Is Concierge Medicine A Smart Choice for Doctors?

Business savvy physicians making the switch to concierge medicine are changing the face of healthcare- one subscription at a time. The concept behind concierge medicine is simple: patients pay a monthly “subscription” fee to a physician, sometimes with a small “per visit” fee for access to a physician’s services. Subscription fees for a basic, primary care office can range from $50-$150 per month, which increase for higher end, more  in depth services. This model often allows physicians to evade the hassle of dealing with insurance companies altogether while potentially reducing healthcare spending for patients who are “frequent” visitors, and give them better access to services.As the Affordable Care Act mandates begin to take effect, experts predict a rise in the number of doctors who will no longer accept insurance. Conversely, as the number of insured Americans grow and traditional practices begin to flood with patients, people may find concierge doctors more accessible.

But is Concierge Medicine a Smart Choice for Doctors? We took a look at a few variables:

Does it Make Sense Financially?

A Bloomsberg Businessweek article reported that the average salary for a concierge physician ranged from $150,000 to $300,000, which absolutely falls inside the range of the national average salary for a primary care physician.

Dr. John T. Kihm from Durham, North Carolina reported in a
Medical Economics article that in making the switch to a concierge model, patients are directly paying the majority of practice revenue. “In my case, appreciative patients directly pay me two-thirds of my revenue. Insurers contribute one-third. The insurance third is diversified across numerous private and government payers. If an insurance contract becomes less favorable, I needn’t develop balance sheet anxiety, because I have diversified my revenue stream.”

Then there is the question: If people are forced to purchase health insurance through the ACA, why would they also pay a subscription fee? – There’s a loophole. A clause in the ACA allows “direct primary-care” to count as a compliant form of insurance when bundled with a catastrophic policy.

How Does it Affect the Work Environment?

Many physicians working in this model report it is more satisfying work, allowing them to reduce the number of patients they work with, and get back to the core of practicing medicine. In a
MedCityNews article, Dr. Ivan Castro of Winter Park, Florida shares his experience, “I was constantly running behind to see the next patient and had to focus

more on paperwork than on patient care,” Castro remembers. After making the transition to concierge medicine Castro tells MedCityNews, “I really feel like a doctor and that I’m making a difference,”. According to MedCity, Castro went from having more than 3,000 patients with whom he spent about 10 minutes per appointment to 400 patients where he averages 30 minutes for each appointment.

How Does It Affect The Business Model?

Because this model depends less on insurance companies and more on patients for revenue (or equally so) practices considering the move need to strengthen their focus on marketing and referral programs.  With the goal to establish a strong enough patient “subscription base” to sustain a practice, marketing and advertising across social media, health expos and networking groups will become a top priority for concierge physicians. The messaging should be clear: Ease of Access. As the impact of healthcare reform sets in, this becomes more of a pain point for healthcare consumers, those with the luxury to pay for a monthly subscription fee for ease of access to care will happily do so, even if they don’t make regular visits to the doctor.

It’s important to note in order for this model to work, a physician should be practicing in the space of primary care or internal medicine. These types of practices are the best fit for concierge.

Is your practice a good fit?

Medical Economics.com says the answer probably is yes if:

•    You practice high-quality medicine.

•    You don’t mind working hard for your patients.

•    You can persevere through the conversion process.

•    You tolerate a certain amount of business risk.