Does concierge medicine pose a threat to traditional primary care relationships?

Various healthcare policy and industry changes have put pressure on many physicians' incomes, influencing more providers to opt for hospital and health system employment. For those who prefer to remain in independent practice, many have found that concierge medicine has the potential to lend substantial financial benefits to providers and enhanced care for patients.

Concierge medicine is a practice in which a patient pays his or her primary care physician an annual or monthly fee or retainer. In exchange, physicians provide superior care and commit to limit patient loads to ensure sufficient availability and time to meet the needs of each patient, with the cost of all services and treatments provided included in the flat fee. There are several different business models under the concierge practice umbrella, each varying in structure and payment requirements.

According to a recent article in Forbes, physicians who launch their own concierge practice or join an existing one can seriously boost their incomes — even becoming millionaires — if they successfully demonstrate some essential characteristics. The four factors for success outlined in Forbes include a client-centered mindset, efficient operations and processes, appropriate financing and targeted business development.

For many primary care physicians and patients with the economic resources, this setup may appear to be a more attractive method of care than traditional primary care relationships.

The Patient Protection and Affordable Care Act mandates most Americans to have health insurance, so why pay extra for non-insured care? According to the Wall Street Journal, many new health plans have high deductibles that most members will likely never reach, meaning patients will still be paying high out-of-pocket costs regardless. In this case, concierge medicine may be the more cost-effective route for patients.

Another cost-saving aspect of concierge medicine is that they charge flat fees that generally include basic checkups, treatment of minor conditions and electrocardiograms, accord to WSJ. In comparison, traditional physicians typically charge for each treatment and test, which can quickly add up. However, concierge practices focus on basic services, so patients will have to go elsewhere for advanced treatments and technology.

Additionally, because each physician sees fewer patients, they have more time to spend with each.

More opportunities exist for providers, too. Although they have smaller patient bases, they don't need in-patient visits to get paid — they are paid for providing care through video chatting, email and phone calls, according to WSJ.

All of these points could be of concern for many hospitals and health systems, as they continue to employ primary care physicians in hope of capturing more market share. If patients turn to other modes of receiving primary care, the employment model could be fruitless.

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