What is concierge medicine?

So, what exactly is concierge medicine?

Concierge medicine is a relationship between a patient and a primary care physician in which the patient pays a fee, often referred to as a membership fee.

At its heart, concierge medicine is about building a personal relationship between physician and patient — a relationship that keeps the patient’s specific wellness needs in mind along with their likes, dislikes, goals, and dreams.

The membership fee enables this personal relationship to form by allowing doctors to drastically shrink their panel size, usually from somewhere between 3,000-4,000 to somewhere between 500-600.

In return, patients get a hassle-free primary care experience. Most concierge medical practices offer:

• Longer appointments (at least 30 minutes)
• Same-day or next-day appointments
• Little to no waiting in lobbies
• 24/7 access to care

Concierge medicine goes by many other names, including retainer medicine, membership medicine, subscription-based medicine, and boutique medicine, among others. Hybrid models exist as well.

The most important thing to keep in mind as you evaluate different options is that not all concierge practices are the same. Terms, costs, and benefits vary widely.

How does insurance work with concierge medicine?

Most concierge practices work with health insurance the same way a traditional practice would. Here are a few things to know about insurance and concierge medicine.

• Your membership fee does not replace your health insurance.
• Your health insurance will be billed for medical care, including office visits, lab work, and tests.
• You are responsible for co-pays/deductibles, but your health insurance will cover the costs of approved services/procedures, just as it would if you were seeing a traditional PCP.
• Some concierge practices accept fewer carriers than a traditional practice, and some may not accept Medicare or Tricare. 
• If you're exploring a concierge medicine practice that does not accept insurance at all, it might be better described as direct primary care. 

So be sure to double-check that a concierge office works with your specific carrier. See if they take government plans, like Medicare, Medicaid, or Tricare, that you might use now or in the future.

You can check out a list of insurance plans we accept here. 

Do HSAs or FSAs work with concierge medicine?

Yes, but with a few caveats.

• Typically, concierge membership fees cannot be applied to an HSA or FSA.
• HSA and FSA accounts are primarily applied to medical services only.
• They work the same way whether you choose to see a traditional primary care doctor or a concierge doctor.
• Your membership may include some services that can be applied to one of these tax-free accounts.

Check out our blog on how to use your HSA or FSA for concierge medicine. 

Read More: How to Use Your HSA or FSA for Concierge Medicine

What's the difference between traditional primary care and concierge medicine?

Before we go any further, you’re probably wondering…ok, so what’s the difference from the traditional primary care that we all grew up with? And it’s a good question.

Nearly 20 years have passed since the first concierge medicine practices opened and it’s still not a well-known or understood concept in healthcare.

First, it’s important to understand the difference is not in the doctor. Primary care doctors, regardless of the type of practice, are typically family or internal medicine physicians and can be either medical doctors or doctors of osteopathy.

Within both traditional and concierge practices, you’ll find capable doctors who strive to provide the best possible care to their patients.

The big difference is the environment in which the primary care physician practice. See the chart below for a comparison of the big differences. 

Why is the concierge medicine model better for patients?

The short answer of this is that concierge medicine removes all the hassles of the traditional primary care experience and puts the focus back on you, the patient. 

• Have you called to get an appointment only to find out your doctor is booked for weeks? 
• Have you sat in a waiting room at a doctor's office for 15 minutes, 30 minutes, an hour? 
• Have you called for care after-hours or in the middle of the night and had to leave a message or gotten an impersonal nurse line? 
• Have you finally gotten an appointment, made it through the waiting room, and then been dissatisfied with seeing a doctor who barely knows you for about seven minutes? 

The concierge model allows patients to be proactive regarding their health and removes the roadblocks preventing that from happening. That's one of the biggest reasons why people choose concierge medicine. 

Why is the concierge medicine model better for doctors?

Doctors feel the effects of the traditional primary care system as well but in a different way.

Many physicians in the U.S. feel stressed, overworked, and frustrated since they can’t deliver the type of care they would like to, simply because there isn’t enough time to do so.

In fact, a Medscape annual survey noted, “42 percent of physicians reported that they were burned out."

Some primary care doctors live with a constant "fear of missing something" because they weren't able to spend enough time with the patient to unlock the puzzle.

Concierge doctors are able to practice medicine the way they've always wanted — with patience and time for each and every patient who needs it. 

Why do people switch to concierge medicine?

Pretty much everyone who thinks about joining concierge care has something in common: They’re ready to ditch 7-minute medicine. The question is, why now? Why is now the time to make the jump?

Let’s look at the 5 top reasons for joining a concierge practice.

1. High achievers like concierge medicine. If you’re the type of informed consumer and health advocate who wants a proactive outlook, not a disaster relief mentality, from your physician, then you’re fitting in with many who choose concierge care.
   
   
2. Existing condition requires attentive care. If you have a condition that necessitates a doctor’s in-depth attention, then 7-minute medicine is likely driving you crazy, bankrupt, or both. 
   
   
3. Medical scare. Plenty of people choosing concierge care came from a moment of reckoning. They have a jarring experience that makes them re-examine their decisions, including their physical wellness choice. 
   
   
4. Done with the waiting. If you're tired of waiting days or weeks to get an appointment and then waiting again in the lobby or the exam room, then concierge medicine is a fit for you. 
   
   
5. Peace of mind for themselves or their loved ones (or both). For many, the deeper relationship with a physician and the 24/7 access to care provides peace of mind. You know you, or your loved ones, will get the care they need, when they need it, whether it’s the middle of the day or the middle of the night.

Read More: Top 4 Reasons Patients Choose Concierge Medicine

What are the benefits for healthy people?

We talk a lot about how concierge medicine benefits people who need better access to a doctor. But what if you’re younger and seem to be healthy?

Why should healthy people take the next step and switch to concierge medicine?

1. Healthcare available when you need it. Squeezing a doctor’s appointment into your schedule can be nearly impossible when you have to plan three weeks out and count on a 30-minute wait in the lobby and a 20-minute wait in the exam room.
   
   
2. Long-term prevention for lifelong health. What do you want to be able to do in 10 years? 15 years? How do you want to be able to live when you retire? There are things you can be doing right now, while healthy, to help you meet those goals down the line.
   
   
3. Know your risks. You may be healthy now, but what are your risk factors based on your family history? What medical issues have you had in the past that might crop back up in the future?
   
   
4. Your entire family can see one doctor (and get a nice price break). Whatever your family situation, choosing the same concierge doctor for your whole family allows for better-informed care on the doctor’s end and more efficiency for your life.
   
   
5. It's like insurance. Don't wait until you need it to get on board. You’re only healthy until you’re not. Concierge medicine gives you and your doctor more time to look for root causes and work to prevent illnesses from developing down the line.

Read More: 5 Benefits of Concierge Medicine for Healthy People

Are children a good fit for concierge medicine?

The benefits of choosing concierge medicine for your children’s primary care are the same as the benefits for adults. Enhanced access and a deeper relationship with the doctor can pay dividends for anyone looking for a better healthcare experience, including kids.

For your children, they get a partner in health they can trust who has time to get to the root of their issues. And as they grow up and go through life’s changes, they’ll have a doctor they know and trust.

For you as a parent or guardian, that trust can provide you peace of mind your children will get the care they need to live a healthy, prosperous life.

But in the short-term, the convenience of guaranteed same- or next-day appointments, no waiting in the lobby, and 24/7 access to physician care (for those 3 a.m. wake-up calls from a sick child) can make a huge difference for your busy life.

Read More — Concierge Medicine for Your Children’s Primary Care: Doctors, Age Limits, Cost, and More