Hate watching your afternoon tick by on a waiting room clock? Disgusted by Susie Sniffles lobbing definitely-contagious sneezes in your direction? Already caught up on your entertainment news? If this describes you (or your patients!), you may be ready to jump on the concierge medicine bandwagon.
Also known as boutique medicine, direct care, or membership healthcare, concierge care upgrades the patient’s experience – for a fee. In return, the patient gets a “membership” with her provider, meaning near-instant access, constant availability, and as much face time as she needs to feel like her questions have actually been answered. The overall quality of a patient’s healthcare often skyrockets from these lengthier and more in-depth visits, as the provider gains a more comprehensive understanding of her health, symptoms, and concerns. If you’re a provider looking to offer concierge care, here are 3 things you need to know.
1. You’ll have fewer patients.
In the traditional office-practice model of care, doctors have thousands of active patients, leaving them with only10 to 15 minutes per visit. This can make appointments feel rushed, leave stones unturned by both provider and patient, and ultimately make patients dissatisfied with the quality of care they’ve just received. Our insurance-based healthcare system doesn’t tolerate longer visits without sacrificing the practice’s profitability (or, more commonly, its survival), so this system of equally unhappy providers and patients prevails.
In contrast, providers offering concierge care treat fewer patients. Yet, they still earn a sustainable income because their patients pay higher fees for their services and compensate them for the lengthier visits. Frequently, patients pay monthly or annual membership fees, guaranteeing them the opportunity to make same-or-next day visits when needed. Insurance companies rarely get any of the money, allowing the providers to keep all of their earnings, and thus focus on a smaller patient population.
2. Some of your patients will be priced out of your practice.
Some suggest that concierge providers might make twice the amount in concierge practice as would be possible under an insurance-based model. The exact pricing structure for any one provider’s practice is a bit of art and science – it must be low enough to yield enough patients to sustain the practice, but high enough to warrant a patient’s switch to concierge care and allow the provider to spend more time with individual patients. When setting a patient fee structure, it will become immediately apparent that some patients won’t be able to follow you into concierge care – and that can trigger some hard conversations.
How can you explain to the patient who is losing access to their provider that you’re entering this practice model to offer better care? One option is to create a financial need policy, whereby you reserve either a percentage of your time or patients for those who cannot afford your full rates, or you evaluate patients’ finances on an as-needed basis. You might also provide your financially-strapped existing patients with a discounted membership to your concierge practice for a limited time, giving them an opportunity to locate a new provider with whom they feel comfortable.
The concierge model levels the playing field so both sides are happy. The annual fee paid by patients, usually untouched by insurance companies, to retain their “membership” with the practice allows the providers to sustain themselves on a much smaller pool of patients. Thus, the doctor’s time is stretched between a couple hundred, rather than a couple thousand—which means more time taking care of patients. For patients, this also means Additionally, patients can receive more than bargained for. While traditional forms of care focus on identifying and diagnosing current issues, concierge providers focus on preventative care. This includes annual physical checkups, health guidance, even support with diet, nutrition, and fitness goals.
3. The demands on your time will be different, but they likely won't be lessened.
Patients paying for concierge care will, unsurprisingly, expect a higher standard of care from their providers. This may include same-day appointment, 30- to 90-minute visits, a 24/7 medical team, and often, your cell phone number on speed-dial! Because concierge providers have fewer patients, though, offering this level of personal care isn’t insurmountable or overwhelming. It allows for providers to really get to know their patients as people, including those patients’ medical files and full medical history. These patient relationships often become much more rewarding for providers as a result, as providers are more able to flex their preventive and diagnostic care muscles in dynamic ways without the typical insurance-imposed restrictions.
Concierge patients often demand more attentive and responsive care, though, meaning that providers aren’t likely to find themselves with lots of extra leisure time. For starters, you’ll often travel to your patient’s home or work, rather than them spending an afternoon in your waiting room. You’ll still need to spend time charting, ordering labs, and refilling prescriptions. And, you’ll also still have supervisory responsibilities for your support staff, which will continue to consume your time. However, having the time to get to know a patient’s history on such an intimate level often allows you to identify health concerns as they’re developing.
You can also get creative in how you spend your time. Were you a personal trainer in college? Start offering those services to your patients. If offering a combination of licensed and unlicensed services, however, be sure to have separate informed consent documents (and clear practice policies) distinguishing those services (something we create frequently for our entrepreneurial concierge clients!).
about the author
Erin K. Jackson is Jackson LLP's Managing Partner. She is responsible for all aspects of firm management, is a sought-after speaker for healthcare conferences, and is a published author. She is specifically focused upon the intersection of the patient experience in healthcare with the legal and ethical responsibilities of providers.
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