Concierge Medicine: The Good, The Bad, And The Ugly

Concierge Medicine: The Good, The Bad, And The Ugly

by from Medelita | Tuesday, Apr 12, 2016

With the AAMC estimating a shortage of between 12,500 and 31,100 primary care physicians by 2025, and growing concerns from current physicians regarding profit losses, concierge medicine is becoming increasingly popular among both physicians and patients, more and more of whom are able to afford the service. 

Dr. Samir Qamar is a pioneer in the concierge medicine industry who decided to open his own Direct Primary Care company after feeling dissatisfied with the relationship between primary care and insurance. In this concierge medicine model, patients pay a monthly or annual premium directly to a physician who assumes all responsibility for the patient’s healthcare needs, essentially becoming that patient’s own personal doctor.

Now, before deciding to go and open your own boutique medicine company, it is important to learn about all aspects of this emerging model.


 

Patient Experience 

The amount of time you are able to spend one-on-one with patients is the most critical aspects of healthcare for both patients and physicians. Being able to secure an appointment more quickly, feeling less rushed while in the office, and having a more personal relationship with your doctor are all aspects that improve the patient experience. Physicians are taking fewer patients, but the financial effect of this reduction in patient volume is offset of the monthly premiums that are being collected from each patient. Patients are often highly satisfied with the longer appointment times, which allow physicians to get to know them personally.

Reduced Overhead Costs 

It is hard to imagine a world where time extensive coding and billing are not present, but for some direct-pay providers this is reality.  Note, this only applies if patients are simply paying their monthly fee and service charges without any insurance, but even in cases with insurance the overall time of bill processing is reduced and simplified.

Lack of Insurance Recognition

 Though there are some insurance companies that are starting to offer plans that entail concierge services, many insurers still only offer traditional plans. This deters patients from wanting to purchase additional concierge services on top of their required insurance plan. Depending on the model of the concierge provider, and the type of expense incurred, an HSA or FSA may cover the expense. However more often than not, the patient would have to pay for the fees out of pocket.

Price Matters

In traditional models involving insurance, the amount of patients relative to profitability is easy to determine. When providing direct-pay services however, physicians are in charge of their own fees and therefore a solid financial plan is necessary to ensure profitability. Figuring out a price that is attractive enough to secure new patients, while still maintaining profitability can be a daunting task without thorough knowledge of the concierge market.