Essential provisions of retainer contracts

Contract Language. By Steven M. Harris, AMNews contributor. March 10, 2008.

CONTRACT LANGUAGE

A column examining the ins and outs of contract issues

SEE ARCHIVES

Physicians who elect to try concierge medicine in an attempt to be free of health plan contracts, should remember that they are not completely free of formal arrangements with payers.

It's just that the payers are now your patients.

Whatever you call your arrangement -- "concierge medicine," "retainer medicine," "boutique medicine," "executive health program," "platinum practice," "personalized health care" or "luxury health care" -- a formal contract with patients is key to ensuring that what you will give patients for their annual and/or monthly fee is spelled out clearly.

In 2003, the American Medical Association issued ethical guidelines for retainer contracts. According to these guidelines, the physician and the patient should understand and agree upon the terms of the relationship.

The patient should not be subject to undue pressure from the physician or the physician's staff to enter into the agreement. Also, the retainer contract should not be promoted as a promise for more or better diagnostic and therapeutic services.

There are three provisions that should be included in every concierge medicine retainer agreement: services, fees and termination.

The retainer agreement should clearly define which services are covered and which are excluded.

Services that are typically covered are same-day or guaranteed next-day appointments; 24-hour pager, cell phone and/or home phone access to the physician; and limited waiting times.