Concierge and membership medicine have faced the same headwinds that greeted every healthcare innovation before them. Here’s what the trajectory of those earlier models tells us about where this one is going.

By the Editor-in-Chief, Concierge Medicine Today

There is a quote I have returned to often over the years — not from a healthcare executive or a policy analyst, but from a business thinker reflecting on what makes organizations worth sustaining:

“For some reason, profitable organizations are viewed as evil in today’s society. While it’s true that some organizations engage in unethical practices, I believe that’s the exception rather than the rule. A thriving world is one where we have successful, profitable organizations, and vibrant communities that rely on them.”

I believe the same is true of membership medicine. These are not organizations designed to extract value from patients. At their best, they are practices designed to restore it — to the physician-patient relationship, to the community, and to a healthcare system that has been quietly failing both for decades.

The Headwinds Every Innovation Faces

Over the years, the culture and economics of most concierge medicine practices have evolved significantly. The marketplace narratives, however, have been slower to follow. Concierge medicine has frequently been characterized as elitist — a service for the wealthy that commodifies physician access and creates a bifurcated system.

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This is worth examining honestly, because the same critique was leveled — often by the same type of institutional voices — at plastic and aesthetic surgery in its early decades. Academic research published in the Aesthetic Surgery Journal Open Forum (Jones, Faulkner & Losken, 2022) documented how aesthetic procedures were long associated in public discourse primarily with vanity and superficiality, despite growing empirical evidence of their psychological benefits for carefully selected patients.¹ The specialty struggled for years to communicate its legitimate clinical value against a narrative that had already decided what it was.

Today, plastic and aesthetic surgery sets a standard that other specialties study. The early criticism didn’t disappear — it simply became less relevant than the outcomes.

Concierge medicine is on a similar arc. From my experience engaging with both media and physicians over many years, the cognitive bias against these models has measurably softened. Patients today show more curiosity than resistance. Media coverage, while never uniformly positive about change in healthcare, is less adversarial than it once was. The momentum is not manufactured — it is earned, practice by practice, relationship by relationship.

What Is Actually Happening Inside These Practices

Inside most membership medicine practices today — regardless of terminology, price point, or geography — something important is happening that rarely makes headlines.

Each day begins with a mission. Not a mission statement on a wall — but a lived orientation toward the patient in front of the physician. The goal is not to process a chart. It is to understand a person. To anticipate what they need before they have to ask. To remove every obstacle — in a moral, legal, and ethical way — that stands between that patient and the care they deserve.

“When you have a heart for your community, you don’t have to compete on price. Without community, you’re a commodity.”

— A mentor

Hospitality in healthcare is not a soft concept. It is a clinical differentiator. Research consistently shows that the quality of the physician-patient relationship is one of the strongest predictors of treatment adherence, patient satisfaction, and health outcomes. A patient who feels seen, heard, respected, and welcomed is a patient who comes back, who follows up, who calls early rather than late. The experience IS the medicine, in ways that healthcare has historically been reluctant to quantify.

As a former CEO and industry consultant in the concierge medicine space told us at Concierge Medicine Today: “It’s about believability. Would it work for me? Could it work for me? 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.”

I have met physicians in every corner of the membership medicine landscape — concierge, DPC, bespoke, hybrid — and I can say without hesitation: the overwhelming majority are people of extraordinary dedication and integrity. They are not in this for the margins. They are in this because they remember why they went to medical school, and they found a model that lets them practice that way.

On Fairness, Price, and What Patients Actually Deserve

Let me be direct about something.

Today’s primary care billing system routinely produces situations where a patient visits three different offices for the same condition and receives five separate, confusing bills containing eleven different codes — three of which might overlap. That is not a healthcare system. That is a complexity tax imposed on patients who are already struggling.

The fairness argument against membership medicine largely ignores the fairness of what it is replacing. Patients today are more informed, more discerning, and more frustrated than at any point in recent memory. They understand, at a practical level, that variable pricing already exists throughout healthcare — it is simply not disclosed in ways that allow them to make meaningful decisions. They will — and do — go where they feel they will not be treated like a chart in a drawer.

What membership medicine offers, at its best, is not a luxury exemption from this system. It is a transparent alternative to it. Patients know what they are paying, what they receive, and who they will see. That clarity is not elitist. It is what every patient in every income bracket deserves and rarely gets.

Understanding the Membership Medicine Landscape

For anyone navigating this space — as a patient, a physician, or an observer — here is how we at Concierge Medicine Today describe the current landscape of models:

Classical Concierge / Bespoke / Ultra-High-End Models: These practices typically range from $10,000 to $50,000 annually per patient or family. Each is unique in structure and service offering. They represent a small fraction — roughly 4% to 7% — of the overall membership medicine marketplace. They are not intended to replace health insurance and do not cover hospitalization. They exist to serve a specific clientele with a high level of personalized attention.

Contemporary Concierge Medicine (Most Common): These practices represent approximately 70% to 75% of available concierge medicine options for patients today. Think of them as Concierge Medicine 2.0 — subscription-based, primarily in primary care and family medicine, and marketed to middle-income patients who want more preventive care and a closer relationship with their physician. Price points typically range from $100 to $750 per month. Many still accept insurance or Medicare for covered services; the subscription fee covers what those plans do not. Hospitalization remains the patient’s responsibility under their insurance plan.

Direct Primary Care (DPC): DPC is not the same as concierge medicine, though the two are frequently conflated. DPC is typically the budget-conscious option, with monthly fees ranging from $8 to $99 per patient. There are an estimated 1,500 to 2,500 DPC practices across the country as of 2025. Most do not participate in Medicare or maintain payor relationships, though exceptions exist. DPC is a distinct model serving a distinct need — and it belongs in the same conversation without being confused for the same thing.

These are not competitors. They are distinct pathways — for patients and for physicians. Having choices in healthcare, as in business, is beneficial for all.

The Physician as a Community Asset

A physician I’ve known for many years — now retired — once said something that has stayed with me: “Instead of viewing the status quo PCP model as the center of the universe, maybe we should take some plays from the retail clinic playbook before we become obsolete.”

He was right. The physician who stays in a model they dislike a little less each year, cycling through jobs that slowly drain their sense of purpose, is not serving their community well. They are surviving it. And a healthcare system populated by surviving physicians rather than thriving ones is not a healthcare system that will rebuild the patient trust we documented losing so rapidly in the years since 2020.

The physician who finds the model that lets them practice medicine the way they envisioned it in medical school — who builds relationships that last years, who prevents the hospitalizations rather than managing them, who responds to a patient text at 7pm not because a contract requires it but because they care — that physician is a community asset of the highest order.

I’ve been told, by physicians who made this transition, that it saved their marriages. That it saved their careers. That it reminded them why they chose medicine. These are not small things. They are the whole point.

The Standard Worth Holding

The critics of membership medicine are not wrong that access and equity in healthcare are urgent and unresolved problems. They are wrong to assume that these models make those problems worse. A physician who transitions to a concierge practice with 400 patients they know deeply is still practicing medicine. A physician who leaves the field entirely from burnout is not.

For every physician in every corner of this landscape who has chosen a different path, the same question applies: are your patients better off because of the care you provide? For the overwhelming majority of membership medicine physicians I have met and spoken with over nearly two decades, the answer is yes.

It is no longer just about being the best doctor in the world. It is about being the best doctor for the world — for your patients, and for your local community.

Editor’s Note: Membership medicine models are not medical specialties and are not a replacement for, nor an insurance product. Physicians and patients considering these models should consult appropriate legal and compliance counsel regarding their specific circumstances.

Sources & Citations

1. Jones, H.E., Faulkner, H.R., & Losken, A. (2022). “The Psychological Impact of Aesthetic Surgery: A Mini-Review.” Aesthetic Surgery Journal Open Forum, Oxford Academic. DOI: 10.1093/asjof/ojac077. Also available via PubMed: https://pubmed.ncbi.nlm.nih.gov/36447649/

Note: The original article cited Dunn (2018) in the Aesthetic Surgery Journal and Wong (2015) in the Journal of Medical Ethics. Neither citation could be verified as published. The Jones et al. (2022) citation above is a verified peer-reviewed paper on the same topic from the Aesthetic Surgery Journal Open Forum and is used in its place.

2. For additional context on DPC practice counts and fee ranges, see: Concierge Medicine Today industry data and the American Academy of Family Physicians DPC resources at https://www.aafp.org/practice-management/payment/dpc.html
3. For context on physician burnout and career satisfaction in membership models, see: American Medical Association Physician Burnout Survey (2024) and Medscape National Physician Burnout & Suicide Report (2020). https://www.ama-assn.org

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