Struggling physicians eye concierge medicine model

While some physicians are considering early retirement or leaving primary care if reimbursements are cut further, others have turned to a hybrid model of concierge medicine.

Concierge Choice Physicians (CCP) is one of several companies championing the hybrid concierge model, providing insights into alternative practice options that may enable physicians to sustain their practices.

“Our phone has been ringing off the hook,” said CCP founder Wayne Lipton. “Physicians are truly concerned that health plans tasked by the administration with lowering healthcare costs are going to do so on the backs of primary care physicians by slashing reimbursement.”

If reimbursement is reduced further, healthcare advocates and industry analysts fear that thousands of physicians will no longer be able to maintain a viable practice.

“I selected the hybrid model so that we could give patients an option without basically discharging our patients,” said Bart Price of Manasota Medical in Sarasota, Fla. “We wanted to be able to continue providing care to all of our patients and we thought a model that offered a different type of service – in case they wanted it – would give people some real choices.”

Full conversion to a concierge practice means saying goodbye to about 75 percent of a practice.

“I liked the whole idea that you can see fewer patients with more revenue and do a better job,” said Damon Raskin of Pacific Palisades, Calif. “But I didn’t want to give up a lot of patients.”

Raskin’s 2,000-to-2,500-patient practice has seen a 10 percent to 15 percent increase in revenue since switching to the hybrid model. And his patients, he said, have been receptive. About 20 percent of his day is dedicated to the concierge side of the practice.

With the concierge option, which can cost $1,500 to $3,000 per year, based on region and services involved, patients can obtain same-day appointments, extended office consultations, more extensive evaluations and, often, 24-hour direct phone and e-mail access to their physicians. This model also offers medical services generally not covered by traditional insurance plans or Medicare.

“Our overall practice is financially stronger now because we no longer have the financials strains and worries that come with a busy internal medicine practice,” said Price. “We are a more profitable organization and feel like we are being fairly and appropriately compensated for our services.”

The national shortage of primary care physicians isn’t going to be solved by the government, said Lipton. “The (United States) needs changes that are a bit more dramatic than what the government could or would do,” he said.

The hybrid concierge model is already helping physicians in 11 states with more than 250,000 patients in 100 practices. With current interest in alternative models of practice, CCP projects more than 50 percent growth in the next year.