“Concierge medicine is driven by patient dissatisfaction over our present fast-food medical model of HMOs, PPOs and a failing Medicare system. Patients love the time they have with their concierge doctors. Doctors love having the time to do what they were trained to do. Unless primary care medicine becomes more attractive to young doctors, by implementing models such as concierge medicine, no one will opt for a career in internal medicine, family practice or pediatrics and the shortage of primary care doctors will only worsen.” ~Dr. S.K., Arizona
By Michael Tetreault, Editor-in-Chief
UPDATED, DECEMBER 1, 2018 -| ATLANTA, GA | It was 20+ years ago and the year was 2016. That was the moment Concierge Medicine turned 20-years old. At least according to the history books.
HowStuffWorks.com wrote “the roots of the title, “concierge” are from the Latin word conserves, meaning “fellow slave.” The word itself is French, meaning “keeper of the keys.” During the Middle Ages, concierges did just that. When castles across Europe hosted visiting nobility, the concierge kept the keys to the castle rooms, and ensured that guests had everything they needed during their stay. By the 1800s, a number of buildings in Europe, from government offices to prisons, had their own concierge on staff. It wasn’t until the 1970s that the concierge position emerged in the United States, although hotel bell captains and front desk staff had unofficially been performing the same duties for many years. Thomas Wolfe is known as one of the first American concierges. He worked in Europe for several years before taking up a position with the Fairmont Hotel in San Francisco in 1974, and he founded the original West Coast chapter of Les Clefs D’Or (the West Coast and East Coast chapters eventually merged to form the organization’s modern incarnation).
In 1996, MD² Founder Dr. Howard Maron found it increasingly difficult to keep up with the ever more demanding pace of traditional medicine. This pace was not conducive to the extraordinary quality of care he always wanted to give.
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So, he asked an intriguing question: what would it mean to practice “medicine in the ideal?”
The answer came in the form of the first MD² office, where he did something that was unprecedented at the time – he limited his practice to just 50 families. Unencumbered by insurance, he finally had the time and resources to offer the caliber of care he dreamed of in medical school.
“I never expected that by opening my one practice an entirely new category of healthcare would be created. It’s amazing for me to see all the different levels of concierge medicine that are now available to people,” said Dr. Maron. “Our practice was designed around this ideology: provide the professionalism, convenience, and best-of-class service you expect from every service provider in your life. The very nature of these relationships necessitates we limit our practice to so few. It’s what sets us apart.”
Twenty Plus Years Later
Physicians who were visioneers of their own careers in Concierge Medicine 20-years ago, remember the days when their colleagues [and patients] winced at the notion of such a business practice.
Long gone are the days when Concierge Medicine was exclusively for the professional athlete or the wealthy celebrity, although many like to say and believe that it still has not evolved and innovated. As with most business, consumer awareness, need and competition will drive prices down. They have in Concierge Medicine as well, considerably.
Yes, it is true that Concierge Medicine does have a rich history (no pun intended) with its 20-year old start date rising in 1996, the “application” of Concierge Medicine, “in practice,” is much older than 20-years, more like, decades and decades old — but back then, it was not referred to commonly in history by its current brand name. Back then it was “… just like having a doctor in the family.”
In fact, if you talk to the people on the street [and we have and do, regularly], the majority of them understand exactly what it is … and most, are readily willing to listen and learn more about it because they know they’re misinformed. That’s a tremendous step forward from both a public relations point of view and an educational perspective. Indeed, we’ve come a long way.
Chuck Longanecker wrote a story just last year for Entrepreneur [Magazine] and a story entitled “Why You Should Use a Subscription Business Model” and noted, Since consumer buying habits are trending toward more simple and hassle-free experiences, more and more companies are jumping into the subscription space and seeing incredible growth … The subscription model owes its success to the optimal balance of value it provides to both the company and the customer. For customers, the value lies in the convenience. First, there’s the autopilot simplicity of subscriptions that removes the thinking out of a purchase decision. Subscribers never have to remember to reorder every month, which gives them the reassurance that they will have whatever they need before they actually need it. Second, subscriptions offer a flat rate which helps customers stay within their budget — always. Lastly, subscriptions usually bring added value to the customer through bundling or getting it all for the price of one.
Enter, the Subscription Business Model
Today, subscriptions have come to medical care and they are quite a common business practice. You may have heard of Direct Primary Care, a no insurance, low monthly fee, mass market variant distinguished by cash-only subscription business model.
We have Concierge Medicine to thank for the many subscriptions business model variations and lessons pioneering physicians have taught others across the U.S., Australia, the United Kingdom and other places around the world [yes, Concierge Medicine operates successfully in other countries … but it’s more commonly called “Private Medicine” ~M. Tetreault, Editor]. Because of the success of Concierge Medicine programs over the last 20-years, additional subscription business model practices in healthcare have been created.
Another example, First Stop Health. First Stop Health provides urgent care and around-the-clock online medical advice. As an adjunct to its telemedicine services, First Stop Health provides employers with advocacy services that consist of patient advocacy for employees and financial advocacy (bill remediation) for employees and their employers. First Stop Health has raised $2.2 million from angel investors to scale up and expand its reach to more employers, according to a company statement. Its CEO Patrick Spain believes that the future of healthcare, the convenience of having access to a doctor when they need one will be a valued supplement to a primary care physician.
Concierge Doctors Are Not Millionaires. The Patient Care Comes First.
Every physician we’ve talked to, interviewed, Coached or conferred with in the past decade confirms that they made the jump into Concierge Medicine because patient care was suffering and there had to be a better way. Concierge Medicine Today and our research and data collection arm, The Concierge Medicine Research Collective, has surveyed, interviewed and polled hundreds of physicians over the years and reported their annual earnings.
Longanecker adds, “Moreover, it also forces service providers to be accountable in their client relationships. In a project, the goal is to finish, whereas with a subscription, the goal is to accomplish the objective — and continue to provide value over time. We must always be pushing for innovation and exploring ways to make a greater impact, to be proactive instead of reactive.”
Much like the popularity of other service subscriptions in the marketplace like Prime, Netflix or Costco, Subscription-based medical care performs the functions of several different services. It provides a fair amount of selection, cost-saving deals, family discounts, and its ultimately up to you to decide each month, quarter or year if you want to keep the same doctor. It puts the patient in control and tells them how much it costs. Look for more subscription-based telehealth services from doctors, PAs and NPs in the months to come.”
Services must adapt to avoid falling behind like Blockbuster. There are already a number of successful service providers using the subscription model. Global web and software developer Pivotal Labs offers their services through coaching subscriptions — clients retain their team’s expertise and learn their processes by working side-by-side with them on location. Their success didn’t go unnoticed. EMC acquired them in 2012. Innovative medical startup One Medical Group has remade the office visit into a convenient and efficient process. Members of One Medical pay an annual fee of $149 to $199 (depending on the city) and enjoy benefits such as same-day appointments made online, more personal treatment plans and direct access to doctors outside the office. The group raised their second round of funding in 2014, bringing in $40 million in additional investment. ~Longanecker
Stephanie Baum, a writer about investments in the healthcare space notes, “Companies with self-funded plans make up 40 percent of its base, and it wants to boost that to 60 percent. Its services are also available to individuals who pay a monthly subscription fee. There are loads of healthcare startups seeking to tap the demand … Some include Practice Fusion Consult-a Doc, AmeriDoc, SNAPMD, PhoneDoctoRX, 1-800MD, iTerpret, iSelectMD Ring-a-Doc, Advantage Home Telehealth. With so many companies competing with each other, as well as with health systems and insurers that are offering these services as well, it will be interesting to watch this space and see which companies have staying power.”
Indeed, Concierge Medicine has awakened physicians entrepreneurial spirit. So much so, that Concierge Medical care and its subscription business model is now [and has been for many years] being used by patients inside: Academic Medical Centers; Hospitals; large and small Hospital & Medical Centers; Executive Health Programs; Homeless Shelters; Rehab and Surgery Centers; Specialty Medical Facilities; Urgent Care Centers and countless others. In fact, we hear of new subscription medical care programs and ideas each week through our business coaching and mentoring arm, The DocPreneur Institute. We’ve coached and educated countless physicians over the past two years, their staff, executive leadership, pharma reps, and even investment groups about the multiple facets and forms that Concierge Medicine, Private Medicine and Subscription based medical programs are taking on in the marketplace today.
C.J. Miles, MBAHCM, MSA Research Analyst at the AMAC Foundation writes … ‘Any type of healthcare and health insurance-related issue is going to have legal and ethical issues that everyone will not agree on. The bottom line with concierge medicine is that it is quickly growing, presumably due to physicians and patients fed up with the current state of America’s healthcare system and where it could be going due to The Affordable Care Act. In fact, even with the growing number of concierge physicians, “the number of patients who are seeking concierge medical care in the past 24 months is far greater than the actual number of primary care and family practice concierge physicians available to service them” (Concierge Medicine Today; CMT, 2014b, para. 22). Only time will tell how this will pan out, but for now, it looks like this is where our country is heading.’
“Obamacare helped,” writes Sonja Horner, President at Private Medical Partners in an editorial contribution published in Concierge Medicine Today, October 2014. “I know, trust me it’s hard to admit, but I’m referencing how it helped consumers understand the sheer demand for the small number of physicians in this country compared to the growing number of people that need care. It also caused the media, in all forms, to cover options to Obamacare and concierge medical care was one of those options. USA Today and Forbes did a beautiful job of educating consumers through info-graphics about concierge medicine and even so far as to recommend it in an article on, “How to Survive Obamacare?”.”
“Concierge Medicine must be treated seriously by physicians and Patients alike because it is a concept that is here to stay. Paying a set annual fee for “special services” may appear to some to focus on money and greed but to others it may be redirecting the focus of medicine back to preventing disease and seeking wellness. If concierge physicians are successful in preventing illness and keeping Patients healthier then it is in the best interest of Patients, physicians and society as a whole.” ~Peter A. Clark SJ, PhD Professor of Medical Ethics and Director, Institute of Catholic Bioethics, Saint Joseph’s University
Enough said. Happy Anniversary Concierge Medicine! As Dr. James O’Connell of Boston, MA said in a recent interview with Concierge Medicine Today, “Concierge Medicine is saving the soul of physicians …!” Thank you for rescuing the careers and lives of countless physicians and you’re continuing to live on in all new ways. You know who you are and you ought to be proud of what you’ve accomplished in the past many years. Thank you!
Original Post, JANUARY 15, 2016 | Updated, December 2018
Categories: CMT Position Statements