Want to see doctor quickly? Go ‘concierge’
A growing segment of physician practices in Houston and across the nation are seeking to upend the traditional medical business model as patients pay a membership fee for better access and more attentive care from their doctor.
Known as “concierge” medicine, these type of practices are spreading. On Wednesday, for example, First Primary Care, announced its membership-based primary care practice recently opened as second office in The Woodlands after opening its first in west Houston last year. Company officials said they hope for more.
“We want to expand into every corner of Houston,” said Art Goetze, chief operating officer at First Primary Care, in an interview on Wednesday.
This trend of direct-access medicine is further evidence of the changing status quo in health care. The way it works is that a patient pays a monthly or yearly fee to a medical practice in exchange for quick and unrestricted access to their primary care physician.
The idea has been around for about two decades and has been growing steadily, presumably to address patient and physician frustration with an increasingly complex health care system in which the doctor-patient relationship sometimes seems to get the short shrift. While firm numbers are elusive, a website for the American College of Private Physicians, an advocacy group for doctors offering the service, says it
serves 10,000 providers nationwide.
But some public health watchers warn buyers to beware. Pauline Rosenau, professor emerita of policy and community health at UTHealth School of Public Health, is highly skeptical of the trend and urges both patients and doctors to read the fine print before committing to the model.
“This introduces yet another player in an already too complicated system,” she said.
But mostly, Rosenau worried that the nation already suffers from a shortage of primary care physicians, especially for lower income patients, and this model siphons from the pool of available doctors and shifts care to those who can afford the membership fees, she said.
Vivian Ho, a health economist at Rice University’s Baker Institute of Public Policy, agrees, adding that the trend only further widens the income-based health care inequality in the nation.
But doctors who offer the service counter that a concierge model can save people money because they typically do not take insurance for routine visits. This is especially beneficial for its small business clients, said Goetze, since often they cannot afford the premiums to cover their employees. “We’re a dream come true for them,” he said.
First Primary Care practice touts same-day appointments for illness and injuries, wellness and preventive medicine, and chronic disease management a membership fee of $100 a month for individuals and $125 for seniors. The arrangement is mostly in lieu of traditional health insurance coverage, he said.
"None of us are good consumers of health care, we've become good consumers of expensive insurance," said Goetze.
A cap of 500 patients per doctor is set, Goetze said, to guarantee more time with each patient. Typically doctors at the practice only see a handful of patients per day rather than the 20 to 30 at most busy medical offices, he said.
“Every one of my patients has my cellphone number, said Dr. Thi Vo, a physician at First Primary Care, in a statement, “It’s like having a doctor in the family.”
If a patient needs more extensive care, Goetze said his company will help refer to a specialist. It also offers catastrophic health plans through a cost-sharing company which is not traditional insurance.
Dr. Rishi Bhardwaj, a internal medicine physician in Bellaire who has a concierge practice, added that if a patient can see their doctor sooner, their ailment will be treated sooner and it reduces the risk and ultimate expense of a complication.