Lessons Learned: 8 Years Practicing Concierge Medicine … ~Warshaw, MD

By Joel Warshaw, MD

mdbag (2)Apr 3, 2015 –  For many people (even some physicians!) the concept of concierge medicine is a new idea. The reality is that concierge medicine has been around since the mid-90s and boasts extensive media coverage. Concierge medicine even plays a central role on the popular TV show, Royal Pains.

As the direct care model of medical practice continues to get attention, more and more physicians and patients are showing interest. I consider this a good thing, as concierge medicine offers many benefits to both the physician and patient.

Having started my practice eight years ago as an early adopter of the direct care model, I’ve seen this movement take shape and learned many lessons along the way. In this post, I’ll explore some of the most important things that I’ve learned as a concierge physician.

#1 Converting your practice means that you have to be willing to endure short term pain in exchange for long-term gain. The response will be mixed and you are taking a leap when you decide to transition to a concierge practice. You have to be willing to take the good with the bad and ride out the short-term storms in order to have a successful practice in the long run.

#2 In fact, the greatest disappointment that I’ve faced as a direct care physician was saying goodbye to many long-term patients after I decided to adopt the concierge model. Eventually, however, some of them did join my new practice.

#3 The good news is that many will follow you (usually between 5-10% of your traditional practice), which establishes a solid foundation for your new practice. Since the concierge model is based on doing more with less patients, you don’t need many of your current patient roster to get started.

NEW RELEASE -- now available! It took nearly 3 years to write ... The Doctor's Guide to Concierge Medicine (nearly 400 pages of industry insight plus, over two dozen physician contributions compiled in one book) -- On Sale $129.95 Until May 1 (Reg. $189.95)

NEW 2015 RELEASE — And now available! It took nearly 3 years to write … The Doctor’s Guide to Concierge Medicine (nearly 400 pages of industry insight plus, over two dozen physician contributions compiled in one book) — On Sale $129.95 Until May 1 (Reg. $189.95)

#4 The people that follow may surprise you. Often, there is an assumption that the concierge model is only appealing to the wealthy. I found this to not be necessarily true. Several well-to-do patients were not willing to spend the extra money, while others on a fixed or limited income were willing to because they felt it was the best decision for their health.

#5 The greatest joy in running a direct-care practice has been the ability to properly allocate time for patient care and have meaningful conversations with patients, getting to know them as people. There is no pressure to rush in and out of exam rooms in 5 minutes or less.

#6 Your decision may be controversial among your colleagues. In my experience, specialists were more supportive than my fellow primary care physicians. Build a network of other concierge physicians to lean on when times get tough or advice is needed.

#7 Being on call 24/7 isn’t such a big deal. This is one of the most common questions that I am asked regarding my direct care practice. The lower volume of patients, familiarity with patient cases and patient access to health records lowers the burden. In addition, I’ve found that patients are very respectful of my time and are often less likely to reach out after hours as long as their needs are being met during the business day.

#8 One of the most important decision you will make is which technology to use. Choose a cloud-based EMR system that includes all the functions you will need to practice medicine.  It should offer patients access to your schedule, their chart and integrate with wearables so that you can make communication and monitoring as seamless as possible.  Including the patient in their health is a huge component to a successful practice!

#9 Direct marketing (ads, direct mailers, etc.) provides very little return at a high cost. I’ve found that the best way to grow my practice has been through practicing medicine the best way I know how and allowing the praises of my existing patients to refer family and friends.

#10 Like many things, you get out of it what you put into it. When you bring your passion for medicine and your eagerness to help patients optimize health, success will flow your way.


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