Before the development of modern health care systems and insurance, it was common for wealthy individuals to keep a personal physician on retainer. The concept currently referred to as “concierge medicine” (sometimes referred to as direct care, or boutique medicine) is based on this idea – the patient pays a yearly, quarterly, or monthly retainer to receive enhanced care from a physician, usually a primary care physician. The enhanced care is most often in addition to the coverage provided by the patient’s insurance, and consists primarily of improved access to the physician.
The benefits to the patient are many, including immediate and continuous access to the physician via phone and electronic media (texts, email), little to no waiting for appointments, appointments scheduled with sufficient time to fully discuss health issues and concerns with the physician, unlimited number of office visits with no co-pay, a relaxed atmosphere with a focus on preventative medicine, and the development of a personal relationship with a trusted physician. In addition to the psychological and well-being benefits of concierge medicine, patients may realize real health benefits. The Concierge Medicine Research Collective reports that concierge patients are more likely to comply with prescriptions and physician recommendations than are traditional-plan patients, which may lead to improved health outcome. In addition, many believe that the increased personal attention from a concierge physician may prevent health issues from worsening, or even prevent them altogether.
However, what about the physician? Physicians who offer concierge medicine cannot see as many patients per day as physicians who offer traditional-based medicine, and they must be available to patients via phone and electronic media continuously, aspects that may seem to be negatives for physicians. But many physicians are disillusioned with the insurance-based system of health care and find the patient-centered concierge model to be more satisfying on a personal and professional level. In addition, the concierge model automatically promotes patient retention for the practice – the Concierge Medicine Research Collective reported in 2010 that 60% of the concierge practices retain their patients for 7-9 years- and many enhance the practice’s ability to attract new patients. As to the requirement to be available to patients at all times, a survey conducted by the Concierge Medicine Research Collective found that the majority of phone calls received by a concierge physician occurred during normal business hours.
The increased demand for access to physicians that is expected to occur due to implementation of the Affordable Care Act (Obamacare) may make concierge physician practices more attractive to patients versus over-booked, rushed physicians operating in traditional practices. In addition, a “loophole” in the Affordable Care Act allows concierge practices to be considered compliant with the act as long as the concierge services are bundled with some type of medical insurance that covers emergencies.
Converting to a concierge practice may just make good medical and business sense for many physicians. Practices that want to combine the concierge concept with the traditional can try a hybrid model, where patients can choose to either enroll as traditional patients or pay and additional retainer to be enrolled as concierge patients and receive enhanced care and access.