Although concierge medicine is more affordable, it is still not as widespread as DPC.

Healthcare is delivered through several different models. There is a traditional model under which the physicians see large numbers of patients every day and then bill their services to insurance companies. However, in the past few years, a new care delivery model has gained popularity in the healthcare sector: Concierge Medicine. Although not being a new approach to healthcare, concierge medicine puts the patient in the driver’s seat.

What is Concierge Medicine

Concierge medicine essentially means that the patient has a direct relationship with the physician. A concierge doctor is typically a private practice, who neither works for any hospital system nor any insurance company. Instead, he works directly for the patient. This means that patients enjoy more face-time with their physicians.

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Concierge medicine comprises a national network of physicians and allows billing the patient’s insurance companies for the covered services. Most concierge practices have a range of services that can be delivered for an extra monthly or annual fee that is paid directly to the practice, outside of insurance. Now, some patients who use concierge medicine have additional health insurance coverage, but others don’t. This is purely at the patient’s discretion and subjects to their affordability. Patients generally choose to add additional insurance based on their health status and the level of disposable income.

How is Concierge Medicine Different from Direct Primary Care?

There are several differences between concierge medicine and the DPC model:

• Membership fee – There is an annual membership fee under concierge medicine that can be paid in full or split up during the entire year. In DPC, members typically pay a monthly fee.
• Cost – Concierge medicine membership fee is higher than DPC membership fees. DPC fees are generally priced on a sliding scale, where younger patients pay less than older ones.
• Third-party payers – Concierge practices accept insurance plans and government programs, billing the patients conventionally. In DPC, the physicians do not accept third-party payment reimbursements.
• In-network referrals – Concierge practices are generally affiliated with insurance networks and can refer to specialists who are within the patient’s network. A DPC practice is an out-of-network provider; hence referrals may not be accepted by the insurance carrier.
• Services Included – Since concierge medicine physicians are in-network providers, they can serve as a patient advocate with an outside specialist, hospitals, and other healthcare providers. However, since DPCs are out-of-network, they don’t enjoy referral relationships, making it challenging to advocate for patients with outside specialists.

Benefits of Concierge Medicine

The most prominent benefit that accompanies concierge medicine is more personalized attention. Patients always prefer this when seeking medical care. And because of this significant benefit, several versions of concierge medicine are popping up. This offers the much-needed change from the conventional medical model where the patients are typically allowed a 15 minutes window with the physician and rarely get the same-day appointment.

Timely access to care is the second most widely acknowledged benefit accruing from concierge medicine. Shorter wait times and more extended visits times with the provider are two significant pros of concierge medicine. Appointments are generally scheduled online via apps or by calling the doctor’s office directly.

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Additionally, concierge medicine offers more choices over the treatment and tests administered. For many patients, this may mean better long-term health. Since many patients don’t enjoy adequate insurance coverage or affordable access to healthcare providers, they may suffer from a lack of knowledge to identify their health-related problems. They can then seek alternative and more affordable care options for their medical conditions.

Finally, concierge medicine allows a closer physician-patient relationship. With more personalized care, reduced wait times, and longer visit durations, patients enjoy higher satisfaction levels as well.

Cons of Concierge Medicine

There is, nevertheless, a downside to concierge medicine. The biggest demerit of all is the high price. Concierge medicine is typically more expensive than health insurance. This is because concierge practices charge an extra cash fee for non-covered services. Hence, concierge medicine might not be a good financial option for all patients, especially for those with pre-existing or chronic health conditions. Since concierge medicine typically only covers primary care-type services, services for severely chronically ill patients are generally only covered by their health-care plan.

There is a broad spectrum of services offered under both camps. Concierge medicine focuses on delivering value-added services outside of the bounds of typically covered insurance. In contrast, DPC rests on the idea of avoiding insurance to lower overheads and keep the costs down. However, since concierge medicine is more affordable, it is still not as widespread as DPC.