Dallas OB/GYN moves into a hybrid concierge model

Feb 21, 2013 | Bill Hethcock | Staff Writer | Dallas Business Journal |

Dr. Connie Casad thinks she has found a better way.

The Dallas gynecologist transitioned her practice in August from the traditional model to a hybrid concierge model. The new approach gives choices to patients who want a concierge-style of medicine, but doesn’t force the physician’s longtime patients to find a new doc.

I spoke with Casad earlier this week to find out how the hybrid model is working out.

In Casad’s case, she has added a physician assistant to manage most of the day-in/day-out appointments and wellness checks. That allows her to spend more time with concierge patients so she can truly educate them, rather than sending them on their way with a prescription in their pocket but no long-term plan, she said.

“What I really wanted to do was be able to invest in my patients’ health and help them understand what health care means,” Casad said. “It’s not just waiting for something to happen so you get a diagnosis and a prescription. The goal is to recognize early on when things are going on, so we can turn things around.”

The hybrid approach allows Casad’s practice to continue to bill and file insurance claims for patients seen by the physician’s assistant.

So far, about 100 of her approximately 2,000 patients have opted for the concierge route and paid the $1,800 per year membership fee. For that, the concierge patients receive an executive physical, blood work, specialized testing such as heart rate variability, skin analysis and pap tests.

Overall, patients have reacted positively, Casad said. But about 15 to 20 percent of her patients have requested their medical records and are looking for another physician — in most cases because they’re concerned that as non-concierge patients, Casad won’t be able to carve out enough time to spend with them, she said.

Under traditional concierge programs, physicians close their practice to the majority of patients and offer it only to the small percentage — typically about 500 patients — who want to pay a set fee that sometimes exceeds $5,000.

In the hybrid concierge model, doctors are given a way to continue to see all of their patients, including those on Medicare, but patients who want a concierge style of care can get that, too. Typically about 5 percent to 10 percent of patients opt for concierge care.

With the hybrid model, all patients retain their current insurance. That piece is critical because if a patient needs hospitalization, referrals to a specialist, coverage for lab work or other testing, they still have that access, and that care is coordinated by their primary care physician.

Casad said she has received several phone calls from other physicians looking into the hybrid model, and she thinks its popularity with physicians and patients will grow.

“My goal is for patients to have a picture of what real health looks like,” she said, “and you just can’t do that in a short visit.”


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