Concierge Practice: Could the New Models Be Right for You?

Leigh Page


June 17, 2018

In This Article

Hybrid Concierge Attracts Different Physicians

Physicians have been tinkering with the concierge model for a long time. For example, many of them keep patients who won't convert to the membership model—either because they don't want to lose those patients or because they can't find enough memberships to replace them.

According to a 2016 survey, only 30% of physicians who take any kind of membership fee have all of their patients under that model.[1]

This approach, called "hybrid concierge," is now being adopted by specialists who had been shut out of the concierge phenomenon, according to Wayne Lipton, CEO of Concierge Choice Physicians, a concierge care consultant in Rockville Centre, New York.

Seeing only concierge patients on a long-term basis is impossible for specialists, who provide episodic care to most of their patients. But many specialties do see some patients on a long-term basis and function in many ways as their primary care provider, Lipton says.

Specialists and Large Group Practices Might Benefit

These specialties include cardiology, gastroenterology, pulmonology, rheumatology, and endocrinology. Lipton says that cardiologists became interested in concierge as a new form of income, as reimbursements have declined in the past 2 years or so. "We've also seen more interest among gastrointestinal (GI) docs, who are shifting from scoping to doing ongoing GI issues," he says.

These specialists convert a small but significant portion of their patients to concierge—something like 2%-3%, Lipton says. According to a recent assessment by the editor of Concierge Medicine Today, specialists make up almost 10% of concierge practices, and interest in concierge is growing "moderately" among specialties.[2]

Meanwhile, Lipton believes that large group practices will be the next market for concierge medicine. Until now, he says, large groups haven't really needed an extra source of income. Owing to their size, they have been able to negotiate higher reimbursements with payers.

In the future, however, "income will flatten out and they will need another source of revenue," Lipton says. "We have already started working with some larger groups that want to convert to some form of hybrid concierge practice."

It is up to the practice's leaders to decide whether its physicians can offer concierge medicine, and they are doing so also for quality reasons. "Concierge [medicine] has been shown to be more satisfying for doctors, and it is linked with higher-quality care," Lipton says. Typically, each physician in the organization then decides whether or not to choose concierge medicine.

According to a report in Modern Healthcare, Mayo Clinic has adopted the concierge model in some areas of operation. In addition, some hospitals and health systems have gotten on board, including Virginia Mason Medical Center, Massachusetts General Hospital, Stanford Health Care, and Duke Health.[3]

The article notes that a concierge model allows hospitals to offset the costs of primary care, which is one of their least profitable sectors. Still, most hospitals don't offer concierge medicine because they aren't comfortable about offering different levels of care to different patients.


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