About a year ago, my mother called me to tell me her doctor was going the Concierge route, Managed care was taking up his profits and he of course wanted her to ‘follow him’ to pay for the privilege of having his personal cell phone. She did not do it, but I know of others that have become Concierge Members. While this concept is not new (1996), it is certainly a growing business trend among the medical profession. It is big enough to warrant a Wikipedia entry: (interesting reading)
Concierge medicine (also known as direct care) is a relationship between a patient and a primary care physician in which the patient pays an annual fee or retainer. This may or may not be in addition to other charges. In exchange for the retainer, doctors provide enhanced care. Other terms in use include boutique medicine, retainer-based medicine, and innovative medical practice design.
The practice is also referred to as membership medicine, concierge health care, cash only practice, direct care, direct primary care, and direct practice medicine. While all concierge medicine practices share similarities, they vary widely in their structure, payment requirements, and form of operation. In particular, they differ in the level of service provided and the amount of the fee charged. Estimates of U.S. doctors practicing concierge medicine range from fewer than 800 to 5,000.
In February 2010, an informal one year summary of findings related to the concierge medicine marketplace was released. The summary of the study concluded that at the end of 2009:
- Over 66% of current U.S. concierge physicians operating practices today are internal medicine specialists.
- The second most popular medical specialty in concierge medicine is family practice.
- A surprising finding in this study was the increasing number of concierge dental and pediatric practices arising since February 2009.
A similar poll related to the economy and the recession was conducted online between October 2009 to January 2010. Concierge physicians were asked ‘how is your practice performing financially compared to one-year ago?’ Surprisingly, concierge physicians across the U.S. polling data shows:
- Nearly sixty percent (59.0%) of all current concierge physicians are doing ‘Better’ financially than one-year ago.
- Twenty-nine percent (29.0%) indicated ‘No Change’ and;
- Twelve percent (12.0%) indicated ‘Worse.’
Mostly concentrated on the East and West Coasts, in 2004 the Government Accountability Office counted 146 such practices. The American Medical Association does not track the number of concierge practices because the concept is still so new.
How many Concierge Eyecare Providers are out there? (Google Results: Concierge Eyecare 476,000 , Concierge Optometrist 3,290,000 Results, Concierge Opticians 4,240,000 Results)
What are the Advantages?
- Income- If you have 500 patients paying $1500= $750,000 in revenue.
- Get loyal patients
- Not dealing with managed care and insurance
- Less Paperwork- (don’t know that for sure, but less insurance paperwork)
- Dealing with people that can afford to pay the $1500/ yearly cost. (That has pluses and minused)
- Spend more time with patients, if not cattle-calling them in due to managed care.
- Work for patients rather than an insurance company
- Work smarter not harder business model.
What are the Disadvantages?
- Oncall 24/7
- You really have to be up on customer service to warrant the yearly fees.
- Alienate old customers and potential customers.
- Membership fee
As a person who encouraged my mother to seek another doctor (I did not like her doctor or the staff) I can understand why docs are going the concierge route. Would I pay? I doubt it, there is a certain and probably old fashioned feeling that a doctor (any doctor), should have gone into medicine to help all people and most people cannot afford concierge services. The other issue that I find difficult to fathom, that just because they are a Concierge Doc, doesn’t mean they are a good doctor. People will think, hey they must be good if we have to pay them to see them.
If this trend continues to grow, does that mean we are going to have Concierge Plumbers? Concierge Accountants, Concierge Vets? Concierge Bloggers? When does it stop?
Conciege Medicine Today