As medicine increasingly becomes a business, will it's characteristic collegiality be eroded?
As a specialist, I am often asked for "curbsides" about patient I don't see and for which I don't get reimbursed. As one of my life's overall goals is helping sick kids (or keeping them well in the first place) and as a faculty memeber at an institution that promotes learing, I don't particularly mind this. Plus, there may be some indirect benefit in that docs who I give advise to are more likely to send me patients in the future. In fact, many who call for advice already refer a lot of patients my way. Plus, I see most pediatricians as overworked, (relatively) underpaid, and struggling to keep up with the constant flow of new information about how to treat every disease of childhood as well as what is and isn't recommended for well-child care. To the extent I can help, I'm happy to. Heck, I answer all the crazy and not-so-crazy emails I get from people who read this blog and want free medical advice
But a recent experience has me wondering if this kind of attitude won't change. A few months ago I got a call from a physician I didn't know and spoke with him for 10 minutes or so about chronic urticaria (hives). I even sent him a review article on the subject. Later I found out he operates a "concierge" practice in which he charges patients just to be in his practice. The fees are steep (>$1000 a year for younger kids, less for older) and I presume he makes a lot more than the average pediatrician. I found myself a bit mad that he'd felt free to take up my (uncompensated) time so he could pass the information on to parents (probably crediting it as coming from a specialist at my locally prestigious hospital) and justify his fees, which effectively exclude most children.
I'm still not sure exactly how I feel about this issue, and I still talk to whoever calls me, but if calls from concierge docs became more frequent, I'd consider tryng to charge them for advice. My rationale would be they've made their practice into businesses first and foremost, why shouldn't that same principle apply to them?