HealthJuly 15, 2020

What is concierge medicine?

By: Brian Wu, MD, PhD

What is concierge medicine? As physicians look for ways to cut through the noise and focus on their patients, this trend is gaining steam.

If you've found yourself frustrated with having too many patients to see and not enough time to see them, you may have considered transitioning to a concierge medicine practice.

While the number of concierge doctors remains small, concierge medicine is a growing trend among individual clinicians and medical centers. But before you convert, it's important to understand what this type of medical practice entails.

What is concierge medicine?

According to Concierge Medicine Today, concierge practices are characterized by:

  • Round-the-clock patient access to the doctor, usually via cellphone.
  • Same-day appointments.
  • Appointments that last long enough for patient needs to be thoroughly addressed.

According to Healthcare Dive, this kind of system was first developed in 1996 in Washington and Oregon by a company originally called MD2. Other companies across the country eventually followed suit.

Under this system, physicians often cut out the third-party payor, creating a direct financial relationship between patient and doctor. What does this look like monetarily? In return for the amenities listed above, members pay a fee, usually on a monthly or yearly basis. DocWire News reports that fees for concierge medicine average around $135 to $150 monthly, though they can be as high as $25,000 a year. The average salary for a concierge physician is $300,000, though these doctors have 80% to 90% fewer patients than their traditional practice counterparts.

It can be hard to collect data on this particular brand of medicine, but it does appear to be catching on. In the 2018 Survey of American Physicians, 6.6% of respondents reported that they were currently practicing concierge medicine, and another 2.4% planned on transitioning to this model fully, while 9.9% said they would transition in part.

Concierge Medicine Today notes that growth in this industry is estimated to be 6% to 7% a year. While most of this growth is in family and internal medicine, there was also a 6% to 7% increase in specialists entering concierge practices between 2014 and 2018. It's also important to note that many well-known medical centers, including the Cleveland Clinic in Ft. Lauderdale, have opened concierge medicine programs.

The pros and cons of concierge medicine

Advantages

One of the most frequently cited reasons for converting to a concierge medicine practice is having more time to spend on patient care. In an interview with Forbes, Jeffrey Friedman, MD, director of medicine at Community Health Associates, said, "My decision to convert my medical practice was based on my desire to be able to provide patients with the level of care I believe is essential not only to treat illness but also to help them avoid becoming sick."

Many physicians also feel that a lighter patient load makes their practice feel more personal and targeted to the communities in which they practice. There may also be economic advantages to concierge medicine, since it cuts overhead costs and takes away the need for medical billing and coding staff.

Drawbacks

However, physicians who are considering this move should be aware of the possible disadvantages. When making the switch from traditional to concierge medical practice, physicians can risk the loss of patients from their practice, and just because a doctor has fewer patients doesn't mean that they'll have more time for themselves. Concierge medicine patients tend to have high expectations for their providers, including house calls and 24/7 access.

There's also an economic balancing act involved. If a physician charges fees that are too high, they risk pricing themselves out of many people's ability to pay. However, if the fee is too low, a physician will have to see as many patients as before in order to make ends meet.

In addition, concierge medicine has raised ethical concerns. The authors of an article in Becker's Hospital Review note that the sometimes high fees charged by concierge physicians can make these services inaccessible for anyone who can't afford to pay out of pocket. Forbes writer Russ Alan Price also found that "with the strong and persistent rise in concierge healthcare, a lot of the best primary care physicians are no longer accessible to most patients."

Concierge medicine has become attractive for physicians who want patient care that's individualized and not under the time constraints that often come with modern medical practice. Because of that, the movement toward this kind of practice may, in part, be a commentary on the problems of the current healthcare system and the issues that arise when there isn't enough time for quality patient care.

Brian Wu, MD, PhD