Concierge Practices Even for Doctors Who Don't Like the Idea

Neil Chesanow


January 09, 2014

In This Article

Why Buy the Cow When the Milk Is Free?

Why pay an annual fee -- which can range from $1500 to $5000, depending on the doctor's specialty and the services offered, but which averages about $1800 among his clients, Lipton says -- when patients can see the same doctor for the cost of an insurance copay?

A hybrid model may not be for you if maximizing revenue is the primary goal, Lipton admits. A mixed practice is mainly for physicians who want to maintain a relationship with all their current patients, get relief from heavy workloads and stress from struggling to meet overhead costs, and seek security and stability amid marketplace uncertainty -- without drastically changing the practice.

"By now, most of my patients know I have this option," Ficarola says. "If patients are new, I tell them about it. They can elect to join the concierge part of the practice or stay traditional. Many times a patient will say, 'I'm really satisfied with your traditional practice.' I've even had people use the old analogy 'Why buy the cow when the milk is free?' They feel they're getting what a concierge patient would receive. They're so satisfied that they don't think they need to upgrade to a concierge membership."

Ficarola is fine with this. Most patients don't need more time with him. The sicker ones who do -- including those with diabetes, heart failure, emphysema, and dementia -- know who they are, or their families and caretakers do.

"The demographics of my practice are elderly, very conservative patients who are not necessarily interested in bells or whistles or workshops and seminars and clinics," he says. "They'd rather be one-on-one with me than in group therapy, so to speak. They were willing to pay extra for more of me."

"These are patients whom I've had for many years -- decades," he adds. "We've grown fond of each other. They realize that the insurance companies cannot pay me enough for that extra time that we feel they need."

His practice, Tustin Irvine Internal Medicine, is not luxuriously appointed. There's no coffee or tea, no snacks, no upgraded waiting room, no weight loss or nutrition seminars. "That's not what we have here," Ficarola says. "If my office were in a more upscale town, that would be the expectation. But my patients would look at it as frivolous, unnecessary."

CCP helps client practices market such concierge services as wellness seminars and weight loss clinics, which are one justification for the fees that patients pay. But Ficarola's patients aren't interested in these noncovered services, he says.

CCP also trains doctors and staff to deliver the level of service that concierge patients expect. But Ficarola didn't feel the need for that either.

"They offered it," he says. "But to be honest, my staff actually is quite good. They treat our traditional patients the same way they would our concierge patients. There wasn't much tweaking needed inside the office."

"However, the firm helped me locate all my patients," Ficarola says. "That was a very big deal. They sent announcement letters, spoke to patients, had someone in the office who was making follow-up calls, and recruited my first 80 concierge patients. And they handle all billing and collecting, which is huge."


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