Balancing Patient Ages in a Hybrid Concierge Practice

Concierge medicine was first introduced into primary care as a full-model program. The style of practice was most compatible with internists in strong economic areas with larger practices -more than 2,000 active patients per physician.

The model answered many physicians' most important concerns: too many patients, not enough time, and poor compensation. The transition to a full-concierge care practice delivered a quality professional life change, but it also delivered some unexpected challenges.

The truth is, not every internist can support a full-model membership, and it can be more difficult for family physicians, even though they may have a large and economically strong practice.

The family physician patient panel

Family physicians tend to care for a larger percentage of younger families with children, all of whom are patients. Children and young families are generally not as willing to commit to the costs associated with a concierge membership approach, largely because these patients are at an economic point where spending money on healthcare is not as important to them as it is for older patients. Family physicians need to consider this carefully. Though it may seem like they have a very large and loyal patient panel, and even for those in upper income markets, it's the age breakdown that can make or break the success of a full-model concierge program.

New models, new options for family physicians

But there is good news for family physicians. Like all things in healthcare, even concierge care has changed and adapted, introducing a number of variations that a much larger percentage of family practices can support.

One model that can work well is hybrid concierge, where patients have a choice to participate or not in the concierge portion of the practice, without having to leave altogether. This model allows family practitioners to keep younger families in their practice, and continue to enjoy the diversity of working with patients of all ages, from infants to geriatric patients. It will help the family physician who needs to plug the holes left by declining reimbursements, but who still wants to maintain a large patient panel and work pace.

For physicians who are perhaps nearing retirement or cannot work at the frantic pace they kept when they were younger or who have a patient panel that has grown and aged with them, a full-model concierge practice could be attainable and preferable.

And there are even transitional programs available for those family physicians who ultimately wish to transition to a full-model practice, but are risk averse - the flexible transitional programs can ease them toward their goal.

The take away for family practitioners is that concierge care isn't limited to just full-model concierge practice anymore. Though that model can work well for particular family practitioners with specific goals in mind, there are other options like hybrid concierge and flexible models to be considered.