What it's like to be a concierge medicine doctor

Medical Economics Journal, Medical Economics November 2021, Volume 98, Issue 11

Four physicians discuss why they left their traditional practice model behind and made the leap to offer a membership-based primary care program.

Click here to access the full session video and slide deck (registration required).

Introduction:

Many physicians are disenchanted with traditional practice models. Payer hassles and the fee-for-service hamster wheel often leave physicians burned out and unable to spend enough time with their patients — the reason they pursued medicine in the first place.

In response, some physicians have chosen to transform their practice into a concierge model. During this session, four physicians discussed why they left their traditional practice model behind and made the leap to offer a membership-based primary care program. The following discussion was transcribed and edited for length and clarity.

Learning objectives:

  • Physicians who practice concierge medicine will discuss the benefits and how to overcome challenges.
  • Best practices in discussing the transition with patients.
  • How to select a vendor partner.

Meet the panelists:

James Jones, M.D., Internal Medicine

Mark Gomez, M.D.,Internal Medicine

Bradley Hunter, D.O., Family Medicine

Gay Purcell, M.D,. Internal Medicine

Derek Hill (Moderator) MDVIP

The breaking point: Why I switched to concierge

Mark Gomez, M.D.: My breaking point was that it came down to family. I was trying to find a way to get to get home to my family faster. As physicians, we make a lot of sacrifices. And some of the sacrifices come at the cost of our own personal relationships. And I thought for me, it was more valuable. I saw more value in me being a better father, a better husband. The reason why I made the switch from traditional primary care to MDVIP was I was trying to find a way home.

Gay Purcell, M.D.: I am in my 22nd year of private practice, and I joined MDVIP in January of this year, so very recent. My big breaking point was I was starting to get to the point where I had such a huge patient panel that I would come in every day, and I would have 70 to 100 documents. And I started to worry that I was going to miss something; it was my biggest fear that I was going to miss something really important. And it just felt like, how do I get home to my family and still not miss anything? And I knew that there were so many things that I wanted to bring to my patients and the way that I was practicing medicine, it really wasn’t practical.

Bradley Hunter, D.O.: I was seeing myself lose the empathy. The burnout features were all there, I was just checking all the boxes for burnout. And so were all my colleagues. And we finally got to a point within our practice where we all said, ‘We give up!’ The entire practice folded, a practice of about 30 providers, and each of us took separate directions. And I chose to go the MDVIP way. And I can’t tell you how happy I am that I’ve done this because and every day, it’s reinforced by my patients saying, ‘Wow, this is what I was always hoping for from my doctor’s visits.’”

James Jones, M.D.: I was frustrated with the incompleteness of being able to do a good job, you know, seeing 30 or 40 people a day. I was at a point in my practice where I couldn’t even see my sick people because the schedule wouldn’t allow anybody to be put into the practice. And that was just unacceptable for me. But I haven’t looked back since. I can tell you that this was the right decision for me and it was right decision for my patients.

What were your biggest fears about the switch?

Purcell: I went into it with a lot of fears I think a lot of people would have about completely changing your traditional practice of medicine and the way that you’ve done medicine as long as you’ve done it. I think one of the things that is scary when you first start out is wondering whether or not the patients will accept this type of model, whether they’ll actually understand it — I think that is that is the biggest hurdle to overcome. … But the wonderful thing is that so many people loved the model, and they love coming in every day, they love being able to call me on my cellphone if they need anything.

How did you determine concierge was right for you?

Jones: I was fortunate enough to have two close partners who were already practicing in the MDVIP model. So I learned through them how it exactly works, but it still took me a year or so of meetings and talking to MDVIP. I can’t emphasize how much that the analytics that they use are so accurate. We now have six practicing MDVIP physicians in our organization and they have hit the nail on the head with all of us as far as predicting how many people will join us and how big our practice would be.

How did you tell your patients?

Gomez: We certainly do tend to develop these amazing relationships with a lot of the patients that we’ve taken care of. When I went through the process, it was a very difficult decision to make, because you’re talking about having some finality to these relationships that you’ve cherished for a long time. But I had to be honest with my patients. I said, ‘Hey, I’m doing this, these are my reasons for doing it, and I hope that I can continue to be your doctor. I’m giving you the choice of choosing to stay with me.’ It’s good to give ourselves as doctors permission to take care of ourselves. And so my approach with patients was to be honest with them, and they understood.

Advice for physicians

Jones: It’s not necessarily right for every doctor, just like it’s not necessarily for every patient. But I’d also encourage people not to wait too long. If you wait till you’re 65 or 70 years old, you may have missed the boat of the real benefit of being able to practice this way.

Hunter: I’m 58. It’s about the average age of conversion. I am glad that I got in the door at this time. But I could not have gone back to becoming an employee because I think you’ll just not get out of the burnout loop that’s set up in this system. Your patients are going to be looking for personalized health care models like this, and they are out there waiting for you.

Click here to access the full session video and slide deck (registration required).