Concierge Practice?

I’m occasionally asked, “Is your practice a Concierge practice?”  My answer is, “Yes and no.”

It depends on how you define “concierge”.  If you define concierge as a practice that provides individualized care, great service and the direct attention you deserve in a doctors office, then yes that’s what I do.  Most current offices cannot do this well because their minds are cluttered with regulatory rules, formularies, referral requirements, ICD-10, CPT codes and the dozens of other things that are imposed by the “payors” who are other than the patient.

Not me!  Since my patients pay me directly I am saved from the misery of the above.  Payment to me reinforces my professional instinct and the Hippocratic ethic to advocate for patients and treat them the best I can.  Direct payment is honest and simple and both the patient and doctor are generally satisfied.

“Concierge” has taken on a slightly more precise meaning in the last 10 years or so.  Concierge not only describes practices that “place patients first” and provide “personalized” or  “attentive” care, but in real terms it describes a practice where patients pay a fee, usually about $1,000/year.   This allows the doctor to keep a small number of patients in his practice, say 500.  Such a small patient load allows the doctor to spend a lot more time with the patients and truly provide individualized and very attentive care.

I do not have this type of practice for several reasons.

1.  One premise of the Concierge model is that you can prevent diseases by regularly seeing a doctor.  Generally, I don’t believe this is true.  You can absolutely prevent diseases by changing your lifestyle and for that advice you are probably better off going to a good dietician, fitness trainer, chiropractor or just use your common sense.  You can also go to a good doctor (like me) who can give you advice, but you don’t need to pay $1,000/year for that.  You can just schedule an appointment.

2. Many people who truly need medical help also do not have the resources to pay for entry to a Concierge Practice.  Who is going to see them? People of humble means or who are truly sick need the most attention and I think my system can do that best.  I prefer to keep my prices reasonable and a good value for everybody.

3. People who are overly obsessed with their medical care, but are really healthy, would gravitate to a Concierge Practice.  I don’t enjoy seeing these kinds of patients, nor do I help them much.

Concierge is a great alternative style of practice that fills a need and I’m confident it will grow.  I wish it well.  I hope good and qualified doctors will continue to establish their own private practice, each different from the other, so patients can best find suitable care.

Free markets are best able to provide for the infinite desires of the consumer.

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