Do Physicians in Membership Practices Work More Hours?

In July 2014, internist Michael Freedman opened Evolve Medical Clinics in Annapolis, Md. His practice, which he calls a "direct-pay membership medical home," provides patients with access to perks such as secure virtual visits, and communication with providers via e-mail and text. In return, patients pay a $35 monthly membership fee. Since Freedman's practice does not accept insurance, patients also pay fees for services, out of pocket.

Due to their access to virtual care, Freedman's patients have access to him and his partners 24/7, which could raise some red flags for physicians who value their personal time and work-life balance. Still, Freedman says, he is not inundated with patient calls and requests after hours.

One reason: Patients who are willing to pay an additional fee for services are more likely to value their physicians, says Freedman. As a result, they are more likely to respect their physicians' time. "... They're much less likely to bother you at night or in off-hours for something that's not urgent," he says. "When someone is calling us in an off-hour, it's because they need something and it's a genuine need."

In addition, Freedman says his patients have a positive relationship with him, and they appreciate the extra steps he takes to provide them with a friendly, comfortable practice setting (including hardwood floors; a coffee, tea, and water bar; and artwork from local artists).

"... They're so appreciative of the efforts we're putting out," he says, noting that this also makes them more respectful of his time. "I think there is a certain level of animosity that is generated when you go into a [practice with a] grumpy staff and a disgusting office and you're trying to get something done and it takes three calls or four visits. They don't think that much about bothering the provider at night because they're just so frustrated with that office."