The Evolution of Concierge Medicine: What 20 years in the industry have taught me

​By Wayne Lipton
Managing Partner, Concierge Choice Physicians

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​The Origin Story

It was the early 1990s when I embarked on a career in concierge medicine. The industry was new then, developed largely as a response to the feeling that HMOs were taking over healthcare and making decisions that should be between a patient and their doctor. Our job was primarily to inform private physicians and patients that there was another way to secure that one-to-one relationship and to get away from the bureaucracy that seemed to have taken over medicine.

​The model took off. Concierge medicine is, after all, an excellent way to practice and experience medicine. But it became increasingly clear that not all physicians could transition their medical practice to an exclusive concierge practice. Perhaps their patient base was small, or they were practicing in a more rural, less wealthy area. And many doctors who could successfully make the transition didn’t want to dismiss patients who couldn’t afford to join.

However, even though these doctors couldn’t or wouldn’t transition to an exclusive concierge medicine practice, they still saw the value in membership medicine. The value that exists in bonus revenue that would stabilize a private practice struggling with declining reimbursements, and the value in patient relationships that were being threatened by the pressure of volume care. That was when the first major change began.

A New, Blended Approach That Offers Choice Emerges

I am proud to have pioneered what I call “the hybrid approach” to concierge care. Twenty years ago, I built an entire company around this opportunity. I called my company “Concierge Choice Physicians” (CCP) precisely because choice was what was missing in the industry, and choice is still what actually matters today. Physicians needed choices, not an all-or-nothing model. And patients want the choice to select the practice experience that’s right for them.

Initially there were skeptics that said a blended model, where a physician could offer concierge care as a service option for patients who want this level of support, would never work. Why would a patient buy a concierge membership when they could continue to see their doctor as a traditional patient? These skeptics underestimated how much patients valued the relationship they had with their doctor. Our model skyrocketed in popularity. CCP became the second largest company in the industry, and the only company that allowed physicians to decide the kind of membership medicine they wanted to offer: a full practice transition, or the hybrid approach.

Because we were flexible and physician-friendly, we developed a reputation built on trust. Physicians could and still do trust us because we don’t force them into a particular model. In fact, our very first client is still our client. We never forced physicians to overhaul their practice in order to participate. They could dip their toe into concierge medicine with a hybrid program. Without any upfront costs, they could test it, check the reaction from their staff and patients, and see how the revenue impacted their bottom line. And because the nature of a hybrid program means traditional patients remain, we had ongoing relationships with clients that offered continuous marketing and support. We weren’t consultants that swooped in, upended everything, and left. Our relationship was always built on ongoing service and support.

Models That Adapt as the Market Changes

The flexibility of our approach is what has contributed to our longevity. When we launched, it was mostly private primary care physicians who contracted with us. They had ongoing relationships with patients so they were naturally the right fit. But soon, specialists got on board. In fact, some of our most successful clients have been cardiologists and rheumatologists, gastroenterologists and endocrinologists. Today, we have unique programs to support pediatricians, gynecologists and more.

The biggest change has occurred in the last decade, with large medical groups absorbing small private practices. As the pool of private physicians able to make their own business decisions declined, we wondered how a shrinking private market would impact our growth. It turned out we didn’t need to worry at all. A funny thing happened. When large healthcare organizations purchased a client’s practice, they quickly recognized the value in the existing hybrid concierge program. For example, a Hybrid Choice program with just 50 members can generate an additional $100k in new, private revenue. Why would a health system want to cancel that? They didn’t.

Large healthcare organizations are now our fastest growing market. They have the same challenges as small private solo physicians, but at a larger scale. Our programs are scaling to meet their needs. At one time it seemed concierge medicine was incompatible with a vertically integrated healthcare organization that relies on third party payers and referrals. But our hybrid programs don’t interfere with their business structure, they just add revenue. And, it turns out, there are more perks.

CCP’s blended models have proven instrumental in improving physician satisfaction by allowing doctors to practice a more satisfying style of medicine for a period of their day while generating bonus revenue. They are being used to extend the careers of senior physicians who would otherwise retire. And they are being offered as an incentive to recruit new, high-quality physicians to a network. Patients also report high levels of satisfaction when they get to select the practice experience they want to have: traditional or enhanced.

A Future with Choices
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So what have we learned from all of this? Twenty years ago, I felt strongly that the future of the industry lay in flexibility. I knew there was a strong market for concierge care and I could see the consolidation of medicine on the horizon. Today, there are other changes looming on the horizon. Change is the only constant, after all. I remain confident that a company built on choice can adapt to whatever comes next: AI, direct pay, telemedicine, physician shortages, changes to Medicare payment structures, etc. After all, it’s not the strongest that survive. It’s the most adaptive! Concierge medicine will continue to grow in popularity and diversity. CCP will continue to adapt our programs to meet the needs of physicians, healthcare organizations and patients in a changing and often challenging marketplace.