Concierge Medicine vs Direct-Primary Care vs Hybrid Systems
Updated: Aug 13, 2018
Concierge medicine, sometimes referred to as “membership medicine”, started in 1996 with Dr. Howard Moran. Dr. Moran wanted to improve the patient-physician relationship and put the focus of healthcare back on patients. He did this by limiting his patient panel and offering unmatched care to his patients.
Today, both physicians and patients are discovering the benefits of concierge medicine and its similarly structured models. Physicians are able to decrease their patient load, spend more time with their patients, and lessen their administrative work, while patients have better access to their doctor, which can include same-day and after-hours appointments, house-calls, and remote telemedicine services. For patients, this may also mean less wait times, longer and uninterrupted visits with the doctor, as well as improved communication.
Twenty years ago, these services could have cost thousands of dollars per month. As concierge medicine as evolved, though, and other models have been created, concierge services have become more affordable, allowing the middle class, and even the uninsured, to take advantage of such boutique-like practices.
Types of Concierge Care
There are three main types of concierge medical practices; however, not every practice falls into one of these three models. Some physicians have taken pieces from each and created their own practice model, which can make it difficult to fully grasp the concept and intentions of each. Below, I have attempted to note some of the basic differences and similarities between the models. Physicians are entitled to build their practice as they see fit, but it is also up to them to make sure their patients are informed of their benefits and responsibilities as members of the concierge program.
In a concierge medical practice, doctors charge an annual, or a monthly, fee to patients and in return, patients receive a predetermined, and usually extensive, list of benefits and services. The patient load of a concierge physician may be 600 patients or less, which is significantly lower compared to the 2000-3000 patients in a regular practice setting (1). This means the daily schedule for a concierge physician may be less than 10 patients, which equates to more time allotted with each one and less administrative work required at the end of the day.
Most concierge practices are in urban areas and are made up of general practitioners, although many specialties are seeing more of their physicians offering concierge services (1). According to Concierge Medicine Today, the retainer fee of a concierge doctor may be anywhere between $1200 and $3000, annually, but these physicians typically accept insurance and some services may be billable to insurance (2). It is important for patients to have their own insurance, though, because concierge practices will not cover outside referral services, surgical procedures, and hospitalization stays.
Direct-Primary Care (DPC)
Coming into play about 10 years after concierge medicine, direct primary care (DPC), at its core, is similar in that these physicians have smaller patient panels and charge a monthly, or annual fee to their patients and, in return, offer additional benefits and services. The two biggest differences between DPC and concierge medicine probably lie in pricing and insurance involvement. Most DPC practices do not accept insurance, but their costs tend to be more affordable, with monthly rates as low as $100 or less. Like concierge medicine, having an ancillary insurance plan to the DPC membership is necessary for outside services.
With physician burnout occurring at an alarming rate, some doctors are opting to convert their current practice into a hybrid model. Physicians that practice under a hybrid model have some patients enrolled in a concierge, or DPC, practice while their remaining patients receive treatment under their customary practice model. This way, the physicians don’t risk losing their current patients, who may not want to transition into the concierge program but wish to continue receiving treatment from the same doctor.
The objective of forming a concierge practice, from a physician standpoint, is to create more of a work-life balance and to improve patient-physician relationships. This is done by decreasing the patient load, allotting more time for patient visits, and making themselves more accessible to patients between visits. Patients, in turn, benefit from little to no wait times, longer visits, and remote care. These concierge models are all designed to meet these goals, but each is structured differently. The biggest difference between concierge medicine and direct primary care involves pricing and insurance involvement; however, there are practices that combine different elements of each model, so it’s important for patients to understand their benefits and responsibilities prior to signing a contract with a concierge practice.
DISCLAIMER: The above information is meant for educational purposes only and should not be construed as medical advice. Please consult the doctor, or your own healthcare professional, should you have questions or concerns related to your health.
1. Dalen, J. E., & Alpert, J. S. (2017). Concierge Medicine Is Here and Growing!!. The American journal of medicine, 130(8), 880-881.
2. Stats & FAQs. Concierge Medicine Today (July/Aug 2017). Retrieved from https://conciergemedicinetoday.org/stats-faqs/on Aug 1st, 2018.