What is Concierge Medicine?

February 21st, 2013 By Steven Knope, MD

What is Concierge Medicine? Concierge medicine, boutique medicine and direct practices are all terms used to describe a new form of medicine in which patients pay a doctor directly for enhanced medical care. In return for payment, the patient receive services such as guaranteed same-day appointments, 24/7 access to the physician by cell phone or beeper, house calls, emergency room visits and hospitalizations directed by the physician. In addition, wellness care and preventative care are often provided. A comprehensive approach to healthcare allows time to address the unique needs of the individual.

What is central to all forms of concierge medicine is that third-party reimbursement to the doctor is either eliminated or relegated to partial payment for the doctor’s services. Patients take responsibility for payment. They decide to make a personal investment in their own healthcare. In practice, concierge medicine is not a single entity. It is a term used to describe many different private financial arrangements between doctors and patients. What all forms of concierge practice have in common is that they represent a return to the privatization of medicine.

Though the retainer aspect of concierge medicine is new, paying a doctor directly for his services is nothing new at all. Before the advent of Medicare in the mid 1960s and before HMOs, PPOs and every other kind of “O”, patients paid doctors directly for their care. By creating this massive bureaucracy, patients have lost the ability to simply call their doctor and get immediate medical care. Doctors have been forced to run from room-to-room, often seeing 30 patients per day, spending precious little time with each. Most physicians have no time to advocate for their patients. They have become the unwitting financial advocates for insurance companies, their CEOs and their stockholders. Concierge medicine restores order to the doctor-patient relationship by removing the financial interests of the middleman.

The cost of concierge medicine varies widely depending on the services offered and the local market. At the present time, concierge care ranges from $1,500 per year at the low- end (often payable in monthly installments of $125) to $15,000 per year at the higher-end. (Myth: Concierge Medicine is just for the wealthy.)

The overwhelming benefits of concierge medicine can be summed up in a single word: TIME. There is time for the doctor to listen to the patient; time to delve into complex medical problems; time to do meaningful preventative care. Concierge doctors also serve the important role of patient advocate during a medical crisis, helping people negotiate through our broken medical system when they become ill. When necessary, they can find the best specialists to meet your needs. At 2 o’clock in the morning when you develop chest pain, there is a familiar voice at the end of the telephone. The concierge physician also becomes the captain of your medical ship, providing continuity of care, from the office, to the hospital, to the medical intensive care unit, to your home. In short, the concierge physician is a modern-day Marcus Welby. Not some old codger with a reflex hammer and a nice bedside manner, but a modern professional, with the time and skills to help you when you need it most.

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