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Former Surgeon General Dr. C. Everett Koop, Pioneering Pediatric Surgeon, Public Health Leader and Dartmouth Graduate, Dies at 96

February 25, 2013

 HANOVER, N.H.—Former Surgeon General of the United States C. Everett Koop, MD, a pioneer in the field of pediatric surgery, a leader in the fight to create a smoke-free nation, and founder of the C. Everett Koop Institute at Dartmouth's Geisel School of Medicine, died peacefully in his home in Hanover, N.H. on Monday, February 25, 2013. He was 96 years old.

A 1937 graduate of Dartmouth, Dr. Koop was known as "America's Family Doctor" during his time as Surgeon General of the United States from November 1981 until October 1989. Surgeon General Koop applied his skills as a clinician and healer to address the health challenges of all Americans and all people worldwide. During his tenure, he continued the fight against tobacco and focused new national attention on diet and nutrition, the benefits of physical activity, mental health issues, environmental health hazards, disease prevention, and health promotion. At a time of a new emerging threat to the public's health, Dr. Koop became the voice of calm and compassion, of knowledge and facts as the federal government's chief spokesperson and educator on HIV/AIDS. Using the best science and evidence he spoke candidly and honestly to young and old to address the many dimensions of this threatening disease.

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Why concierge medicine will get bigger. Practices could shield patients from health-care turmoil

By Elizabeth O'Brien

If you've joined a concierge medical practice, recent trends in the worlds of health care and insurance may have you feeling good about your decision. If you haven't signed up with one of these practices—also called "boutique," "personalized" or "private-physician" practices—some of those same trends may lead you to consider it down the road.

Certainly, plenty of baby boomers have done the math and deemed the investment worthy. In the typical concierge experience, a primary-care doctor accepts insurance for routine services but also charges a non-reimbursable fee that pays for amenities like 24/7 access to the doctor, same-day appointments, longer appointment times and a greater degree of personalized attention. The annual fee for such practices currently averages about $1,800.

Now that the business model has been around for a while, more patients are saying that it involves less stress than a traditional medical practice. What's more, two recent studies that tried to measure the health impact of one popular concierge model found its patients had lower hospitalization rates and other benefits.

The approach has its critics, with some arguing that concierge medicine exacerbates the disparities in care between the haves and have-nots. But for people with the resources to afford it, the boutique-practice model clearly has a growing appeal.

While the number of concierge doctors remains small, it's growing at a rapid clip. In the U.S., there were about 4,400 private physicians in 2012, a 25% increase from 2011, according to the American Academy of Private Physicians. That's out of some 600,000 practicing doctors nationwide. At an average of roughly 350 patients per concierge doctor, that means more than 1.5 million Americans are under the care of a physician who provides an additional level of service in exchange for a fee.

Concierge medicine's perceived advantages will only grow in the coming years, experts say, as the traditional health-care system becomes even more strained. The full implementation of the Affordable Care Act next year is expected to bring more than 20 million formerly uninsured patients into the health-care system through 2022, exacerbating an existing physician shortage.

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