Concierge Medicine is Available to Everyone

The New York Times recently ran an article about extremely high-end concierge practices. These elite programs charge patients upwards of $20,000 per year for membership-a figure that is obviously way out of reach for most Americans.  

The truth is, most Americans don't need anywhere near $20,000 per year of medical attention-they just need a relationship with a physician they trust. That relationship is what is slowly being eroded in today's healthcare marketplace. 

Concierge medicine answers that need-and certainly at price points far below what the New York Times reported.  Most concierge programs cost around $150 per month, making it something many Americans, particularly those with health needs, can prioritize.

But for many physicians, charging patients a membership fee feels wrong. They worry about the moral implications of treating only those who can afford to pay them directly. Even the high-cost physicians in the New York Times article expressed concerns about developing concierge programs for such an exclusive clientele and what it could mean for the future of medical care.

Having worked in the healthcare marketplace for more than 20 years, these ethical concerns are no surprise. Most of the physicians I've worked with love their patients and the communities they support and want to do right by everyone. They don't want to stop seeing patients at a time where there are reports of physician shortages, nor do they want to contribute to a two-tiered healthcare system.

But what happens when an older, respected physician is becoming burned out due to the pressure of volume care and new mandates he's never had to deal with before? Oftentimes, he retires sooner than he ever expected to. He closes his practice and stops seeing all of his patients. With decreasing reimbursements and increasing overhead, it doesn't make sense to stay in business.  

What about the busy group practice with several physicians and lower level providers? They work hard to care for and accommodate as many patients each day as they can. Often, that means that someone with an acute problem has to see whatever provider is available at the time they need care. Or, for less acute issues, they may have to wait weeks for an appointment with the physician of their choice. For some of these patients, in particular those with complicated health histories, this doesn't feel right either. The chosen provider wants to have time to manage that particular patient, but case load and schedules simply cannot guarantee it.

That's where a blended approach to membership medicine can be the solution. In a blended program, known as hybrid concierge, a physician sees all patients in their traditional practice, but offers the option of a concierge care. Typically only a small percentage of the patient panel joins, but financially, the numbers add up to significant revenue and space.

Hybrid concierge programs allow an older or stressed physician some breathing room in their day so they can take their time without losing income. It allows a larger group to offer their patients the option of mapping one-to-one with their chosen physician, so that their care can always be delivered by the physician who knows their medical history. Patients can buy that peace of mind-something they couldn't get before. 

Hybrid concierge programs don't create two-tiered medical care. The care that patients receive is the same, no matter what. It's the service and convenience that is enhanced. Not everyone requires the extra service and convenience. Only those people who need help coordinating care with a specialist, or who need the extra lifestyle coaching and support, or who value the convenience of easily made/easily scheduled appointments join. 

Everyone in the practice wins, without concerns about dismissing patients or creating different levels of care.  The doctor gets to spend more time with the patients who need more time, while receiving appropriate compensation. The patients who choose not join notice very little impact on the practice. 

While it can be glamorous to think of concierge medicine as a velvet-rope service that caters only to mega millionaires like in the New York Times article, the truth is, concierge physicians come in all shapes and sizes and many are using adaptations of the model in order to continue to see all of their patients-not just their wealthy patients. It's a tool to keep practices solvent, stable and healthy for the long term.