A growing number of primary care doctors are going into concierge medicine, meaning they charge patients a flat fee of often a couple thousand dollars a year, or more, to be part of their practice.\u00a0<\/p>\n
They\u2019re still a minority, but between 2018 and 2023 the number of practices charging an annual fee almost doubled, according to a study from Harvard<\/a>.\u00a0<\/p>\n Concierge doctors still bill insurance, too, but charging that annual fee means they can afford to have fewer patients on their roster and give the ones they do have a lot more time and access.\u00a0<\/p>\n When Dr. John Siedlecki first started working as a primary care doctor in Virginia almost 30 years ago, he loved it. Physicals were an hour long, follow up appointments were 20 or 30 minutes, there was plenty of time to spend with patients. It was great.\u00a0<\/p>\n But it didn\u2019t last.\u00a0<\/p>\n These days, he said, \u201cthe patients you’re taking care of tend to be older, sicker, they take more time.\u201d<\/p>\n Yet primary care doctors have less time. Reimbursement rates have declined over the years, so doctors make less money now, per patient, than they used to.\u00a0\u00a0<\/p>\n \u201cAnd so there’s more pressure to see more patients, who are more complicated, who take more time,\u201d he said. \u201cThere’s more requirements for you to ensure you’re giving them good care. And so it tends to lead to a lot of burnout amongst providers.\u201d<\/p>\n That is what happened to Siedlecki. He started to burn out, seeing about 25 patients a day and consulting on cases with the nurse practitioners and physician assistants at his private family practice near Richmond, Virginia. Then, two years ago, his partner retired, which left him as the only doctor at the practice. It wasn\u2019t sustainable. He decided to transition over to a concierge model and start charging patients an annual fee of about $2,000.<\/p>\n A growing number of primary care doctors are going into concierge medicine, meaning they charge patients a flat fee \u2014 often a couple thousand dollars a year, sometimes much more \u2014 to be part of their practice. In exchange, patients get longer visits and better access to their doctor; doctors get to have fewer patients on their roster and spend more time with them. Unlike direct primary care<\/a> practices, which also charge patients a fee, concierge practices bill insurance, too.<\/p>\n Both models are becoming more popular. They now account for an estimated 10 to 20% of practices.\u00a0<\/p>\n \u201cIt’s still a niche product, but it’s a growing niche product,\u201d said Wayne Lipton, the founder and managing partner of Concierge Choice Physicians, which helps doctors implement concierge programs.\u00a0<\/p>\n When Lipton founded the company 20 years ago, it was difficult to get doctors interested in the model. Now it\u2019s \u201cbooming,\u201d he said, among both doctors and patients.\u00a0<\/p>\n \u201cThere are fewer people going into primary care,\u201d he said, \u201cand given the realities of the economics of practice, [doctors] really are compelled to see a fairly large number of people per hour.\u201d<\/p>\n For patients, ever since the pandemic, \u201cgetting appointments became tougher and tougher. That and also, if you’re looking to have a new primary care doctor, that was getting to be more and more difficult,\u201d Lipton said. \u201cIf there’s no convenience left at all in medicine, there are going to be some people who are willing to pay for convenience. It’s as simple as that.\u201d<\/p>\n Dr. Shantanu Nundy, a primary care doctor near Washington, D.C., is not concierge, but he hears versions of this from colleagues all the time now.\u00a0<\/p>\n \u201cI get this phone call at least monthly,\u201d he said, \u201cfrom people who are saying, \u2018hey, like, what do you think about concierge medicine? Should I consider it?\u2019\u201d<\/p>\n Almost everyone he knows who is considering it is just hitting a wall in traditional practice, overwhelmed by the relentless pace, paperwork, and insurance demands. But he said doctors are also torn about turning to the concierge model.\u00a0<\/p>\n \u201cI think on one end, they want to do it for the right reasons, which is, hey, I want to just get back to taking care of patients,\u201d Nundy said. \u201cAnd on the other side, they’re going to be taking care of a lot less patients, and doesn’t that mean that more patients aren’t going to have doctors?\u201d<\/p>\n