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The History and Transition of Concierge Medicine: Where is it now?

history-of-concierge-droneal2For those who are unfamiliar with the concept of a concierge medical practice, it is a retainer-based membership practice that charges a monthly or annual fee to its patients. The purpose of this is to restrict the number of patients in order for physicians to devote more time and energy to fewer patients, creating a more manageable and collaborative practice environment. Ultimately this concept allows for the physician to provide a higher level of service to patients willing to invest in their health. However, Physicians differentiate between three primary types Membership Medical Practice (MMP) Business Models: Concierge model, Direct Primary Care model, and Hybrid model.

The concierge model is a low volume practice environment, less financial dependency on managed care reimbursement, and supported by an annual membership “retainer” fee paid by patient subscriber. The Direct Primary Care model (a ‘watered-down’ dialect of concierge medicine) is comprised of a lower monthly fee ranging from $50-100/month, and includes basic medical care, yet fewer amenities, such as house calls, hospital care, etc. Lastly, the Hybrid model is comprised of two practice arms, one traditional and one concierge. Collectively, these retainer-based practices are referred to as membership medical practices.

Yet this overall concept of concierge medicine is anything by new. The first concierge practice was founded in Seattle in 1996. Shortly after in 2002, Dr. O’Neal founded the first concierge practice in Tampa, FL and he became the first physician to open a concierge medical practice from scratch in the United States. However, besides being the first concierge medical practice in Tampa without a preexisting client base, CooperativeMed is also credited as being the first non-transitioned concierge practice in the United States. Since the origin of concierge medicine in 1996, the concept has cultivated rapidly throughout the country.

How has concierge medicine transitioned since its origin? During the year of CooperativeMed’s inception in 2002, there were only a mere 50 physicians practicing concierge medicine. According to the Government Accountability Office (GAO), in 2004 it was estimated that there were 146 concierge physicians. Since then, the numbers have inflated disproportionately. In 2010 the GAO estimated 756 physicians existed and now the GAO currently estimates that there are 10,000 retainer-based/ subscription-based practices in existence. Nonetheless, it is important to keep in mind that many of these statistics are inflated a result of the GAO lumping different types of concierge medical practices together rather than controlling for each model.

However, despite its lack of overall accuracy, there has been undeniable exponential growth within the field of concierge medicine during the last 10 years. A concept that had first began in sporadic regions, is now found in nearly all states. What are the causes of this recent rapid growth? This can be attributed to several factors including: expanded consumer awareness, popular culture (e.g. television), increasing understanding of the potential value, as well as heightened consumer and physician frustration with traditional, high-volume practice model.

Research suggests that concierge medical practices exist predominantly in metropolitan areas, however its highest concentration is located in Naples, FL. The average patient demographics are Caucasian males ranging from 54 to 65 years old with a household income of $125,000-250,000. The atypical patient is generally a person who appreciates the investment value of a concierge practice such as one who is medically complex despite a lack of discretionary income. On the contrary, Dr. O’Neal’s practice remains an outlier within these baseline statistics. He maintains a wide variety of patients ranging in age, race, gender, income, region, etc.

Ultimately, it is a widely accepted opinion that concierge medicine proves to be a beneficial investment in health. Moreover, the beauty of Dr. O’Neal’s concierge medical practice is that all of his patients receive the same level of service and care. Perhaps most importantly, Dr. O’Neal remains a strong advocate for his patients, a difficult endeavor for a physician in a traditional, high-volume practice. He will travel with his patients to see specialists or other various doctor appointments to ensure they receive the utmost quality and care.

Dr. O’Neal is proud to play a role in the history of concierge medicine by offering a spectrum of primary care medicine to anyone interested in investing in their health, within a more convenient environment whereby all boundaries between the physician and patient are dissolved.

Learn more about Dr. O’Neal’s Concierge Medical Practice, Cooperative Med! Be sure to follow Dr. O’Neal on Twitter or visit its Facebook page!

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