Ten (10) Best States To Grow A DPC or Concierge Medical Practice In 2014

By Michael Tetreault, Editor

ten best places direct primary careSEPTEMBER 10, 2013 –In recent years, significant venture capital has been poured into the concierge medicine and direct primary care marketplace. Investment groups are not only attracted to these transparent and innovative healthcare clinics but they see them as a viable investment for their clients. Where concierge medicine and direct primary care practices are struggling is in the ability to scale their business for mass-market, employer appeal.

But the future looks bright for those doctors considering a career in cash-only or retainer medicine. Large groups like MedLion, MDVIP, Qliance and One Medical are building and scaling successful medical practices across the country and in various parts of their home states that are attractive to investors like Cambia Health (a large Blue Shield company), Google Ventures, Proctor and Gamble, Benchmark Capital, DAG Ventures, Oak Investment Partners, Maverick Capital and others.

More recently, Entrepreneur Magazine, Forbes and others published their list of The Best States for Entrepreneurs. Analyzing that data along with data compiled from over 5,000+ small businesses and concierge medicine consumers, Concierge Medicine Today’s (CMT) research arm, The Collective, identified a list of The Best Cities and States for a Career in Concierge Medicine or Direct Primary Care in 2013-2014. The cities and states on this list support, not only small business but healthcare innovation and provide a growing but friendly patient population who support these types of modern medical delivery systems.

“Direct practices should be successful in most cities and states where there is an inadequate supply of primary care physicians,” says Dr. Chris Ewin, Founder and physician at 121MD in Fort Worth, TX. “This may be true in the country with the correct practice model. Most important, a physician needs to have social skills to sell him/herself and there new practice model to their patients and their community.”

top ten best states concierge medicineAccording to CMT’s research initiative The Collective, The Top 10 Best States To Start A Career in Concierge Medicine or Direct Primary Care in 2013-2014 include:

  1. Utah
  2. California
  3. Texas
  4. Florida
  5. Washington State
  6. New York
  7. Colorado
  8. Georgia
  9. Tennessee
  10. North Carolina

NOTE: These States were carefully selected based on data and analysis by Concierge Medicine Today’s research arm, The Collective, where concierge medicine and direct primary care practices are growing and the ability to scale their business for mass-market, employer appeal is likely to occur.

“The reason for the growth of direct access in NY is likely due to the mounting frustration on both the part of the patients and providers,” says Raymond Zakhari, NP and CEO of Metro Medical Direct. “I remember when I started my direct-access, home-based primary care practice ( in 2009. Patients were skeptical and reluctant because of how accessible and convenient the service was. They expected to be kept waiting on hold. Some seemed puzzled by the fact that when they called I answered the phone and knew who they were. One patient even inquired as to how come they only had one form to fill out. Direct-access primary care patients who have been referred post hospital discharge, have not been readmitted to the hospital in the last 4 years because I can see them without delay or red tape. In NYC, despite the high number of physicians per patient, particularly on the upper east side of Manhattan, direct-access primary care can still be a viable practice solution for patients and providers. It helps patients cut through the red tape that has become expected in accessing health care.”

According to CMT’s research initiative, The Collective, The Top 25 Best Cities To Start A Career in Concierge Medicine or Direct Primary Care in 2013-2014 are listed below.

  1. Salt Lake City, UT
  2. Provo, UT
  3. Los Angeles, CA
  4. San Francisco, CA
  5. Dallas/Fort Worth, TX
  6. San Antonio, TX
  7. Miami, FL
  8. Fort Lauderdale, FL
  9. Seattle, WA
  10. New York, NY
  11. Denver, CO
  12. Colorado Springs, CO
  13. Atlanta, GA
  14. Nashville, TN
  15. Charlotte, NC
  16. Chicago, IL
  17. Montgomery, AL
  18. Birmingham, AL
  19. Lincoln, NE
  20. Omaha, NE
  21. Minneapolis, MN
  22. Columbus, OH
  23. Boise, ID
  24. Nashua, NH
  25. Philadelphia, PA

“I think northern GA is a great place to start a Direct-Pay (non-third-party) medical practice,” said Dr. Robert Nelson who operates a Direct Primary Care medical practice in Cumming, GA. “Based on conversations I’ve had with several people in this area since I started my Direct-Pay House Call practice, they are definitely open to the idea of innovative changes in healthcare; and they are paying attention to trends. It is a diverse economy with an abundance of innovators & business professionals that are looking for an edge to help them personally and professionally. The slow steady economic growth in the region, combined with a diverse population, makes the Forsyth County area of GA a good match for entrepreneurs & innovators in medical care services.”

According to a national survey of over 13,000 physicians conducted by Merritt Hawkins on behalf of The Physicians Foundation, 6.8% of physicians in the United States will embrace concierge/direct pay medicine in the next three years. Business leaders, concierge medicine and direct primary care industry experts and physicians expect the number to be higher – around 15%, according to a recent report by Concierge Medicine Today.

“It’s about believability.  Would it work for me?  Could it work for me?” says Richard Doughty, CEO of Cypress Concierge Medicine, a Louisiana-based company helping doctors move into this industry. “Where physicians have taken an early leap of faith, if you build it they will come, overwhelmingly they have been satisfied.  As a result, physicians now have many examples of colleagues experiencing the benefits of concierge medicine for themselves and their patients.  In those areas, we see momentum continuing to build.”

“We believe the growth rate will be much higher in the coming years – possibly around 15% due to the Affordable Care Act (ACA). Although this is our opinion,” said Catherine Sykes, Publisher of CMT. “We have certainly seen an increase in physician interest to support it.”

CMT’s research initiative, The Collective, recently released 2013 data summarizing concierge medicine physician satisfaction data highlighting a concierge doctor’s happiness with a career path in concierge medicine. The data is based upon surveys, polling analysis and verbal responses received from concierge doctors throughout the U.S. from 2009-2012 collected by The Collective. Here are some of the highlights:

Concierge Medicine Career Satisfaction

  • 55% of concierge doctors across the U.S. state they are very satisfied with their decision to enter concierge medicine and would make the same decision.
  • 27% of concierge doctors across the U.S. are somewhat satisfied with their decision to enter concierge medicine but would make the same decision.
  • 18% of concierge doctors across the U.S. are not satisfied with their decision to enter concierge medicine and would not make the same decision.

“I think the most powerful piece of the data we’ve reviewed recently is this one … the data that speaks to career satisfaction,” says Michael Tetreault, Executive Director of The Concierge Medicine Research Collective and Editor of Concierge Medicine Today. “Concierge medicine [and direct primary care] are career paths physicians can trust that have over time proven themselves to be sustainable and rewarding business models for both a physician and his or her patients.”

The Collective also found that Concierge Medicine is thriving in metropolitan markets with the majority of incomes remaining the same or increasing slightly. Satisfaction in the field remains high. Only 18% of physicians stated they would not make the same decision again. In previous years, it was 25% but even so, the number overall is low and satisfaction with the business model is high when compared to traditional, insurance-based or managed care medical specialties.

Overall, concierge medicine and direct primary care prices are dropping dramatically due to increasing competition among physicians entering the marketplace, retail medicine pricing, price transparency demand from patients and uncertainty about the implications of the Affordable Care Act.

“Patients are seeking an affordable relationship with their doctors,” adds Sykes. “A relationship that doesn’t involve third party payors, paperwork and confusing EOBs. By letting each state define their own business regulations, taxes and policies, there has been a competitive marketplace for doctors to create strong businesses.”


topdocs in direct primary careUntil recently, people mostly based choosing a doctor on the personal recommendation of a trusted friend or relative. Now with the advent of social media, word of mouth marketing is changing from a spoken word referral to a social media link referral. To find a concierge medicine or direct [primary] care doctor near you, Concierge Medicine Today has created an iTunes and Android App, Concierge Doc, a free App and search engine resource to find and learn about concierge medicine and direct primary care in your area available at

1 reply »

  1. Some Impressive statistics about Concierge Medicines program. I quite impressed to read your article. Thanks.

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