A recent study by Johns Hopkins has rekindled the discussion regarding the effects of fee-based primary care models, like concierge and direct primary care, on healthcare accessibility. The common belief is that these models might deteriorate access. Nonetheless, this view neglects the existing issues in conventional primary care. Access had already been hindered well before the emergence of fee-based models, with patients facing considerable delays in securing appointments and physicians managing unmanageable patient volumes.

The shift of physicians towards concierge and direct primary care is a reaction to dysfunctional systems, not a desertion of primary care. These models provide relief from the limitations of traditional practice, allowing for reduced patient panels and more significant patient interactions, which may help prevent physician burnout. Therefore, the movement of physicians does not equate to the loss of physicians.

The expansion of concierge and direct primary care should not be viewed as the root cause of physician shortages but rather as a sign of underlying systemic problems. Fee-based models did not originate the current crisis; they arose as remedies for it. Misidentifying the problem could result in ineffective solutions.

The issue lies not in the availability of alternative care models but in their corporatization. Corporate influences could apply pressures akin to those in traditional practice, jeopardizing the very benefits that concierge and direct primary care offer.

To tackle healthcare access difficulties, attention should be directed towards why physicians feel the need to transition to fee-based models, emphasizing the necessity for systemic reform instead of restrictions on physician choice.