What is Concierge Medicine?

I recently (maybe a bit later than some) heard of an emerging medical phenomenon; concierge medicine.  In an attempt to reinstate the personalized doctor-patient relationship, physicians are breaking away from the traditional medical model.  Why? Maybe nurse practitioners can do the same?

What is Concierge Medicine?

Concierge medicine (also known as boutique, direct or private medicine) aims to restore the doctor-patient relationship by eliminating constraints set by the government and insurers.  Rather than accept private insurance, physicians in these practices charge patients a retainer fee, usually ranging from $60 to $15,000.  The average retainer fee runs somewhere around $1,500.  Some concierge medical practices operate on a hybrid model accepting private insurance as well as charging a retainer.

In eliminating third party (Medicare, Medicaid and private insurers) involvement in their practice, doctors feel they are able to focus more on their patients.  Concierge physicians take on a lighter patient load in order to provide same-day appointment services, direct 24/7 cell phone access and longer appointment slots.  Patients and physicians report that this model of practice allows the formation of a closer relationship between provider and patient.

How Did Concierge Medicine Develop?

The concierge medicine phenomenon began in Seattle in 1996.  Howard Maron, former team doctor for the NBA team the Seattle Supersonics left his traditional medical practice of 3,000 patients and founded a company called MD2 providing medical care exclusively for about 50 families.  For this individualized attention, Maron charged these families a retainer fee.  This began a movement of physicians departing from the traditional medical model in order to increase control of their medical practices rather than deal with third parties such as Medicare and Medicaid.  An estimated 2,500 to 5,000 physicians now practice this privatized model of medicine.  This number is expected to double over the next 12 to 18 months for the next three years.

Why Do Physicians Switch to Concierge Medicine?

A study published in Health Affairs shows that physicians on average spend $82,975 each year to process insurance claims and billing. Physician staff on average spend over 20 hours per week interacting with patient insurance plans.  With the ever-increasing hassle of complying with government and insurance regulations, more and more physicians are tempted to create medical practices that eliminate these hurdles.  Medicare and private insurers are threatening to decrease payment for healthcare providers making cash payment and retainer fees directly from patients a more attractive option.  Physicians working in concierge practices report that although this model does not ultimately result in a lighter work load, they are able to focus on the doctor-patient relationship rather than billing and coding.  This leads to a more satisfying career.

Can Nurse Practitioners Open Their Own Concierge Medical Practices?

Yes!  If you live in a state where NP's are allowed to practice independently, you can become a part of this innovative medical model.  The American Academy of Private Physicians (geared toward physicians but non-physicians can attend) offers conferences for healthcare providers working in or looking to start their own concierge medical practice.  If you are frustrated with your inability to maintain satisfying provider-patient relationships due to time and insurance constraints, concierge medicine may be a good option for you.