A growing number of doctors are ditching the status quo and adopting an entirely different business model: concierge medicine.
In fact, a recent survey of 862 independent physicians found nearly half are considering this alternative method of practice management.
We created this guide to help you stay on top of the concierge medicine trend and figure out whether it’s a fit for your practice. Just click on a section below to learn about concierge medicine salaries, set-up considerations, software tools and more.
What Is Concierge Medicine?
Here are some characteristics of concierge medicine practices (aka boutique or retainer practices) that differentiate from traditional ones:
- Payment: Patients pay a flat membership fee in advance for medical services. According to Tom Blue, executive director of the American Academy of Private Physicians (AAPP), this fee ranges from $50 a month to $25,000 a year, with $135 to $150 per month being the national average.
- Insurance: Blue estimates about 75 percent of concierge physicians take insurance, while the remaining have cash-only practices. “You are directly contracting with patients, in addition to or in place of their insurance,” he says.
- Patient panel: Doctors usually have 80-90 percent fewer patients under the concierge model compared to more traditional practices. The average concierge practice will have 500 to 1,000 total patients, according to Blue.
- Physician access: This decrease in patient population allows concierge physicians to promise same-day or next-day appointments, 24/7 access and longer examination times.
- Additional perks: Many concierge physicians offer incentives, such as house calls, nutritional counseling, emergency room visits and executive-level annual exams.
Concierge medicine doctors may choose to run their own practice or become affiliated with a physician network, such as the Procter & Gamble-owned MDVIP. Below are some key differences between these two options:
Independent vs. Network-Affiliated Concierge Physicians
The Average Concierge Medicine Salary
A 2012 Medscape study found that the average salary for a primary care physician ranged from $156,000 to $315,000, while Bloomberg Businessweek reported that the average salary for a concierge physician ranged from $150,000 to $300,000.
These numbers are in line with more recent physician survey data from the trade publication Concierge Medicine Today:
Concierge Medicine Physician Salary Data: 2014-2015
Concierge doctor salaries are apparently on par with their colleagues’ income, since the average compensation for non-concierge primary care physicians is approximately $195,000.
“I tell physicians this is not entirely a recipe to work a lot less and make a lot more. It is just a different, more satisfying, type of work,” says Blue.
Keep in mind that the amount of income you earn depends on how many concierge patients you serve. Some people opt to turn their entire practice into a concierge format. This is often referred to as the “full” model. It allows doctors to work at a slower pace because their revenue per patient is significantly higher.
Other doctors may prefer to implement a “hybrid” concierge model: The practice keeps operating in the traditional manner, but several hours a week are blocked off to care for a percentage of the practice’s concierge patients. This is particularly attractive for doctors who fear their salary will take a hit if they convert to concierge overnight without securing enough membership fees to cover costs and make a living.
Although converting to concierge practice may not result in a huge salary increase, it can lead to potential cost savings. Since you’ll presumably have fewer patients, you may be able to operate effectively with a decreased staff or a smaller office.
Is This Model Right for You?
At this point, you may be wondering whether transitioning to concierge medicine is worth the effort. For many doctors, including concierge medicine mythbuster Dr. Steven Knope, the answer is a resounding yes.
“I really didn’t have any conflict over making the move to concierge medicine. I had fought the HMOs and insurance oligopolies for years. I knew that the system was corrupt, and I learned that I could not change that system.”
Dr. Steven Knope, author and internist
Like Knope, many practices are drawn to concierge because they believe the health care industry has become too bureaucratic. They are frustrated by the relentless financial squeeze on providers from the government and insurance companies due to reimbursement rate reductions and claims processing changes.
A switch to concierge medicine is a way to break through some of that red tape, allowing doctors to spend more time on personalized patient care and less time worrying when or how they’ll get paid for their efforts.
That said, concierge medicine may not be ideal for everyone. According to Dan Behroozi, executive vice president of business development and operations at MDVIP, the most sought-after types of physicians for the concierge medicine model include internists, family practice, endocrinology and cardiology.
“The physician needs to function as a general practitioner. If they don’t have that primary care relationship, this is not the right model,” says Behroozi.
Still having trouble picturing yourself in a concierge practice? Read our case study below to learn about one doctor’s experience.
Case Study: Birmingham Medical
L. Scott Grant, MD, a primary care doctor in Birmingham, MI, has a three-tiered concierge medicine model at his practice, with patients paying $500, $1,000 or $2,500 per year, depending on age and services.
His income thus far “has stayed about the same with a slight bump up, but I see fewer patients. I don’t have to work nearly as hard to make the same financial target,” he says. His direct patient contact has shrunk from 60 hours per week to 30, while his after-hours time commitment, including phone calls and emails, has remained about the same, he reports.
“The pace of the day is different,” says Behroozi. “On average, our doctors see about 10 patients a day, give or take one or two. Our doctors don’t spend hours completing paperwork.”
Software to Support Concierge Practices
Those transitioning to concierge care will find it’s a good time to re-evaluate workflows and invest in new or upgraded health IT tools. Below are some types of applications that can optimize concierge model operations and examples of highly-rated software vendors to consider.
Electronic Health Records (EHR)
Every physician could benefit from digitizing their patient records, but concierge practices have unique incentives to go paperless. For example, EHRs make it easier to document a patient’s condition over time, so you can provide them with detailed and comprehensive clinical documentation that supports your recommendations for their health plan.
Since patients are essentially paying for more personalized service and will anticipate greater access to this documentation, it makes sense to invest in an electronic system to realize these expectations.
Billing software automates the collections process for your office. Some solutions are particularly well-suited for concierge practices because they offer helpful functionalities, such as generating pre-collection letters, compiling a list of all payment plan patients and running a report to calculate outstanding balances.
The value of concierge medicine from the patient’s perspective is that they get to feel a greater level of accessibility and attention from their doctor. Patient portals are great because they provide a platform on which doctors and patients can securely exchange messages, schedule appointments and review medical notes any time of day.
Concierge medicine can be a great option for physicians who are ready for a change of pace thanks to the smaller patient panel and reduced dependence on insurance reimbursements.
Just keep these conclusions in mind as you make a final decision about the future of your practice:
- There are many ways to offer concierge care. Consider the options (e.g., full vs. hybrid models, independent vs. network-affiliated) and choose what’s best for you.
- Beware of double billing. You cannot bill insurance companies for services your membership fees already cover.
- Don’t expect to get rich. Concierge medicine is more about improving your relationships with patients and limiting insurance hassles than it is about making more money.
- Check out new software tools. For a smoother transition, consider EHR or practice management systems that meet and exceed concierge practice needs. Email me at firstname.lastname@example.org if you want some free guidance.