Throughout the past decade, physicians must work harder and see more patients daily just to earn a decent living. It has become increasingly difficult for private practice physicians to cover skyrocketing overhead expenses such as soaring malpractice insurance and other costs of owning a practice.
America’s highly bureaucratic healthcare system has transformed a very personal experience of patient care into a relatively cold, impersonal business transaction. Like it or not, medicine is a business. To turn a profit, doctors now must cram more patients into a day than ever before, which causes patients to feel more like cattle and less like individual human beings with real needs.
Concierge medicine seems to address some of these issues for both patients and physicians, particularly those in primary care such as family practitioners or internists.
How it works: Physicians charge an annual fee to each patient in their practice. I’ve talked to physicians who charge each patient between $1,500 and $2,500 per year, but retainers can be in the five-figure range!
In exchange for paying that fee or retainer, patients receive 24-hour access to the physician, including last-minute appointments, prescriptions, or to answer medical questions. Additionally, appointments can be up to an hour long, as opposed to the standard 10-20 minute appointment time most traditional patients are allotted. Patients don’t have to wait weeks or months for appointments, they have medical aid at their fingertips, and they can spend time with the physician so that the doctor will truly know the patient’s medical needs inside and out. Some concierge physicians even make house calls (of office calls).
For doctors, this enables them to partially circumvent the healthcare insurance payers, and managed care reimbursement crunch. How? The annual cash fee from each patient supplements their practice, which enables them to free themselves from the restrictive numbers game of seeing 25-35 patients per day in order to cover their costs and earn a fair salary.
Do the math: at $2,000 annually per patient, a physician can survive on much less than the thousands of patients typically needed for a successful, profitable practice. Some concierge physicians have as few as 50 patients in their practice.
Job outlook and availability: Most physicians practice concierge medicine on a self-employed basis. There are, however, a few corporations which have popped up to provide concierge medical services. These companies are usually physician-owned or physician partnerships, which most likely wouldn’t need to hire another physician as an employee, unless that new physician is willing to invest in the company as a whole. In which case, you are back to owning your own business as opposed to being employed.
Government health care agencies are watching concierge medicine closely, for any unethical or illegal insurance abuses or patient care. Therefore, there may soon be additional regulations enforced by the government to try to discourage or prevent physicians from practicing boutique medicine.
The bottom line: if you are a physician interested in practicing concierge medicine, you’re probably going to have to do it on your own, as opposed to someone hiring you as an employee and paying you a salary to do it, which would somewhat defeat the purpose for a physician to practice concierge medicine. Additionally, because only upper-middle class patients and above can afford such care, the patient base is limited. The concierge model works best in affluent or professional populations. For example, the state of Florida is a popular location for concierge medicine, where concierge medicine makes sense for wealthy executives or retirees who need more frequent medical care, and the annual investment is cost-effective for such patients.