Understanding Concierge Medicine: Is the Service Right for Your Practice?

Concierge medicine is a unique doctor-patient relationship. Sometimes called retainer medicine, this service was once only available to the wealthiest people, but it's now growing among middle-class patients. You'll want to weigh a few factors before deciding if this service is right for your practice.

How Concierge Medicine Works

Concierge or retainer medicine allows patients to have a closer relationship with their primary care physician. Patients pay their doctors an annual or monthly fee, and in exchange, doctors limit the number of patients they see and extend appointment lengths. This allows physicians to provide more specialized care for each patient. For example, Dr. Cyrus Peikari, a concierge doctor who only sees 200 patients at his Dallas office, according to D Magazine, spends at least 30 minutes with a patient per visit and is always available by phone or email.

Concierge medicine includes:

• A limited number of patients
• Monthly or yearly fees for unlimited visits (often instead of insurance)
• Longer patient visits (30 minutes or more) and shorter wait times
• Closer, more personalized care for chronic conditions, which might lead to better treatment plans
• Lower overhead and fewer employees, especially if insurance isn't used

No Longer Just for the Wealthy

In the past, concierge medicine was synonymous with VIP medicine. Patients used to pay $30,000 a year or more for luxury clinics. Now primary care doctors are seeing value in offering a pared-down clinic for middle-class patients, who pay as low as $50 a month and, in some cases, bypass insurance all together. These less-expensive clinics may require payments up front and offer a menu of extra services, such as free X-rays or blood work.

Advantages of Concierge Medicine

The concierge system allows you to pay closer attention to your patients, according to some in the business. Dr. Peikari explained that doctors tend to get empathy burnout after seeing too many patients in a small amount of time, so this type of service can be a huge help for doctors searching for empathy and compassion in the face of a daily grind. Concierge services can also lead to happier, more loyal patients, who see a better return on their investment thanks to more personalized care for their specific health conditions.

You may also see benefits in your practice's bottom line. In traditional medicine, primary care physicians have a median salary of about $160,000 a year, but also face huge overheads, paperwork, and packed waiting rooms. In fact, in 2011 the average medical practice's spending reached $82,975 per doctor dealing with insurance. Meanwhile, some doctors who run lean concierge practices -- and only charge $50 a month -- may bring in $200,000 a year.

But money isn't the only reason why doctors switch to this model. Some make the transition because they feel controlled by third parties in the traditional system and want more autonomy. They're freer to make their own schedules, and instead of feeling stressed with quick visits , they can focus more on preventive medicine.

Right for Your Practice?

Despite the advantages, concierge medicine isn't right for every practice or every community. If many of your patients have low incomes, you may lose a lot of them if you switch to this model - and your patient may have a harder time accessing care as a result. You'll also need to consult a lawyer to make sure your new practice isn't discriminatory in any way. Finally, be very careful with your retainer contract. It should answer questions such as:

• What types of services are included in a monthly or yearly fee?
• Are same-day appointments available?
• Will a practice doctor be available 24/7?
• How much will à la carte services cost?

Changing to a concierge service is typically an all-or-nothing type of venture; you can't make the leap and stick with traditional services at the same time. If you're risk-averse, then upending your entire practice might be outside your comfort zone. You may need startup money to fund the switch or extra income to help pay costs until you break even.

Consider the makeup of your patient base, and talk to other concierge doctors before you make a decision. You might also consider talking to a health network to see whether it's working with similar concierge services in your region and if they have any advice to help you make your final decision.