Cooling on concierge: Selling the service not so easy

Retainer practices were once touted as the hot new idea that would take over health care, but reality has not matched expectations.

By Mike Norbut, AMNews staff. June 6, 2005.

When the idea first took shape, it sounded so promising: Charge patients a monthly or annual fee and offer extra services, such as same-day, extended appointments and 24-hour telephone access. Limit your patient panel to a fraction of what it would be under typical managed care parameters, giving you a chance to get back to the personal care that appealed to you when you first decided to be a physician.

Concierge medicine was touted by many as a viable alternative to the current health care maze when it started gaining popularity a few years ago, especially as monthly fees came down to a level that could entice the middle class. A few reports even projected a health care industry that relied on the membership concept, with patients having little choice but to pay above and beyond their normal insurance premiums for physician access.

While physicians knew it wouldn't get as big as those predictions, concierge medicine also never took off the way it was expected. While a few businesses have sprouted out of the movement, doctors still are generally slow to make the transition, mainly because it's a difficult model in which physicians can find success.

The concept still has considerable merit, judging by the anecdotes of doctors who are happy they made the switch and the statistics they produce about their patients renewing at a high rate. Entrepreneur magazine even lists concierge physician services as one of 13 "Hot businesses for 2005."

Running the practice is quite different from starting it, however. From having to find the right fee structure and the right group of patients willing to pay for it, it's not as easy as declaring yourself a concierge, boutique or retainer physician; flipping a switch; and collecting revenue.