“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.
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.
Top Benefits of Concierge Medicine
“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.
