Retainer medicine: an ethically legitimate form of practice that can improve primary care

Retainer medicine has become an important yet controversial form of primary care practice in the United States, coming under attack for its purported failure to measure up to professional ethics. Critics opine that retainer medicine obstructs professional commitments to health care access and social justice. Some ethicists urge that society should restrict or ban retainer medicine; professional organizations have yet to take a stand. The authors believe that retainer medicine is compatible with professional ethics and will more likely aid in solving the difficulties facing primary care rather than add to them. Although professional ethics should evolve to address new conditions, a condemnation of retainer medicine is warranted neither by traditional ethical precepts nor by contemporary developments in medical ethics. Any move to sanction retainer medicine under the banner of professionalism or professional ethics will be counterproductive. The primary care shortage will only get worse if physicians in retainer practice leave primary care altogether, a likely outcome of legal or professional condemnation of retainer practice.