Working with physicians over the years, I have witnessed firsthand how practitioners have been largely ignored in the government’s attempts to reform healthcare. I have seen physicians, naturally primed to be problem-solvers, pushed aside to become silent data entry clerks and patient care factory workers forced to await orders from third parties with questionable intentions, on how to deliver medical care.
First there was the 2009 EHR mandate that effectively ended any spontaneous communications with patients. This transformed physicians into data entry clerks, and for some practices, it meant the end. Physicians have only just adjusted to the October 1st ICD-10 transition and its 69,000 codes that had to be mastered if they wanted reimbursement for services performed. And now, physicians are being asked to cozy up to the idea of the Patient Centered Medical Home. This well-intentioned, but poorly practiced mandate may mean financial suicide for many practices. Research by Dr. Michael K. McGill from the University of Utah’s School of Medicine, indicates that it will cost each Physician within a practice, $105,000 per physician, per year, to maintain a PCMH model (1). Additionally, Obamacare, or the Affordable Care and Patient Protection Act, have set Physicians up to lose up to 6.7% of their annual salary over the next 3 years, according to an analysis by Forbes Magazine (2). All of these changes have translated into even less time spent with patients and on the patient encounter. This leaves both the patients and the physician feeling dissatisfied, and as a result, leads to many physicians falling victim to burnout.
If you have not been alarmed at the changes in medicine occurring over the past several years, perhaps you have been in a deep slumber, or perhaps you have already joined the ranks of the 12,000 physicians for whom these mandates pose no threat. October 1st was not Y2K after all; it was just another day at the office if you have already discovered Concierge Medicine. I have seen the emergence of concierge medical practices in which for the most part, patients pay a membership fee to become a member of a smaller panel with more individualized attention, including: longer appointment times, 24 hour direct access to the physician, and enhanced services. Such services include: anti-aging medicine, special testing (such as body composition profiles), cortisol levels, hormone levels, cardiac inflammatory markers, and bioidentical hormone replacement. Alternately, there may be further transparency with a defined menu of services and clearly delineated prices with no surprise bills in the mail.
Concierge providers state that they offer a “more patient-centered approach, without becoming distracted by insurance claims or superbills” (3). A 2014 Survey conducted by the Physicians Foundation discovered that 20% of physicians either practice currently, or are planning a transition to one of these concierge models in the next few years (4). Physicians have finally begun to be vocal and take action, becoming entrepreneurial and innovative instead of allowing bureaucrats and corporate executives to make decisions which do not place patients squarely in the center of the equation. In a survey by the Concierge Research Collective three out of eight concierge medicine doctors are incorporating a number of “value added solutions” within their practices such as B12 injections, Hormone Replacement Therapy, testosterone injections, medically supervised weight loss programs, and a cadre of wellness focused and anti-aging solutions (5). The addition of these simple services increase “foot traffic”, a valuable part of building a practice, as statistics demonstrate a 90-97% retention rate of these first time patients. Other services noted on the menu are pharmaceutical grade supplements, human growth hormone, and other hormonal therapies, vitamin supplementation, IV formulations, HCG weight loss diet therapy, along with compounding pharmacy consultants for pharmaceutical grade therapies such as testosterone sub dermal pellets, as well as physicians with expertise in all aspects of Men’s and Women’s Health Issues.
What is the Earning Potential of Concierge Medicine Physicians? 19% of physicians earn 100,000-200,000 23% of physicians earn 200,000-300,000 15% of physicians earn 300,000-400,000 20% of physicians earn 400,000-500,000 22% of physicians earn 500,000 to 1 million plus/annually Concierge Medicine Compensation Data from 2014-2015 (6)
The Top 5 States to practice as a Concierge Medicine Physician: (Concierge Today, 2015) (6) 1. Utah 2. California 3. Texas 4. Florida 5. Washington
What Challenges Lie Ahead for Concierge Physicians and what Resources are there?
As an advocate for concierge medicine, I believe that the main challenge is the absence of business training, specifically marketing training. The Concierge Medicine Model is inherently entrepreneurial and will always involve a fairly sophisticated marketing program in order to be successful. For the first time, the doctor must enroll his/her own patients, who pay with their own money, for this direct relationship. Acquiring these skills is a not an insurmountable obstacle and I have met very few newly board certified M.D.’s who understand the essentials of marketing. Luckily, EC3Health is here to help overcome the challenges that lie ahead. I am looking forward to helping you. Sincerely, David Caddell
1. McGill, Michael, Annals of Family Medicine 2015 Sep 28 184-189.
3. Medscape, Business of Medicine. Concierge Practices: Even for Doctors Who Don’t Like the Idea by Neil Chesanow Jan 09 2014