US doctors turn to 'concierge medicine'

Doctors in the United States appear to be turning to "concierge medicine", a service in which they charge patients a fee to reduce waiting times while also lowering heavy patient loads.

Concierge medicine has been offered for more than 20 years in the US. At least 1 in 5 people with the highest incomes in the US have been getting such healthcare for years, a 2020 study by National Public Radio (NPR), the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health found.

With concierge medicine, physicians charge a patient a membership fee. They also charge the patient's insurance company or Medicare for the doctor visit and any services not covered by the membership fee. That gives a physician two forms of revenue. Insurance is still necessary for hospital visits, even with membership.

The fee for concierge medicine depends on the healthcare provider and state where the patient lives. It ranges from $2,200 to $30,000 per year. It is usually paid in one sum, but some plans may allow monthly payments.

Another type of medical service known as "direct primary care" (DPC) charges patients a flat fee that covers everything — including lab work and visits. Unlike physicians in concierge medicine, the doctors aren't in-network with Medicare or commercial insurance. Members can set up monthly payments and pay lower membership fees than concierge medicine.

There are approximately 1,000 DPC practices in 48 states serving some 300,000 US patients, Erin Sullivan, associate professor of healthcare management at the Sawyer School of Business at Suffolk University and Harvard Medical School, told NPR, citing the Direct Primary Care Coalition.

There is less known about how many patients receive care in true "concierge" practices, she said.

The Physicians Foundation found in a 2016 survey of more than 17,000 US physicians that 6.9 percent planned to switch to concierge care. By 2030, the concierge medicine sector is expected to be worth $13.3 billion, according to data from researchandmarkets.com.

As it becomes more popular, there are concerns that concierge medicine could penalize those with low incomes. And as more primary care providers join concierge practices, fewer physicians are available to provide general medical treatment.

There already is an expected doctor shortage in the US of between to 37,800 and 124,000 physicians in both primary and specialty care by 2034, according to data from the American Medical College published in June 2021.

Most primary care doctors have more than 2,500 patients, work more than 51 hours a week and see at least 20 patients per day for approximately 15 minutes each, according to the American Association for Physician Leadership, a Tampa, Florida-based organization that focuses on physicians in management positions.

Specialdocs Consultants, based in Illinois, has helped doctors switch from conventional care to concierge medicine since 2002. It has approximately 120 clients across the US.

Terrence Bauer, CEO of Specialdocs, said concierge medicine provides benefits to doctors and patients.

"As reimbursement goes down and their [doctors] operating costs go up, the only way to make the math work is to see more patients, and they get to the point where it's just unsustainable. I mean, how many patients can you see in a day?", he told China Daily.

"For physicians, [concierge medicine] is a dramatically different work-life balance, as opposed to today (where) they have to see more patients just to make ends meet. They get the opportunity to really focus on health and wellness and the disease, not just on the symptom of the day."

On average, doctors who operate under the concierge model have 600 patients and see six to 10 patients per day for 30 minutes at a time, according to Forbes Health.

"They get same-day or next-day appointments, number one, as opposed to many times, you have to wait weeks or months to see a doctor," Bauer said. "No waiting in the waiting room. You're not sitting there with a lot of other sick people or waiting for the doctor to come in, and then maybe getting six to 10 minutes with him or her."

Agencies contributed to this story.