Dear Dr. Roach: Two years ago, my doctor (whose patient I had been for many years) decided to switch to a concierge practice. He charged $2,000 annually per patient. Neither my husband nor I chose to participate. We found a new doctor who we have been very happy with for the past two years. Now he has decided to go concierge as well.

He is charging $2,000 annually or offering patients who do not wish to participate in a concierge practice an opportunity to pay an “administrative” fee of $500 annually to continue as one of his patients.

Both my husband and I have very good insurance that covers 100% of our medical costs, and I saw my doctor three times last year. I told him that paying an additional payment of over $150 per visit is ridiculous. So, once again, we are looking for another physician.

This appears to be occurring quite often in my area. My question to you is, do you think this is right? — P.E.

Answer: In my opinion, concierge medicine can be done ethically, but I have real questions about the way your physician is moving to a concierge or “retainer” medicine practice.

If a physician chooses to move to a concierge model, which by itself is not unethical, they ought to help their existing patients find care and aid with the transition.

I don’t agree with the $500 “administrative fee” per year, which sounds like a charge solely to remain as his patient and get no additional service.

I understand the benefits of a concierge practice to a physician, and for those who can afford it, there are advantages for the patient, too. But it is my personal opinion that we physicians have an obligation to provide care.

I have known concierge physicians who volunteer at free clinics as a way of fulfilling their professional obligations.

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