Pros and cons of the concierge practice model

More time with patients to deliver quality care. Better profit margins. And an enhanced quality of life. Those are the top three reasons for switching to direct-pay or concierge practice models, doctors told Physicians Practice.

The requirement to see a certain number of patients to bring in revenue is one of the frustrates my physicians in traditional practice. "And the more patients you have to see, the fewer minutes you have to spend with each of them," Heather Pearson Chauhan, M.D., founder of Exceed Hormone Specialists in Tennessee, told the Commercial Appeal. "And the more minutes you have to cut back on, the less-in depth you know that person. And the less you know that person, the less likely they [will] listen to your recommendations."

Patients see it, too. In a recent survey by concierge company MDVIP, 74 percent of 1,049 baby boomers said that they should be doing more to better manage their health. But they didn't accept all the blame: One quarter of respondents said they don't get enough time with their PCPs during visits and were thinking of switching doctors as a result. A significant minority of 22 percent said they were considering changing to a concierge practice.

Breaking the cycle of having to see too many patients has allowed Chauhan to put more time into working with patients on lifestyle management, she told the newspaper.

Meanwhile, in South Carolina, Joe Oliver, M.D., described a similar experience with converting to direct primary care. "It allows me time to address issues instead of doing it piecemeal," he told the Salisbury Post. "This practice model fits my style of practice preference."

Moreover, by cutting ties with insurers, a practice no longer has to employ full-time people to work on claims and coding, who are often the highest-paid non-clinical members of the staff. The savings, then, can be re-invested into the business and boost physicians' take-home pay. Indeed, the average physician who makes the switch doubles or triples his or her income, Matthew Jacobson, CEO and co-founder of SignatureMD, told Physicians Practice.

Success in alternative models is not a given, though, as physicians must count on enough patients signing up for membership. By design, that number is usually in the hundreds--compared to thousands in traditional practice--which means physicians' livelihoods hinge on a smaller pool of patients. Hybrid models can help offset these risks, but there are still potential financial downsides for patients.

In particular, patients must understand the limitations of what their membership fees cover, FiercePracticeManagement reported previously, and be advised to carry at least catastrophic health insurance.

To learn more:
- see the Physicians Practice slides
- read the article from the Commercial Appeal
- here's the story from the Salisbury Post