As fees have come down and frustration with traditional primary...

As fees have come down and frustration with traditional primary care has gone up, concierge services are getting more attention. Credit: AP / Rogelio V. Solis

Concierge medicine — a model in which patients pay a membership fee for a more direct relationship with a primary care doctor — used to feel like a perk for the superwealthy.

But as fees have come down and people have gotten more frustrated with the state of traditional primary care, concierge services may not seem like such a pie-in-the-sky option. There’s less waiting, more access, longer visits and greater coordination of care. However, the fees can be high, and if you don’t have complex medical needs, it may not feel worth the expense.

What is it?

Your membership fee may cover a wide range of services, with insurance covering any needs you have outside the practice, or your fee may cover basic preventive care and the practice might accept insurance for the rest.

But your experience, overall, is more personal. Concierge medicine typically offers same-day appointments and 24/7 access to your doctor (who, by the way, isn’t rushed during visits).

Patients like it because they have more time with their provider, says Terry Bauer, CEO of Specialdocs, a company that helps doctors transition to concierge medicine.

People with a medical situation after hours can call, text or email and avoid some trips to the emergency room. “They have that doctor, in essence, on speed dial,” Bauer says. “It makes people a lot more comfortable and a lot less anxious.”

How much does it cost?

Membership fees vary widely. For one large concierge network with doctors in 44 states, the fee is typically between $1,800 and $2,200 per year (or between $150 and $183 per month). Other practices can run much more.

“I know a couple that charge $4,000 a month,” Bauer says. Doctors who charge those prices may be board certified in two specialties — cardiology and internal medicine, for instance — or they may be in an extremely wealthy area of the country, he says.

The good news is that if you have a flexible spending or health savings account, you can use those funds to pay your annual membership fees as long as they go toward wellness benefits.

Advantages

There’s plenty to like about concierge medicine. It’s usually possible to get same-day or next-day appointments with your doctor, and wait times are minimal, says Bret Jorgensen, chairman and CEO of MDVIP, a network of concierge medicine physicians. Typically, you have access to your provider at all hours of the day, and because they have fewer patients, your doctor has more time to spend with you.

“With a smaller patient roster, your doctor can take the time to know you and your health history intimately, which can lead to more personalized and effective care,” says Dr. Shoshana Ungerleider, a practicing internal medicine physician and host of the TED Health podcast.

Disadvantages

The biggest stumbling block for most people is the price tag. “For people on a tight budget or those without substantial health care needs, this could be a significant cost without enough perceived benefit,” Ungerleider says.

On top of the cost, there are practical concerns: While a concierge doctor can manage your regular or chronic issues, you’ll still pay for visits to the hospital or emergency room, major surgeries and visits to other specialists.

“It does not negate the need for health insurance,” says John Hansbrough, an employee benefits consultant with The LBL Group, an insurance and financial services company. “You need the insurance because bad stuff can still happen.”

Who might consider it

If you can’t afford the membership fee or are an infrequent health care user, this model probably isn’t a good fit.

But it can be a game changer for patients with chronic illnesses who would benefit from the higher level of care. And for people frustrated with the conventional medical system, concierge care offers an alternative.

“There are great outcomes for the doctor and patient alike,” Jorgensen says. “We consistently renew in excess of 90% of our patients every year.”

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