Re "Full access to a medical specialist? It'll cost you," Column, Sept. 24

David Lazarus misses the target. The medical marketplace is not about having the right mix of Corollas, Cadillacs or Bentleys. The concierge movement in medicine — in which patients pay a premium to have increased access to their physicians — is a reaction to our failed healthcare system.

With unfunded mandates, rising expenses and reduced reimbursements, what is a physician to do?

The real blame for concierge medicine lies with failed government policy that allows our health insurers, pharmaceutical companies and hospitals to continue their feeding frenzy while the rest of us struggle to stay above water.

Remember when physicians could practice medicine unencumbered? Today, they are under siege from all sides and have difficulty focusing on the patient. The healing process has not yet begun.

Jerome P. Helman, MD

Venice

These concierge programs strike me as a terrible idea. They are unnecessary, they play on the fears of patients and they hurt the image of doctors.

If a concierge patient receives care that improves her health and survival, then that care should be provided to all patients. However, it is more likely that concierge care does little to improve a patient's health and is actually a shakedown.

Omar Araim, MD

Visalia

As a registered nurse and patient at the Pacific Heart Institute in Santa Monica, the clinic Lazarus profiled that provides concierge care, I would like to speak to the other side of the issue of extra care costs.

If Mike Oppenheim — the Pacific patient who pays for increased access to his cardiologist — wants his personal specialist on call 24/7, he is living in the past. If every patient thought this way, there would be long lines of requests for overworked, tired doctors.

I have at times chosen to pay $500 extra a year to receive priority appointments and prompt test results, and at times I have been unable to do so. I carefully self-evaluate before every call to my cardiologist. I have received appropriate care each time.

The alternative of repeated emergency room visits is ultimately much costlier.

Donna Rosien

Los Angeles

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