I don't personally have a problem with people paying extra to receive what they perceive to better care. But I think if you look at outcomes, I doubt you will find that they have received better care by paying the extra 40k or whatever it is a year. It's great that the kid in the story was able to be seen by a established orthopedist in a city hospital - but most general orthopedists know how to set a kids leg, and I doubt the outcome would have been much different if they had gone to the originally intended ER.

It's certainly a good gig for the family practitioner, but I think the following quote at the end of the article:

"“The traditional model of having a good internist is dying,” said Mr. Traina, a scion of a prominent family here that arrived with the California Gold Rush.

will apply to the concierge doc in the longer run as well. If you are reasonably healthy, checking your blood work once a year and your blood pressure every so often, you don't have much need for a family doc. If catastrophe strikes, then you will probably need a specialist - and if you're willing to spend the money, it's best to save it for these times - yes your cash will get you in as easily as a concierge doctor can - rather than dishing out 40k annually.

I recently chose a medical clinic that's part of a university system for my own healthcare, as opposed to a family doc who charges $1400 for an initial exam and $400 for follow ups. Do they spend as much time with me? No, I'm in quick and out quick. I get my shots and blood work and I'm out the door. Since I'm pretty healthy, that's the way I want it.