The pros and cons of a doctor on retainer.

Concierge medicine is luxury healthcare, literally. The goal of a concierge medical practice is to provide more accessible and convenient medical care to the consumer.

In a traditional general medicine practice, a physician sees 2,500 to 4,000 patients a year, and up to 30 patients each day. A concierge practice sees an average of 600 patients a year. This framework changes the entire medical practice landscape.

There are an estimated 4,500 concierge physicians in the United States, according to the American Academy of Private Physicians. The number represents a 30 percent increase in this practice format over the past year. Some concierge physicians are in private practice while others are work in a healthcare network system.

What You Get

Concierge or retainer medical practices offer patients significant healthcare perks. The main areas of such a physician-patient partnership include some of the following:

• Longer office visits, typically lasting at least 30 minutes and running as long as needed versus the traditionally rushed 10-minute appointment
• Patients are often seen in a setting most convenient for them, whether in a physician’s office, at home or at work
• Same day or, at the very least, next day appointments versus the usual long wait time
• Direct physician access via email and/or cell phone 24/7
• A thorough annual physical examination, usually including such evaluations as advanced cardiac screening or psychiatric screening for depression
• Physician support to talk directly to specialists and segue emergency room care, if the need arises
• Frequent and personalized physician counseling about a variety of health issues: heart health, emotional well-being, diabetes risk and/or weight management; the focus is wellness, not illness

One research firm, the Center for Studying Health System Change, states the concierge concept very simply, it is “improved access and ease of accessibility” to medical care.

It is important to understand that routine visits (for respiratory or flu symptoms, hypertension or other common illnesses) to the doctor are charged to the patient’s health insurance plan, so those premiums are still necessary. There are some patients who choose not to enroll in a traditional health insurance plan and pay out-of-pocket for non-covered services. This is not highly recommended because hospitalizations and specialist consultation and care can be extremely expensive.

The Extra Expense

There is a program membership fee associated with concierge health care services. They range from $1,500 to $25,000 annually, depending upon the particular services chosen by the patient.

The concierge membership fees pay for services not covered by insurance such as a wellness plan.

Analysts say that there are two patient populations who strongly benefit from concierge medicine:

• Those who want to focus on wellness and prevention
• Patients with a chronic illness

The downsides of such medical care include:

• Creating a two-tiered healthcare system in the U.S., where there is already a shortage of primary care physicians (PCP)
• Further increasing the PCP shortage since in concierge medicine, physicians see significantly fewer patients annually

Is It Worth the Added Expense?

If a patient is only looking for a rapid response for an occasional medical problem, like the flu or a sinus infection, and not a lot of extra attention at other times throughout the year, concierge medicine is not worth the additional cost.

Statistically, the time spent one-on-one with the concierge medicine patient population has reduced:

• Emergency room visits by 65 percent
• Hospitalizations by 35 percent
• Specialist visits by 66 percent

The overall trend towards concierge medicine is evolving in the United States. Patients who desire more personalized medical care and can afford this style of health coverage do experience the benefits.