Time well spent: Reflections on seven years as a concierge physician

When I made the change from a large, busy hospital-based primary care practice to a personalized care concierge model in 2013, the health care landscape was already starting to crumble under the weight of escalating demands. I experienced it every day, recognizing that patients who needed to see me couldn’t or saw a nurse practitioner instead. No matter how smart or efficient I was, it wasn’t possible to provide patients with any more than a cursory evaluation in the fleeting amount of time allocated.

One case I still remember well: an elderly patient dealing with three different cancers slowly walked into my office 10 minutes late for a 15-minute appointment. Toward the end of this already too brief visit, his wife mentioned that he was also experiencing short-term memory loss. This, coupled with the complexity of his other conditions, made it impossible to conduct an appropriately thorough evaluation and I reluctantly asked them to schedule another appointment some weeks out. The reality was that this patient was far from an anomaly but represented the everyday challenge of trying to make a broken system function.

For me, launching a private membership practice proved to be an ideal solution. I had considered it for years, but as we all know, it’s so much easier to keep the status quo, no matter how unsatisfying. Now I only regret not doing it sooner. Long hectic days and exhausted nights have been replaced by a manageable workload with a much smaller number of patients — every one of whom I know well — and time restored to spend with family and friends. I really feel like I got my life back.

The journey was gratifyingly devoid of unexpected drama or challenges, thanks to a supportive community and expert guidance from my consultant partner, Specialdocs. I am very good at medicine, but I am not a businessman, and freely admit I could not have done this myself. They provided a road map to follow which covered everything from meeting patient expectations to setting up a new office, and most importantly, gave me the confidence to know that my concierge practice could, and would succeed. It did from the start, and in the past six months, has gained more traction than ever in the face of COVID-19’s hard lessons about lack of available primary care in many communities. Even before that, patients were frustrated by an overcrowded, confusing health care system and searching for a better way to receive care.

The pandemic also illuminated — in ways I never could have imagined back in 2013 — the irreplaceable value of a one-to-one relationship with my patients. What stands out most to me is the universally positive feedback received from sending personal email updates on the situation to every patient in the practice. They’ve shared how difficult it is to decipher what’s relevant and accurate in the constant onslaught of news and are incredibly grateful to receive information and guidance they can trust.

More recently we held two drive-through flu shot clinics, enabling patients to stay safely in their cars for this important preventive action. The response has been amazing, and I’m again reminded of the enormous privilege of being able to deliver care with no constraints on time or need to seek administrative approvals…the only meaningful measure is benefit to my patients.

My advice to physicians still hesitant to make the leap: talk to other concierge doctors in your area and educate yourself on your options for a partner with expertise, experience and an outstanding reputation (in my opinion, Specialdocs has all three). Think back to your initial hopes and dreams: as a primary care resident, I intended to guide patients through unrushed acute care and wellness visits, continue to care for them if they were hospitalized, and be proactive and thorough about disease prevention. While that became impracticable in a traditional setting, as a concierge physician, I am thankful to have restored my original passion for medicine. Don’t settle for anything less than being able to run your practice exactly the way you want.

Daniel R Jasper, M.D., is an internal medicine physician in Creve Coeur, Missouri.