– The other day I walked about two city blocks on the Scarborough end of Old Orchard Beach and came back with a shopping bag full of an assortment of nylon ropes.

These multicolored ropes apparently had been cut and tossed into the ocean and were now coming ashore on Old Orchard Beach as well as Scarborough Beach. Because these ropes are an inorganic material, like nylon, their life span could be 10 to 20 years.

My guess is that the lobstermen don’t want to drag cut rope, etc., back to the dock as garbage. Today, responsibility is aroused only by the expectation of financial return.

The only way to stimulate lobstermen into returning pieces of rope rather than dumping them into the ocean is to set up a recycle program and pay per pound for recycled rope — something like the bottle program.

Let’s clean up our Maine beaches and put some money in the lobstermen’s pockets.

Robert J. McManus

Scarborough

Concierge medicine no cure for health care system

In the Nov. 27 Maine Sunday Telegram article (“The doctor is (always) in”) and the Dec. 1 Portland Press Herald editorial (“Concierge medicine shows value of quality”), you wrote about concierge medicine.

Both the article and the editorial profiled local physician Dr. Philip Frederick and his new affiliation with MDVIP. This would allow Dr. Frederick to cut his patient load from 2,000 to 600 patients, thus allowing him to spend more time with and give better service to each patient. All this for a mere $1,500-per-patient annual fee.

The Telegram and Press Herald reported on the positive benefits that may result from this form of preventative medical care. Little was reported on the negative impact it may have on the remaining 1,400 of Dr. Frederick’s patients like my wife and me.

We are retired and on a fixed income, and we already pay thousands of dollars annually for our medical and dental insurance. Spending an additional $1,500 to $3,000 annually is not an option we can afford. I wonder how many of the other 1,399 castaways are in the same boat.

If this is what our medical future holds for us, it is one more reason why we need a national health plan. I’m still trying to accept why a doctor I trusted and respected would even consider such a move. I recently read a quote in The Press Herald: “Don’t place anyone on a pedestal, the only way they can go is down.”

Harold Larrabee

Cumberland

Really? Concierge medicine in Maine? When I read the front-page article on this type of practice in our state, I was astounded. How is it morally acceptable to discard two-thirds of your medical practice in order to “cherry-pick” the wealthier clientele so that they get “better” care?

Bad enough, but then write an editorial extolling the virtues of this elitist practice. As a practicing physician in Maine for 31 years, I am embarrassed at this blatant disregard for the poor and less fortunate.

Who will care for these disenfranchised patients? The burden will be shifted to other practices in the area and the emergency rooms of local hospitals.

I am sure not many people will shed any tears for the “underpaid” doctors only making $100,000 to $200,000 per year in a state that is no stranger to abject poverty and raging unemployment. Shame on doctors who embrace this exclusionary practice, and shame on the newspaper for thinking this is a good idea!

William F. Frank, M.D., A.B.F.M.

Sanford

I was very disappointed in the Nov. 27 feature article on “concierge medicine” and again in the Dec. 1 editorial, which appeared to tout this as the ideal practice of medicine (although it did include some limitations). Both pieces showed lack of insight into and knowledge of the practice of medicine.

I have practiced primary care internal medicine in Westbrook for 33 years and retired a month ago. I have also been involved with (prior president of) the Maine Medical Center Physician-Hospital Organization (including more than a thousand physicians), with its many efforts at quality improvement in the community for years.

Maine Medical Partners, my practice, provides preventive care, in-hospital care and teaching, including initiatives such as the patient-centered medical home to promote primary care. Night and weekend care are provided by all providers in rotation as a team.

Concierge annual fees will award to an individual $600,000 a year before even talking to or examining a single patient (that is obscene and more than three times the annual income of the average full-time internist). Also, $300,000 goes to a company for “support and marketing” for only 600 patients.

Being on call sounds great, but don’t get sick. A telephone call will not treat the problem.

Invariably, these physicians do not admit their patients to the hospital; rather, they pass them on to the emergency room or hospital doctors they’ve never met. This breaks up continuity of care and leads to more mistakes on medications and readmissions because of miscommunications.

I know of no medical literature proving that concierge medicine keeps people out of hospitals better than good-quality primary care does.

Finally, concierge medicine seems like a way for physicians to make more money caring for fewer patients while creating more inequalities in society.

Being on call all the time is to sacrifice one’s family, social and recreational life, and this seems incompatible with normal life activities. Hopefully, this is not where the practice of medicine is heading.

Robert A. Sturges, M.D.

Westbrook