1.Introduction
You know your medicine. Do you know your practice? Most physicians can explain their care in one precise sentence. Far fewer can say, with any confidence, whether their patients trust them, whether their marketing is reaching the people it's meant for, or whether a quietly unhappy patient is already planning to leave.
For eleven years, Concierge Medicine Today has asked prospective patients directly: why are you searching for a new doctor, why are you leaving your last one, and what matters most to you in making that choice. The resulting archive, over seven thousand patient conversations, reveals a pattern this industry has not previously had the data to see clearly. Patients seeking concierge and membership-based care are not one audience responding to one value proposition. They are four groups, each solving a different problem.
This finding does not stand alone. A substantial peer-reviewed literature on continuity of care in primary medicine has independently established that the relationship between a patient and a single, consistent physician is associated with higher patient trust,1 lower rates of acute, potentially preventable hospitalization,2 and reduced overall health care costs.3 What CMT's patient research adds to that literature is not a claim about outcomes, but a market-facing map of how patients themselves describe wanting that relationship, and what, specifically, they are willing to trade for it.
"Eleven years of data, and the finding that mattered most wasn't complicated. Patients don't leave because the medicine was bad. They leave because they stopped feeling like a person to you."
2.Method
This study draws exclusively from Concierge Medicine Today's own patient-inquiry survey, collected from individuals actively searching for a concierge or membership-based physician through CMT's channels between January 2013 and December 2024. Four rating questions, patient trust in their current doctor, satisfaction with their current doctor, importance of hospitality, and importance of insurance or Medicare compatibility, were added to the survey in 2018 and form the basis of the four-group model presented here, drawn from 561 respondents who answered all four. A separate, larger question set spanning the full eleven-year archive (n=1,149) was used to test the model's stability over time.
This is a self-selected sample of patients who chose to respond, not a probability-based sample of the general population, and findings should be read accordingly, as a strong signal from real patients rather than a nationally representative statistic. Full methodology and disclaimers appear at the end of this study.
3.The Two-Axis Framework
Numerous variables were tested against the survey data, including age, income signals, geography, referral source, and specialty need. Most failed to produce a meaningful split. Notably, hospitality and customer-service expectations were rated highly across nearly every respondent, regardless of group, indicating this is a baseline expectation of the category rather than a differentiator within it.
Two questions, however, consistently separated respondents into distinct groups:
Relationship orientation: is the patient happy with their current doctor, or ready for something new?
System orientation: does the patient want their next doctor to remain compatible with insurance and Medicare, or do they want independence from that system entirely?
4.The Four Patient Types
Plotted on these two axes, Concierge Medicine Today identified, categorized, and organized patient responses into four distinct groups, each with a profile drawn from the 561-respondent compass sample.
Trust 4.23, like 4.19 of 5 for their current doctor, but insurance importance only 2.21. Not fleeing a bad relationship, reaching for more before anything breaks. Skews Baby Boomer and Gen X, youngest average age of the four.
Trust 4.38, like 4.40. Insurance importance 4.67, the highest score of any group measured. Want the concierge experience added to a trusted relationship, not traded for it. Oldest-skewing group.
Trust 2.65, like 2.56. Insurance importance 2.34. Done compromising with the relationship and the system at once. Most likely of the four to cite feeling like a number as their reason for leaving.
Trust 2.60, like 2.60. Insurance importance 4.64. The smallest group, solving two problems at once. Skews older, more likely managing a chronic condition than any other group.
"Underneath four very different answers, every one of these patients is looking for the same thing: somewhere to belong, with someone who actually sees them. That part never changed in eleven years, and I don't expect it to."
5.A Decade-Spanning Consistency Check
To test whether this pattern reflects a durable feature of the market or a temporary artifact of recent data, the underlying driver, relationship as the primary search motivation, was checked against 1,149 patients spanning the full archive: 416 from 2013–2018 and 733 from 2019–2024, using an identical direct question in both periods.
| Period | Sample | Cited relationship/trust as top reason for searching |
|---|---|---|
| 2013–2018 | 416 patients | 74.3% |
| 2019–2024 | 733 patients | 74.5% |
For eleven straight years, roughly three out of every four patients searching for a concierge or membership doctor were looking for a relationship first, not a perk.
A supporting open-ended measure corroborates this finding: patients describing their search in their own words used relationship and trust language nearly three times as often in the recent period as in the early period, a different question converging on the same conclusion. This internal consistency mirrors what the continuity-of-care literature has independently documented for two decades: interpersonal trust, not simple duration of contact, is the mechanism through which continuity produces its benefits.4
6.Findings Common to All Four Types
Several patterns held regardless of group membership. Across every type, 67% named finding a doctor they like and trust as their top reason for searching (n=1,044), ahead of cost or convenience. The single most-cited reason for leaving a prior doctor was feeling like a number (n=1,085), not wait times, not cost. 52% of respondents said they would still choose an M.D. alone over N.P. or P.A. access, even when speed was offered as a trade-off (n=1,993). And one in ten searches were conducted on behalf of a family member rather than the respondent, a pattern present in every group (n=4,088).
This study concerns concierge and membership medicine. It does not concern Direct Primary Care.
This research, and the CMT Patient Study more broadly, is limited to patients searching for concierge medicine in its various forms, including traditional retainer-based concierge practices and hybrid membership models. In practices of this kind, patients generally retain their existing insurance or Medicare coverage for medical services, and pay a separate membership or retainer fee for enhanced access, longer visits, and a more personal relationship with their physician.
This study deliberately excludes Direct Primary Care (DPC). DPC is a structurally distinct model in which a patient typically pays a flat membership fee directly to a primary care physician in place of, rather than alongside, insurance-based primary care billing. DPC practices generally do not bill insurance for primary care services at all, and DPC patients are often motivated by different considerations, frequently cost transparency and avoidance of insurance administration entirely, rather than by the insurance-compatibility question that defines one of the two axes in this model.
CMT's survey instrument identifies and separates patients indicating interest in a DPC-style arrangement from those searching specifically for a concierge or membership-based doctor, and DPC-indicating responses were not included in the sample analyzed here. Readers interested in DPC-specific research should consult CMT's separate coverage of that model, which is analyzed independently and not combined with the findings in this study.
7.Practical Implications
These findings suggest three concrete actions for practices marketing concierge or membership-based care. First, tag new patient inquiries by relationship orientation and insurance orientation at intake; most practices will find one or two of the four types dominate their actual local market rather than all four in even proportion. Second, differentiate messaging by type rather than relying on a single value proposition; a Coverage Keeper requires reassurance about continuity, while a Fresh-Starter requires permission to start over, and the same headline will not serve both. Third, track outcomes by type over time, which over the course of a year becomes practice-specific validation of where this model holds for a given local market.
"You can't be FOR every patient with the same headline. The practices that grow aren't the ones with the cleverest tagline. They're the ones who finally figured out which patient they're actually talking to."
Referral behavior deserves particular attention here. Independent research on lead conversion across industries has found that referral-sourced leads convert at roughly 7.2%, while inbound web inquiries convert at roughly 14.6%,5 both well ahead of cold outreach. Given that 67% of the patients in this study named trust as their primary motivation, practices with a deliberate referral system are likely converting the exact patient this research describes, not by accident, but because trust transfers efficiently from an existing patient to a prospective one.
- Mainous AG 3rd, Baker R, Love MM, Gray DP, Gill JM. Continuity of care and trust in one's physician: evidence from primary care in the United States and the United Kingdom. Family Medicine. 2001;33(1):22–27. PubMed
- Annals of Family Medicine. New studies tie long-term primary care relationships to fewer acute hospitalizations and deeper physician trust. Published December 10, 2025. PRNewswire
- De Maeseneer JM, De Prins L, Gosset C, Heyerick J. Provider continuity in family medicine: does it make a difference for total health care costs? Annals of Family Medicine. 2003;1(3):144–148, as discussed in Christakis DA. Continuity of care: process or outcome? Ann Fam Med. 2003;1(3):131–133. Annals of Family Medicine
- Tarrant C, Dixon-Woods M, Colman AM, Stokes T. Continuity and trust in primary care: a qualitative study informed by game theory. Annals of Family Medicine. 2010;8(5):440–446. Annals of Family Medicine
- Ruler Analytics. Marketing attribution and lead-source conversion benchmarks, cited in Tetreault M. Unhurried. Concierge Medicine Today, 2026.
- The four-group compass (Section 4) is based on 561 patients who answered all four rating questions used to construct it. These questions were added to the CMT survey instrument in 2018; this subset therefore reflects 2018–2024, not the full 2013–2024 archive.
- The decade-consistency check (Section 5) draws on a separate, larger respondent pool (n=1,149) spanning the complete archive, and should not be assumed to comprise the same individuals as the 561-respondent compass sample.
- The open-text theme comparison referenced in Section 5 was derived by grouping similar free-response answers by common words and phrases, not by a formal, independently validated classification scheme, and should be read as a directional, corroborating signal rather than a precise measurement.
- Figures in Section 6 are drawn from response pools of varying size, as noted parenthetically after each statistic; these pools are not identical to one another or to the 561-respondent compass sample.
- The peer-reviewed sources cited above establish an association between continuity of care and patient trust or reduced hospitalization; they were conducted independently of CMT and do not study concierge or membership medicine specifically. They are cited as corroborating context for the general importance of the patient-physician relationship, not as direct validation of this study's specific findings.
This model is built exclusively from Concierge Medicine Today's own patient-inquiry survey and has not been independently peer-reviewed. It is a self-selected sample of individuals who chose to respond after actively searching for a concierge or membership-based physician through CMT's own channels, not a probability-based or nationally representative sample of the general population. Correlational patterns described in this study are not claims of causation. This is a working, early-stage model intended to inform editorial coverage and practice marketing decisions; it is not a clinical, actuarial, legal, or financial instrument, and nothing in this study constitutes medical, legal, or financial advice. Practices should consult qualified professionals before making business decisions based on these findings, particularly regarding insurance participation, Medicare compliance, or patient-facing marketing claims. Direct Primary Care patient data was not included in this study; see Section 6 for further detail. This study, the CMT Patient Study model, and the associated psychographic type names are proprietary research developed by Concierge Medicine Today, LLC. © 2007–2026 Concierge Medicine Today, LLC. All rights reserved.