What Is "Concierge Medicine"?

Many patients struggle with finding a primary care or specialist doctor, obtaining an appointment, and taking time from work for a traditional office visit. And even those that have a doctor find it very hard to reach him/her by phone, e-mail, or after office hours. A new report by the National Center for Policy Analysis suggests that “concierge medicine” might present a solution to some of these problems.

Concierge (also called boutique) medical practices offer exclusive access to patients for an annual fee. Doctors are typically available after traditional office hours by e-mail or telephone and through house calls. These services reduce the time-cost to patients to access care and improve quality by utilizing new technologies such as electronic medical records. Services are priced and bundled in a way that offers value for the patient’s money.

These services are likely to solve several problems that are endemic in our healthcare system. For example, 33% of patients report problems getting a timely appointment with their doctor, 24% report problems getting appointments after hours, 12% report problems getting the doctor on the phone, and 12% report that their doctor is too far away. One in every four people report problems taking time from work to see a doctor. And since less than 25% of doctors communicate electronically with patients, patients are required to schedule an office visit for a simple question or a routine prescription.

For patients, this lack of communication is perceived as leading to lower quality care. Research shows that 72% of people believe that insufficient time spent by doctors with patients is one cause of preventable medical errors, while 78% believe that medical errors could be avoided if physicians spent more time with patients.

For example, the concierge practice of DocTalker Family Medicine in Virginia allows patients to schedule an in-office appointment or even request a house call, but about half of the consults are by e-mail or telephone. The only requirement is that patients must at first have a face-to-face consultation with the doctor to establish care. After that, consultation fees are based on the amount of time required.

Unlike other concierge practice, DocTalker has no annual membership fee, but patients who prepay $300 annually receive a 25% discount. A five-minute phone consultation or an e-mail consultation is priced at $25. While the practice does not bill insurance companies for services, patients can file their own claim.

While membership in a concierge practice can cost patients up to $2,500 per year, these services are not limited to wealthy people anymore. For example, one concierge service in Dallas costs $500 per year and is aimed at small business employees who would otherwise likely be without insurance. About 70 small business owners have memberships with the practice. They pay $40 per employee per month for their employees to get same-day primary care services and steep discounts on diagnostic tests and specialist care. While specialist services, surgeries and diagnostic tests are out of pocket, the practice negotiates on behalf of the patients much lower rates for these services.

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