Some physicians have turned away from the traditional payment model in an effort to provide better service for their patients and increase profits. One such model is concierge medicine, where patients pay an upfront fee to retain the services of a physician. 

Dr. Travis Miller, M.D., founder of The Allergy Station in Roseville, CA, is just one of over 12,000 doctors that have made the move to concierge medicine, similar to direct care medicine.

According to Dr. Miller, “I knew as a teenager that I wanted to be a physician, but it wasn’t until my mid 20’s, after some training, that I realized that I wanted to specialize in allergy, respiratory, and immunologic diseases. I soon got tired of the rat race and working for insurance companies and greedy corporations.”

Like others, Dr. Miller found that by switching to the concierge model he was able to provide his patients with more comprehensive, personalized care in an unhurried environment. He also found that the overall medical costs for his patients were less, resulting in higher value for them.

How does the concierge medical model work?

Not all concierge practices are the same, but most share certain similarities.  In concierge medicine, a doctor charges an annual fee that can be paid in full or split up, but the contract is for the entire year. The annual fee covers in-depth comprehensive care with screenings that go beyond what traditional insurance or government programs would support.

Some concierge medicine physicians continue to accept insurance plans and government programs, and patient visits are billed in the traditional manner, apart from the annual fee. 

At The Allergy Station, Dr. Miller’s patients pay a monthly or annual fee which covers their in-office care. They receive longer appointment times, same-day appointments, after-hours phone calls, email, and online telemedicine conferencing sessions. Dr. Miller’s concierge model also includes routine screenings, allergy testing, and spirometry, and immunotherapy, including allergy shots or drops.

“I try to be approachable. The Golden Rule sits on the dry erase board in our office. Treat others how you’d like to be treated. It never fails.” – Dr. Travis Miller, M.D. 

How can a concierge practice help control a patient’s healthcare costs?

In an article published by Medical Economics, Dr. Simon Murray, M.D. describes what he saw contributing to the rising cost of patient healthcare:

“I realized that about half or more of the daily patient visits were actually unnecessary. Many of these patients could be managed safely over the telephone or with remote monitoring devices or didn’t need to come at all. I realized that we had been keeping our schedule full to keep it full.”

Like Dr. Miller, Dr. Murray made the switch to concierge medical care. After moving to the new model, he only saw patients who actually needed visits and treated others via telemedicine or through remote monitoring.

Patients Get More for Their Money

During an interview, Dr. Miller described the ways in which his concierge practice helps control his patient’s healthcare costs but still provides a higher level of service.

“A concierge practice is built on service. You do anything within your capacity to help your patients. The main difference is, my compensation doesn’t flow through medical insurance. Health insurance is a very complex, somewhat murky industry. There are so many loopholes and regulations that make it difficult for transparency. Concierge care allows us to manage many chronic health conditions with far lower costs than associated with going through insurance/payor models. Patients appreciate access. Instead of having to go to Urgent Care or the ER for their health issues, they can contact us directly 24/7 and we can go manage the problems. Our model is both efficient and responsive.”

What have been the benefits of Concierge Medicine during COVID-19?

Even before the COVID-19 public health emergency, Doctors had been looking for ways to monitor chronic health issues remotely. COVID-19 has pushed telemedicine and remote monitoring to the forefront.

According to Dr. Miller, the greatest challenge was access. However, because of its concierge model, The Allergy Station already had a telehealth platform in place and were able to serve new patients immediately. 

Remote monitoring of chronic conditions, such as asthma, eliminated the need for patients to come to the office for lung tests. This kept those at high-risk safe at home and reduced the possibility of exposure to the coronavirus.

Can a doctor increase revenue by switching to concierge medicine?

Physicians who research properly before getting started generally increase their revenue when they start a concierge medicine program. This is the most frequently stated benefit of switching to concierge medicine. The upfront fee allows a physician to bring in more revenue per patient. Because of this, most concierge physicians can cap their patient base at around 300 or so with no loss of revenue.

In the aforementioned Medical Economics article, Dr. Murray claims that before switching to the concierge model, he was making about $150,000 a year. Most people would agree that for a professional with 20+ years of experience, that is not at the top of the wage scale. 

Even though he doesn’t divulge his income after moving to concierge medicine, he does state that he began to earn a salary more in line with what his skills were worth. He also commented that for certain practices with 400 patients it would not be unusual to see earnings of $300,000 a year.

What are the challenges faced by concierge medical practices?

Without a doubt, the primary challenge faced by doctors interested in making the switch to concierge direct care is patient education. Most patients are used to the standard model of healthcare and shy away from the unfamiliar. When a doctor transitions, they could lose a portion of their existing patients.

In one study, physicians switching over to a concierge model from a standard model only kept 12% of their patient base on average. 

A second thing to be aware of is that seeing fewer patients does not necessarily equate to more personal time. Patients willing to pay the up-front fee expect 24/7 physician access, house calls, and in many cases, the physician’s cell phone number.

Finally, like any business owner, a concierge doctor has to adhere to state business regulations and manage the practices operating expenses so that there is a net profit. This includes the time management of both the doctor and other medical personnel. 

A doctor must set the upfront fee high enough to cover those expenses and make the switch profitable but not too high or they could run the risk of patients looking elsewhere for cheaper solutions. Getting the price point just right can present a challenge initially.

Regardless, more and more doctors and patients are looking at concierge medical care as a solution to rising healthcare costs and the need for higher-quality care. With the COVID crisis pushing telehealth services into the spotlight, consumers are becoming more aware and accepting of new ideas. Now, more than ever, the public needs innovation in the healthcare industry.


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