Would it make a big difference in your life if you had to switch primary care physicians?
Michael Tetreault, editor in chief of Concierge Medicine Today, posed this question to a variety of patients, and the resounding answer was “no.”
When it comes down to it, most of us just don’t have a close relationship with our doctors, so switching would have little impact on our lives. We don’t see them often, and when we do, the appointment is rushed. But many of us would appreciate a deeper relationship with our primary care physician—especially in our times of greatest uncertainty and need.
That’s one of the reasons why the concierge model has been attracting more physicians and patients alike.
The concierge medical model attracts new patients year-over-year. In the concierge model, members (patients) pay a fee to take advantage of a wide array of enhancements that make for a less hurried, more connected and collaborative approach to their healthcare. These membership-based programs focus on enhancing the physician-patient relationship by allowing for smaller patient panels and a more personalized and preventative healthcare experience.
Tetreault explained that because there is no federal registry of physicians using a concierge model, it is difficult to accurately track a precise number of those in the industry and the number of people they care for. However, his publication estimates that concierge doctors and membership programs have become more popular over the last decade. There are undoubtedly more concierge offerings for patients within a larger market size, but even less densely populated areas are seeing more opportunities for boutique medical care.
“We seek the input of physicians and expert consultants in the space and feel that growth is about 3% to 5% each year,” said Tetreault. “Our estimate is that there are between 12,000 to 13,000 physicians in the United States doing some sort of subscription-based medical program, and those are conservative estimates. It’s steady, incremental growth.”
The concierge model offers holistic, responsive medical care. The steady growth in the membership medicine model is driven mainly by individuals who want or need more time and attention from their doctor, which is a rarity in U.S. medical practices. On average, physicians practicing in more traditional care models spend only 27% of their time with patients.
Dean McElwain, co-Founder, president, and COO at Castle Connolly Private Health Partners, a firm that helps physicians transition their practice to a membership model, explained, “There is a crisis in primary care in this country. The reimbursement rates are so low that it’s not sustainable for small private practices, and primary care physicians are moving to larger institutions to survive. This becomes a challenge for patients because they become part of a much bigger population, which is erosive to having a personal connection.”
Tetreault echoed this sentiment: “As patients, we are starting to see that doctors in our communities are overwhelmed. They’re busy. They don’t have time for us. They’re on a treadmill. We’re on a conveyer belt [when we see our doctor]—and we don’t want to feel that way anymore. We want our needs to be important.”
Choosing a physician with a concierge care model brings back personal, preventative care with a high degree of responsiveness. The model is dependent on having a smaller panel of patients—typically only about 400 to 600 rather than 2,500 or 3,000—which allows the doctor to spend much more time with each patient.
“That compression of panel size results in longer visits that are unhurried and often go beyond what’s medically necessary,” explained McElwain. “You have time to explore other issues like your social circumstances, your goals and aspirations. It really allows unhurried, unrushed communication and interaction with your physician, which is key to your longevity.”
The concierge model also allows for flexible scheduling. Tetreault said, “Concierge doctors can adapt to those unique schedules and offer the necessary flexibility to care for the patient on their time.”
Concierge physicians are on the cutting edge.
Another key benefit of investing in a concierge physician is their ability to explore and practice evidence-based medicine. Thanks to a more forgiving schedule, physicians practicing in a concierge model have more time to stay current on the research.
Tetreault verbally surveyed a variety of physicians several years ago and found that most practicing in a traditional model have only about 15 to 20 minutes a week to read the latest medical research and familiarize themselves with conditions and treatments impacting their communities. That block of time for reading medical journals and researching evidence-based literature increased to between two and eight hours a week for doctors practicing in a concierge model.
This extra research time allows concierge physicians to be on the forefront of beneficial medical advancements, such as artificial intelligence. As a recent article in Medical Economics explained, “Artificial intelligence (AI) technology will be increasingly utilized in medicine, especially by concierge physicians drawn to its remarkable potential in enhancing patient care…It may prove to be a source of continual innovation that enables physicians to interact more profoundly with their patients.”
Tetreault has also seen concierge doctors lead the charge to advance what’s known as “precision medicine,” in which patients, as a regular part of their care, are getting their DNA sequenced. Their doctors can then select treatments that are most likely to help their members based on a genetic understanding of their illness. This may also be called personalized medicine. All of this allows physicians to provide care that is highly personalized to each patient’s genetic makeup, adjusting medications and dosages, for example, or addressing previously undetected intolerances and allergies.
“A lot of concierge physicians are leaning into precision medicine,” said Tetreault. “This is really the future of where healthcare is going.… When I had my genome sequencing done, the results were a paper ream thick. I went over the results with my physician for almost four hours. I don’t know when the last time was that you spent four solid hours with your doctor, but that’s what this [concierge model] means. They have time to unpack your questions. They have time to go over things that are important to you.”
The most important benefit is peace of mind.
At the end of the day, one of the most important benefits of concierge medicine is confidence and peace of mind. Concierge members get 24/7 direct connectivity to their doctors through a variety of channels, often including phone, text, video, and email.
“Having a concierge doctor provides security and peace of mind that when our kids get sick, or a loved one gets sick, or when we develop some kind of issue, that there’s someone in our corner who says, I can help you. You’re not alone. We’re going to do this together,” said Tetreault.
McElwain agreed: “If you can’t get in touch with your doctor when you need them, that’s a big problem.” He continued, “This is a huge reality check right now. Many doctors have been called to the front lines to work in emergency rooms or COVID-19 clinics, and you can’t get through to them. It’s important to know that when an issue arises, you have a responsive, responsible advocate—that’s priceless.”
It’s that peace of mind and that personal connection that both Tetreault and McElwain believe will keep the concierge model growing, come what may in the U.S. healthcare market.
“I think there will always be a need for a doctor and patient to have a close relationship,” said Tetreault. “We need more of these types of physicians leaning in and saying, I’m here. You’re not alone. So, I think we’ll continue to see concierge medicine thrive.”
How to find a physician with a membership model.
McElwain explained that choosing a doctor should be a decision that carries as much weight as choosing a financial professional, for example.
“People will hire the best attorney they can find, the best accountant they can find, but they’ll take a physician based on a list provided by their insurance company,” said McElwain. “They don’t focus on that same deliberate assessment and quality that they do for other professionals.”
For those who would like to become a concierge member or add a concierge physician to their family office, McElwain suggested finding a doctor who is well established in the community with an excellent reputation. Beyond that criteria, it’s important to consider what other health services will be included in the membership.
“You should make sure that you’re getting a supportive ecosystem with your membership—you should not just be paying for access to a doctor’s cell phone number,” McElwain explained. “You should have the ability to connect with your doctor in a multitude of ways, but you should also have services embedded in the membership, such as personalized health coaching and wellness programs and navigation to a network of top doctors and specialists nationwide, that round out the complete concierge experience.”
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