I’ve been asked this question many times in my twenty-three years of practicing medicine, although mostly in the last five years. Concierge medicine, in a nutshell, is when a doctor asks for an annual pre-paid fee to give his/her enrollees more direct, convenient, timely, personal care compared to the traditional model. For example, most of us in primary care practice have 2000 -3000 patients under our care. In a concierge practice, the doctor would send a letter to all his panel of patients describing the new practice model and telling them that the first 300-500 who sign a contract and submit the fee will be on-board while the remaining patients will need to look for a new doctor. The annual fee per patient can vary from $1500 to $3000 and that is in addition to insurance billing.
Most concierge doctors I know are great doctors. The patients seem happy with the personal attention and ease of access to the doctor. The financial benefits to the doctor are usually better in a concierge practice, although some concierge practices have failed due to mismanagement.
Everyone wins, right? Wrong! Only a few winners come out in the concierge model. The physician and the patients with the financial means to enroll are the winners. The roughly 85% of the rest of the patients have lost. The primary care shortage is made worse as the residual patients are left looking for a doctor still accepting new patients.
Concierge medicine is a good thing for very few. I am interested in a healthcare system that expands coverage and primary care access. I didn’t choose family medicine to get rich, so from that standpoint I succeeded. I chose family medicine as a service industry not a profit industry.
The following article by author and Boston Globe columnist, Alex Beam, gives a personal story about concierge medicine.
The answer to the question, “Hey, doc! When are you going concierge?” is, “It is not in my foreseeable future.”