What is Concierge Medicine?

Concierge medicine describes a model of primary care in which physicians charge patients a monthly or annual retainer fee in exchange for providing greatly enhanced access and coordination of care. In general, the only real difference between concierge medicine and direct primary care is cost, given that direct primary care evolved out of concierge medicine as a way to provide the same benefits at a more affordable price.

The Evolution of Concierge Medicine

Concierge medicine began as a movement in the mid-1990s in California as a way to offer high net-worth individuals and their families enhanced access to high quality primary care. Members of a high-end concierge medical practices pay a monthly or annual subscription fee just as in direct primary care. Unlike direct primary care, however, the fees range between $375 and $2,000 per patient per month, with some high-end practices charging up to $4,200 per patient per month ($50,000 per patient per year). Also in contrast to direct primary care, the monthly subscription fee may only be an access fee and the patient’s insurance may also be billed for any medical care provided.

The Difference Between Direct Primary Care and Concierge Medicine

As in direct primary care, concierge medicine practices offer 24-hour-a-day, 7-day-a-week access to their patients’ own physicians, extended time for appointments, access via telephone and texts, and, in some practices, house calls. As in direct primary care, concierge medicine physicians take care of far fewer patients—sometimes no more than 50—than in traditional fee-for-service medicine. (In contrast, primary care physicians practicing in the traditional fee-for-service model usually care for 2,500 to 4,000 patients, seeing 20 to 22 of them per day.)

In general then, an accurate way to think about the difference between direct primary care and concierge medicine is that concierge medicine was designed to serve the wealthy while direct primary care was designed to serve the middle-class and lower-class as well as employers. What often confuses patients is that direct primary care physicians whose practices don’t fit the definition of concierge medicine may still refer to their practices as “concierge” to imply that they deliver white-glove customer service in addition to top-quality medical care.