An article in Family Practice management this month provides us with what feels like a blueprint for the future of primary care in the USA
Here is the reference: https://www.aafp.org/pubs/fpm/issues/2024/0700/addressing-social-needs.html
You will notice that the article is about a primary care practice model that addresses the Social Determinants of Health [SDOH].
The last paragraph in the article hints at the true value of this business model. The heading reads:
THE OPPOSITE OF BURNOUT
Working in this new, hybrid system allows the doctors to reclaim their primary role in patient care and reconnect with meaning and purpose in their practice of Medicine.
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The Model: Concierge Care Meets Charity
This practice model is a hybrid, where each concierge patient funds their own care while also covering the care of two low-income patients.
SPECIFICS:
Each patient panel is composed of:
- 300 concierge patients at a $200 per month premium ($720K annual gross income)
- 600 charity patients from the local community
- Total panel size = 900
From the article:
"The concierge fees cover the clinic rent, supplies, and salaries for the physicians and a small staff consisting of a receptionist, patient navigator, and medical assistant. The clinics are organized as nonprofits and also receive donations and apply for select grants. As funding allows, we employ staff who work full time addressing SDOH. We also have a network of volunteers.Our clinics can bill insurance (e.g., for certain procedures that aren't covered under the membership fee), though sometimes this requires more staff time than it is worth. The nature of the funding model allows our clinics to be creative and responsive to our patients' unique needs.
By focusing on specific neighborhoods and hiring staff from within those communities, these clinics creatively address SDOH like joblessness, educational gaps, and cultural disconnects. The flagship clinic, for example, serves Spanish-speaking immigrants and offers tailored programs that build trust and deepen relationships."
What sets this model apart is its flexibility, allowing physicians to focus on providing care without being tied down by insurance bureaucracy. The concierge structure provides steady revenue, which allows the clinic to address unique community needs while sustaining its mission to deliver high-quality care.
Why Concierge Care Is Already Superior
Concierge care is a vastly superior business model for the health and well-being of primary care physicians. Here’s why:
- You make twice as much money seeing half the patients: With membership fees that ensure stable income, you can focus on fewer patients while providing higher-quality, personalized care.
- No insurance middleman: Your patient is your client. You don’t have to deal with insurance claims, denials, or delayed payments. This eliminates a significant source of stress and much of the administrative burden from EMR.
- You are your own boss: As an independent practitioner, you have full control over how you run your practice, without the hassles of hospital administrators telling you how much money you're losing the organization.
- Total flexibility with patient encounters: You can freely choose between virtual visits, in-office visits, or even home visits, tailoring care to the patient’s needs and your schedule.
In the past, when discussing concierge medicine with burned out Physicians a common objection is, "what about patients who can't afford it?"
This model directly addresses that concern in leveraged fashion. Notice you have 2:1 coverage of underserved patients based on a reasonable monthly concierge rate of $200. Your paying patients even get the experience of supporting the health of the underserved members of their own community.
Why This Model Matters for Physicians and Patients
This blended concierge-charity model can allow you to reconnect with why you decided to be a doctor in the first place.
- You can step off the hamster wheel of production medicine.
- Stop working yourself to burnout to support the overhead of your massive hospital system employer.
- Spend more time with your patients
- Disconnect from EMR tasks meant only for the business office.
- Build the deeper relationships you are longing for.
- Have a direct and visible impact on your community.
I believe this blended model is a blueprint for a significant portion of the future of primary care.
It offers a way for physicians to reclaim autonomy, reduce burnout, and deliver patient-centered care while contributing to broader community well-being. The model is adaptable, scalable, and can be incrementally incorporated into existing practices. For many physicians, it will provide a path to a more sustainable, fulfilling career.
In a healthcare landscape that is tilted to favor money over meaning, this approach offers a refreshing alternative. With the freedom to choose how you care for your patients and the financial stability that comes with the concierge model, this blended practice could be the very survival of primary care in America.
It’s a model where physicians can make more money, see fewer patients, have more impact and finally enjoy practicing medicine again—without the burnout.
PLEASE LEAVE A COMMENT
- What do you think about this model?
- Do you use a business model like this?
- What are your concerns about concierge medicine?