A Comparison of Public and Private Medicine

Most patients today are familiar with the traditional model of primary care. That is, they belong to a medical practice where the doctor carries a large patient load (several thousand patients), schedules dozens of appointments every day, and spends very little time with each patient.

stethoscopeHowever, there is another way that you can receive care, and in many cases patients are finding that it offers several perks and benefits that the traditional model for care delivery does not. It is called concierge medicine, and here is a quick comparison of how it differs from the primary care model that you already know.


There is a myth that concierge medicine is only for the very wealthy, or that it costs several thousand dollars per month. The truth is that it is becoming more and more affordable for families at all income levels who want better care.

Private Medicine: Most concierge doctors charge a retainer or fee to be part of the practice. This generally does not take the place of insurance, and is an additional cost beyond what you are paying to your insurance provider. Fees are paid annually, quarterly, or monthly, and can range from as low $600 to as much as $15,000 or more per year. With many preventive care needs covered under the retainer, patients often find they can change their insurance coverage to a high deductible plan just to cover catastrophic illness, which may even reduce your overall healthcare costs each year.

Public Medicine: Patients of a traditional practice will often use insurance to pay for care, and the average insurance premium paid by employees in 2011 (since a majority of patients get insurance through their employer), according to the Kaiser Family Foundation, was $921 for an individual and $2,124 for a family. In addition, doctor’s visits often require a co-pay ranging from $15 to $40 per visit, and if you need any additional procedures, you will have to pay out of pocket until you reach your deductible.

Appointment Wait Time

One of the perks that many patients appreciate with concierge doctors is the ability to get same-day or next-day appointments any time you call.

Private Medicine: The average wait time for patients to get an appointment is less than 1 day for members of private medicine practices. In addition, many private physicians offer patients the ability to contact them 24/7 by phone, email, and on social media to get immediate answers to questions and concerns.

Public Medicine: Wait times to get an appointment vary depending on where you live, but the U.S. average is 20.3 days—nearly three weeks—according to the Associate of American Medical College’s Center for Workforce Studies. If you have a chronic condition or something serious occurs, waiting three weeks could significantly affect your health.

Focus of Care

Traditional primary care physicians are required to carry very high loads of patients in order to make a living, which means less time to spend with each patient. That often translates to a different focus when they meet with each patient.

Private Medicine: Your physician will generally spend at least 30 minutes with you, and up to 60 minutes each year during your annual physical. The focus is on managing any chronic conditions you have and preventing future health complications through a comprehensive health and wellness plan. This model also allows for better follow-up since patients can keep in touch with doctors via cell phone, email, and social media. Studies have shown that this translates to as much as 53% fewer hospital visits for concierge patients.

Public Medicine: When the doctor has to see as many as 50 patients per day, he or she will only have about 10 to 15 minutes to spend with each patient, and the focus is on treating existing diseases with little or no attention paid to preventive care. Generally that means offering a quick prescription or treatment with little or no time spent reviewing medical history and examining symptoms from a holistic perspective.

There are several key differences between private and public primary care physicians. If you like the idea of having better access to your doctor, and a more in-depth doctor-patient relationship, concierge medicine just might be right for you.

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How to Attract Concierge Medicine Patients

concierge-medicineMany primary care physicians are choosing to convert traditional medical practice into a concierge medicine practice. These boutique practices offer many advantages to the care providers and patients, including the ability to reduce overhead expenses, increase time spent with patients, and provide a higher level of preventive care and service to the people in your practice.

At the same time, there are a lot of things that people don’t know about concierge medicine, so attracting patients to your practice means having a well-defined outreach and marketing strategy to educate them about the benefits that private medicine can offer and convince them to join your practice. Here is a framework for developing a solid plan.

Build a Brand

You might not be a marketing professional, but in order to attract patients to your practice it’s important that you create a brand identity that appeals to patients who are looking for a higher level of care from a physician. You may want to hire a marketing firm to help you create a brand and logo, and professional marketing materials that reflect the brand, such as brochures, a website, and business cards.

Educate Potential Patients

Concierge medicine is a fairly new concept for most patients, and many people still don’t know a lot about the benefits of working with a private physician. When you are creating your plan to attract new patients, make sure you provide plenty of education on what concierge medicine offers, and why it is beneficial to all types of patients (not just the wealthy or chronically ill). Have marketing materials prepared that will show potential patients how they might benefit from joining your private medicine practice.

Get Online

Today most people find the information they need on the internet, which means that in order to attract patients, you should also be online. Create a professional website, keep it updated, start blogging and participating in social media such as Facebook and Twitter (or hire a marketing firm that can help with this), and improve your search engine rankings with proven SEO (search engine optimization) strategies.

Focus on the Right Patients

Not every patient is a good candidate for concierge medicine services, so spend your time and money focusing on the ones that can benefit most from your services. That might include:

  • Busy professionals, families, and executives who value their time and will appreciate having quick access to the doctor, same-day appointments, preventive care, and wellness services.
  • Senior citizens who generally have more medical needs, and who will enjoy the peace of mind that comes with building a relationship with their doctor and being able to get in touch with you 24/7.
  • Patients with chronic conditions who will appreciate a more managed and holistic approach to care, including coordination with specialists and hospitals.

Retain High Value Patients

Collect data on your existing clients and identify the ones that offer high value to your office by paying on time and recommending your practice to others, who are very satisfied with the care you provide, and have been loyal to your practice for many years. As you develop your marketing plan, include a strategy for retaining these patients by showing them how much you value their business, then help them find easy ways to share your business with others through word-of-mouth advertising.

Be Ready to Let Some Patients Go

If you have been working in a traditional medical practice for a while, you probably have a patient load in the thousands. Understand that when you convert to concierge medicine, you are going to have to let some of those patients go (providing a higher level of service is not possible with so many patients). In addition, understand that some of these patients will leave because they don’t want to pay the fees for a private doctor, and that is okay. If you’re prepared to let some clients go, you won’t take it personally when they do.

If this is your first medical practice and you’re planning to start as a concierge doctor, understand that not all patients are going to want to be part of your practice, and that is okay too. Let go of the patients that don’t understand the benefit of what you are offering so you can focus on the patients who will bring value to your practice.

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What Does Concierge Medicine Cover?

concierge-medicine-overall-healthConcierge medicine is not a new thing, but it has long been regarded as something primarily for wealthy individuals who could pay for a higher level of care. Today it is becoming a valuable option for individuals from all different income levels who are interested in getting more from their primary care provider. If you have heard about concierge medicine but you are not sure exactly what it would mean for you, here is an overview of the most common services that are covered when you join this type of medical practice.

Reduced Waiting Times

A concierge physician will generally reduce his or her patient load from the typical 2,000 to 4,000 patients to a much more manageable volume of just 500 or fewer patients. As a result, concierge doctors often guarantee that you can get same-day or next-day appointments any time you call. If you have ever tried to get an appointment with your current primary care physician only to find out that it will take several days, weeks, or in some cases even months to get on the schedule, you know the benefit of a guaranteed quick appointment time. In addition, private doctors often schedule patients to ensures you will get in right away without long wait times at the office.

Longer Appointments

Another benefit of a reduced patient load is the ability to spend more time with each patient. The “family doctor” of decades past knew everything about you and could help manage your care accordingly. Today people find primary care physicians rushed to get through dozens of appointments every day, leaving only 10 or 15 minutes at most with you. This means your physician has little time to get to know you and listen to your symptoms, and he or she could misdiagnose something, or miss something important with regard to chronic or complex conditions.

Comprehensive Annual Physical

All patients are advised to get an annual physical, but with a typical doctor it is probably limited to a quick screening and provides very little time for you to discuss your overall health and wellness. Many concierge physicians offer executive-level annual physicals for all patients, which means you get to spend up to 60 minutes with the doctor, and frequently includes additional preventive procedures, such as a more extensive blood panels and screening for conditions like Alzheimer’s.

24/7 Access to the Physician

Another perk of working with a private doctor is the ability to reach him or her any time of the day or night. Most concierge doctors give patients their private home and cell phone numbers and email address, and also offer the ability to quickly connect through social media such as Facebook or Twitter. That means you can contact your doctor with questions at all times, which can give you tremendous peace of mind.

Basic Tests and Procedures

Many concierge doctors cover all the basic tests and procedures you will get, such as an annual physical and other similar screenings, as part of the monthly or annual fee. This doesn’t eliminate the need for insurance, but similar to your vehicle, your insurance can protect against major events while the concierge medicine fee covers the basic “maintenance” like oil changes and tire rotations.

Closely Managed Care

One final thing that concierge medicine offers is a more comprehensive approach to managing your care, regardless of who provides it. Many private physicians will monitor and manage your care even when you go to the hospital or go see a specialist, which can help ensure that all your care providers understand your medical needs and you get the highest quality care at all levels. This is especially comforting for patients who have complex or chronic conditions, or those who require major surgeries or other treatment from someone besides a primary care doctor.

Switching from a traditional practice to a concierge physician can offer tremendous benefits. With the wide variety of options available today, chances are you can find one that provides all the services you want at a fee that fits within your budget.

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Are Cash-Only Healthcare Providers in Our Future?

Are Cash-Only Healthcare Providers in Our FutureIf a cash-only physician practice sounds like it might not be entirely above-board, you probably haven’t heard about concierge medicine. Today there are many legitimate doctors who are switching from traditional healthcare models, where they receive the majority of income from insurance providers, to a cash-only practice where patients pay monthly or annual retainer fees that cover most of the services offered. These practices cater to people from a variety of situations, including wealthy individuals who want better access to physicians, uninsured patients looking for options beyond the traditional fee model, or those who have insurance for catastrophic events but prefer to pay for preventive and “maintenance” care out of pocket because it can be cheaper.

Benefits of Cash-Only Models

There are many doctors who offer several different versions of the cash-only model; not all of them are concierge doctors, but many are transitioning to this type of practice because it offers several benefits, including:

  • Simplified billing procedures
  • Easy-to-understand fee schedules
  • Reduced need for non-medical staff in a medical office
  • Unlimited care for patients for a single fee
  • Discounted prices on often-inflated medical costs for routine procedures
  • Physicians who are focused on patients, not paperwork

A Changing View of Insurance

For patients, the idea of being uninsured is often a scary one—after all, with the rising costs of healthcare a single catastrophic event can bankrupt you and your family. It makes sense for most people to have at least a high-deductible plan that will cover major illness or injury, but it doesn’t always make sense for patients who are otherwise healthy to use insurance. In many cases these preventive procedures, such as an annual physical and routine tests and screenings, are not very expensive and they are something you can pay for out of pocket while saving money on your insurance premiums each year—money you can put toward concierge medicine fees.

In today’s healthcare environment, insurance companies hold a lot of power, and physicians often have to focus a significant amount of energy on understanding and working within the rules that insurance companies set. This takes the focus off of providing the best care for the patient and onto providing what is approved and covered by the insurance company. Plus doctors must accept whatever reimbursement insurance companies will pay, regardless of actual costs, which means they cannot increase revenue by charging more, they must see more patients and spend less time with each person.

Can Cash-Only Practices Change the Healthcare Landscape?

One of the most difficult challenges that primary care faces today is the lack of physicians. Since doctors can make significantly more money in specialty areas than they can make as a primary care physician, many medical schools have seen a drop in the number of students who intend to practice primary care upon graduation. Those who do often find that it is stressful and difficult to keep their practice going, given the high volume of patients they must see just to pay the bills.

Many physicians who offer cash-only practices find that the work they do is more satisfying, and they can focus on the reason they got into medicine in the first place: caring for patients. This higher job satisfaction could lead to more medical students choosing primary care in the future, which can help relieve the stress of a medical system experiencing substantial physician shortages.

Cash-only practices also create more of a free market when it comes to healthcare services, allowing patients to see the actual cost of care and shop around, compare costs, and determine what benefits they want from their doctor. These practices also help doctors create more profitable practices, shedding things that put a financial squeeze on their practice, such as overhead and staff costs.

A Healthcare Bargain

The idea behind cash-only concierge medicine is to make care more available, not less. Today there are many private doctors who are charging very low fees—as little as $50 a month—for unlimited care. In addition, since these healthcare offices receive payment from monthly membership fees and not from traditional fee-for-service reimbursement models that only pay for procedures, they don’t have to prescribe unnecessary tests, treatments, or medications just to make money.

Based on current trends, cash-only practices could become the future of healthcare—a move in the right direction to create more affordable options for patients and better business models for physicians.

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5 Benefits that Concierge Doctors Offer

healthcareWhen you hear the words “concierge” or “boutique” medicine, perhaps you imagine a group of wealthy individuals with expendable income who pay very high fees for increased access to their physician. While that might be true of some concierge medicine practices, today there is a much wider range of services available for patients who are seeking more personalized (and still affordable) care.

An Innovative Approach to Care

Many primary care physicians today operate a practice with several thousand patients on the roles at any given time. In order to keep up with this large patient load, doctors schedule as many as 50 appointments per day, spend only a few minutes with each patient, and have a large number of non-physician employees on staff to help with all the administrative work that must be done, including paperwork and insurance billing.

Private physicians, on the other hand, reduce the total volume of patients that they see to just a few hundred, allowing them to offer a higher level of care and service to each patient. The way private physicians structure their practices offers many benefits to patients—here are some of the things that private physicians do differently to provide a higher level of care.

1: Comprehensive and Coordinated Care

A concierge doctor offers different services than more traditional practices. Most traditional doctors provide episodic care; they see patients when they are sick, and try to provide a quick resolution for the immediate problem. A private physician offers a more comprehensive and coordinated level of care, taking time to identify not only the current issues, but how they might be related to overall health and wellness.

Doctors also help patients coordinate care with other providers, such as specialists or hospitals, when the scope of care goes beyond the primary physician. Having someone who understands your medical needs helps ensure you get the best possible treatment from all providers.

2: Access to the Physician Anytime

To provide better peace of mind to patients, a private doctor offers immediate and round-the-clock access for members of a concierge practice. They often give out their personal cell phone number and email, answering patient questions even after hours.

In addition, most private physicians promise same-day or next-day appointments—a welcome change from traditional practices, where it is common to wait several days or even weeks before you can get in.

3: Quality Time with Your Physician

In addition to 24/7 access, members of concierge practices get more time with the doctor to discuss medical issues. By limiting the total number of patients that he or she sees, a concierge doctor can spend more time with each patient—as much as 30 minutes or more during routine appointments. When compared with the 10 or 15 minutes that most physicians have with each patient, this gives you more time to discuss symptoms, ask questions, and receive a comprehensive diagnosis rather than just a quick fix.

4: Chronic Disease Management

Patients who suffer from chronic disease benefit from the additional attention and care that a concierge doctor provides. Rather than requiring patients to take on the role of care manager, a private doctor can ensure that you are following an appropriate treatment plan to manage your symptoms and do what you can to avoid disease progression whenever possible.

5: Cost-Effective Convenience

When your physician is tuned in to your needs, it can actually help control your healthcare costs. Without the time to spend analyzing your situation and asking the appropriate questions, many doctors err on the side of ordering unnecessary tests and procedures that may or may not benefit you. With a private physician you get a doctor who understands your medical history and knows your personal health, and can prescribe only the necessary treatments.

In many cases these doctors also offer basic procedures and services as part of the retainer fees, so you may be able to lower your personal healthcare costs by switching to a high deductible or similar insurance plan to cover catastrophic events, while still getting all the preventive care you need through your physician’s office.

A private physician offers many benefits that you won’t find in a traditional primary care model. If you are looking for a higher level of service from your physician, perhaps a concierge practice is right for you.

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