concierge-medicineBloomberg published an article that asked the question “Is Concierge Medicine the Future of Healthcare.”  If you ask the physicians at Atlas MD, they will tell you that they found the “fix” for healthcare (at least for themselves).

Josh Umbehr, MD says about his service at Atlas MD, “We are $10 for kids and $50 for adults and offer 1) unlimited access, 2) unlimited home/work/office/technology visits, 3) all procedures and testing in the office, FREE, 4) up to 95% discount on medications, 5) up to 95% discount on lab tests, 6) up to 50% decrease on insurance.”

Concierge medicine, for the most part, has been misunderstood on many levels over the years and has also accumulated quite a few criticisms.  It has been said that it excludes patients who can’t or are not willing to pay the membership fees; It has been included as a contributory factor in primary care physician shortage discussions; And most of all, it has been said that it is only for the “elite” or wealthy.

The main question one must ask in looking at any new healthcare delivery model is, “does it contribute to making quality healthcare affordable to all Americans?”  It is very hard to read the description of Dr. Umbehr’s service model at his practice and not answer “yes” to the question.  Maybe not ALL Americans, generally speaking, but surely those who are local to his practice’s area.  So then I would ask, “what if you had an Atlas MD in your area, would you be interested?”

Before you answer that question, it may help to understand where the concept originated from and why it has the criticisms it does.

This concierge model of Direct-Pay started out of Seattle in 1996.  The idea was actually formed by Dr. Howard Maron as he provided services to the Seattle Supersonics Basketball Team.  He was able to get to know them individually and provide exceptional levels of personalized care.  He wondered why this type of healthcare couldn’t also be provided to the “non-elite.”  Hence, the concept of “highly attentive medicine” as he calls it, or concierge medicine, was born.  He went on to start a company called M2 (M Squared), where they would charge upwards of $25,000 per family annually to have 24/7 unlimited access to your physician, limited to 50 families per physician.  This original model of concierge medicine, founded by Dr. Maron, was an “elite” service and did cater to the wealthy.  However, as more concierge businesses/practices started to open up, they offered similar services, but for reduced annual membership fees, such as $2,500 to $5,500 annually.  Today, participating in services like MDVIP and similar, annual membership fees can be as low as $1,650, limited to 600 patients per physician.  And of course there are stand-alone, local direct pay practices, like Atlas, that can offer care at even more affordable levels.

So, as with anything in business, a concept is born and competition/innovation find ways to get it to larger numbers of people at lower costs.  Some say that the name “concierge” does not help in the branding of the concept and does more to maintian its “elitist” stereotype than to progress the idea.  Currently, there are more than 4,400 physicians participating in the direct-pay model and more than a few hundred-thousand patients nationwide.

As a patient, the biggest challenge is to change the way you think about your healthcare coverage.  Dr. Umbehr describes it best saying, “Health insurance should work more like car insurance. We have car insurance for all the big stuff, but we pay for gas, tires, and oil changes ourselves.”  One of the biggest challenges concierge medicine faces in gaining widespread adoption as a delivery model, is convincing patients to pay for the routine stuff themselves and get coverage for the major medical, like hospital, ambulance, surgery, or expensive scripts.  This means putting patients more in charge of their own care and the costs that come with it.

Today, all to often, doctors get stuck with the cost of patient care and have to take responsibility for all aspects of care coordination.  No wonder there is a shortage of Primary Care physicians and medical school students are going everywhere but general practice.  High overhead, loaded waiting rooms, not enough income, and administrative nightmares.  Concierge medicine could be a savior to the medical school student wanting to go into family medicine, but not willing to deal with the cluster health insurance has made of it.  It is going to take innovation and change to bring Primary Care as a specialty back into a good light for providers. Concierge medicine may be a contributing factor in doing just that.

So, to consider options available today to most patients, such as, high premiums, unrealistic deductibles, undecipherable health plans, and limited access to care, does conceirge medecine really seem like that far of a stretch from reality?  I think once patients begin to understand it better in comparison to the options available today (or to come…), it may begin to strike interest and attract a larger following.