All The Details About The Growing Trend Of Concierge Healthcare

Thanks to the COVID-19 pandemic, health is more of a concern for most Americans than it has been in the past. This increased interest in wellness has shone a new light on the drawbacks of the current primary care healthcare system model, such as lack of pricing transparency, long wait times, and limited personal attention (via Medifind). According to a study published in the journal Health Services Research, the average office visit with a primary care provider lasts just 15.7 minutes. Now, a different model is gaining more attention, providing an alternative to standard care for those who have the means to access it.

Concierge healthcare, also known as direct or boutique care, changes the game when it comes to how doctors and patients interact. The system offers 24/7 access to medical professionals, extended visit times, home visits, and a more holistic approach to health (via The Knope Clinic). Many doctors who offer concierge healthcare offer supplemental healing modalities like nutritional counseling, IV therapies, and even cosmetic treatments (per Concierge MD). If you think you may be interested in investing in a new way to embrace your health, here is your guide to concierge healthcare. 

Concierge healthcare is essentially a membership-based approach to medical care, according to WebMD. A concierge patient pays an out-of-pocket monthly or annual retainer fee to a physician rather than billing their insurance company per visit. In return, they receive personalized, in-depth, and on-demand preventative care. Due to the membership fee arrangement, concierge physicians are able to afford to keep the volume of patients they see low, which allows for more time to be spent with each person.

Since they aren't limited by what an insurance company will cover, a concierge physician can offer more alternative and supplemental treatments. This paves the way for a more holistic approach to healthcare that can incorporate options like nutritional counseling and checking for food sensitivities, as detailed by Concierge MD. This approach typically appeals to those who are interested in overall wellness as opposed to symptom management and those who desire an opportunity to access alternative treatments. 

While paying a monthly fee can make concierge healthcare seem more expensive up front, the issue of cost isn't quite so simple. Within a primary care model, even those with health insurance often face high costs when it comes to urgent or emergency care, as well as laboratory testing. According to Dedication Health, the out-of-pocket cost of an x-ray averages about $100 at a standard hospital or doctor's office and about $30–$50 with a concierge healthcare provider.

When deciding whether or not concierge healthcare is the wisest financial decision for you, consider the fact that people who receive regular care from the same primary care physician are less likely to be hospitalized (via UCLA Health). This is especially true when that regular care includes a focus on overall wellness and prevention rather than reactive acute symptom management. If you're interested in spending now to save on potential emergency or surgical care later, concierge healthcare might be right for you. 

In a traditional primary healthcare setting, a patient's insurance company will not pay for them to see a specialist unless they are given a referral by their primary care provider (via Majority). This increases costs to the patient by requiring an office visit to their primary care doctor to get the referral, along with the resulting visit to the specialist. Each of these visits will incur a co-pay, and the co-pay for a specialist visit is typically higher than the one for a regular office visit. This is in addition to any testing the specialist might order, which may or may not be covered by the insurance company.

When you work with a concierge physician, you will typically still be given a referral if care from a specialist is required. However, the referral process can be expedited and your doctor can suggest a specialist — though you will have to find out if the doctor is within your insurance network yourself, as explained by AARP. Many patients who utilize concierge care choose to continue their health insurance coverage to cover care from specialists, as well as for potential emergency care. 

If you wish to build a relationship with your healthcare provider, there is no comparison when it comes to the amount of time spent with patients between primary care and concierge physicians. While a primary care physician typically spends about 15 minutes per patient, a concierge provider's time can be allotted however they see fit. It is not uncommon for a direct care physician to spend 30 minutes or more with a patient in order to thoroughly address all concerns and provide guidance on overall health and wellness practices (via Partner MD).

The advantage of increased time with a physician is a major perk of concierge care. However, it is only one factor to consider when making the decision of what kind of healthcare model is best for you. Regardless of what is most accessible to you, it's important to focus as much as you can on preventative care and healthy living habits at home (via HealthPartners). 

In a country where people struggle to access standard healthcare due to economic limitations, there are those who criticize concierge healthcare as being part of the problem. At its core, concierge healthcare is the privatization of medical care (via The Knope Clinic). While this can cut out insurance as the middleman for people who can afford direct care services, it still faces the ethical dilemma of leaving low-income people without care. According Physicians for a National Health Program, it also opens the door to medical services that are geared more toward making a profit than for individual health.

While most people both inside and outside of the medical care system agree that the current healthcare system is broken, there is no agreement on how to repair or replace it. In the meantime, the best you can do is to find which option works best for you and your family's individual set of needs and resources.