Dos and don'ts for creating a concierge practice

As a recent report predicted, as many as one in three (remaining) independent practices will rely on subscription fees to survive financially in the coming years. While many physicians that make the switch to a concierge or retainer model report higher satisfaction among them and their patients, there are several caveats to consider before adopting this model.


Survey patients to gauge their interest. Colorado-based internist Floyd Russak, for example, told Physicians Practice that he calculated he'd need 200 to 300 of his existing patients to stick with the transformed practice in order to make the model work. Rather than chancing it, he worked with a consultancy to conduct an extensive survey to determine whether that goal was attainable. "I think the biggest fear is, 'What if I start this party and nobody comes?'" he said.

Preempt criticism. Because of the controversy surrounding fee-based practices, the words "concierge," "retainer" or "boutique" may trigger fears in your community that your new services will come with an exorbitant price tag. If that's not the case, address the local media directly to debunk myths and explain the basics of how your practice will run. For example, Texas-based retainer physician Sharlet Slough recently clarified to that the practice charges $150 a month for adults and $42 a month for children. Other helpful information to share with the press would be what if any insurance you accept and whether you file claims on behalf of patients.


Don't assume you'll get rich. "I've seen countless physicians over the past decade dive into concierge medicine without doing their homework first," Wayne Lipton, managing partner at Concierge Choice Physicians, LLC, wrote in Physicians Practice. "Some try to develop programs on their own--others work with outside companies or consultants--some of whom do not fully understand the market, the physician/s in the practice, and patients. I've seen some heartbreaking failures …."

Don't forget about potential staffing changes. According to Lipton's post, you may need to reduce your number of employees in a downsized practice or even add new staff to help deliver the higher level of service you've promised. Whatever staff you wind up with, such personnel may need to be retrained to learn to provide a higher level of service.

Concierge and direct-pay practices have been steadily on the rise since last year. 

To learn more:
- read the advice from Physicians Practice here and here
- see the story from

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