Concierge medicine is a fringe healthcare concept that’s been around since the 90s, but lately it’s been gaining momentum. The American Academy of Private Physicians reports there are still under 5,000 practices in the United States, but surveys show a growing number of physicians — especially the younger generation — are becoming interested in this type of practice model.
So how does it work? Basically, it’s a private form of care (similar to direct care) in which physicians charge their patients an out-of-pocket retainer fee in exchange for full, immediate access to their services. Physicians who operate under this structure maintain a much smaller pool of clients, ranging from 500 to 1,000 versus several thousand in a traditional practice.
The unpopularity of this type of care is based on the perception that it only benefits physicians and wealthy patrons, but the rising cost of health care is starting to level the difference between concierge plans and Obamacare or private insurance, making it appealing to a larger group of consumers. For instance, physicians in one of the larger concierge networks charge an annual retainer fee ranging from $1650 to $1800 a year; in contrast, an average Obamacare plan costs thousands more. For some, the upfront cost difference is enough to give it a second glance.
But is it worth it for you? Here’s a rundown of both the good and bad so you can decide for yourself.
Advantages of Concierge Medicine
Essentially, concierge medicine differs from traditional care in that it is not sick care, but preventative care. One of the greatest advantages of concierge models is more personal care. Because physicians have fewer patients, they can devote more time to the ones they have. A smaller workload can also mean faster diagnoses and treatment for life-threatening conditions. Many deliver same or next-day appointments, longer appointment time, in-home visits, fast emergency care, and preventative screenings and tests not offered by most insurance plans.
If your physician is part of a network such as the MDVIP, you may even be able to see another network physician if you have an emergency while away from home.
As for expenses not covered by the retainer fee, many concierge models and networks coordinate with insurance providers or Medicaid. Out-of-pocket expenses (excluding your retainer fees) may also qualify for flex-spending reimbursement from your regular insurance provider.
The Downside of Concierge
On the other hand, concierge medicine still represents an out-of-pocket medical expense many people cannot afford, especially since most still need insurance to pay for whatever the retainer fee doesn’t cover (Obamacare and other insurance providers cover many procedures that a concierge membership does not). Otherwise, you’re paying even more out-of-pocket. Unless your insurance is free, that’s a monthly/yearly retainer fee plus your insurance premium.
Secondly, retainer fees are not covered by insurance, and some companies even refuse to work with physicians who collect retainer fees, mostly because they believe it fosters inequality. In other words, you may have difficulty reconciling your insurance with your preference for a concierge-platform physician.
Lastly, retainer fees vary widely and tend to be higher in more expensive areas. If you live in one of these areas, the fees for a concierge physician may be higher than you can afford.
What Do You Think?
In spite of the potential problems with concierge medicine, it still might be the right option for you. Can you afford it, or is actually cheaper than your other insurance options? It might be something to think about. You may also be willing to pay a little extra if fast, personal and preventative care is very important to you and your health situation — some people especially value being able to call, e-mail, or even text their physician directly. If you think you might be interested in concierge medicine, check out the locator tool provided by the American Academy of Private Physicians to see if there are any physicians or networks near you.
{ read the comments below or add one }
I am a Honolulu-based financial planner. At the recommendation of one of my clients who is a highly regarded M.D., I signed up six months ago to be a member of MDVIP. It has been a remarkable experience. While I truly liked my previous PCP, he had thousands of patients and I only saw him for 15 minutes twice per year. My MDVIP PCP has met with me 4 times in the past six months and each visit was an hour or more. She designed a customized wellness program, and, with her guidance, I have lost 20lbs and she and I have a detailed undestanding of my health and issues to monitor. People have asked me why I pay $1600 on top of my ridiculously high $23,000 annual group medical insurance premium. I respond that the value I receive for the $1600 is far greater than what I receive fro the $23,000.
ITS ALL ABOUT MONEY. DRS ARE IN IT 4 THE MONEY. GIVE ME MY OLD SCHOOL DR, NOW THEY CARED!!!!!!!
I signed up with a concierge practice earlier this year and while it’s expensive, it’s currently worth it to me.
I’ve been struggling with obesity most of my life, and this is the first time that a doctor has really taken the time to help rather than just saying “you need to lose weight”.
My annual physical was a full hour minutes with the doctor. Not waiting room time, but actual doctor time. The tests were far more extensive than a normal physical and were adapted to my medical history and family medical history. Appointments are easy to get, and I have monthly to bimonthly check-ups to hold me accountable for lifestyle changes and weight loss.
I’m not 100% sure if I’ll renew for a second year or not, but it’s been very helpful to get me on the right path.
Sometimes you really do get what you pay for.
I am currently looking for a new primary care physician. I have been going to the same one for many years, originally when I went to my doctor I saw him. Over the many years, his practice has gotten bigger and he has added more PA’s and nurse practitioners, I very rarely ever saw him. Then the wait times increased and the quality of care decreased. The only reason I stayed so long is because one of the PA’s was absolutely great, but unfortunately she left. Now there is nothing to keep my at this practice. I started looking for a new PCP. I found a doctor who was very highly recommended and also has great reviews, but he is a member of the MDVip concierge practices. I am a 50 year old woman with very little health problems, thankfully. While I like the benefit of having a qualified and attentive doctor, especially coming from a practice that couldn’t even keep my name right, the reality is I don’t go to the doctor’s all that much but I am getting older so will this be a benefit or not. I am so torn because the thought of shelling out 1600.00 is scary.
This really makes me want to move some place where there is universal medicine. I don’t blame doctors who want to provide more care to their patients and are frustrated by the limits insurance companies impose on them. But there is something inherently wrong with the idea that people who can pay for it will get better care. The rest of us will not. Concierge medicine promotes inequality on the basest level: an individual’s health. Concierge medical practices don’t address the real problem of PCP’s 1) not getting paid what they should get paid and 2) having to limit the care they do provide because they have to follow insurance companies rules. Doctors, like anyone, want to be paid for what he or she gives. Now, with Concierge medical practices, they will be–and a good many patients, that these doctors care about, who cannot pay the Concierge fees, will be aware of the patients who CAN pay, who will be receiving the better care, only because they can afford it. This country is already so split economically, it makes this new type of medical practice just another way to divide us further. This idea is elitist and will hurt more people than it will help.
Have you actually researched universal healthcare? According to many patients who have no other option, it’s not any good either.
MDVIP is fine if you can afford it. Really not worth the cost if you only see a Doctor 2 or 3 times a year.My Doctor had been with MDVIP for 6 years and now his service is not that good –guess he has decided money will come in anyway regardless of the attention to his patients.
Don’t waste your hard earned money!!
I am a huge proponent of preventative care – so this in some ways appeals to me. If you are going to spend money somewhere I believe healthcare would be the way to go. I still find it frustrating that there is not more preventative care available in our current system. When was the last time anyone talked to you about diet and chiropractic when you saw the doc?
We can only hope that one day someone will come up with a better model where the doctors are compensated by quality of care rather than quantity of care. Otherwise I’m afraid many will only do as much as what will get patients out of the door.
I have had a concierge medicine plan for the past year. I pay an annual fee to have access to a private physician through secure email, phone calls, and next day appointments.
Office visits are billed through my insurance similar to any other provider. I pay the co-pay or out-of-pocket until my deductible is met. Plus, the provider may be considered out-of-network by your insurance in which case, you will be paying higher fees and a higher deductible must be met. So it’s definitely not lower cost. If anything, it’s the same or more plus the concierge fee.
I am struggling with whether to continue the plan as I only accessed my physician on a few occasions. My health is good, but if I had issues, it would definitely be worth it.
One of the unwritten benefits is your concierge physician getting you a quick appointment with a specialist. Normally, it might take a few weeks or even months to get in with a certain specialist. In my experience, a concierge physician can shorten that wait considerably. But again, this is only a benefit if you have the health need.
It’s comforting to have a physician available whenever needed, but it definitely comes with a cost.
See the payment as insurance if you decide to continue, then be glad that you don’t need to use the coverage because that means you are healthy!
Dave, thanks for your honesty regarding MDVIP. My doctor recently informed me that she was changing to this and offered me the opportunity to join. I agree with you in all!!! I don’t think I’ll be joining this service.
Oh well, I guess I’ll be looking for another physician…
Thanks again for the the info
Sandy
I think this is an awesome idea and a great way to get more money into the hands of those that deserve it (doctors) and out of the hands of those that don’t (insurance companies). This could really help to lower healthcare costs for most folks if it catches on!
Right on Derek.
The more efficient we can make our health care system, the better everyone will be!
I’ ve never heard of concierge medical services. It’s not something to rule out for anyone though if it saves them money in the long run. May be worth looking into. Thanks for sharing!
You’re welcome Latoya.
Hiring concierge doctors isn’t common, but the move can definitely be a lifesaver if you happen to need prompt attention. The other advantage is that since you are likely to see the same doctor for years, he/she will know your medical history and can work with other specialist to give you a more suitable medical treatment in times of need.