Private practitioners who wish to remain independent, but who are struggling to survive because of decreased third-party reimbursements and increasing overhead expenses, are being aggressively courted by various business entities that will analyze-often for free-whether the concierge model of medicine, or some variation thereof, might add significant profitability to the practice’s bottom line.
The earliest concierge models generally required patients to pay an annual membership fee in order to receive enhanced accessibility to their physician. In return, the physician would agree to limit his patient base to, say, 600 patients. In this way, the physician would conceptually be able to spend more time with each individual patient, yet still maintain (if not increase) his historic revenue stream. This meant that those patients who chose not to participate in the physician’s new concierge program would be required to leave the practice in order to find another physician to care for their healthcare needs.
In the past, many patients who have been approached to transition to a physician’s concierge practice chose not to do so because they did not perceive that the enhanced accessibility to their physician was worth the cost of the annual membership fee. Oftentimes, they were already able to get same day or next day appointments, and prompt return phone calls from their doctor so, the thought went, why pay all that money? What does one get in return?
To counter this reluctance on the part of patients, a number of concierge companies have been expanding upon the traditional concierge model by promoting a “hybrid” concierge model. Under the hybrid model, patients are given the choice of whether to participate in the concierge program or not. If they choose not to, they can still remain as a patient of the practice and the physician does not have to contractually “shrink” his patient base.
By allowing the physician to maintain his existing patient base under this new “hybrid” model, it would appear that one of the most significant selling points of the concierge model (i.e., providing the patient with more time with his doctor) would be undermined because the physician would still be under the same time constraints as he was before converting to a concierge model (since he needs to still treat the same number of patients).
To entice patients to pay the annual membership fee in order to join a “hybrid” concierge program, today’s concierge companies are now offering additional enhanced benefits as an improved “value proposition” for those patients who join. Generally, these enhanced benefits are included in the annual membership fee, and as such, are free for the program participants. For example, a number of concierge companies now provide program participants with access to health coaches who can help them improve their health and/or control their chronic illnesses by providing personalized nutrition plans; ongoing motivation and support to achieve their objectives; and integration of technology and easy-to-use “apps” so they can monitor their progress. Others provide personalized wellness plans as well as monthly newsletters with health tips. As such, the current marketing emphasis by concierge companies is no longer just about providing patients with better access to their physician (through 24/7 e-mail, cellphone numbers, and expanded office hours), or promoting the physician’s availability to spend more time with each patient because of his/her significantly reduced patient base.
Physicians interested in exploring whether a concierge model might be beneficial to them should consult with more than one concierge company. Each has its own organizational model, operational requirements, and profit-sharing arrangements. They should also consult with a knowledgeable healthcare attorney who can help them avoid compliance pitfalls and negotiate the best deal.