Chances are, you are in a waiting room reading this very article to pass time before a nurse calls your name. If that is the case, soon you are going to put this magazine back on the coffee table and you will follow the nurse to a room so they can weigh you and check your blood pressure. A medical assistant may ask for your medical history, ask if you have any allergies and ask what prescription medications you take. When they finish their line of inquiry, you will be left to your own devices as you sit on a sheet of paper that covers the cushioned examination table.
When the doctor walks into the room and greets you, what is going to happen? Will they talk fast and conclude the three-minute conversation with a subliminal message suggesting they have to get to another patient? Will they be swift to refer you to a random specialist and send a prescription to your pharmacy?
To many, these occurrences are too common, but make no mistake: this issue is entirely systemic. It is not out of disregard for patients that doctors rush them out; they are just busy people who oftentimes see dozens of patients in a day. Any physician who has earned their license would agree that every patient deserves quality healthcare personalized for your accommodation, but, for most doctors, that is a tall order. Even primary care physicians who run considerably successful practices do not have the resources to administer this quality of care.
But what if they did?
What if your doctor devoted an entire hour to seeing you? What if your doctor personally visited you in the hospital on a weekend and coordinated with nurses to explain your specific medical needs? What if you had your doctor’s personal cell phone number for after-hour appointments and never had to set foot in an urgent care clinic again?
Thanks to a business model called “concierge medicine,” people can opt for this type of doctor-patient relationship. It has not been without its controversy, but even concierge medicine’s most ardent critics concede that it has substantially improved the quality of life for physicians and patients alike.
Despite the image it conjures, “concierge medicine” does not mean your Vancomycin refill comes with a complimentary hot towel. “‘Concierge’ is kind of a boujee term,” says Dr. Blake Jenkins, who has been with North Texas Preferred Health Partners of Frisco since October. “It is really more of just personal care.”
Dr. Jenkins runs his practice the same way most concierge physicians do: patients pay an annual retainer, get more personalized treatment and have access to their doctor after-hours. Like most non-concierge practices, Dr. Jenkins accepts insurance and Medicare. The copays patients pay are about the same as those of any traditional doctor’s office.
The annual fee patients pay varies by practice. In fact, some charge quarterly instead of annually. Some of the most exclusive concierge practices charge tens of thousands per year, while more accessible ones only charge $3,000 or less. These retainers exist because concierge doctors usually only accept 200-400 patients in order to make personalized care possible. Most primary care physicians have a panel of 1,000-2,500 patients, and in some cases, even more. Because concierge physicians have such a comparably small customer base, profitability without the fee would be virtually impossible. But to paying members, this extra sum is worth it.
“My patients do not go to Baylor Scott & White, sit there for three hours and see the doctor for seven minutes, who then refers them to 14 different specialty doctors,” says Dr. Bryan Lowery, the primary care physician behind Frisco Concierge Medicine. “When my patients see a specialist around here, the specialist knows who they are, knows that I am their doctor, takes good care of them and knows they are a concierge patient.”
Dr. Jenkins can also vouch for a similar patient experience. “A regular follow-up is a 30-minute visit, and, typically, we schedule physicals for an hour,” he explains. “If it is an annual check-up, we have an hour, so we sit down with them and talk about preventive health care and risk factors related to their genetics. We can really do a deeper dive because of time.”
To most patients, this personalized level of care is refreshing in a healthcare industry that people unanimously consider a headache. This is a sentiment Dr. Jenkins shares, as his morale has seen drastic improvement since his transition into concierge medicine. “Previously, I was working around 11 hours a day in the clinic, and, on average, probably about two hours at home in the evenings doing charts,” he recalls. “And you never caught up!”
On the differences concierge practice has made on his quality of life, Dr. Jenkins says, “I have patients who were patients at my first practice 17 years ago and followed me to this practice. They can tell a huge difference in just the demeanor and how relaxed the atmosphere is versus where they were before.”
You would be hard-pressed to find someone who does not view these as favorable outcomes, but critics of concierge medicine argue that the business model disproportionately favors the wealthy and widens America’s class disparity. This is an assessment both Dr. Jenkins and Dr. Lowery dismiss, as the practices of both doctors are priced quite modestly compared to those of most concierge physicians. If a doctor charges a $3,000 annual retainer, that translates to monthly payments of $250, which is by no means a hefty medical expense, yet many times includes all visits and consolations throughout the year, including wellness exams, illness treatments as well as all the other reasons patients see their primary care physician. Additionally, lab services and diagnostic scans are provided either at very low cost or even without cost.
Both physicians make it a point to be accessible and have a considerably strong panel of middle-class patients, but there are some practices that are far more exclusive. “Some doctors do what is called a hybrid,” explains Dr. Lowery. “Some of their patients pay an extra $50 or $100 a month, where they can get same-day appointments, access to the doctor … that kind of stuff. Most of the patients do not pay the fee, so nobody ever calls back, and they cannot get in until three weeks. I could not do that. I could not just say, ‘This person calling me right now – are they paying a fee or are they not paying a fee?’”
The concierge model appears to improve the lives of doctors and patients alike, and to those immersed in the confusion surrounding the U.S. healthcare system, it is a complete oasis. Whether you are a critic or supporter of concierge care, it is indubitable that its quality is a vast improvement from that of traditional primary care.
Just how drastic are these differences? The answer may depend on the waiting room you are reading this from.
Garrett Gravley is a Dallas-based arts and entertainment writer, journalist and music critic.
