Concierge medicine refers to a system where an individual pays a regular retainer to a doctor in exchange for some assurance of medical care throughout the year. The retainer may cover routine visits and examinations, though in some cases the patient will also pay an individual bill each time a service is rendered. At one time, concierge doctors catered mostly to wealthy patients, though this type of direct care medicine has become more popular with the middle class as well. The majority of concierge medicine is practiced by internists, though family and general practitioners do as well. Direct primary care (DPC) refers to a similar concept, though DPC practices may offer less access to the physician and charge no yearly retainer fee.
The primary difference between a concierge doctor and a physician in a traditional practice is how many patients are seen each year. A typical concierge doctor will see about 70% fewer patients in a year than another doctor in a comparable traditional practice. With fewer patients to tend to, concierge medicine can allow a doctor to provide more and better care to each individual. Concierge medicine often comes with the implicit promise of expanded access to the physician, and patients may be provided with cellphone numbers, personal email addresses or other means to contact their primary care physician any time during the day.
In order to make up for seeing fewer total patients, concierge doctors can use a number of different methods. The primary way that a concierge doctor makes money is through an annual retainer paid by each patient. This retainer can be quite small or very expensive, depending on the agreed upon level of care. Concierge plans with very expensive retainers may have fewer charges associated with treatment, while those with smaller retainers may charge for each visit to the doctor.
Another way that concierge medicine can result in higher pay for a doctor is by operating as a cash only practice. This typically refers to not billing through insurance, rather than not accepting checks or credit cards. Insurance related costs often make up a significant amount of each dollar spent on health care, so a concierge practice that only bills patients directly can result in more money for the doctor and lower costs for the patient. Direct primary care is a type of concierge medicine that focuses on this type of direct billing with no involvement from insurance companies.