care needs while they are here, and we coordinate our care with their primarycare provider back home. Some folks may confuse that idea with “boutique medicine”.
For more information about “boutique medicine”, Click here: aarp: Is a ‘Boutique’ Doctor for You?