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photo source: Doctors' Single-Payer Prescription for Health Care Reform by By Steffie Woolhandler, David Himmelstein -

The Membership Medicine Straw Man

Tommy McElroy, MD

'Membership Medicine Does Not Provide Universal Access'

What would you say If I asked you ‘What is wrong with that statement?’

If you say, ‘Dr. Tommy nobody ever said it did,’ then go to the head of the class, as Walter Williams likes to say.

That is, membership medicine in all of its forms (Direct Primary Care, Concierge Medicine without Insurance, and Concierge Medicine in addition to Insurance) has never purported to be a way to provide ‘universal access.’ That doesn’t stop it from being used in straw man arguments against membership medicine as a solution to high-cost, high volume primary care.

Membership medicine has a higher profile in the past several months due to ongoing negotiations amongst politicians and lobbyists in DC. As they debate the best way to provide medical care to ‘all Americans’ we should focus on who is a good fit for membership medicine.

The truth is membership medicine will continue to be a minor player in the healthcare world, at least for the near future. Why is that you ask? The cost? The elitist nature of doctors who practice it? The unfair practice of not taking insurance payments? The doctor shortage? The answer is: none of the above.

Membership medicine appeals to patients who want to optimize their health AND spend their own money on their health care. Those who would rather use insurance (third-parties) to pay for their medical care and those who only want to see a doctor when they are sick or need refills will not see the benefit of having a membership medicine doctor. And that is perfectly fine. Also those who would rather have the state provide a ‘universal system’ of health would find membership medicine particularly unappealing for a variety of reasons. Membership medicine is a revolutionary force and it not welcomed among the medical establishment. In fact a leading physician organization, the American College of Physicians, has taken a formal policy stand on Direct Primary Care and Concierge Medicine (

Membership medicine is not the panacea that provides medical care for every American. There’s isn’t one, just like there is no Easter Bunny, Santa Claus, or a federal government ‘plan’ that will provide high quality ‘access’ to everyone. There’s just doctors and patients doing their best to find solutions that fit their needs. Luckily for the ones looking for a
free market approach to private medical care that utilizes technology for optimal delivery with an individual touch, there is membership medicine.

Dr. Tommy McElroy is a concierge medicine physician in Wesley Chapel, Florida.

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