A recent Press Herald editorial seems to imply that concierge medicine is a step forward in dealing with the desperate problems of our medical care delivery system (“Concierge medicine shows value of quality,” Nov. 30). I believe this is definitely not the case.

There are those among us who have the financial means and a desire to have an investment in a physician who will have more time to provide individual attention to their medical needs. There are primary care physicians who desire to have less professional responsibility through caring for fewer patients, while at the same time preserving high income. Ergo, the market for concierge medicine.

In spite of the improved time/patient ratio, and the possibility of increased patient satisfaction, there is little or no evidence that the quality of care will improve with this new concept.

It is easier to see that physician quality of life and income will rise. If a significant proportion of physicians follow this lead, the results will be a further separation between patients with financial means and those without, and the dilution of physician talent in the community. Doctors not changing to this form of care will become increasingly responsible for those patients who are unable to pay for health insurance.

Their incomes and quality of life may worsen as those of concierge physicians improve.

Therefore, concierge medicine affects much more than those who are involved in it. It is not a concept that will improve the medical care of Portland, in general, and may not even improve the care of those 600 patients who have elected to participate in this new adventure.

David Scotton, M.D., is a resident of Cape Elilzabeth.