Concierge Medicine

Overview

Concierge medicine is a membership model of healthcare in which patients pay a recurring fee on top of their insurance, copay, and deductibles. These fees may average around $3,500 annually, and come with the promise of around-the-clock access, same-day and longer appointments, and more personalized care. Some practices offer clinician house calls. Older, medically complex patients and patients with challenging schedules comprise the majority of concierge medicine subscribers.

The concept of concierge care—sometimes referred to as retainer medicine or VIP medicine—is often traced to the 1996 establishment of MD2 International, a medical office in Seattle, Washington. By 2005, it was charging $13,000 per year for an annual membership. Concierge medical practices, including direct primary care ones that require membership fees but also don't take insurance, grew swiftly between 2018 and 2023—increasing an estimated 83%. Physician assistants and nurse practitioners are now seeing many of the patients in these concierge practices, a change from earlier concierge medicine models but consistent with a larger healthcare shift in which more nonphysicians are seeing patients.

Supporters say the concierge model offers comprehensive, improved care, and its smaller patient load combats physician burnout. Critics contend that concierge care widens healthcare inequity and worsens primary care physician shortages by making it harder for people to see primary care physicians outside of membership-based offerings as more doctors move to concierge practices.

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