Concierge Health Programs

The Health Program that’s Finding Its Footing

Photo by Ani Kolleshi on Unsplash

In the typical medical structure, patients see their doctors whenever they get sick, and the doctors get paid when their patients see them. One doctor might have many hundreds of patients, the majority of whom she sees less than once a year. Her schedule is made up of episodes of acute patient illness, mixed in with the occasional health checkup for sports or international travel. If her schedule is a little empty, she takes on more patients until it is full.

The problem with this is that it reduces the physician to a state of reactivity. She isn’t invested in her patients’ overall health or wellness; she’s more like an adjunct consultant, or fire-putter-outer, for patient health. It falls on the patient to take charge of their health. But since we patients are not medically educated, we often don’t even understand the first steps. We might try diet and exercise, but we pick the wrong diets and the wrong exercise. We get discouraged. Perhaps we injure ourselves.

This model also doesn’t work because when more of her patients get sick at once (say, around flu season), her schedule suddenly becomes jam-packed.

Enter concierge medicine.

Concierge Medicine is a form of membership in which doctors provide medical care to Patients generally providing 24/7 access, a cell phone number to connect directly with their physician, same-day appointments, visits that last as long as it takes to address their needs and varying other amenities. In exchange for this enhanced access and personal attention, the Concierge Doctor receives a fee… which enables them to increase the amount of time they spend with Patients.

Concierge medicine exists to solve the problem of physician overcommitment. If each patient is paying the physician, the physician needs fewer patients to make a living. With fewer patients on her roster, each one can get more of her time.

One positive aspect of concierge medicine is that physicians are incentivized to keep patients healthy proactively. The typical model incentivizes physicians to react to acute patient sickness. But in the concierge model, a physician has fewer patients to see (allowing them more time to be proactive) and has a retainer they’d like to keep (incentivizing them to be proactive).

For MDVIP, this proactivity comes in the form of a yearly health checkup and wellness plan. According to their website, this wellness plan includes:

  • Meal plans, recipes, and shopping lists if you’re following a diet that can help prevent or manage diabetes or cholesterol levels;
  • Customized exercise videos tailored to your fitness level;
  • A nutrition and fitness plan that can actually help you lose weight and finally keep it off.

This is the kind of wellness plan we’d all make for ourselves if we had the time to do so. Because physicians are trained, it takes them a fraction of the time it would take us to create such a program. And of course, their program will be more effective. (This doesn’t solve the problem of patient compliance, but one step at a time).

Concierge medicine doesn’t solve the problem of physician overcommitment at scale, but it does for an individual doctor. As long as she can find a patient base that has the funds to pay the concierge fee, she has solved her problem of overcommitment.

Right now, though, concierge programs are a luxury only for the wealthy. Insurance programs don’t cover the cost of concierge programs, meaning only people with the money to afford a retainer of hundreds of dollars a month have access to this kind of medical care. This is to say nothing of Medicare and Medicaid patients, who already have a restricted selection of doctors due to the difficulty doctors face in getting paid by these programs.

However, it might be in an insurer’s best interests to consider covering these programs. Patients who comply with the wellness recommendations will be healthier over the long-term, which means decreased acute costs. Healthier people, after all, don’t go to the hospital for heart attacks.

This may be where AI steps in. Concierge medicine may pair well with Artificial Intelligence. With AI taking over the drudge work of doctoring (like taking clinical notes and doing laborious coverage checks), physicians can reclaim that time. This may increase the number of patients a physician can see while providing all the concierge benefits (increased time per patient, wellness checks, etc.) Higher volume will allow for lower retainer fees.