What Is Concierge Medicine?

Getting personalized, same-day care from a doctor isn’t just for the “rich.” Here's what you should know about the healthcare practice called concierge medicine.

Not long ago, the term concierge medicine meant you could see your doctor whenever you wanted — if you were rich. These days, the concept, in which you typically pay an annual fee for quick access to your healthcare provider, is more mainstream and accessible.

Concierge doctors — sometimes known as private physicians or direct care doctors — offer patients more personalized care. You can typically call or email your doctor at any time and schedule same-day appointments. Sometimes you can chat with your doctor by video, or the doctor may come to your home.

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The concept started in 1996, when two doctors, Howard Maron and Scott Hall, decided to ask their patients to pay a flat fee, like an attorney’s retainer, in exchange for direct care. It works as a private (direct) financial relationship between you and your doctor, with a commitment to restoring the doctor-patient relationship, eliminating long wait times, and reducing the need for an insurance company to make decisions about your healthcare.

Instead of the typical 15-minute visit you might get with your normal primary care doctor, concierge doctors may see you for 30 to 45 minutes.

Such practices also eliminate fee-for-service healthcare determined by insurance companies that reimburse a portion of what a doctor would normally charge for a service. Without basing their financial dependence on insurance and Medicare, doctors can eliminate overhead (like billing and medical coding staff) to focus more on their patients.

You’ll typically pay an annual fee to one of these estimated 12,000 U.S. doctors. The average ranges between $150 and $183 a month, with some doctors charging less than $100 a month, according to the American College of Private Physicians (ACPP), an industry advocate. The ACPP website offers a Meet the Doctors page for people seeking concierge medical care. The list includes contact information and links to information about each physician’s background and experience.  

While health insurance covers most preventive procedures and tests, according to federal law, a concierge practice may include additional services, such as screening for Alzheimer's disease or expanded blood tests for other conditions.

You’re still required to have health insurance even if you see a concierge. Because concierge medicine is private, out-of-pocket care, it may work well with a high-deductible health insurance plan and a health savings account (HSA). You’ll still have to pay for some tests or procedures you might need outside of your concierge plan. Your doctor will work with your insurance company to try to get you some coverage.

Be careful, however, if you do you use your HSA account to pay for concierge services. Your annual physical with your concierge doctor may be an applicable HSA healthcare expense, but your monthly retainer won’t.

Some hospitals offer concierge medicine, but don’t confuse the concept with the name for a staff member called a concierge, which some hospitals employ like the guest services staff of a hotel to elevate your experience in the hospital by, for example, fetching you a gourmet meal or a robe.

As concierge medicine began attracting more doctors more than a decade ago, there was hope the move toward this type of practice might help relieve the physician shortage in the U.S. So far, however, it hasn’t.

Erin Sullivan, PhD, the research and curriculum director at the Center for Primary Care at Harvard Medical School, explained in an interview on NPR that doctors who practice concierge medicine see fewer patients than standard medical practices in the U.S. Because there is a shortage of primary care doctors in America, many more doctors will need to practice concierge medicine for the model to become more widespread.

"We have issues with access to primary care in this country. We don't have enough trainees or enough clinicians choosing primary care. To have (providers) suddenly hopping over to this model would continue to probably decrease access for patients to primary care."

The trend isn’t going away. More doctors than ever are opting to practice concierge medicine. In an interview with Scientific American, Terry Bauer, CEO of Specialdocs Consultants, a firm that advises concierge medical practices, pointed out a key reason for doctors switching to concierge medicine. “As the healthcare landscape began its shift to volume-based care in the early 2000s, physicians became increasingly frustrated — challenged by rising operational costs, an intensified administrative burden, and sharp cuts in reimbursement.”

There’s plenty of reason to think concierge medicine will likely attract more physicians over time to primary care. With the rise of mobile health (mHealth) technology, concierge medicine can be a model for healthcare for all. For instance, PlushCare, a San Francisco startup, charges you $44 to get diagnosed, treated, and be prescribed medications via a phone call or video chat with a doctor.

While many people these days like to "shop" for healthcare, they still want to develop a trusting relationship with their doctor. Quicker access to physicians and longer appointment times give you the opportunity to really talk to your doctor. mHealth companies like PlushCare are betting you’ll transcend from being a “consumer” to developing a close doctor-patient relationship, and that you’ll come back for their version of concierge care the next time you have a non-emergency health issue.

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