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  • Nancy Webb

Concierge Medicine - What Is It and Is It Right for You?


There is no substitute for a doctor who one knows and trusts, and who acts exclusively on behalf of one's own needs and interests.



Concierge Medicine, also known as Membership, Subscription, or Boutique medical practice programs have become quite normal and far more popular in the past ten years. These practices are located primarily in the country's middle-class and upper-middle suburban and metropolitan areas. It is important to note that Concierge Medicine is a business model, not a medical specialty.


Just how many practices are there? This is not that easy to calculate as there is no federal registry or official national database of physicians utilizing subscription-based business models. However, according to the independent industry trade publication and its sources – Concierge Medicine Today, LLC, ascertains that in 2023, - there are between 10,000 and 25,000 practices in the US and abroad. This is a small number compared to the roughly current 1.1 Million Professionally Active Physicians in the U.S.


Overall, Concierge Medicine – is thriving in the more densely populated metropolitan and suburban parts of the country. This segment of the medical industry continues to grow at a moderate and sustainable pace (between 3% - 7%) each year with physician earnings increasing gradually.


According to Concierge Medicine Today, LLC, the top 5 specialty areas for Concierge Medicine include:

· Family Medicine: 32%

· Internal Medicine: 23%

· Osteopathic Physician: 11%

· Cardiology: 8%

· Pediatric: 5%


How Concierge Medicine Works


Subscription (Concierge) Medicine works much like Netflix and HelloFresh. Patients pay a monthly fee and receive unlimited access to their providers. Use it as many times as you want in a month, and you only get charged once. This business model allows medical practices to drastically reduce the size of their patient load. Fewer patients equate to more personal attention. When medical practices use the traditional fee-for-service model, they have to fill the days with as many people as possible because you can bill for each one. This ends up prioritizing quantity over quality. Practices using the Concierge model, practices can have fewer patients and subsequently have more time with each one. This is quality over quantity. This approach benefits physicians and patients alike – as doctors are incentivized to keep patients healthy - because the healthier they are, the fewer issues they will have – which equates to less work for the practitioner.



"The aim of medicine is to prevent disease and prolong life, the ideal of medicine is to eliminate the need of a physician." - William James Mayo




How much does Concierge Medicine Cost?


The costs for concierge medicine vary widely. According to a 2005 report by the Government Accountability Office fees can range from $60-$15,000 per year. A more recent article in The American Journal of Medicine suggests annual fees average between $1,500 and $1,700 per year.


More about the Numbers


· Medicare does not cover the concierge's annual retainer.

· Some physicians offer reduced retainers for less extensive access.

· Patients are not charged with co-pays or deductibles for office visits, home or hospital visits, or office procedures.

· Most concierge physicians will bill Medicare and other insurance for office visits and procedures.

· Concierge patients still need health insurance for hospitalizations, specialists, prescriptions, and tests performed outside the concierge office.

· Many concierge patients choose high-deductible insurance that will help pay for specialists, medical emergencies, or hospitalization.


Is Concierge Medicine For You?


If you are considering concierge medicine, remember it is a personal choice and there are several factors to consider:


· Does the cost of the annual membership fee fit into your budget?

· Are you willing to pay a premium for the potential to have increased access to your doctor through longer appointments and email or phone communications?

· If your current physician is changing to concierge medicine, how important is it to you to continue the relationship? Or would you prefer to avoid the fees and find a new physician?


Criticisms of Concierge Care


The primary criticism of concierge medicine is that it is elitist, available only to the rich, but not to low-income patients, and that the practices cherry-pick only healthy patients. Studies have shown that concierge practices have fewer low-income, minority, or Medicaid patients. This could result in a 2-tier health care system: healthy and wealthy patients versus chronically ill poor patients. It is important to note that most concierge physicians also care for charity patients.


Summary


Choosing a physician is a personal decision, and the same is true for whether or not concierge medicine is right for you. You may find that some of the potential benefits of concierge medicine provide the convenience and service for which you are willing to pay. Alternatively, you may feel that a doctor in a traditional practice can address your healthcare needs without the upfront cost.

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