Concierge medicine was once thought of as only for high-profile celebrities and elite individuals who could afford access to healthcare in a different way than the average person. Over the years, the concept of concierge medicine has become a less exclusive, alternative option to traditional primary care models.
"Concierge medicine is typically defined as a practice with a lower volume of patients, designed with higher availability and attention for the members that join," says Jeremy Fine, M.D., a Los Angeles–based concierge medicine doctor. "Typically, it allots for same-day appointments, oftentimes the doctor's cell phone is given to patients, there's email communication, and some practices also offer house calls with either a doctor or nurse."
Because there is no health system dictating the rules of how to structure a concierge practice, there are many iterations of it. Brian Blank, M.D., owner of Ember Modern Medicine in Greenville, S.C., prefers to call his practice direct primary care, which is often perceived as a less expensive, but still high-touch model. There are also hybrid models like you see with national companies like One Medical, who charge a membership fee that includes easy access to 24/7 virtual care, but still bill directly to insurance. Other terms used to refer to it include retainer medicine and boutique medicine.
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How does the fee-structure work?
Almost all concierge medicine practices are membership-based and require an annual or monthly fee, which can range from $20 to $2,000 per month. Many practices don't bill insurance, and the cost of membership includes things like an annual checkup with labs (blood work, urine, etc.), easier appointment access, and direct physician access. Some practices bill insurance for subsequent appointments, and others have a menu of services with transparent costs.
The most notable negative to going with a concierge practice is often the cost. Some concierge medicine practices can be very expensive, which makes it prohibitive for some patients. Many direct practice primary care doctors are aware of this and try to lower fees where possible while still providing more personalized care to patients. "We try to keep our membership fees less than a cell phone plan," says Dr. Blank, who has a patient load where half don't have health insurance at all.
Who is concierge medicine best for?
Costs aside, concierge medicine is something that can work for all patient types, both healthy and ill. "There are benefits both for people who are low-acuity on the medical front, but perhaps very busy and don't have time to see a doctor or wait to see a doctor," says Dr. Fine. These people may have busier careers, and the convenience of concierge medicine allows them, for example, to send in a photo of a skin concern or have a quick call with their doctor about an earache. It also allows more flexibility for labs.
"Then there are people who are high-acuity medical friends who need to see a doctor frequently," he says, and some of those patients can be seen weekly. Dr. Blank sees a patient with diabetes often and he is able to spend the time educating him on diet, the need for insulin, and really spend the time he wouldn't be able to in a normal practice setting.
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Top Benefits of Concierge Medicine
Minimal Wait Times
Joining a concierge practice allows you easy access to scheduling. Most patients are seen the same day or immediately the next day. Plus, most practices are already pros at telemedicine. "It took COVID-19 for many doctors to offer televisits," says Dr. Blank. "In the concierge world, they've been doing telemedicine for years." This can often help patients avoid urgent care of emergency room visits. And it's not just telemedicine—in-person appointments also tend to happen within 24 hours. Some doctors, like Dr. Fine, will make house calls for patients. Certain concierge medicine groups will even meet you at a hospital stay (if necessary) to help you navigate your care there.
Direct Physician Access
In a concierge practice, there's often more direct access to your doctors. They'll often give out their cell phone numbers and personal emails for quick questions, prescription refills, or off-hour needs. This eliminates the wait for a doctor to call you back or become available for an appointment, and can quickly get you the care you need.
Quality Time With the Doctor
One of the tenets (and biggest benefits) of a concierge medicine program is that they usually take on a smaller patient load than regular primary care physicians do. Concierge physicians may have a patient load in the low hundreds, instead of thousands. This gives them the opportunity to spend real time with their patients that a typical primary care physician wouldn't be able to.
"They do this so that they can give as much attention as each patient needs, or wants, or as the doctor deems necessary," Dr. Fine says. "And there's less of a rush during visits, or time allotment is much less of a factor."
Doctors in boutique practices have the opportunity to spend time thoroughly getting to know their patients and educating them on different pertinent topics. The dynamic is much more personal and personalized. "We can go into things like people's diet or exercise regimen, dive deep into mental health, and create a healthier experience," Dr. Blank says.