Concierge Medicine

How Does Concierge Medicine Work?

December 14, 2020

Harsha Moole, M.D., MBBS

Like all other membership-based models, the concierge care model provides patients with first-rate, personalized care via a subscription fee.

These membership-based subscriptions follow a set of terms and conditions between you and your concierge doctor, including convenient payment terms that allow patients to settle fees either monthly, quarterly or annually.

Does Concierge Medicine Really Work?

If you're interested to know how concierge medicine works and how different it is from the traditional, insurance-based health care system, here are key details you should keep in mind if you are considering making the switch:

concierge care model

1. Concierge doctors spend more time with their patients.

This is possible because they limit the number of patients they see to ensure enough time is devoted to every patient. In contrast to traditional primary care physicians who are frequently overworked and overbooked, concierge doctors are in charge of their own time.

Concierge doctors only see 15 patients or less each day instead of traditional primary care physicians who see at least 30 patients or more per day.

2. Patients have 24/7, unrestricted access to their concierge doctor.

Apart from unlimited office visits, concierge doctors can also spend more time with their patients by being conveniently available. A concierge medicine subscription merits direct access to your concierge doctor’s personal line.

You can contact them for health emergencies, teleconsultations online or via mobile, or even home visits, especially when you are sick and unable to move around.

3. Concierge doctors offer a more proactive form of patient care.

By being in touch with their concierge doctors consistently and for more extended periods, patients receive a more individualized, preventive healthcare level.

Concierge doctors can assess your complete medical history and develop long-term health management plans to keep you healthy, rather than addressing medical problems only when they get worse.

4. Your concierge medicine subscription covers all the primary care basics like how a DPC subscription does (and more).

Unlimited appointments, 24/7 access to your concierge doctor’s direct line, discounted out-patient services, and medicine at wholesale cost – all of these benefits are also available in a typical concierge medicine subscription.

The only difference is that a concierge medicine subscription includes selecting additional premium services, which a regular DPC subscription does not.

5. Concierge medicine is high-end service-focused and added-value oriented.

In comparison to Direct Primary Care, which is more concerned about being cost-efficient, your concierge medicine subscription offers many added perks.

These added perks include comprehensive care and routine preventive services such as in-depth physical exams and screenings, and even coordinating and accompanying your specialist visits.

6. A concierge medicine subscription is perfect for those who have chronic conditions.

Although everyone is welcome (and encouraged) to have a concierge medicine subscription, the patients who benefit the most from this type of subscription have chronic illnesses, like hypertension or diabetes.

If you are a patient who requires more meticulous care, you will significantly benefit from having a doctor who is familiar with your entire medical history. A concierge doctor recommends and coordinates specialists whenever necessary and ensures that overall treatment and care is seamless, hassle-free, and has the patient’s well-being at heart.

7. Hybrid DPC-concierge medicine characteristics within a single practice is not uncommon.

Each DPC or concierge medicine practice offers different perks, payment terms, and subscription guidelines. It’s all about finding a practice that fits your price point and covers all the benefits you need.

8. Membership-based health care models like concierge medicine, offer transparent payment terms.

If there’s anything concierge medicine and DPC have in common, it’s that both allow patients to settle primary care fees in a clear, upfront manner.

Much like your Netflix or Spotify subscription, patients are charged a retainer fee that costs anywhere from $101-$4000 a month – slightly higher than DPC, which can charge as low as $30 per month. Time to say goodbye to chaotic insurance billing!

9. Say goodbye to copay fees with concierge medicine.

Concierge doctors do not usually charge copay fees every time you need to see them, although some of them continue to bill their patient’s insurance company for covered services on top of the subscription fee.

10. Most concierge doctors continue to accept third-party insurance billing.

This results in two subscriptions paid by patients — the concierge medicine fee and the insurance premium. Notably, a few concierge medicine practices do not bill insurance for medical visits, as the monthly fees cover both access and primary care visits already.

Limitations of concierge care model:

1. Your concierge medicine subscription does not replace your health insurance.

Although your concierge medicine subscription already covers everything about premium primary care services, it does not include catastrophic health expenses, hospitalization services, and other subspecialty services.

This means that you still have to retain your insurance plan, albeit a much cheaper, more basic one that only covers these services as mentioned above.

A concierge medicine subscription is something you should consider getting into as a patient, as it provides top-quality direct patient care without the intervention of intermediaries – something that is virtually unheard of in your traditional health insurance.

Authored by Harsha Moole, M.D., MBBS

Advocate of healthcare models that promote direct relationship between patients and doctors. Founder @ FindMyDirectDoctor, LLC.

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