Concierge, Direct Pay, or Hybrid: Is One Right for You?

Leigh Page

Disclosures

April 06, 2016

In This Article

Hybrid Practices

Many experts advise against hybrid practices, which are usually confined to the concierge model. Greenspan says that when physicians convert only part of their practice, it causes more trouble than it's worth. "Physicians have to work much harder," she says. "They are seeing the same number of patients as before, but they have committed themselves to spending more time with their concierge patients."

But some physicians make hybrid practices work successfully. Tiffany Sizemore-Ruiz, DO, a young physician in Ft. Lauderdale, Florida, created a hybrid practice by default. When she and her husband, Camilo Ruiz, DO, graduated from training in 2012, they wanted to open a full concierge practice. Both doctors offer general internal medicine, while Dr Sizemore-Ruiz also practices cardiology, and Dr Ruiz practices sleep medicine.

But as new physicians, they didn't have a patient panel to convert. They had to go out and find patients, which proved difficult. They paid Google for search engine optimization and relied on word of mouth, but they didn't get enough concierge patients to fill the practice.

"We realized that we wouldn't be able to keep the office open with just concierge patients, and we didn't want to turn away traditional patients who were interested," Dr Sizemore-Ruiz says. In the end, they managed to recruit a little less than 100 concierge patients, while the rest of their 800-patient practice is made up of traditional patients.

Traditional patients have managed to coexist with the concierge patients. "One concern with the hybrid model is that the nonconcierge patients get the short end of the stick," Dr Sizemore-Ruiz says. "Our concierge patients can go to the front of the line for appointments, but our regular patients don't get upset because they don't have long waits for a regular appointment."

The practice recently raised its concierge fees. Initially, the rate was $1500 a year, with discounts for some patients. However, "we began to see a surge in the number of patients that were joining, and some patients were mentioning how the price was 'so cheap!'" Dr Sizemore-Ruiz says. Consulting "supply and demand," the practice raised it rates to $2000, without any discounts.

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