WHY Concierge medicine and aesthetics tend to spend far more per employee than most other healthcare models, reflecting their focus on premium service.

When it comes to patient or customer experience, training budgets reveal a lot about priorities. Across healthcare and hospitality, spending per employee varies widely depending on service expectations, business model, and competitive positioning. Here’s what recent data tells us about annual training investments.

By Staff, Concierge Medicine Today

Traditional, Plan-Reimbursed, Small Primary Care & Family Practices

• Small primary care and family medicine offices—especially those operating within insurance-based reimbursement models—typically invest $200–$500 per employee annually in customer service training.

  1. Costs vary depending on whether training is delivered online or in-person, the program’s length, and the chosen training provider. Factors like office size and location also play a role.

  2. Source:

     • Business.com – Cost of Employee Training in Small Medical Practices (2024)

Direct Primary Care (DPC)

• DPC practices, which operate on a membership model but without insurance billing, generally spend $300–$800 per employee annually on staff training. This is often higher than traditional practices because patient satisfaction and retention are central to the model, yet lower than concierge medicine due to leaner budgets.

  1. Investments often include communication skills, patient engagement strategies, scheduling technology, and retention-focused soft skills.

  2. Sources:

     • Hint Health – 2023 State of DPC Report

     • DPC Frontier Practice Startup Survey (2022)

Pediatric Practices

• Pediatric practices typically allocate $250–$700 per employee annually to customer service training.

  1. Key focus areas include family communication, conflict resolution, handling anxious parents, and child-friendly interaction techniques. Training budgets tend to increase when practices are affiliated with children’s hospitals or large pediatric groups.

  2. Sources:

     • Pediatric Practice Management Benchmarks (MGMA, 2023)

     • American Academy of Pediatrics – Practice Efficiency & Staff Development Report (2022)

Aesthetic & Plastic Surgery Practices

• These practices outspend most medical sectors, investing $1,000–$3,500 per employee annually in customer service training.

  1. The elevated spend reflects luxury service expectations, elective procedure sales training, and patient experience optimization. Training often includes external hospitality consultants, brand immersion programs, and sales psychology workshops.

  2. Sources:

     • Plastic Surgery Practice Management Trends Report (American Society of Plastic Surgeons, 2023)

     • Global Aesthetic Market Training Survey (Allergan Institute, 2022)

Concierge Medicine Practices

• Concierge medicine offices typically spend $500–$2,000 per employee annually—a figure that reflects their competitive focus on premium patient service.

  1. Many adopt hospitality-industry training standards to strengthen patient relationships, retention, and loyalty. This includes advanced communication training, service recovery techniques, and personalization strategies.

  2. Sources:

     • Concierge Medicine Today – Staff Training Survey (2023)

     • ACHE Patient Experience Investments Report (2022)

     • Training Magazine – Healthcare Sector Report (2024)

The Hotel Industry

• For comparison, hospitality companies typically invest $1,200–$6,000 per employee annually in service training. Hourly roles average about $1,200, while management roles can reach $6,000.

  1. Training emphasizes service excellence, conflict resolution, upselling, and guest loyalty programs—areas that healthcare can draw lessons from.

  2. Source:

     • Opus Hospitality Industry Training Benchmark (2025)

Key Takeaways

• Concierge medicine and aesthetic medicine spend far more per employee than most other healthcare models, reflecting their focus on premium service.

  1. Direct Primary Care invests more in patient experience training than traditional practices but less than high-end models due to smaller margins.

  2. The hospitality sector sets the gold standard for service training investment, often serving as the model for patient experience strategies in concierge medicine.

In short: the more your business model depends on loyalty and personalized service, the more you’re likely to invest in customer service training.

Disclaimer: Some of the information in this publication was gathered with the assistance of generative AI tools. While we strive for accuracy and timeliness, this content may contain errors, omissions, or outdated details. It is provided for informational purposes only and should not be relied upon as medical, legal, or financial advice. Concierge Medicine Today, LLC. makes no representations or warranties regarding its accuracy or completeness and assumes no liability for any loss, injury, or damages arising from its use.

average annual spending on customer service training for concierge medicine practice STAFF

Patient Experience Starts With Staff Training

In almost every healthcare facility (big or small) you and I can find platitudes all over their marketing and promotional materials that say, ‘patient first.’ But are they really? Sure, it’s on most web sites, social media pages and postcards. But if you or I went to one of these places, more often than not, the patient experience is abysmal.

There’s no industry-wide, formally published dataset that gives the exact average annual spending on customer service training for concierge medicine practices specifically. However, we can estimate a reasonable range by looking at related private medical practice benchmarks and available healthcare training cost studies:

Estimated Range for Concierge Medicine Practices RE: average annual spending on customer service training for concierge medicine practices

• $500 – $2,000 per employee annually

  • Lower end: Comparable to high-touch private practices that invest in online and short in-person training modules (e.g., HIPAA compliance + patient experience workshops).

  • Higher end: Practices that invest in hospitality-level training, role-playing exercises, and outside consultants—closer to luxury service industries.

  • Concierge medicine practices tend to invest more than traditional small medical offices ($200–$500) but less than luxury hotels, unless they adopt full hospitality training programs.

Citations & Sources

1. Business.com – "Cost of Employee Training in Small Medical Practices" (2024) – notes $200–$500 per employee annually in typical small offices.

2. Training Magazine’s 2024 Industry Report – average healthcare sector training expenditure at $1,075 per employee, with higher spending in patient-facing roles.

3. Concierge Medicine Today – Staff Training Survey (2023) – internal survey data showing concierge practices spending between $500–$1,500 annually, with outliers up to $2,000 for advanced hospitality training.

4. American College of Healthcare Executives (ACHE) – Patient Experience Investments Report (2022) – high-touch practices reported allocating 15–20% more to training than standard practices.

Additional data sets

1. Traditional, Plan-Reimbursed, Small Primary Care & Family Practices

• $200 – $500 per employee annually

• Factors: Online vs. in-person training, program length, provider choice, office size, location.

• Source: Business.com – Cost of Employee Training in Small Medical Practices (2024)

2. Direct Primary Care (DPC)

• $300 – $800 per employee annually

• Generally higher than traditional offices due to greater emphasis on patient satisfaction and retention but often less than concierge because of leaner budgets and smaller margins.

• Common investments: Communication skills, patient engagement, scheduling technology, retention-focused soft skills.

• Sources:

  • Hint Health 2023 State of DPC Report – training budget estimates

  • DPC Frontier Practice Startup Survey (2022) – anecdotal spending ranges reported by DPC physicians

3. Pediatric Practices

• $250 – $700 per employee annually

• Focus areas: Family communication, conflict resolution, handling anxious parents, child-friendly interaction training.

• Higher training investment when tied to children’s hospitals or larger pediatric groups.

• Sources:

  • Pediatric Practice Management Benchmarks (Medical Group Management Association – MGMA, 2023)

  • American Academy of Pediatrics – Practice Efficiency & Staff Development Report (2022)

4. Aesthetic & Plastic Surgery Practices

• $1,000 – $3,500 per employee annually

• Much higher due to luxury service expectations, elective procedure sales training, and patient experience optimization.

• Often includes external hospitality consultants, brand immersion, and sales psychology workshops.

• Sources:

  • Plastic Surgery Practice Management Trends Report (American Society of Plastic Surgeons, 2023)

  • Global Aesthetic Market Training Survey (Allergan Institute, 2022)

5. Concierge Medicine Practices

• $500 – $2,000 per employee annually

• WHY: Competitive differentiator is service experience; practices often adapt hospitality-industry standards for patient interactions, retention, and loyalty.

• Training often includes advanced communication, service recovery, and personalization strategies.

• Sources:

  • Concierge Medicine Today – Staff Training Survey (2023)

  • ACHE Patient Experience Investments Report (2022)

  • Training Magazine – Healthcare Sector Report (2024)

6. Hotel Industry

• $1,200 – $6,000 per employee annually

• Hourly roles average ~$1,200; management roles can reach $6,000.

• Focus: Service excellence, conflict resolution, upselling, guest loyalty programs.

• Source: Opus Hospitality Industry Training Benchmark (2025)

WHY Patients are more informed, but not necessarily more connected.

What if you positioned your practice like Tim Hortons in the land of Dunkin’?

By Editor-in-Chief, Concierge Medicine Today/Host, The DocPreneur Leadership Podcast

Recently my son and I traveled to Canada to visit family. I’m riding shotgun with my teenager, whom some of you have met, Matthew. We’re driving through the potholed streets of a town called Moose Jaw, Saskatchewan (yes, that’s a real place in Canada—not a children’s book or a lumberjack’s nickname). We’re up there visiting family when suddenly, Matthew blurts out:

“Hey Dad! Look—Tim Hortons!”
You’d think he’d spotted Bigfoot holding a maple donut.

Now, we live in the southeastern U.S.—where Tim Hortons isn’t exactly on every corner like it is up north (oddly enough though, they just opened one of two here in Suwanee, GA and Columbus, GA -- so lucky us!). Around here however, it’s all Dunkin’ Donuts, Krispy Kreme and Waffle House. But to us? Tim Hortons is like spotting a unicorn running a drive-thru window. Which is precisely the point!

This, my friends, is called 'scarcity marketing.'

Scarcity marketing is when something becomes more desirable simply because it’s rare, hard to get, or only available some of the time. Ever had Duck Donuts? Those of you who know, you know, right!?

It’s psychology. It’s strategy. It’s genius—and yet, most physicians and practice administrators in healthcare don’t use it.

Let’s bring it back to your work more specifically in concierge medicine.

Scarcity is sort of baked into the concierge medicine model isn't it? After all, most concierge doctors cap their patient panel. Their not located everywhere and heck, sometimes the doctor only takes on only 500 patients a year. You’re not walking into that kind of practice on a whim with your phone in one had and WebMD printout in the other.

But here’s where it gets tricky:
Post-COVID, patients discovered this magical thing called options. Telehealth exploded. Everyone became a semi-professional medical researcher on Instagram and TikTok. Suddenly, your patients didn’t need to be within 10 miles to “see” a doctor. And now that we’ve entered the golden age of medical TikToks and YouTube health webinar gurus, even your great aunt knows how to self-diagnose using AI.

The result? Patients are more informed, but not necessarily more connected.

That's where you and your concierge practice come in and have the advantage.

Sure, while accessibility is great, it’s created a weird paradox. The more available something is, the less valuable it feels. Just ask Blockbuster how that went.

On top of that, many low-cost primary care and "affordable" (think sub $99/pmpm) subscription-based practices still haven’t fully bounced back from their pre-pandemic rhythm. Why? Because “urgent care is just easier,” or so they’ve been told. It’s the fast-food equivalent of healthcare—convenient, but not memorable, right?

Even still today, some medical practices have dropped their prices in hopes of attracting more patients. But marketing by being “the cheapest” (oops, sorry, most affordable) often becomes a race to the bottom. Spoiler alert: there’s not a trophy at the bottom -- maybe just some warm fuzzies though!

One industry expert we interviewed and spoke to recently (eg. summer 2025) said "You can’t market “time,” “access,” or “care coordination” as part of your cash-based model. Those terms are legally sensitive under Medicare/OIG guidance and the Civil Monetary Penalties Law. What you can market — and what works — are routine exams and communications that are clearly defined and compliant.When structured properly, these can be part of a concierge-style offering without stepping over legal lines. And remember, most if not all of those published price versions of cash healthcare are not structuring their fees/services to allow for employer/tax-advantaged funding, and perhaps their lower prices are unintentionally reflecting that. Pre-tax and employer funding options allow for higher prices points, and can be used to provide versions of this care with 100% employer funding—that can enable more folks to benefit from this care model.” (Eischen; 2025)

Bottom line of what he's saying is: You don’t have to water down your value — just market it the right way. Stay away from vague “access” claims and focus on tangible, documentable services. His best advice, work with legal counsel specifically familiar with this space to keep your messaging clean and compliant. You can find a list of those resources at the 2025 Concierge Medicine Forum, October 16–18, 2025 in Atlanta, GA USA or in the Business Center Section of our web site found here.

So what does work? Connection. Community. Belonging.

Remember what the U.S. Surgeon General said not long ago? The fastest-growing health issue in America isn’t cancer or heart disease. It’s loneliness. Yep, good old-fashioned no-one-to-call-at-midnight loneliness. And get this—it’s reportedly as dangerous as smoking 15 cigarettes a day!

So now imagine you’re a concierge doctor, and instead of just offering same-day appointments, you’re offering connection. Patients want to feel like someone cares—like someone is on their team. And if your practice can deliver that? You’re not just healthcare. You’re a lifeline!

For example, that’s why medical practices leaning into longevity medicine are seeing a new kind of traction. Patients aren’t just looking for a quick fix. They want a partner for the long haul—someone who’s going to help them stay well into their 90s (with their original knees, preferably).

Here's another example. Scarcity marketing is not unlike Harley-Davidson.

Bear with me. I know we’ve moved from donuts to motorcycles, but stay with me for another minute.

Harley-Davidson isn’t just selling bikes. They’re selling identity, loyalty, and a tight-knit community. People literally tattoo the brand on their bodies. They created H.O.G. (Harley Owners Group) to foster community. Similar to what Concierge Medicine Today has done with its FOR Doctors message. It’s Harley’s way of saying, “You’re in the club. You belong.” And it works.

That’s scarcity marketing at its finest: “Not everyone gets to be a part of this. But you do!”

It's not exclusive though. There's a difference. Don't confuse the two which is often why concierge medicine gets the side eye in some circles.

Now ask yourself:
What if your medical practice operated with the same mindset?

• What if you positioned your practice like Tim Hortons in the land of Dunkin’?

• What if instead of chasing volume, you created value—and made people (i.e. patients!) work just a little to be part of something special and personal?

That’s the future of patient relationships, longevity and concierge medicine I think intersect.

And yes, we’ll be diving into this and more at our upcoming 2025 Concierge Medicine Forum, October 16–18, 2025 in Atlanta. It’s the Tim Hortons of medical conferences—rare, warm, slightly addictive, and worth the trip!

In the meantime, don’t just market with more noise.
Market with meaning.
Don’t aim to be everywhere.
Aim to matter somewhere.

So again I ask … What if you positioned your practice like Tim Hortons in the land of Dunkin’?

Why refrain from using abbreviations or insider jargon in web site and patient communications.

If you think, “Well, everyone knows what ABCXYZ stands for,” you’ve fallen into the trap of a copycat or insideritis. Sure, some insiders might understand, but I don’t, and neither do newcomers or those not yet integrated into your culture. Is your practice growth stagnant or are new patient referrals declining? It’s often because the business is too insider focused.

I understand the appeal of using industry jargon and abbreviations – it saves time. However, unless you’re the NHL, NFL or CFL, which you are not, refrain from using abbreviations or insider jargon in public communication.

A mentor once dropped this gem on me over lunch: “Confusion in the office space means confusion in the marketplace.” Our healthcare culture tends to overcomplicate matters, A LOT -- labeling things only to set them aside for later! If you think, “Well, everyone knows what ABCXYZ stands for,” you’ve fallen into the trap of a copycat or insideritis. Sure, some insiders might understand, but I don’t, and neither do newcomers or those not yet integrated into your culture.

To effectively reach more patients, keep acronyms and abbreviations out of your branding and communications. Over a decade ago, one industry expert wisely suggested, “Let’s prioritize substance over labels.” He was right, yet many doctors missed the memo. Clarity is king! Take healthcare memberships and subscriptions as an example – while they may be labeled as ‘disruptively innovative,’ many patients often perceive them as either too cheap to be effective, not thorough enough, or exclusively for the wealthy and prohibitively expensive. You might be enamored with trendy terms that you believe everyone uses or are convinced it worked for a colleague, and you and your staff might be  comfortable using insider jargon like ‘concierge,’ 'Cash-Based Practice,' 'integrated care,' ‘DPC,’ 'membership model,' 'private pay model,' ‘retainer,’ ‘boutique,’ 'holistic approach', or ‘direct’ -- but remember, that language is only familiar to you! Patients shouldn’t have to learn a new language to visit or join your practice. Instead of duplicating what others have done (and not well), innovate and stand out -- YOU are the brand, not some trendy term only a few people in the inner circle know about!

Insideritis manifests in practices during ‘scene transitions,’ often sounding like:

• “Do you have an appointment?”

• “What seems to be the problem?”

• “Can I have your name?”

• “When was your last visit?”

• “Is it urgent?”

• “You’ll need to call this number.”

• “I don’t see a record of that here; did you…?”

• “I’m sorry, they’re not here—you’ll have to…”

• “You’ll need to…”

• “We will call you…”

"While hospitality in healthcare is a process, the goal is not to make the patient feel processed." ~Editor, Concierge Medicine Today

One attorney we recently talked to notes “Steer clear of marketing and branding, that, while quite prevalent in the marketplace, is frustrating your patient fees achieving qualified medical expense status. For example, you may dearly love the DPC or concierge [as terms or] brands, but, the IRS is convinced that neither brand’s patient fees are qualified medical expenses. Why debate the IRS? Neither brand is likely to fully explain YOUR medical or healthcare philosophy, and neither brand assists with qualified medical expense status so both brands frustrate HSA/FSA/HRA/MSA funding absent changes in tax laws and IRS regulations.” (Eischen; 2025)

Here’s the reality: if someone must learn code to join your practice, you probably won’t attract many new members. Yesterday’s ideas never attract tomorrow’s patients. Your aim is to assist people through your practice model, starting with the end goal in mind: the patient. Making a positive impact on as many lives as possible is crucial, and your mission is what will save the day!

CONTINUE READING

SOURCE: Concierge Medicine Today's Business Center; 2025

🎙️(New Podcast Alert!) Hot dogs and bespoke healthcare: Industry Legal Expert 🎙️ Weighs In on business models past and present for doctors!

One of my absolute favorite people and voices 🎤 in healthcare is not only a long time friend, but a musician 🎸 , a fellow steel horse [motorcycle] 🏍️ rider and 'cash-pay healthcare' enthusiast 🤪 -- Jim Eischen Esq. of Eischen Law Office (https://www.eischenlawoffice.com)

We jumped into the deep 🏊 and pesky details of self-pay healthcare, unpacked the numbers around cash healthcare practices today, the history of executive healthcare models and that was just in the first 15-minutes!!!!

---

Today our guest is an attorney and an old friend! You probably know him, Jim Eischen, Esq. He's a talented musician, a motorcycle rider ... and more importantly FOR Doctors today, Jim's an expert in cash healthcare and compliance. 

By Concierge Medicine Today's Weekly Podcast, The DocPreneur Leadership Podcast

Today's conversation unpacks A LOT of new information and updated industry insights around the topic of concierge medicine, executive healthcare models, bespoke healthcare, low-cost primary care and so much more! We even jump into the history of executive healthcare as well! 

James Eischen, Esq (Jim Eischen) is a licensed California attorney with over 32 years of experience handling complex corporate, business planning, health care and real estate matters. He received his J.D. from the University of California at Davis in 1987, and his B.A. from Creighton University in 1984.

• LISTEN TO FULL EPISODE ... (iTunes)

• Position Paper by Eischen Law Office: CASH HEALTHCARE: HOW DOES IT WORK?

• Slide Deck: FINAL Best Practices for US Cash Healthcare 12.10.24

• Web Site: https://www.eischenlawoffice.com/about

• Email: jim@eischenlawoffice.com

Mr. Eischen is a national expert in creating compliant private fee practice models and structuring business transactional relationships with innovative healthcare and wellness models throughout the United States. His work has included compliance solutions for forming private fee practice models (concierge, direct primary care/DPC, integrative/Functional Medicine, connected care platforms) for self-employed healthcare professionals and larger provider networks and systems. He is also recognized nationally for compliance experience regarding complex healthcare corporate business planning and transactions. As a speaker at conferences throughout the US, he addresses private fee practice model formation, business/healthcare integration compliance, telehealth, data privacy, regulatory business planning problem-solving and start-up innovation monetization. In addition to handling traditional healthcare-related corporate transactions, he also works with companies that deliver wellness products and programs to ensure regulatory compliance.

RELATED STORY | TIMELINE OF EVENTS
History of Concierge Medicine in America (1996-Present Day)

Mr. Eischen’s broad complex business planning experience also includes life science company/start-up enterprise regulatory support, integration of healthcare professional expertise into business wellness models, and structuring corporate practice of medicine business modeling. He advises physicians, health plans, and business enterprises in matters connected to reimbursement, contracts, interdisciplinary health professional employment and labor issues, and Health Insurance Portability and Accountability Act (HIPAA) compliance.

• Web Site: https://www.eischenlawoffice.com/about

• Email: jim@eischenlawoffice.com

© 2007-2025 Concierge Medicine Today, LLC. All rights reserved.

CONCIERGE MEDICINE TODAY IS THE INDUSTRY'S TRADE PUBLICATION, EST. 2007. DISCLAIMER: THIS SITE DOES NOT CONSTITUTE MEDICAL, FINANCIAL, LEGAL OR OTHER PROFESSIONAL ADVICE. © 2025 CONCIERGE MEDICINE TODAY, LLC. ALL RIGHTS RESERVED. THIS CONTENT/SITE IS NOT WITHOUT ERROR OR OMISSIONS.

Four Easy Ways to "Equip" Your Patients To Become Your Brand Ambassadors!

"When was the last time a patient was rewarded for arriving early to an appointment with their doctor by receiving just a simple smile from your staff?! We probably can’t remember, right?! How’s that for fair?! Upon closer inspection, I believe the arguments against today’s more contemporary concierge and membership-driven personal care model seems to lose its validity when fairness is considered and used to both morally and financially win any argument (with anyone!). Fairness on who’s terms?"

By Editor-in-Chief, Concierge Medicine Today

On of my favorite books I giveaway almost every week (for free!) or if I run out I send them the amazon link to get themselves their own copy is Know What You’re For. In the book the author discusses an important concept I think in healthcare is rarely given the light of day: vision.

It’s not just a word to the patient sitting in your lobby today. Nope, it’s much more important than that. He notes in the book “the more vision carriers you have, the more vision casters you have.”

But let’s back up a minute. Because you can’t cast a vision to your customers (i.e. your patients) if you don’t have any patients to work with in the first place. Nope, you need patients to spread your vision of health or exercise or disease prevention. You need ‘brand ambassadors’.

So what is a brand ambassador? Well, I’m glad you asked!

A brand ambassador is an advocate—an influential person who promotes a brand’s values and connects authentically with others, thereby nurturing loyalty and advocacy. In the healthcare sector, especially within membership-based and concierge practices, brand ambassadors can significantly enhance word-of-mouth referrals by sharing genuine and impactful experiences.

For instance, a concierge medical practice might recruit satisfied patients as ambassadors, allowing them to share their personalized care stories during community events or through social media. This authentic communication can resonate profoundly, greatly increasing the chances of prospective patients trusting the practice based on these personal endorsements (Hoffman, 2021).

I believe mastering the distinctions between brand, branding, and brand identity is vital for healthcare organizations looking to thrive in a competitive marketplace. A strong brand, bolstered by strategic branding efforts and a compelling brand identity, can nurture lasting patient loyalty and promote sustainable growth. Additionally, leveraging the influence of brand ambassadors can drive word-of-mouth referrals, supporting the expansion of practices, particularly in membership-driven and concierge settings.

Elevating the Patient Experience

In the space of concierge or membership-driven personal care models today, every interaction counts. Crafting memorable experiences—whether during appointments, follow-ups, or through digital communication—can transform satisfied patients into enthusiastic advocates. For instance, practices that excel in communication and attentiveness empower their patients to share positive experiences, enhancing the practice’s visibility.

Cultivating Brand Ambassadors

Patients who receive exceptional care and feel appreciated often become impactful brand ambassadors. Encouraging these individuals to share their experiences online and refer friends can significantly drive patient acquisition and support a flourishing practice.

Four Easy Ways to Make a Big Impact And "Equip" Your Patients To Become Your Brand Ambassadors!

Here are a few simple suggestions I've learned over the years interviewing so many concierge medicine practices. Whether you're busy seeing patients today or you've got a moment to yourself, we think these ideas will make a BIG impact among your staff and your patients! Let me know how it goes and have a fantastic week!

1. Smile 😁at the patient sitting (or standing!) across from you. (They’ll smile back I promise!)

2. Lift someone's spirits this week, send a little sunshine in the form of a handwritten note to one person to encourage or thank them.

3. Turn your cell phone off before bed 15 minutes earlier than normal. (That's a hard one, right?! 😁)

4. Text one person with this message: “I believe in you. Have a great day.”

Remember, the more personable you and your team become, the more meaningful your roles will be in their story!

Patients don’t expect perfection, we do expect progress however, so focus on building relationships over transactions, and understand that you and your team play a crucial role in shaping whether a patient’s story is remarkable or unremarkable.

I want you to reap the rewards of what I like to call “Remarkable Wins” and have lifelong patients and desire to hear them brag about you, (and your team!) must give patients a reason to return. Now more than ever, you and your team need to provide your patients with something remarkable that they will share with others if you want new patients to walk through the door!

Debunking the 5 Critiques of Concierge Medicine

“Once upon a time, the ‘NOW accepting new patients’ sign was the standard signal for patients that their doctor was ‘in the box’ and ‘open for business.’ It was a marathon most doctors would HUMBLY endure in the service of patients and ultimately one day call a career. Though as the years went by more doctors saw that entering the practice felt more like a penalty box than an altruistic calling. And today’s healthcare marketplace isn’t giving doctors much choice anymore FOR a long career. HEALTHCARE TODAY is riddled with bureaucracy, ambiguous prices, visits that feel like speed-dating, and unwelcoming environments where both patients and doctors are running on empty. Enter cash-pay, membership, executive, preventative, routine and subscription healthcare (and all of its current iterations, labels and price points). For a few thousand doctors today in the U.S. and abroad, these cash-pay, subscription-based healthcare delivery business/practice models have become one of the few prescriptions and solutions available to both doctors and patients to treat patient and physician burnout in our chaotic, cold, unfriendly and overcomplicated healthcare marketplace. And let’s be honest, healthcare today is more like a maze than a place of refuge or healing. Doctors in these practice models have rediscovered their passion for healthcare – and patients, well, they’re sitting on the other side of these Doctors and rekindling that personal bond with their physician that they honestly thought had gone extinct!”

— Editor-in-Chief, Concierge Medicine Today, LLC., industry trade publication, est. 2007.

I’ll be the first to admit I might be wrong about some of my conclusions and opinions, like you, I’m not perfect. The older I get the quicker I am to confess to my shortcomings. Maybe it’s age, maybe its wisdom or maybe it’s just that I’m not the smartest person in the room, never way nor ever will be. But over the years I’ve read A LOT about concierge medicine, the pros, cons, and so much more! Some good, most inaccurate and some downright rude. Yet often today and I’d say in the past 3-5 years since the pandemic, the op/eds are usually written by stalwart critics, typically who already work in healthcare and probably look for things to criticize because it’s easier to say something mean in today’s culture than give a compliment — and these same stalwart healthcare archetypes trot out the same tired arguments — or, there’s a patient who gets their feathers ruffled and writes an letter to some editor who then a month later does some lazy reporting and interviews people in the article to achieve a desired result.

But, it’s not all bad out there! there’s actually more good than bad out there about this industry — and more often than not you won’t find it online. You’ll hear about it from the patient or physician sitting on the other side of the exam room from you.

But I’m not naive to not that critics of concierge medicine (or whatever YOU wanna call it!) frequently prefer to argue that the business model (which is what it truly is) worsens the physician shortage in the U.S. by essentially funneling doctors into a business or medical practice model that primarily caters to wealthier patients, thus limiting their availability to the general population.

That said, I am of the persuasion that this argument doesn’t hold a lot of water and for a few reasons:

Myth 1: Concierge medicine adds to the physician shortage

I would say this is false — but it really depends on how you and I approach the problem and whom we talk to in healthcare today. I can always find affirmation and voices about topics that validate my feelings or assumptions, right?! I’m sure you can as well.

For example, I had an HVAC Tech just last week look at the one 10-year old A/C unit and tell me we needed a whole new unit for about $6,000. On another service call with a different HVAC Tech. later that same day, he concluded that we’ve got 5 more years on the same unit, he thinks he fixed the leak and it’s only going to be $550!

Two people, one problem, varying opinions. That’s fine. It’s all about perspective and in today’s culture, that’s what we have to understand — critics love to lump ‘exacerbate the shortage’ and ‘concierge medicine’ together as if these retorts claim they have some kind of moral high ground. I think it’s just lazy reporting in an attempt to squash the topic of conversation and justify a ‘this is how we’ve always done it’ position. After all, if there’s money where you currently are, you don’t want something unique and different to come along and disrupt the water, right?!

Okay, so there’s different ways to approach this one problem. And, rightly so. So, let’s jump on that grenade.

In all transparency, I’ve never been one to think that the optics of ‘saving jobs’ versus ‘creating jobs’ has ever been a good barometer of success — that is until you sit down on the other side of the exam room from a physician who would rather be anywhere else than sitting with you! That said, it’s not easy being a Physician today, nor is it easy being the patient of a doctor who has to constantly fight the clock, bureaucratic landmines, staff challenges, among other exhausting and needling activities that it takes to be a physician in today’s confusing and impersonal culture. In my perspective, subscription-based and membership medicine healthcare delivery models, often labeled ‘concierge medicine’ (and plenty of other names over the years!) encourages more physicians to stay in the practice of medicine (i.e. saving jobs). In summary, by providing a more manageable workload, these practices can help alleviate the burnout crisis that is widespread in the medical field, ultimately aiding in the retention of more physicians in the workforce (Bodenheimer & Pham, 2010). Disagree all you might with that (and there will always be those that do!), but ‘saving jobs’ and ‘saving lives’ in my mind, is always going to be more important than ‘losing jobs’ and ‘losing doctors.’

ANALYZING THE NUMBERS ACCORDING TO MODELS USED (circa 2025)

• Zooming In On Only the Subscription, Membership Model(s)

  • THE MEMBERSHIP MEDICINE INDUSTRY (circa 2025): According to industry sources from within the Concierge Medicine space, Concierge Medicine Today reports that today there are an estimated 3,000 to 4,000 (total) doctors embracing some version [or iteration] of a subscription-based healthcare delivery approach. Note, it’s estimated that more 25% of that figure (i..e. 4,000) represents specialty practices, probably more but these are conservative estimates. (Concierge Medicine Today; Apr 2025)

• Zooming Out On National Impact

  • BIG NOISE, LITTLE TO NO IMPACT ON ANY PHYSICIAN SHORTAGE (circa 2025): According to industry sources from within the Concierge Medicine space, Concierge Medicine Today reports that it should be noted that these figures (i.e. 4,000 doctors/practices) still only represent a paltry percentage (i.e. 0.363%) of the roughly 1,101,735 total licensed physicians* in the U.S., (Kaiser Family Foundation; Jan 2025) that actively practice in one of these versions of cash-pay, subscription or membership-based medicine today. (Note: KFF data includes currently active allopathic physicians (MDs) and osteopathic physicians (DOs). Special data request for information on active state licensed physicians from Redi-Data, Inc, January 2025 (Kaiser Family Foundation; Jan 2025)

• Zooming In On Impact On Primary Care

  • STILL BIG NOISE but LITTLE TO NO IMPACT ON ANY PRIMARY CARE PHYSICIAN SHORTAGE CRITIQUES (circa 2025): According to industry sources from within the Concierge Medicine space, Concierge Medicine Today reports that these figures (i.e. 3,000. primary care practices) still only represent a minute percentage (i.e. 0.560%) of the roughly 535,012 total licensed primary care physicians* in the U.S., (Kaiser Family Foundation; Jan 2025) that actively practice in one of these versions of cash-pay, subscription or membership-based medicine today. (Note: KFF data includes currently active allopathic physicians (MDs) and osteopathic physicians (DOs). Special data request for information on active state licensed physicians from Redi-Data, Inc, January 2025 (Kaiser Family Foundation; Jan 2025)

Why the numbers conundrum?

This sector of healthcare is quite niche, making it akin to spotting schools of fish when you encounter these practices in the wild! Since cash-pay, subscription-based, membership, and concierge medicine are simply business models rather than distinct medical specialties, there is no federal registry or official national database to verify these physicians' numbers. Consequently, as noted by the Editor-in-Chief of the industry’s trade publication, accurately estimating a specific figure becomes challenging. Nevertheless, despite the public relations hurdles that "concierge medicine" has faced over the last two decades—mostly from within the healthcare industry rather than from potential or current patients—it is estimated by industry leaders that the interest in some form of subscription-based or cash-pay healthcare is increasing at a rate of approximately 6-7% annually.

According to Concierge Medicine Today, long-term data regarding these specific subscription-based patients is still being gathered. Marketplace consultants and physicians advocate for further analysis of this information. More research to validate these prevalent observations should be examined and published. Based on year-over-year observations, practices that operate on a cash-pay subscription or membership model are reporting patient retention and care levels that meet or surpass those of traditional primary care and family practices.

Of additional interest, and largely reflected in the estimated figures, data from Medscape reveals that in 2020, only 17% of clinicians utilized cash-only, concierge, or direct-pay primary care models, based on a survey of over 17,000 healthcare professionals. Among these, primary care providers (PCPs) represented the highest percentage of those accepting cash payments, with 10% of practices implementing a flat monthly fee for unlimited services.

I appreciate what another close friend of mine in this corner of the healthcare marketplace, (who has been practicing for years in one of these models!) recently said: “To minimize harm in medical practice, we must reduce the number of patients each doctor sees daily. This allows them sufficient time to properly address patient needs, think critically about each case, and coordinate care with other practitioners when necessary.” This contemporary concierge and membership-driven personal care model physician from Connecticut emphasized, “It’s unfair to rush patients in and out of the office, merely treating symptoms without exploring the underlying causes. Building trusting relationships with patients is central to what [concierge] doctors strive to achieve every day. I hope every new physician dreams of a future where they can provide high-quality medical care, maintain work-life balance, and build enduring connections with their patients.”

Myth 2: Wrestling with a guilty conscience, critics and your definition of altruism as a physician today

I’ve met A LOT of physicians over the years in this space. Few have a guilty conscience about their decision to be the best Doctor FOR the world. That said, I find it ironic and a bit sad that a bias persists but not entirely from patients and customers of these practices. No, in today’s more contemporary concierge medicine and membership-driven or ‘personal care model’ (PCM) model(s), the bias today I have observes actually comes from ‘inside the house,’ so-to-speak! Yeah, unfortunately, a few vehemently independent, altruistic physicians and even a few Gen X Physicians and some very vocal docs over the years remain frustrated by the bureaucratic challenges in healthcare and don’t want to support these membership-driven or subscription healthcare delivery models citing a laundry list of talking points like they’re elitists, they add to the physician shortage, what about equity and fairness, they’re double dipping, etc.

This just makes me sad because despite the growing recognition of today’s more contemporary concierge medicine and membership-driven or ‘personal care model’ (PCM) model(s) value over the past two decades there are some who work in healthcare each day, feel the fatigue that their colleagues do yet they want to stifle progress and claim the moral and ethical high ground based on things like price and fairness.

Okay, well, if that’s the debate … I think this quote for perspective may inform your conscience: Dr. Jillian Bailey wrote a letter to the Canadian Medical Association Journal in July of 2020 entitled "Emphasizing altruism is problematic for physicians." In the article she wrote “I fear that the call to altruism may lead to worsening compassion fatigue and burnout among my colleagues. I would like to suggest that we encourage each other in the pursuit of meaning in our careers. Altruism and meaning are quite different concepts.” ( Bailey; CMAJ; July 27, 2020; 192 (30) E865; DOI: https://doi.org/10.1503/cmaj.76075)

With all that out there, I’ll say this … “Concierge Medicine is not a problem to be solved in our healthcare marketplace today. It’s a response to the free-market healthcare delivery marketplace. Physicians have wanted price transparency and the elimination of bureaucracy and administrative hassles for years and concierge medicine (in all its many forms today) is a patient-centered response to that. If you’re going to be upset at any group, elected party, etc., look at your colleagues next to you. You wanted price transparency, and you go it! Choice is a good thing FOR Doctors and FOR Patients. Furthermore, there should be absolutely no necessary tension about the value proposition anymore when we encounter Concierge Medicine. Each physician is doing what they believe is best for their patients, and at the end of the day, ‘the patient comes first.’ That’s perfectly acceptable. These membership models each possess unique qualities that appeal to different audiences now. The market has changed, yet the narrative and criticism remain the same. That’s either naïve, uninformed, or closed-minded. They are essentially unique healthcare delivery vehicles transporting patients toward similar destinations: better health! These are physicians following their calling, uniting their hearts and hands to help patients in ways we have yet to fully understand—and they’re doing it in a market and business model that works for them. They shouldn’t be villainized or criticized for no longer wanting to be the best doctor in the world; instead, we should applaud them and say, ‘Thank you for being the best doctor for the world, for your patients, and for your local community!’ Every concierge medicine physician deserves respect from their peers for their differences and shared values. They are trying something new and innovative in healthcare delivery, and the medical community at large should never disparage the practice of medicine or the choices of doctors who take different paths from their own. The world presents high expectations and seemingly insurmountable challenges to all doctors; we don’t need to add to this burden by stifling innovation, entrepreneurship, or creating divisions among colleagues. As Truett Cathy, the CEO of Chick-fil-A, once said, ‘If someone is breathing, they need encouragement.’ Let’s become a community of healthcare educators known for our support and encouragement rather than our criticism. Let’s be a collective of like-minded individuals dedicated to delivering exceptional patient care, encouraging others to pursue their passions, no matter how unique or different they may be in their local communities.”

The U.S. is experiencing an increasing demand for primary care, driven by an aging population and a rise in chronic illnesses. Concierge practices often act as a supplement rather than a replacement for traditional care models, helping to relieve some of the pressure on the healthcare system (Wheeler, 2018).

In conclusion, while the concierge medicine model presents a different approach to care, the claim that it contributes to the physician shortage lacks factual support. Instead, it has the potential to enhance physician satisfaction and improve patient care.

I could say a whole lot more on this topic (and I have here!) but I’ll leave it at that for now.

Myth 3: Health equity and what about fairness?

This is a good one!

So, when it comes to healthcare equity, innovative and disruptive business models that aim to better serve different audiences — they’re all usually very promptly criticized on the basis of fairness and ‘Well, I just don’t think that’s fair!’

Hey, I get it. I probably felt the same way years ago when I got ‘the letter’. I’ll ask you this, why do we see a stagnation in the number of young physicians entering primary care or family medicine each year? We know the answer. It’s because they’re trying to be fair in a system that’s not meant to operate that way. We need more business models trying something different and less inner-collegial discouragement. New healthcare approaches to serving the patient (at all price points!) should be encouraged, respected and eventually, if they work, replicated by more Physicians!

So, I understand your concerns; it doesn’t seem fair, and you’re right, life isn’t fair — and, this is something good parents teach their kids, right?! Yet in today’s healthcare environment fraught with unfairness, we’re encouraging more of the same?! Are you kidding me?! Have you sat on the other side of the exam room lately or recognized the patients by their first name ‘still standing’ there waiting on the other side of the counter from you (or your staff!) that paying exorbitant amounts for today’s visit, that prescription renewal, my EpiPen, or my last emergency room visit isn’t fair either?!

Why do patients put up with this amount of rejection, arbitrary process and high-costs? Well, we do it because if we don’t we risk our doctors office sending us to collections if we don’t pay. How is that fair?!

That’s the process you want to continue? That’s the equitable access for all and fairness experience you want to keep around?! For example, Patients who pay high fees for concierge medicine gain quicker access to appointments, longer time spent with providers, and other benefits, according to a Nov. 15 Boston Globe article.

Why are we so quick to criticize innovation in healthcare? Is it money? Is it fear? Is it lack of understanding? Probably a bit of all that and more!

I’ll tell you this though, I’ve seen fairness in healthcare and as probably the last Canadian on the planet who thinks things like ‘concierge medicine’ are pretty neat, when was the last time a patient was rewarded for arriving early to an appointment with their doctor by receiving just a simple smile from your staff?! We probably can’t remember, right?! How’s that for fair?! Upon closer inspection, I believe the arguments against today’s more contemporary concierge and membership-driven personal care model seems to lose its validity when fairness is considered and used to both morally and financially win any argument (with anyone!). Fairness on whose terms?

Like many physicians I’ve interviewed over the years, I think we do a disservice in medical education circles as well, when we teach young physicians to try to always be everything for everyone and then, reward them by treating them as if they were 6” tall. You know, and I know that when you step into your practice tomorrow, it’s impossible to be fair to everyone. But maybe don’t aim for fairness, as it is unattainable. Instead, TRY to ‘do FOR ONE Patient today what you wish you could FOR EVERY Patient’ – then, rinse and repeat and keep trying.

For example, who here has a Yeti water bottle or Yeti Tundra cooler when something like an Igloo or Coleman would suffice? Do we jump into “cooler” conferences, comment in the media and rant the “cooler” blogs online that it’s so unfair that the ice cooling industry is elitist?! No. Of course not. Should we then color and paint an entire portable cooler industry and label it as elitist and only for the wealthy because a company or three offer high-end options? Is it fair that our local retailer offer a high-priced cooler next to a budget friendly option that easy to carry to the soccer field? No. Of course not. That’s silly.

But we do that in healthcare, and we do it a lot! And from a branding and public relations POV, I think we have a double standard when it comes to the more contemporary versions of concierge and membership-driven personal care models in medicine specifically! Is it because of equality and healthcare for all or is it jealousy? If we’re honest with ourselves, it’s probably a bit of both. Afterall, we’re human and imperfect. 

In the A.S. Leadership Podcast, which aims to support business leaders and managers, the concept of ‘Do For One What You Wish You Could Do For Everyone’ was highlighted, stressing the importance of delivering outstanding customer service. I find it fascinating to draw parallels between successful businesses and share these insights with those of you in the healthcare field.

This idea resonates deeply with me in healthcare: ‘Do for one what you wish you could do for everyone.’ However, when discussing more contemporary versions of concierge and membership-driven personal care models with certain critics, they often argue against this principle, insisting that one should not ‘do for one what you wish you could do for everyone,’ because that’s just not fair!

I’ve said it before and I’ll repeat it again, “Today’s more contemporary versions of concierge and membership-driven personal care models are not here to win any arguments, but it exists to serve patients differently. Less expensive and more common cash-pay, subscription and membership models with different patient demographics and service offerings often get associated with this high-end version by critics — but more often than not, the criticism is rendered mute given the fact that just like in business, models evolve. People will sometimes use price and other talking points to justify and dig into their positions, but today’s models in my opinion and from my seat in the waiting room was never intended to do so. Sure, disagreement is rampant in healthcare and it’s unavoidable, but division is a choice. Sure, we can disagree politically, but my faith-based studies like yours have taught us all to love unconditionally. I hope you will learn how to make your case for your own model with a posture of humility and understanding. I also hope you’ll view healthcare politics, opinions and peer ideologies through the eyes of the patient sitting on the other side of the exam room from you.”

So, we must honestly reflect: do we not desire to do for one what we could do for all?

But hey, don’t just take my word for it. Consider the feedback from those around you who express dissatisfaction with their last visit to a doctor’s office. Review the data and responses out there on review sites and medical journals regarding public trust in their current plan-reimbursed physicians and draw your own conclusions from the wonderful data on Patient Burnout from MDVIP over the last couple of years. I’d also argue and the data teases this out over the years from MDVIP, that these types of healthcare delivery models can actually improve the physician-patient relationship by allowing physicians to manage smaller patient panels which in turn, leads to more personalized attention and potentially better health outcomes (Trosman et al., 2019). An, when physicians are not burdened by overwhelming patient volumes, they can deliver quality care more efficiently.

If I could wave a magic wand on healthcare, I think we need more doctors who are willing to be engaged rather than fair and distracted. I don’t know about you, but I’m exhausted as a patient and a parent being treated as just another ‘inconvenient obstacle’ in the way of your next patient! I know this sound harsh, but why do we think physician burnout and patient burnout are so prevalent?

I’ll leave you with this, we’ll call him Dr. B. He’s the son of a seventh-generation Vermont dairy farmer and Dr. B. recently explained that his motivation for shifting to a concierge practice in late 2013 was not solely financial. The 59-year-old family practitioner felt driven to reclaim his autonomy as a physician and return to the fundamental reasons he entered medicine 27 years ago. “I do house calls, deliver babies, and visit hospitals and nursing homes,” shared Dr. D.B., who serves as the Medical Director of a long-term care facility in Vermont. “I waive my annual fee for most elderly patients and allow others to pay in installments. This represents a modern medical practice grounded in traditional values.”

Myth 4: Not a zero-sum game

The notion that concierge medicine diverts healthcare resources from underserved populations I think is often misleading. While some physicians may choose this model, many continue to serve a diverse range of patients, including those from lower-income backgrounds. Additionally, concierge practices can offer care to individuals who might have previously struggled to access healthcare due to time constraints or other barriers.

Myth 5: The elephant in the room, ‘Bespoke Concierge Medicine’

Okay, so, why do luxury services even exist in healthcare? It seems unfair given the altruistic nature of physicians in our culture?

We can debate endlessly (and many have for years!) whether healthcare should be perceived as a right or a privilege, or why varying pricing structures and services are designed for the ultra-wealthy while everyone should have access to the same level of care. Ultimately, healthcare, like it or not, is a business that involves costs and customers.

As a Canadian and an advocate for bespoke concierge medicine and today’s more contemporary concierge care and membership-driven personal care models (PCMs), and I understand these questions and your concerns about fairness, access, shortages and altruism in care are all valid! Somedays I also ponder where I stand on these issues as I age – as I appreciate the feedback from physicians of different backgrounds, price points, friends and family!

But perhaps it’s time to abandon the pursuit of fairness and instead engage with the situation. Here’s some food for thought to kick off our conversation: A lot of healthcare providers today (specifically in primary care) see today’s more contemporary concierge care and membership-driven personal care models (PCMs) and bespoke or luxury healthcare practice models as a problem to be solved. There’s no problem here in my opinion. Doctors over the years have advocated, funded and voted for transparency in healthcare for years! Now you got it and think that the marketplace won’t respond with ‘options?’ Bespoke healthcare services are not a problem to be solved – nor are today’s more contemporary concierge care and membership-driven personal care models (PCMs).

A great article I’d encourage you to read was entitled “Letters Emphasizing altruism is problematic for physicians” by Jillian Bailey and it was published in the Canadian Medical Association Journal in July of 2020. One statement I found poignant was this: Altruism is not the solution. I suggest that we encourage ourselves to reconnect with meaning, our “why” that we are in medicine. (Bailey; CMAJ; July 27, 2020; 192 (30) E865; DOI: https://doi.org/10.1503/cmaj.76075)

You see, bespoke healthcare in my opinion are a public relations and educational opportunity to manage the bias and current tension that exists in the marketplace, particularly among your colleagues who have seemingly made up their mind and would rather criticize Physicians’ entrepreneurial spirit in the name of double dipping, fairness or whatever.

I think a few people who feel this way don’t recognize that luxury healthcare serves a purpose. You and I don’t have to buy a $250,000 luxury car but we certainly don’t all need to drive Honda Civics either. The marketplace now offers a choice for patients and options are a good thing – regardless of your mindset on altruism and healthcare.

One aspect I enjoy studying is the parallels between certain elements of the business market and their relevance to the healthcare sector. In business, different price points exist to serve various consumer segments, including the ultra-wealthy, middle-income consumers, and those on a budget. The same holds true in membership medicine.

Bespke care for the ultra-wealthy programs may typically range from $10,000 to $50,000 annually, yet they likely represent less than 6% of the industry’s overall physician offerings.

For most patients, middle-income consumers have access to today’s more contemporary concierge care and membership-driven personal care models (PCMs) options, with price points ranging from $100 to $750 per month, accounting for roughly 80-85% of the available choices in today's marketplace.

For budget-conscious individuals, direct primary care (DPC) usually costs between $8 and $99 per month, with an estimated 1,500 to 2,500 practices across the country by 2025, depending on your sources.

In the business realm, luxury services, including luxury healthcare, coexist with more affordable options, emphasizing how businesses adapt to meet varying market needs. And options are a positive development, right?

As we know, new products often start at high prices but can become more affordable as competition, technology, or market dynamics evolve. This segmentation is particularly evident in healthcare, where services and products can vary significantly in price due to factors like market segmentation, service quality, insurance dynamics, competition, choice, and geographic differences.

Consider rehab centers, for example. Some offer premium accommodations, while others provide more modest services. Should we hold them to the same standards we apply to both bespoke concierge medicine andtoday’s more contemporary concierge care and membership-driven personal care models (PCMs)? That’s certainly worth contemplating.

Despite our collective love-hate relationship with health insurance, the complexity of insurance coverage can influence pricing. Some services, including elective surgeries, may not be fully covered, resulting in higher out-of-pocket expenses.

Conversely, basic healthcare services often come at lower price points, supported by insurance reimbursements. For instance, urgent care centers typically provide affordable services that are more accessible compared to the higher costs associated with emergency rooms (Urgent Care Association, 2022).

Moreover, competition drives down prices, especially for low-cost healthcare options like community health clinics and telemedicine services, which often provide essential care at significantly lower prices than traditional healthcare settings. For instance, telehealth platforms such as Teladoc offer virtual consultations at a fraction of the cost of an in-person visit (Teladoc Health, 2023).

Finally, healthcare costs can vary widely by location, with urban areas generally experiencing higher prices than rural regions. This variability allows for different price points that accommodate the economic conditions of various regions.

This has probably been a lot to absorb today. It took a lot of time to write this as well — but it’s a labor of love. At the end of the day, I’m not looking to change anyone’s mind about this topic. I do hope however that’s it given you maybe (just maybe), a little to think about in the future. I think it’s now clear how these unique healthcare delivery models in our marketplace today illustrate the diverse range of price points we need in our communities — because a one size fits all approach isn’t working!

top five considerations institutions should consider when exploring incorporation of Concierge Medicine programs inside medical centers.

Dr. K. Says:

“The CEO MUST be supportive and the overall organization MUST embrace the concept. This cannot be over-stated.”

A long time ago (some of you) might remember when medical center concierge medicine type programs were just coming onto the scene. We’re talking over a decade ago now (or more!). However, years ago (before his retirement), Concierge Medicine Today was able to catch up with one of the legends in this area, Dr. Kirkpatrick. He shared with us the ‘top five considerations institutions should consider when exploring incorporation of Concierge Medicine programs inside medical centers.’

Here’s what he had to share:

1. The CEO MUST be supportive and the overall organization MUST embrace the concept. This cannot be over-stated.

2. The program needs a Champion. This can be the CEO, or a doctor who is going to provide the care, a VP of Marketing/Business Development, a VP of Foundation or Development Department. Someone must keep the program moving forward. Someone with the clout to promote and do it.

3. The Medical Center should have a well-to-do population base of interested Patients . This program works for Mayo in the Phoenix, AZ area and in Jacksonville, FL but not Rochester, Minnesota.

4. The Medical Center needs two doctors who already provide personalized services to their Patients.

5. Steering committee of stakeholders – Patients, providers, senior administrators, development officers, marketing experts, nursing staff.

CMT recognizes some of the industry's "Top Physician Leaders in Concierge Medicine"

“Over the past nearly 20 years, we have met many Concierge Medicine and membership-driven physicians who possess both great compassion and strong resolve. They are truly the salt of the earth—some of the brightest minds and kindest people you can find. We are fortunate to have them sitting on the other side of the exam room!”

~Editor-in-Chief, Concierge Medicine Today

ATLANTA, GA USA - Last year, Concierge Medicine Today (CMT), the industry's trade publication, accepted nominations for the Top Physician Leaders in Concierge Medicine. This biennial program recognizes and honors the essential role that physician leadership qualities hold in the contemporary landscape of concierge medicine, subscription-based healthcare delivery, and membership-driven personal care models within our communities and the broader healthcare system.

"Inspiring physicians can be found in just about every corner of the healthcare field, and we aim to highlight some of the most exceptional leaders, researchers, entrepreneurs, media contributors, and figureheads in this corner of healthcare who are guiding others toward a preferred future in our communities," says the Editor-in-Chief of Concierge Medicine Today."These doctors have remarkable stories, have built thriving practices, have generous and charitable spirits, tenacity, and have made significant upgrades to major healthcare brands and the healthcare sector as a whole. While there are still many other outstanding concierge medicine doctors leading in various areas who did not make this list, we plan to spotlight them in the months and years to come—these are just a few on our radar right now! Each of them carries a powerful and unique message along with an unforgettable quality that can provide valuable lessons for any physician-leader.”

Concierge Medicine Today evaluated and reviewed Top Physician Leaders in Concierge Medicine applications and answers from patients, peers, business leaders, coworkers, and/or inter- and intra-organizational colleagues and were selected by the trade publications Editor-in-Chief alone based on the many answers to the following three criteria:

1. The Practice of Self-Leadership. Self-leadership involves understanding oneself, managing emotions and behaviors, setting goals, making decisions, and being proactive, self-disciplined, and adaptable.

2. The Practice of Risk Taking. Risk-taking involves making decisions or engaging in activities with uncertain outcomes. It is essential for personal and professional growth.

3. The Practice of Delegation. Delegation empowers leaders to entrust tasks and responsibilities to others, harnessing their teams’ diverse skills and talents for greater productivity.

“Achieving this [recognition] requires a commitment to the practices of risk-taking, delegation, and self-leadership,”says the Editor-in-Chief of CMT. “Embracing change is ingrained in their DNA; rather than acting as critics, they remain curious. This curiosity keeps them relevant, positive, and self-aware. By choosing curiosity over criticism and valuing learning over expertise, these effective Top Physician Leaders in Concierge Medicine inspire their teams. They’re creating a healthcare culture that values patients rather than treating people as mere numbers—all wrapped up inside a business model that many patients find irresistible. This approach conveys the message that 'it's no longer about being the best doctor in the world; it's about being the best doctor FOR the world, FOR your patients, and FOR your local community.'"

Caption: A old medical bag from Saskatchewan, Canada located in a small hamlet, inside a medical office museum building. Photo Credit: Concierge Medicine Today, LLC. May 2024

"Effective physician leaders—especially those we have observed in the concierge medicine industry at-large— recognize that certain aspects of today's healthcare culture are causing medical practices and physicians to unwisely forfeit their influence over patients," adds Concierge Medicine Today's Editor-in-Chief. "Yet despite the challenges present in the broader healthcare marketplace, many more contemporary concierge medicine and membership-drive personal care model physicians possess the self-awareness to step into various leadership roles. Their practice model(s) allow them to leverage their gifts, skills, and strengths for the benefit of their patients and communities. This self-awareness fosters a culture of leadership and innovation within their practices. It serves as a reminder that when physicians connect with patients on a personal level consistently, they can make a significant impact on their patients, teams, and organizations. Achieving this requires a commitment to the practices of risk-taking, delegation, and self-leadership. Embracing change is ingrained in their DNA; rather than acting as critics, they remain curious. This curiosity keeps them relevant, positive, and self-aware. By choosing curiosity over criticism and valuing learning over expertise, these effective Top Physician Leaders in Concierge Medicine inspire their teams. They’re creating a healthcare culture that values patients rather than treating people as mere numbers—all wrapped up inside a business model that many patients find truly irresistible and refreshing. This approach conveys the message that 'it's no longer about being the best doctor in the world; it's about being the best doctor for the world, for your patients, and for your local community.'"

Click here to read more about the Physicians recognized by Concierge Medicine Today ...

Applicants were encouraged to share their insights on many significant initiatives the physician has participated in, their past achievements, and future goals. The application also allowed space for brief examples and stories that demonstrated how these individuals exhibited healthcare leadership over the past 12 to 18 months (or sometimes more). This information was intended to provide a more comprehensive view of each candidate and illustrate their qualifications as a Top Physician Leader in Concierge Medicine.

"In healthcare, there is often a tendency to quickly dismiss disruptive new ideas, but this can lead organizations and individuals toward irrelevance," says the Editor-in-Chief. "Over the past 20 years, I have met many Concierge Medicine and membership-driven physicians who possess both great compassion and strong resolve. They are truly the salt of the earth—some of the brightest minds and kindest people you can find. We are fortunate to have them sitting on the other side of the exam room!”

“In order to prevent doing harm in medical practices, we need to decrease the number of patients that each doctor cares for daily to give him/her the time to adequately address the patients needs, be able to critically think about each clinical situation, and coordinate care with other practitioners if needed,” says one Concierge Medicine Physician from Connecticut. “It’s not ‘fair’ to patients to rush them in-and-out of the office, merely treating symptoms without getting to the root cause of their complaints.  Building a trusting relationship with patients is at the core of what concierge doctors do on a daily basis.  I’m hopeful that every young physician sees a future in which they can practice high-level medical care, achieve a work-life balance, and form a bond with their patients that will last a lifetime.”

Concierge Medicine Physicians at the latest CMF, the industry’s annual conference

“Yet at the end of the day, we are very much the same. We ALL recognized the dead-end traditional healthcare was offering, and we chose to walk away and create something better. And so we need leaders among us to nurture and intentionally create a supportive community we can all find strength and solidarity in. We need leaders among us to listen and respond as society continues to cry and criticize us for the divide we have constructed in healthcare as a whole. And we need leaders among us to acknowledge that while yes, we do provide care for the 'haves' over the 'have-nots' in our communities, we must also be held accountable and practice radical generosity to those who are in need. And our leaders must lead by example, because those are the ones worth following."
~Dr. G, 2025

Photo Credit: Concierge Medicine Today, LLC.

ELIGIBILITY RULES

• Top Physician Leaders in Concierge Medicine nominees must either work or have worked in or for a concierge medicine (or membership-driven) practice or served in a leadership capacity for an organization serving the space within the past 12-18 months.

• It should be noted, there’s no fee, no payment required, nor an award to purchase to make this list, nor is it considered an endorsement, nor is everyone who applies accepted or chosen. This is meant to be recognition of leadership within their given field, not care quality. Listing (below) is recognition of their leadership accomplishments and pursuits in its purest form only. This is also not a paid sponsorship program, nor an endorsement by Concierge Medicine Today. It’s purely and simply, recognition of leadership skills. Additionally, some Physicians have been selected by Concierge Medicine Today that were not nominated but continue to lead exceptionally well within the concierge medicine and related spaces and places. 

• Click to view our online coverage of past recognition by Concierge Medicine Today, supporting the achievements and hard work of Physicians.

“I believe these models play a critical role in our healthcare marketplace today,” notes the Editor-in-Chief of CMT. “They inform all of us all about how healthcare could be and should be delivered in the future. Health systems and so many others now who work tirelessly in the corners of our communities are paying attention to and learning from their example. Concierge Medicine makes us all stand up straight and pay attention — and it gives us a template FOR more.”

Photo Credit: Concierge Medicine Today, LLC.

“Our responsibility as the trade publication isn’t to convince anyone that viewpoints on things like the importance of the Patient-Physician relationship are still paramount or to persuade someone that concierge medicine isn’t what they’ve read about or overheard," concludes the Editor. "Our responsibility is to educate, inform, and, from time to time, showcase the people who organizationally and professionally recognized different when it came along and let you decide how you feel about all of it. We’re here to illuminate, educate, and tip our hats to those who we think redefine excellence in leadership, specifically those in contemporary concierge medicine and membership-driven personal care models. In the ever-evolving healthcare world, let’s not just stick to the status quo; let’s celebrate a Physicians’ leadership abilities, not belittle them for taking a risk, doing something different, being disruptively innovative in their communities, exercising good judgement, seeing a different path forward and sending back road maps and coordinates FOR others to follow.”

• Click here to read more about the Physicians recognized as Top Physician Leaders in Concierge Medicine by Concierge Medicine Today ...

"In healthcare, there is often a tendency to quickly dismiss disruptive new ideas, but this can lead organizations and individuals toward irrelevance," says the Editor-in-Chief. "Over the past 20 years, I have met so many amazing Concierge Medicine physicians who possess both great compassion and strong resolve. They are truly the salt of the earth—some of the brightest minds and kindest people you can find. We are fortunate to have them on the other side of the exam room!”

Photo Credit: Right to left, Top Physician Leaders in Concierge Medicine, Dr. Jeff Puglisi and Suzanne Ferree, MD, FAARM, FSSRP; Concierge Medicine Today, LLC.

About Concierge Medicine Today

Concierge Medicine Today (CMT) is a news organization and the Concierge Medicine and membership-driven personal care model industry’s national trade publication for the Concierge Medicine and Membership Medicine marketplace. Its web site(s) are the online destination for businesses, consumers, physicians, legislators, researchers and other stakeholders to learn about the history of this industry, various business aspects of the marketplace, trends, breaking news and more that drives the conversation that Concierge Medicine and free market healthcare delivery is creating on a national and international level.

For more information, visit: ConciergeMedicineToday.org.

Nomination Application and Future Inquiries

Are there other Physician Leaders out there who we may have missed or do not know about yet? Absolutely! We want to recognize them in the months and years ahead at Concierge Medicine Today, LLC., as well. Visit our contact us page here: https://conciergemedicinetoday.net/contact.

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Disclaimer* - Please remember the following information: The content on this website (ConciergeMEDICINETODAY.org and owned properties) is for informational purposes only and should not be considered an endorsement of quality nor a substitute for professional medical advice, diagnosis, or treatment; The website does not endorse or recommend any specific individual, physician, or medical practice OVER ANOTHER; It’s important to always seek the advice of a physician or other qualified healthcare provider with any questions regarding personal health or medical conditions; If you have a medical emergency, please call 911 immediately; The website and its content are provided as-is and the use of any information is at your own risk; The website does not claim that any particular physician, company, medical practice, service, or product is safe, appropriate, or effective for you; Always seek professional medical advice before making any healthcare decisions. (C) 2025 Concierge medicine today, LLC.

5 Ways to Support the "Dr. Spouse" -- #1) Start With Acknowledgement.

“There is a lack of acknowledgment and support for Physician-Spouses within our healthcare culture, despite their significant impact on a physician's career and practice. If we genuinely aim to address issues like 'Physician Burnout' or 'Moral Injury,' we must begin by recognizing, valuing, and consistently supporting the most influential person in their life: their spouse!”

Every year at our annual conference gathering, the Concierge Medicine Forum, I’m happy to talk to the many spouses of Physicians who walk up to me at the end and tell me how much this program(s) or session meant to them.

One recently said, “I felt like you were talking directly to me."

Another elbowed her husband in the hallway and said, “Michael, I've been telling him that for years. Thank you. Hopefully, he'll listen to me now.”

Whatever the topic might be, your spouse is right next to you. He/she is by your side cheering you on, warning you about your blind spots and if you're spouse is like mine, giving you a stink eye every now and then.

“The countless conversations we had when I was hurt, frustrated, anxious and, concerned kept me going. The times I wanted to quit, she said, “Not yet.” The times I wasn’t sure I was able to do the job, she said, “You got this. The Lord is with you, and so am I.” The moments I needed great advice, she provided it. And the times I needed to be called out or corrected on something, she was a voice of truth.”

~Michael’s Pastor in a farewell letter about how important a spouse is to the success of any organization, non-profit or otherwise; 2021) - Photo Credit: Concierge Doctors at the October 2024 (Atlanta, GA USA) industry’s annual conference address and discussing the role Physicians will play in helping to serve the next-generation of patients.

Comments like this warm my heart. It informs all of us in concierge medicine that your career and life decisions aren't made alone. You're not in this alone

As in many medical offices today, you'd probably not be surprised to learn that the most overlooked person in a church is also the Spouse.

Interesting, right?

Often overlooked because they don't work in the practice (or they run the practice), the impact of a spouse in your practice is critical to the well-being and health of a local Doctor personally and professionally.

First, they aren't afraid to tell you when you're wrong. They have shared their unfiltered thoughts about “so-and-so” and have helped you carry the impossible weight that your job mandates each day.

That’s just who your spouse is.

They’re compassionate. They've cheered you on, fought with you, cried with you, argued with you, and even laughed with you and at you. They’re your unfiltered, unmatched, and unadulterated insights that are your North Star.

Your spouse is there to privately encourage you when you’ve had a bad day. They'll listen to you patiently and quietly (until you're all finished) and then say "Are you done? Suck it up buttercup."

They're with you when you're frustrated. They're problem-solving behind the scenes and have attended the funerals with you when you've lost a Patient.

When there is no regular, ongoing, formal acknowledgment program of the role the Doctor-Spouse plays, the leadership [of the hospital/practice/clinic/health system] does itself and the couple a huge disservice.

They're beside you at every turn, keep you grounded in reality, and tell you when it's time to fly.

However, and this is a BIG, little do most of your employees, medical staff, colleagues, or even Patients know just how remarkably insightful this person is to you. The spouse often goes unrecognized and unappreciated for years, yet they know more about the practice and so and so than your team could imagine.

Here are a few ideas recently shared in an honest blog post written recently by my mentor and pastor about the role his spouse played in his career. I think it's relevant for medical offices to acknowledge the spouse, regardless of whether that person is a coworker, colleague, teacher, or stay-at-home Mom/Dad.

1. Start With Acknowledgement

My pastor, we'll call him J~, notes in his letter/blog about the important role that spouses have inside churches and writes, It’s stunning to me how little this person in their life is acknowledged by employees. At a farewell event the Church staff hosted for [my spouse] and me before our departure, I shared that I had one regret. I regretted that most people had no idea how much [my spouse] had led that Church. The countless conversations we had when I was hurt, frustrated, anxious and, concerned kept me going. The times I wanted to quit, she said, “Not yet.” The times I wasn’t sure I was able to do the job, she said, “You got this. The Lord is with you, and so am I.” The moments I needed great advice, she provided it. And the times I needed to be called out or corrected on something, she was a voice of truth. 

2. Recognize the burnout risks and pay attention to the evidence. 

You love evidence and data probably as much as I do. So, here are some fast facts about this topic for your consideration.

• A study published in the BMJ found that doctors have a lower divorce rate than almost all other medical care workers and significantly lower than the general public. The authors of the report conducted surveys of 200,000 healthcare practitioners, including over 40,000 physicians between 2008 and 2013. They found that physicians experienced a divorce rate of 24 percent, whereas 31 percent of healthcare executives and 33 percent of nurses experienced divorce. This compares to a general 35 percent divorce rate among the general public.The BMJ report seems like it’s good news for the marital bliss of doctors everywhere. Not so fast. One particular group defied these positive statistics. The study found that female physicians were almost one-and-a-half times more likely to be divorced than their male counterparts. The likelihood of divorce increased for female physicians who reported working over 40 hours per week.

  A lead author of the study, Dan Ly explained, “We believe that the higher incidence of divorce among female physicians stems from the greater tradeoffs they are forced to make to achieve work/life balance.”[1]

• Business Insider reported the Top 10 occupations with the lowest divorce rates were Directors of religious and educational activities and Physicians and Surgeons. Number 9 was Directors, religious activities and education — 21.3%; Ranked # 10. Physicians and surgeons — 21.8%[2]

• Physicians Practice writer Janet Kidd Stewart recently penned an article entitled Supporting Your Spouse’s Career where she writes … Your spouse puts up with the long hours and short temper your stressful practice tends to create, but you know it's taking a toll on the marriage. High divorce rates prove this is no easy task, particularly as medical marriages often today include two busy professionals.[3]

• In February of 2020, Medscape cited that One in four women physicians are married to doctors, and 16% of male doctors are married to physicians, says a survey of more than 15,000 physicians in 29 specialties.[4]

• The AJC reported that Female physicians and surgeons are most likely to marry male or female physicians and surgeons.[5]

• The Washington Post wrote not too long ago as well, Physicians had a 24 percent likelihood of divorce; it was 23 percent for pharmacists; 25 percent for dentists; 31 percent for health-care executives; 33 percent among nurses; 27 percent among lawyers; and 35 percent for non-health-care workers.[6]

• Finally, the AMA cites that About 80% of physicians are married, according to a recent online survey, and these doctors often marry other doctors or other health professionals.[7]

3. Talk about how the work is affecting you.

Wayne Sotile, Ph.D., a clinical psychologist and author of The Medical Marriage, said, "One predictor of marriage failure is never talking about work," he says. "Just don't focus constantly on the minute frustrations. Instead of talking about how many procedures you did, explain how the work is affecting you."

So, knowing this, I believe it is improper of medical management, employees and practice colleagues, and leadership in your medical practice or health system if they do not encourage, acknowledge, or care in some way for the Physician’s spouse.

J.H., writes Knowing this, I believe it is negligent if leadership doesn’t encourage, shepherd and care for the lead pastor’s spouse. Now, let me be clear. I’m not suggesting some weird entitlement program.​The pastor and the pastor’s spouse shouldn’t be treated as if they are royalty. That’s not what I am suggesting.​ At the same time, when there is no acknowledgment of the role the spouse plays, the leadership of the church does itself and the couple a huge disservice. 

That's an interesting viewpoint. Does this dovetail nicely into medicine?

Well, yes.

4. Host lunches, random appreciation events, lectures, workshops, etc., for physicians and their spouses. 

Dr. Edward Krall, a psychiatrist at the Marshfield Clinic in rural Wisconsin, started a physician-spouse group several years ago. The informal group, known as The Network, hosts lunches and welcome events for spouses of prospective and incoming physicians at the clinic and some social events for existing physicians.

"The clinic had hired a New York marketing firm to do some research around our brand, and part of that was a survey of recent job candidates to find a profile of what types of spouses would be happy here," he says. "It found the Marshfield spouse drives an SUV, not a BMW, drinks Gatorade, not a Manhattan, and values family activities over ample shopping. [If] the family isn't happy, the physician isn't happy, so we felt we needed to address that more directly.” Krall and the clinic also host lectures and workshops for physicians and their families on work/life balance, workplace stress, and other personal issues. "All of the data suggest that a supportive spouse is key to a physician's success," Krall said.

So what can you do if you’re in leadership at a medical practice and want to implement and/or acknowledge a colleague's spouse or support their role in a Physician's life?

Keep in mind, they don’t have to work there. That’s all the more reason to do something, say something, or write a thank you card. You might never see this person, but you know the role they play in the Doctor’s life, and their decisions are critically important and will impact you.

5. Create a formal spouse program, like hosting a social gathering for all spouses in practice or paid, private, proactive counseling for the "couple"

So to get granular, here are some suggestions from J's email letter that I think you might find quite helpful. We've modified them to be applicable from helping Pastors to helping you, the Doctor.

We modified the specifics to apply to the Physician, and I think (personally) medical practice management and leadership should provide the following immediately to Physician and their spouses:

• Paid, proactive counseling for the [Doctor] and his/her spouse as a “couple”

• Say, thank you. (And don’t wait for the Christmas employee dinner.) The [medical staff, your physician peers], and or senior management should consistently express appreciation to the [Doctor’s] spouse.

• Pay for [one weekend] off-site getaway for the couple.

• Bring the spouse into a leadership team or management meeting and ask, “What feedback do you have to improve how we serve you and your spouse?”

• If you are an extensive [group physician practice], make sure the spouse of the [Doctor] doesn’t get lost in the maze of the organization. Being in a significant [medical group or health system], oftentimes a [Physician’s] spouse can often feel even more invisible, neglected, put on hold, feel like they’re competing for time, confronting a gatekeeper at every turn and ultimately, un-cared for. If you don’t believe me, ask them.

Janet Kidd also notes,… If your [medical practice, or] group doesn't have a formal spouse program, a good place to start is simply hosting a social gathering with spouses. Today's busy lifestyles have put a damper on socializing at work, but a little effort here can help the whole group deepen their commitment to each other.

Theresa, wife of a Doctor, Mom of 3 and working professional penned a blog recently about 15 Non-Glamorous Realities About Being Married To A Doctor. In the post she writes … It’s the saddest fact of all but burnout is a major health crisis for doctors. Every year, over 400+ doctors commit suicide. That’s among the highest of any profession. Try to visualize the equivalent of an entire graduating class of medical students of a state university who die each year.All the stress and burnout doesn’t just stop at the hospital. Our DrSpouses bring it home, emotionally and mentally within the walls of our home.

He drops this final note on us in his letter when he writes ... If you serve in this type of role and disagree with me, then let me close with a question: “When’s the last time you brought the spouse into the [practice] and thanked them?”

Certainly insightful thoughts to ponder.

Thanks for reading.

FOR YOU, FOR DOCTORS,
Editor, Concierge Medicine Today

References and Citations

1. https://www.secondsaturday.com/doctors-you-have-a-lower-risk-of-getting-divorced-unless-you-are-a-woman/

2. https://www.businessinsider.com/10-jobs-with-the-highest-divorce-rates-and-10-with-the-lowest-2017-10

3. physicianspractice.com/…/supporting-your-spouses-career

4. https://login.medscape.com/login/sso/getlogin?wcode=102&client=205502&urlCache=aHR0cHM6Ly93d3cubWVkc2NhcGUuY29tL3NsaWRlc2hvdy8yMDE5LWxpZmVzdHlsZS1oYXBwaW5lc3MtNjAxMTA1Nw&sc=ng&scode=msp

5. https://www.ajc.com/news/national/how-common-are-doctor-nurse-romances-really/A0dZlMIcFN9FH25YZcIgDO/

6. washingtonpost.com/…/divorce-among-doctors-isnt-as-common-as-you-think-study-finds

7. https://www.ama-assn.org/medical-residents/medical-resident-wellness/why-doctors-marry-doctors-exploring-medical-marriages#:~:text=About%2085%25%20of%20physicians%20are,on%20the%20Medscape%20news%20website.

Patients seek respect, clarity, attention to detail, and, most importantly, a meaningful doctor-patient relationship.

One of my all-time favorite quotes I love to share with Physicians who are curious about this industry and desire to follow their own vision for how healthcare could be and should is this quote:

"Somebody is already working on a uniquely better approach, a uniquely better product, a uniquely better environment, a uniquely better model. Someone out there is currently messing with the rules of the prevailing model. The goal isn't necessarily to be the first or the pioneer of uniquely better but people should be in a position organizationally and personally to recognize it when it comes along."

~A.S., Leadership Podcast; Part 2; Dec. 1, 2017

In recent years, the subscription-based healthcare delivery sector has seen a bloom of innovation by Physicians and interest from patients. I say this to inform us all that I think this innovation serves as a testament to the foresight of pioneering concierge practices and visionary physicians who introduced innovative yet old-fashioned values into our healthcare landscape. Some of these business models have even blossomed into your garden variety, low-cost, primary care subscription plans, while others cater to a more discerning patient who values the convenience of a doctor who responds to texts or calls within the hour.

Now, let’s address the elephant in the room: luxury healthcare.

Two or three decades ago, luxury in healthcare primarily focused on specialized medical services and high-quality facilities. For patients, luxury meant access to skilled physicians, private recovery rooms, and compassionate, personalized care. They appreciated amenities such as attentive nursing staff, expert care teams, comfortable surroundings, and reduced waiting times for appointments and treatments. Furthermore, luxury included advanced medical technology and treatments, regarded as indicators of superior care. The entire experience and the environment in which care was delivered were just as important as medical expertise.

Today, luxury in healthcare doesn’t necessarily mean that same thing. Convenience is the new form of luxury for the savvy consumer. Meaning, “I want it now and I want it on my terms.”

That is to say many potential patients are looking for more transparent, modern, and affordable healthcare options, such as subscription services and other cash-pay models, due to their dissatisfaction with current insurance plans and traditional medical offices. They seek respect, clarity, attention to detail, and, most importantly, a meaningful doctor-patient relationship.

In other words, the average consumer no longer views healthcare costs as a burden that only affects the wealthy. Instead, smart patients understand that if they neglect their health, they will end up paying significantly more in the long run. So why not take control of where, when, and how their money is spent?

And, healthcare is expensive—and it’s not becoming any more affordable! Patients today want something different for their money than bills laden with confusing industry jargon that they cannot fully understand nor afford.

But since the mid-1990s, concierge medicine and various membership healthcare models have evolved into diverse business formats, enabling physicians and patients to spend more time together and prioritize prevention over mere symptom management. Currently, annual fees in most subscription-based healthcare practices have become more accessible, reflecting the level of personal attention and service provided by doctors.

It's evident to me (as a patient) that more and more people are willing to invest in their healthcare early, as the costs will inevitably arise in their lives.

I acknowledge the criticism that these business models might contribute to a physician shortage. However, understanding the unique value proposition they offer reveals that these physicians often report higher levels of happiness and satisfaction in their lives. One physician we spoke with recently even remarked, "It saved my marriage."

The inspiration for concierge or bespoke medicine began nearly 30 years ago, initially catering exclusively to the affluent and providing a level of service akin to that found in luxury sectors, emphasizing personal relationships between doctors and patients. Since then, two significant developments have taken place that are not often advertised:

• There has been a noticeable increase in patient burnout.

• These early business models have created opportunities for entrepreneurial physicians to remain engaged as leaders in their communities, even when feeling exhausted, overwhelmed, and ready to leave the field.

Let’s first address patient burnout. Among discerning patients of all ages, there has been a considerable decline in trust towards local healthcare providers and institutions. This erosion of trust isn’t typically attributable to any single doctor or practice; instead, it reflects a broader cultural shift. Events such as the COVID-19 pandemic, systemic inequities, and healthcare disparities have significantly impacted these trends. Criticism surrounding vaccine distribution highlighted unequal access in minority communities, further eroding trust in local healthcare systems. A 2022 report from the American Psychological Association underscored the lack of sufficient mental health services during the pandemic.

Why mention these issues? They highlight the critical need for more healthcare institutions and more medical practices, both large and small, to rebuild trust through transparency, patient-centered care, and equitable treatment.

Just like any innovation in business, healthcare is no exception. Despite some vocal critics defending the status quo, new ideas often emerge from early adopters. If we dismiss the conversation about concierge medicine (and its familiar business model offerings) as being solely for the wealthy, we fail to recognize the innovation and creativity of countless entrepreneurial physicians over the past three decades. Are we not doing a disservice to physicians and inadvertently contributing to the physician shortage argument by stifling their entrepreneurial spirit? Why not allow patients and the local market to determine the viability of a concept, business, or price point? We might be pleasantly surprised by the outcomes.

From virtual primary care subscriptions available at our fingertips to individually owned primary care practices, options beyond the luxury price tag are now available. Memberships and subscriptions in healthcare, in all their forms, have seen a natural increase in demand and will continue to grow and expand to reach more patient segments due to heightened interest from both patients and physicians.

In fact one Physician who recently was the Keynote speaker at the industry's annual conference, the Concierge Medicine Forum held in Atlanta, GA each year says 'In this growing market, patient engagement and behavior change will be requisite skills for physician-entrepreneurs to offer value to their patients in the future.'

Disclaimer: These business models are not medical specialties and they’re not a replacement nor an insurance product.

"It’s no longer just about being the best doctor in the world," says the Editor of Concierge Medicine Today, the industry's healthcare trade publication. "It’s about being the best doctor for the world, for your patients, and for your local community.”

Abridged Overview of Membership Medicine Models: the Mindset, Biases and Opportunities

One of my mentors wisely noted, "When you have a heart for your community, you don’t have to compete on price. Without community, you’re a commodity."

By Editor, Concierge Medicine Today | Listen to the Latest Industry Podcast Episode

Over the years, the culture and economics within most concierge medicine practices has evolved significantly but the marketplace narratives have often remained negative and unchanged. That's okay and to each their own as they say.

Take for example plastic surgery and aesthetics.

Initially, these medical specialties and their business models faced significant headwinds, public relations challenges, similar to those I’ve observed in the concierge medicine space in its early days.

According to Aesthetic Surgery Journal, plastic surgery for example, has often been associated with vanity, largely due to media portrayals depicting individuals as excessively focused on their appearance. These representations hindered the communication of the psychological benefits and transformative potential of these procedures. Exaggerated cases in media created a skewed public perception, making it difficult for practitioners to emphasize the psychological and reconstructive advantages of their services. However, empirical evidence has gradually shifted societal attitudes towards a more positive understanding of plastic surgery (Dunn, 2018). Citation: Dunn, K. (2018). *The Psychological Impacts of Plastic Surgery: A Look at the Journey of Patients*. Aesthetic Surgery Journal.

Concierge medicine has similarly struggled with perceptions of elitism, being viewed as a service exclusive to the wealthy. The introduction of retainer fees led to pockets of backlash, with critics often arguing that it commodified healthcare and created a bifurcated system. This sparked discussions about equitable access to care and concerns about prioritizing profit over quality (Wong, 2015). Citation: Wong, S. (2015). *Concierge Medicine: Pros and Cons of the New Healthcare Trend*. Journal of Medical Ethics.

As someone far wiser than myself recently said (about business in general, not healthcare): "For some reason, profitable organizations are viewed as evil in today's society. While it’s true that some organizations engage in unethical practices, I believe that’s the exception rather than the rule. Call me naive, but I believe a thriving world is one where we have successful, profitable organizations, and vibrant communities rely on them."

Price conscious brands in healthcare, such as concierge medicine have worked very hard over the past 20-years (or more!) now to overcome the cognitive bias’s and public relations challenges rooted in perceptions of vanity and elitism in healthcare by highlighting their benefits to patient well-being. And, I’m proud to report that from my experience engaging with both the media and physicians all these years that the cognitive bias against concierge medicine has softened, with patients now showing more curiosity than resistance. Sure, media coverage will routinely remain negative, maybe report a little imperfection and won't be entirely positive about change in the healthcare marketplace, I have certainly observed that it is less adversarial now than it used to be!

"I’ve met more Physicians (in all the membership medicine models, concierge included!) who have hearts of gold and the emotions of steel over the years, and I can tell you that they’re the salt of the earth. They’re some of the best people on the planet!" ~Editor, Concierge Medicine Today, speaking to a group of physicians in October, 2024

Yet despite the growing recognition of concierge medicine's value over the past two decades there are still some who do the real work in healthcare that want to stifle progress and claim the moral and ethical high ground based on things like price and fairness when it comes to healthcare. “It’s about believability. Would it work for me? Could it work for me?" says a former CEO and industry consultant in concierge medicine space we talked to at Concierge Medicine Today. "Physicians now have many examples of colleagues experiencing the benefits of concierge medicine for themselves and their patients. In those areas, we see momentum continuing to build.”

What you might not know is that inside most 'membership medicine' practices (regardless of terminology, price or location), is that today, each day begins with the mission of transforming patient frowns into smiles and doctors are creating memorable experiences FOR patients. You see, inside most of these subscription-based healthcare delivery practices, it’s no longer just about fulfilling the internal needs of the practice; it’s about recognizing the vital relationship between patient and physician, removing every obstacle in a moral, legal and ethical way that may hinder that relationship and understand the critical role that patient experience and hospitality plays in healthcare today!

This shift in mindset has been proven to enhance satisfaction and foster trust among doctors, staff, and patients alike.

Now, I’m not naïve to the fact that today primary care for example, typically has a uniform reimbursement model they try to follow with complex codes. But is it fair that you and I can visit three different primary care offices for the exact same ailment(s) and (maybe if we're lucky!) see only three codes in common among the eleven different codes on five separate and confusing bills?

Of course not! I highlight this disparity to raise awareness about fairness in healthcare, as today’s patients are more informed, smart and discerning customers. Hospitality in healthcare is a process, but the patient should never feel processed. Nor should we villainize the Physicians out there in concierge medicine for example that want to help their patients feel seen, heard, welcomed, respected and significant!

There’s no arguing that Patients today expect consistent quality without fluctuating costs, unlike the tiered pricing seen in aviation. However, if variable costs are to be implemented in healthcare (and they already are!), I think it is crucial to help patients (i.e., your customers) understand what they are paying for. After all, it is their money, right? Editor's Note: For references on this topic, please consult studies from the Journal of Air Transport Management and the American Journal of Public Health.

Back on point. Discerning patients today are indeed discouraged and they’re keenly aware of the differences that exist among individual physicians and patients will ALWAYS go where they feel they will not be treated like just another number or chart in the drawer.

Currently, concierge medicine and unique other forms of a low-cost subscription practices offer unique opportunities and challenges for doctors navigating a competitive healthcare environment, particularly regarding pricing strategies. If we were to sit down with you today, I would share that I don’t view concierge medicine and other forms of low-cost subscription practices as competitors at all. Instead, I see them as two distinct paths patients and Physicians can choose, and having choices in business (and in healthcare!) is beneficial FOR all. And isn’t doing good always good for business? But, if you were to ask us here at Concierge Medicine Today, how we would describe the landscape, options and business models of the membership medicine marketplace today, here’s what we would tell you:

• Classical Concierge Medicine, Bespoke, or Luxury Ultra-High-End Concierge Medicine Practices: These are ultra-high-end private medicine programs (often but branded as 'concierge' medicine) typically range from $10,000 to $50,000 annually per patient or family. Each practice is unique and may operate differently so inquire and ask questions. Usually these practices will also provide an exhaustive list of services, which may be included in the fees, but not always. They are not intended to replace your health insurance and are not to be considered as a replacement for your health insurance nor cover your hospitalization fees or services. Limited in their sheer number across the U.S., they do exist to serve their clientele well and likely represent less than probably 4-7% of the industry’s overall membership medicine offerings according to sources at Concierge Medicine Today.

• Contemporary Concierge Medicine (Most Common): These practices are the most common in the healthcare marketplace today. In summary, they are a subscription-based or membership healthcare delivery business model (typically primary care, family medicine and some specialties which have routine patients -- not the one and done type) and are primarily marketed or for middle-income consumers that desire more preventative and relational dialogue with their Physician. These practices and business models have emerged in the past 20-years and are today the more common and inexpensive version of a concierge medicine practice. Think of it like Concierge Medicine 2.0. Inexpensive options which are quite commonly available in the marketplace today operate with price points ranging from $100 to $750 per month per patient. These practices may still accept insurance or still participate in Medicare but the subscription fees you pay are for services not covered by Medicare nor thought of to be a replacement for your health insurance. Additionally, hospitalization fees or services are the patients responsibility.  According to industry sources, these more contemporary practice models most likely account for roughly 70-75% of the available concierge medicine subscription choices for Patients in the marketplace today.

• Direct Primary Care (DPC): Do not confuse DPC with a concierge medicine practice, which is often quite common when you run into the membership medicine family tree of options. Today, DPC is typically considered the budget-conscious option for the patient or individual, direct primary care (or DPC) usually ranges in cost for each patient between $8 and $99 per month. Currently, there are an estimated 1,500 to 2,500 practices across the country by 2025. Typically, these practices do not participate in Medicare, nor have payor relationships (but not always).

I am of the persuasion that a Doctors office is a special place in our community. It’s a place of trust and should be (but usually isn’t) a refuge for us all to get relief from our pain, struggles or daily challenges. Why should we belittle the weight our Physicians’ words and expertise by putting them in a box each day that feels more like a penalty bench than a thriving community life center? I know that sounds pie in the sky, but I speak from experience when I say that ‘My Doctors words carry weight with me. His/her words are probably the top five most influential voices in my life behind my wife and kids!”

If we have Doctors routinely switching jobs to other jobs, they dislike a little less, that will (and I’d argue already has!) impacted the health of our communities. Once again, I’m reminded of this statement a Physician (now retired) once told me: “Instead of viewing the status quo PCP model as the center of the universe. Maybe we should take some plays from the Retail Clinic playbook before we become obsolete.”

I’ve met more Physicians (in all the membership medicine models, concierge included!) who have hearts of gold and the emotions of steel over the years, and I can tell you that they’re the salt of the earth. They’re some of the best people on the planet! Sure, there’s an egotistical, self-centered, vulgar doc or three out there but for the most part, I don’t think we’re giving Physicians at-large (especially the frustrated, overworked, underpaid and burned out ones) enough freedom to explore their entrepreneurial tendencies and ideas. Instead, typically collegial opinions want to squash their ideas and keep them in line. I just don’t see this behavior today in our healthcare marketplace at-large as the future I want for the healthcare of my kids and grandkids. Do you?

In closing, for most doctors I’ve met or run into over the years, concierge medicine, albeit in the contemporary or classic version, is a practice model they proudly offer to their patients and communities. They recognize that it fosters more consistent communication and a closer relationship between patient and physician, which is an opportunity only made possible by choosing a different path. For a few peers and colleagues who would negate the good they’ve done I can’t write or say anything that would change their mind. But I will leave you with this: “It’s no longer about being the best Doctor in the world anymore, it’s about being the best Doctor FOR the world, FOR your Patients and FOR your local community.”

Credit: (C) 2025 Concierge Medicine Today, LLC. All rights reserved.

Branding Concierge Medicine: Mindset, Bias and Opportunities

One of my mentors wisely noted, "When you have a heart for your community, you don’t have to compete on price. Without community, you’re a commodity."

By Editor, Concierge Medicine Today | Listen to the Latest Industry Podcast Episode

Over the years, the culture and economics within most concierge medicine practices has evolved significantly but the marketplace narratives have often remained negative and unchanged. That's okay and to each their own as they say.

Take for example plastic surgery and aesthetics.

Initially, these medical specialties and their business models faced significant headwinds, public relations challenges, similar to those I’ve observed in the concierge medicine space in its early days.

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According to Aesthetic Surgery Journal, plastic surgery for example, has often been associated with vanity, largely due to media portrayals depicting individuals as excessively focused on their appearance. These representations hindered the communication of the psychological benefits and transformative potential of these procedures. Exaggerated cases in media created a skewed public perception, making it difficult for practitioners to emphasize the psychological and reconstructive advantages of their services. However, empirical evidence has gradually shifted societal attitudes towards a more positive understanding of plastic surgery (Dunn, 2018). Citation: Dunn, K. (2018). *The Psychological Impacts of Plastic Surgery: A Look at the Journey of Patients*. Aesthetic Surgery Journal.

Concierge medicine has similarly struggled with perceptions of elitism, being viewed as a service exclusive to the wealthy. The introduction of retainer fees led to pockets of backlash, with critics often arguing that it commodified healthcare and created a bifurcated system. This sparked discussions about equitable access to care and concerns about prioritizing profit over quality (Wong, 2015). Citation: Wong, S. (2015). *Concierge Medicine: Pros and Cons of the New Healthcare Trend*. Journal of Medical Ethics.

As someone far wiser than myself recently said (about business in general, not healthcare): "For some reason, profitable organizations are viewed as evil in today's society. While it’s true that some organizations engage in unethical practices, I believe that’s the exception rather than the rule. Call me naive, but I believe a thriving world is one where we have successful, profitable organizations, and vibrant communities rely on them."

Price conscious brands in healthcare, such as concierge medicine have worked very hard over the past 20-years (or more!) now to overcome the cognitive bias’s and public relations challenges rooted in perceptions of vanity and elitism in healthcare by highlighting their benefits to patient well-being. And, I’m proud to report that from my experience engaging with both the media and physicians all these years that the cognitive bias against concierge medicine has softened, with patients now showing more curiosity than resistance. Sure, media coverage will routinely remain negative, maybe report a little imperfection and won't be entirely positive about change in the healthcare marketplace, I have certainly observed that it is less adversarial now than it used to be!

"I’ve met more Physicians (in all the membership medicine models, concierge included!) who have hearts of gold and the emotions of steel over the years, and I can tell you that they’re the salt of the earth. They’re some of the best people on the planet!" ~Editor, Concierge Medicine Today, speaking to a group of physicians in October, 2024

Yet despite the growing recognition of concierge medicine's value over the past two decades there are still some who do the real work in healthcare that want to stifle progress and claim the moral and ethical high ground based on things like price and fairness when it comes to healthcare. “It’s about believability. Would it work for me? Could it work for me?" says a former CEO and industry consultant in concierge medicine space we talked to at Concierge Medicine Today. "Physicians now have many examples of colleagues experiencing the benefits of concierge medicine for themselves and their patients. In those areas, we see momentum continuing to build.”

What you might not know is that inside most 'membership medicine' practices (regardless of terminology, price or location), is that today, each day begins with the mission of transforming patient frowns into smiles and doctors are creating memorable experiences FOR patients. You see, inside most of these subscription-based healthcare delivery practices, it’s no longer just about fulfilling the internal needs of the practice; it’s about recognizing the vital relationship between patient and physician, removing every obstacle in a moral, legal and ethical way that may hinder that relationship and understand the critical role that patient experience and hospitality plays in healthcare today!

This shift in mindset has been proven to enhance satisfaction and foster trust among doctors, staff, and patients alike.

Now, I’m not naïve to the fact that today primary care for example, typically has a uniform reimbursement model they try to follow with complex codes. But is it fair that you and I can visit three different primary care offices for the exact same ailment(s) and (maybe if we're lucky!) see only three codes in common among the eleven different codes on five separate and confusing bills?

Of course not! I highlight this disparity to raise awareness about fairness in healthcare, as today’s patients are more informed, smart and discerning customers. Hospitality in healthcare is a process, but the patient should never feel processed. Nor should we villainize the Physicians out there in concierge medicine for example that want to help their patients feel seen, heard, welcomed, respected and significant!

There’s no arguing that Patients today expect consistent quality without fluctuating costs, unlike the tiered pricing seen in aviation. However, if variable costs are to be implemented in healthcare (and they already are!), I think it is crucial to help patients (i.e., your customers) understand what they are paying for. After all, it is their money, right? Editor's Note: For references on this topic, please consult studies from the Journal of Air Transport Management and the American Journal of Public Health.

Back on point. Discerning patients today are indeed discouraged and they’re keenly aware of the differences that exist among individual physicians and patients will ALWAYS go where they feel they will not be treated like just another number or chart in the drawer.

Currently, concierge medicine and unique other forms of a low-cost subscription practices offer unique opportunities and challenges for doctors navigating a competitive healthcare environment, particularly regarding pricing strategies. If we were to sit down with you today, I would share that I don’t view concierge medicine and other forms of low-cost subscription practices as competitors at all. Instead, I see them as two distinct paths patients and Physicians can choose, and having choices in business (and in healthcare!) is beneficial FOR all. And isn’t doing good always good for business? But, if you were to ask us here at Concierge Medicine Today, how we would describe the landscape, options and business models of the membership medicine marketplace today, here’s what we would tell you:

• Classical Concierge Medicine, Bespoke, or Luxury Ultra-High-End Concierge Medicine Practices: These are ultra-high-end private medicine programs (often but branded as 'concierge' medicine) typically range from $10,000 to $50,000 annually per patient or family. Each practice is unique and may operate differently so inquire and ask questions. Usually these practices will also provide an exhaustive list of services, which may be included in the fees, but not always. They are not intended to replace your health insurance and are not to be considered as a replacement for your health insurance nor cover your hospitalization fees or services. Limited in their sheer number across the U.S., they do exist to serve their clientele well and likely represent less than probably 4-7% of the industry’s overall membership medicine offerings according to sources at Concierge Medicine Today.

• Contemporary Concierge Medicine (Most Common): These practices are the most common in the healthcare marketplace today. In summary, they are a subscription-based or membership healthcare delivery business model (typically primary care, family medicine and some specialties which have routine patients -- not the one and done type) and are primarily marketed or for middle-income consumers that desire more preventative and relational dialogue with their Physician. These practices and business models have emerged in the past 20-years and are today the more common and inexpensive version of a concierge medicine practice. Think of it like Concierge Medicine 2.0. Inexpensive options which are quite commonly available in the marketplace today operate with price points ranging from $100 to $750 per month per patient. These practices may still accept insurance or still participate in Medicare but the subscription fees you pay are for services not covered by Medicare nor thought of to be a replacement for your health insurance. Additionally, hospitalization fees or services are the patients responsibility.  According to industry sources, these more contemporary practice models most likely account for roughly 70-75% of the available concierge medicine subscription choices for Patients in the marketplace today.

• Direct Primary Care (DPC): Do not confuse DPC with a concierge medicine practice, which is often quite common when you run into the membership medicine family tree of options. Today, DPC is typically considered the budget-conscious option for the patient or individual, direct primary care (or DPC) usually ranges in cost for each patient between $8 and $99 per month. Currently, there are an estimated 1,500 to 2,500 practices across the country by 2025. Typically, these practices do not participate in Medicare, nor have payor relationships (but not always).

I am of the persuasion that a Doctors office is a special place in our community. It’s a place of trust and should be (but usually isn’t) a refuge for us all to get relief from our pain, struggles or daily challenges. Why should we belittle the weight our Physicians’ words and expertise by putting them in a box each day that feels more like a penalty bench than a thriving community life center? I know that sounds pie in the sky, but I speak from experience when I say that ‘My Doctors words carry weight with me. His/her words are probably the top five most influential voices in my life behind my wife and kids!”

If we have Doctors routinely switching jobs to other jobs, they dislike a little less, that will (and I’d argue already has!) impacted the health of our communities. Once again, I’m reminded of this statement a Physician (now retired) once told me: “Instead of viewing the status quo PCP model as the center of the universe. Maybe we should take some plays from the Retail Clinic playbook before we become obsolete.”

I’ve met more Physicians (in all the membership medicine models, concierge included!) who have hearts of gold and the emotions of steel over the years, and I can tell you that they’re the salt of the earth. They’re some of the best people on the planet! Sure, there’s an egotistical, self-centered, vulgar doc or three out there but for the most part, I don’t think we’re giving Physicians at-large (especially the frustrated, overworked, underpaid and burned out ones) enough freedom to explore their entrepreneurial tendencies and ideas. Instead, typically collegial opinions want to squash their ideas and keep them in line. I just don’t see this behavior today in our healthcare marketplace at-large as the future I want for the healthcare of my kids and grandkids. Do you?

In closing, for most doctors I’ve met or run into over the years, concierge medicine, albeit in the contemporary or classic version, is a practice model they proudly offer to their patients and communities. They recognize that it fosters more consistent communication and a closer relationship between patient and physician, which is an opportunity only made possible by choosing a different path. For a few peers and colleagues who would negate the good they’ve done I can’t write or say anything that would change their mind. But I will leave you with this: “It’s no longer about being the best Doctor in the world anymore, it’s about being the best Doctor FOR the world, FOR your Patients and FOR your local community.”

Credit: (C) 2025 Concierge Medicine Today, LLC. All rights reserved.

3 CENTRAL FIGURES working in the “theater” of your practice today

Is the patient the Hero, the villain or the inconvenient obstacle? Let’s consider what happens millions of times a day and how "most" medical offices put function and process over patients.

By Editor, Concierge Medicine Today | Listen to the Latest Industry Podcast Episode

Most medical offices in the U.S. and abroad today tend to prioritize functionality and processes. And, rightly so! It's a double edged sword though. This means that each staff member has specific job responsibilities, plays a distinct role within the scheduling process, and has a list of daily tasks to complete. For example:

• Who opens the office every morning?

• Who assists with patient intake?

• Who escorts patients to their rooms?

• Who manages pre-authorizations?

• Who handles paperwork and billing?

• Who answers, makes, and returns phone calls?

In the midst of the functions of the daily processes, you also assign your team the vital responsibility of welcoming patients and ensuring they feel comfortable—ideally with a smile! However, it is all too common for patients entering most traditional medical office settings today to be treated by staff (and sometimes even their physician) as “inconvenient obstacles.”

Unfortunately, patients do not share this same functional and processed viewpoint. I've often reminded doctors "Sure, healthcare is a process, absolutely! But, the patient should never feel processed." Instead, we have to remind ourselves if you work in a medical office that patients are on their own unique journey. Every persons journey is different and you are simply a supporting cast member in the theater of their adventure into and out of healthcare.

You see, patients today are unaware of the specific tasks your nurse will tackle during their visit and they are not concerned with all the complexities involved in processing their payment for the recent exam. Instead, patients perceive their experience in terms of scenes and these "scenes" tend to unfold as follows:

• Scene 1: The drive to the practice.

• Scene 2: Finding a parking spot.

• Scene 3: Approaching the front doors.

• Scene 4: Navigating the lobby.

• Scene 5: Making the most of their waiting time.

• Scene 6: Interacting with staff and completing intake tasks while being escorted to the exam room.

• Scene 7: Entering the exam room, taking a seat, and preparing to meet the doctor.

• Scene 8: Engaging in a Q&A session with the doctor.

• Scene 9: Transitioning from doctor to staff.

• Scene 10: Billing and discussing next steps.

• Scene 11: Walking to the parking area and locating their car.

• Scene 12: Exiting the parking lot while avoiding traffic.

• Scene 13: Picking up a prescription (or the kids, dry cleaning, groceries).

As leaders in the medical field, we need to acknowledge that these interactions (with you and your staff!) and the patient experiences that follow (and reviews!) contribute to the story and narrative about your practice, your brand, your reputation and overall story being told about you in your local community by your existing patients.

Every Patient today should be seen as the Hero of their own story because they’re the ones overcoming a lot of obstacles just to get in the room with you! But inside the theater of your practice (i.e. your brand and your reputation!) your patients will usually encounter two or maybe three different characters in the midst of all the scenes they encounter. There's the villain (or enemy), the ally and the Hero. 

Typically, because of the medical school you went to, your background, fellowship, specialty training or years you've simply dedicated to your practice and profession, you see yourself as the Hero. I do as well, but most patients don't. It's hard to see yourself not as the Hero because you solve complex problems FOR every patient. But, you likely have three types of employees working for you right now that fall into one of these supporting roles that the patient views as just that, 'support'. There's the wise and all-knowing Physician (ie. the Ally), the Practice Manager that makes the busy practice run (ie. sometimes another Ally or perhaps a Villain), and if you're lucky, a Technician, Nurse or Physician Assistant who may also become the patients Ally or enemy.

All of this function vs. patient perspective may seem counter intuitive and according to the healthcare culture you and I live and work in, it is. Throughout every patient journey, patients will encounter moments of tension and will need an ally. The last thing they want is to be treated like they're an inconvenient obstacle by one of your staff (or you!). When you treat patients (which our healthcare culture typically does) as inconvenient obstacles, following repetitive processes, putting bureaucracy and function over people, you immediately become the villain in their story once they leave your practice.

Your team members and staff (even you of course!), all play a central role in either relieving the tension that pops up in the patients journey. Whether it's working around a restrictive policy in a moral, legal and ethical way or resolving a recurring functional problem for the patient, you have the opportunity today to become the villain or Hero of the story that the patient will tell.

What type of supporting character will you and your staff play that helps the Patient (i.e. the Hero!) ultimately reach their destination? Your involvement and leadership today will significantly impact the journey and story that patients will share with others tomorrow. (Hint: this is how that word-of-mouth marketing stuff happens!).

If you become the patients ally and treat the patient with a grateful spirit, you will become the Hero of their story simply because you removed obstacles or provided a little more clarity for them. Don't permit your staff to unintentionally become the patients adversary due to a restrictive policy or barrier -- do everything you can to treat the patient first! I refer to this as 'remark-ology' in the concierge healthcare space because what it does is curate remarkable moments FOR patients that they will one day (hopefully soon!) remark to others about! Those are the memories that patients remember. 

My mentor said it best "When you get small and personal, you become memorable."

If each patient visit begins and ends with this shift in perspective and you become a supporting character (i.e. an Ally!) I believe good things will happen FOR your practice! After all, it's no longer about being the best Doctor in the world anymore, it's about being the best Doctor FOR the world, FOR your Patients and FOR your local community!

Imagine getting a thank you note from your Doctor?!

It doesn’t have to be some grand gesture, just something unexpected. Thank you notes, unlike impersonal holiday cards, don't end up in the trash, they end up in a box!

By Editor, Concierge Medicine Today

I've never been a fan of the holiday greeting cards that are sent by businesses.

If you've received one of these cards usually they're signed by everyone in the office and there's no personalized note.

It ends up in the junk mail trash (or recycling if you do that, of course!)

I love thank you notes, not impersonal holiday cards with all the staff signatures.

Thank-you notes take time. They have greater meaning in the eyes of the receiver on the other end because they know you took time just for them!

Imagine getting a thank you note from your Doctor?!

Notes like that don't end up in the trash, they end up in a box! They leave a lasting positive impression on patients.

Don't just save your gratitude FOR your patients either. If you see your staff do something out of the ordinary and kind to a patient or coworker, acknowledge it.

Want to really be a great boss? Write it then mail it to their house!

Yeah, this little extra piece of gold in the form of a handwritten thank you note to a staff member that they open when you're not around will go miles and miles with your staff culture!

Handwritten notes haven't gone out of style. Saying something right then is good, but don’t stop there!

People need to know their Physician is paying attention. Whether it’s your Practice Administrator going the extra mile to schedule a date night for you and your spouse or a patient who lost their dog, we want to know you care about us.

We need to know you’re watching and paying attention!

It doesn’t have to be some grand gesture, just something unexpected.

If you really want to surprise a coworker, for example, write them a note at the end of the day. Handwrite the envelope and address it to their home instead of putting it on their desk. Try it! Sure, you could leave it on their keyboard or their chair for them to find the next morning. That might make other team members a little jealous and that's not good for morale. Sending the note home informs the receiver that you thought about them and cared enough to take 90 seconds out of your busy day to acknowledge only their actions.

This can apply to your spouse. He/she is your cheerleader. In some ways, they are a vital component of a Doctor's office. They’ve helped you with your career choices, and whether they work in the practice or not, they deserve some recognition, too!

Often, we hear from Physicians about how their spouses sacrificed to help them become who they are today! That's amazing. Finding a quiet moment to write them a note that rewards them with a gift of gratitude is priceless.

“Notice what your wife does regularly for you and take a moment to say thank you for it,” said one psychologist we spoke to recently about implementing a gratitude system in a medical practice. I noticed something the other day. I made dinner (which I probably do about once a week) and when we sat down to eat, my kids said, ‘Thanks, Mom; this was great.' It made me feel good. But you know what? I make dinner the other six nights a week and no one ever says 'thank you' or even acknowledges it."

I'll leave you with this quote from a concierge medicine physician in Florida who practices what she preaches:

"Being a good physician is not just about knowing how to diagnose and treat disease. Honestly...that's what books and studying is for. Being a good doctor entails earning the trust of your patients by being honest and forthcoming. It means knowing how to communicate effectively while still remaining sympathetic. It requires you, first and foremost, to be a human being. It honestly bothers me that young doctors feel like they have to "know everything" to be a great physician. Put down the damn book and go talk to your patient. Be a friggin human being. Be a friend. It's really that simple." ~Dr. R., Concierge Medicine Physician, Florida

Have a great week!

FOR YOU, FOR DOCTORS,

Editor, Concierge Medicine Today

Industry Conference Dates Announced! Oct 16-18, 2025 in Atlanta, GA USA

The industry’s annual medical education conference returns to Atlanta, GA USA, October 16-18, 2025

While you navigate the responsibilities of treating patients, managing a bustling practice, juggling a hectic schedule, and leading your team, this 2.5-day event offers a warm and supportive environment. Our goal is to assist you in excelling at what you do best while staying focused on your mission, adhering to your budget, meeting deadlines, and (ideally) fostering growth!

• Get Tickets: Attend …

• Airports Nearby: Hotel and Travel ...

• Lecture Submissions: Deadline April 1 …

• Sponsorship Opportunities: Learn more …

• Speakers, Topics, Schedule & Agenda: Coming soon!

• Confirmed Partners & Exhibitors: List of Exhibitors You’ll Meet at CMF This Year …

Why participate?

The answer is simple: “It’s no longer just about being the best Doctor in the world; it’s about being the best Doctor FOR the world, FOR your Patients, and FOR your local community!” We aim to share everything we've learned about this vital shift with you!

That’s why we host the Concierge Medicine Forum each year! FOR you!

We’re curating two and a half days packed with clinical and business education, best practices, encouragement, inspiration, and an opportunity for you to recharge for the journey ahead!

Your only task is to join us! We’ve gathered a wealth of new ideas since our last meeting, along with valuable lessons and practical tools to enhance the health and effectiveness of your practice and staff.

Looking forward to seeing you there!

• Get Tickets: Attend …

Attend the Concierge Medicine Forum!

Hosted, Organized & Produced by Concierge Medicine Today

Three helpful reference tools to learn about the concierge medicine industry (Updated for 2025)

History is important to all of us.

We learn from it and we many of our futures are shaped by it.

A lot has happened in the past 20+ years in healthcare. One of my favorite authors, A. Stanley in his book Deep and Wide wrote "We don't drift in good directions. We discipline and prioritize ourselves there. ...often, stepping outside your comfort zone is not careless irresponsibility, but a necessary act of obedience."

What stands out in that quote is that in all of our careers in healthcare, our place in time today is the accumulation [or drift] of a lot of good (hopefully!) little decisions that added up overtime.

It is virtually impossible to capture every moment of history into one document or onto one page, but we gave it our best shot!

We've been around a while so there's more than you probably wanted to know but Concierge Medicine is so wonderfully colorful and has been shaped and molded by so many people.

Looking back [and forward] it has undoubtedly left an impression [for better or worse -- depending on your viewpoint] on our healthcare marketplace!

We felt it was important this year yet again, to summarize some of the noteworthy moments from over the past 20-years from this industry in three informative and general ways.

First, by memorializing some of the most educational insights and quotations that we have received and collected from Physicians, consultants, outliers, on-lookers and others working in, on or close to the business of concierge medicine.

• Physician Perspectives and POVs: "100+ Quotations"

Second, to have an abridged historical timeline of events and voices that have helped cement the membership medicine models into our vocabulary and our culture.

• READ FULL ARTICLE, "History of Concierge Medicine" HERE

And third, in an annual report geared to those who have more of a business interest in the space but are not very familiar concierge medicine and want just the highlights.

• Annual Report (PDF) Download

FOR YOU, FOR DOCTORS,

Editor, Concierge Medicine Today

3 ways staff could support the "Dr. Spouse"

Often overlooked today is the role of physician spouses in healthcare. Their support is crucial for addressing issues like physician burnout and moral injury. 

By Editor, Concierge Medicine Today

Spouses provide necessary insights, emotional support, and help shoulder the burdens of a Physicians life. Whether they're in the practice or not, they often go unrecognized and unappreciated despite their significant impact on doctors' personal and professional well-being.

If you're a Practice Administrator who assumes the role each day as the 'work bestie' or 'work spouse' inevitably the spouse of the Physician knows the rightful and hopefully critical role you place in the practice. Why not take a moment to pen a note or send a card or fruit basket on their birthday or special holiday?

If you are in a group practice for example, make sure the spouse doesn’t get lost in the maze of the practice when they call or visit the practice. Be ready for them when they arrive and let the team know to extend a warm welcome to them when they arrive later in the day. More often than not, it might surprise you to know that a Physicians spouse usually feels invisible, neglected, put on hold and at times, like they’re competing for time during the work week. It's common that the spouse will need to confront a gatekeeper at the practice on occasion and that interaction we all know will spillover into the marriage.

Theresa, wife of a Doctor, Mom of 3 and working professional penned a blog recently about 15 Non-Glamorous Realities About Being Married To A Doctor.

In the post she writes … It’s the saddest fact of all but burnout is a major health crisis for doctors. Every year, over 400+ doctors commit suicide. That’s among the highest of any profession. Try to visualize the equivalent of an entire graduating class of medical students of a state university who die each year. All the stress and burnout doesn’t just stop at the hospital. Our DrSpouses bring it home, emotionally and mentally within the walls of our home.

In speaking with so many concierge medicine physicians and other healthcare practitioners over the years about practice operations, mental health and marriage stressors, taking a moment to write a thank you note to acknowledge the spouse is a great idea. They don't have to work in the practice either. In fact, all the more reason to acknowledge this person!

Today, I would encourage you to consider showing some thoughtful appreciation and gratitude towards the Dr. Spouse. Acknowledging their contributions, remembering an important day or showing appreciation for something that impacted your work I believe is essential for staff morale and creates an open dialogue the next time you see each other. 

I would also argue that practice support teams should extend their appreciation and support, not simply just sign the card. This is not about entitlement or treating the physicians spouse as royalty. When the spouse's important role is overlooked, it negatively impacts both the couple and the business.

Dr. Edward Krall, a psychiatrist at the Marshfield Clinic in rural Wisconsin, started a physician-spouse group several years ago. The informal group, known as The Network, hosts lunches and welcome events for spouses of prospective and incoming physicians at the clinic and some social events for existing physicians.

"The clinic had hired a New York marketing firm to do some research around our brand, and part of that was a survey of recent job candidates to find a profile of what types of spouses would be happy here," he says. "It found the Marshfield spouse drives an SUV, not a BMW, drinks Gatorade, not a Manhattan, and values family activities over ample shopping. [If] the family isn't happy, the physician isn't happy, so we felt we needed to address that more directly.” Krall and the clinic also host lectures and workshops for physicians and their families on work/life balance, workplace stress, and other personal issues. "All of the data suggest that a supportive spouse is key to a physician's success," Krall said.

Here are some additional ideas and suggestions you may want to discuss with your team to acknowledge and extend some gratitude to the bosses spouse. First, don’t wait for the Christmas party or birthday cake in the conference room, send a note and write something personal.

Second, consider chipping-in and pay for [one weekend] off-site getaway for the couple.

Finally, consider inviting the spouse into a leadership team or management meeting and ask, “What feedback do you have to improve how we serve you and your spouse?”

Janet Kidd also notes,… If your [medical practice, or] group doesn't have a formal spouse program, a good place to start is simply hosting a social gathering with spouses. Today's busy lifestyles have put a damper on socializing at work, but a little effort here can help the whole group deepen their commitment to each other.

Thanks for reading. Happy Valentines Day!

FOR YOU, FOR DOCTORS,
Editor, Concierge Medicine Today

References and Citations

1. https://www.secondsaturday.com/doctors-you-have-a-lower-risk-of-getting-divorced-unless-you-are-a-woman/

2. https://www.businessinsider.com/10-jobs-with-the-highest-divorce-rates-and-10-with-the-lowest-2017-10

3. physicianspractice.com/…/supporting-your-spouses-career

4. https://login.medscape.com/login/sso/getlogin?wcode=102&client=205502&urlCache=aHR0cHM6Ly93d3cubWVkc2NhcGUuY29tL3NsaWRlc2hvdy8yMDE5LWxpZmVzdHlsZS1oYXBwaW5lc3MtNjAxMTA1Nw&sc=ng&scode=msp

5. https://www.ajc.com/news/national/how-common-are-doctor-nurse-romances-really/A0dZlMIcFN9FH25YZcIgDO/

6. washingtonpost.com/…/divorce-among-doctors-isnt-as-common-as-you-think-study-finds

7. https://www.ama-assn.org/medical-residents/medical-resident-wellness/why-doctors-marry-doctors-exploring-medical-marriages#:~:text=About%2085%25%20of%20physicians%20are,on%20the%20Medscape%20news%20website.

"I grew up with championship-level worriers."

An emotionally healthy Physician, team, or practitioner is a good thing for everyone, especially Patients, family, and those you work around daily. It will sometimes be a struggle, but it's a struggle worth having because feeling better is a better way to live.

By Editor, Concierge Medicine Today

I worry a lot. I struggle with anxiety. I grew up with championship-level worriers. I overthink entirely too many things and can often jump to the worst possible scenario.

Today, whether it's about kids, work, or family, it's easier to be discouraged when we’re feeling fragile.

It's easier to be inspired when you're feeling good. And it is easier to be cynical when you're feeling resentful. Then, a new day comes, and we rinse and repeat.

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You might be feeling one of these ways right now. We've all been there, including me. Even the slightest bit of criticism can seem overwhelming when I feel fragile.

But when I'm in a good, emotionally healthy state, everything is simply better. The same goes probably for you and most Physicians and healthcare practitioners out there. Obviously, this would be easier if life were easy.

Life is tough, and there are times when we have good reasons to feel fragile and resentful. But life can be hard, and people can let you down. As we get older, we find ourselves waking up with aches and pains for no reason. But there's a cost to feeling fragile—you never realize how strong you actually are.

That's why I've asked my wife and best friend, Kelly, and a few others, "If you see me feeling fragile, discouraged, and becoming cynical, will you let me know?"

This might be a good question for all of us to ask who works in healthcare, regardless of position or status. "As you look back on the past few weeks, which one of these three words describes you most often? Fragile. Discouraged. Cynical?

An emotionally healthy Physician, team, or practitioner is a good thing for everyone, especially Patients, family, and those you work around daily. It will sometimes be a struggle, but it's a struggle worth having because feeling better is a better way to live.

FOR DOCTORS and FOR YOU,

Editor, Concierge Medicine Today

Leave on-time today!

"I will leave on time today!" was the last thing I said to my wife and daughters this morning before entering my commute. I have a date tonight together around the dinner table with my wife! If you have a significant other, may this serve as your gentle reminder that you should do the same today!

By Editor, Concierge Medicine Today

Doctors are guilty of working entirely too late, too much, too often!

If you're married, a Parent, single and a Physician of any specialty, more than likely, you've burned the candle at both ends as well on more nights than you can remember.

You may have even missed a few important events as well.

You are not alone. Don't beat yourself up too much.

Being devoted to your career, Patients, your team, and a profession you love (and loathe at times!) is honorable.

Today, however, leave on time!

Set a reminder.

In fact, set three or four reminders when you ignore the first two! I do it all the time for important events.

If you don't take a moment to adjust your schedule now, you won't get around to it later.

Make time for those that make time for you and mean the most to you!

As Kevin Coster who plays John Dutton in Yellowstone said, “That's the one good thing about problems, they'll still be problems tomorrow.”

As many of you know, I'm a father of three, a husband to the most intelligent middle school math teacher in the world (who is embarrassed by consistently my poor math skills -- which is why I'm a writer, btw), and married me anyway!

To my surprise, this morning, I opened an email from my Inbox that caught my eye. The subject line was Rules for Dads of Daughters.

I'll share the link to the full article, but the author, All Pro Dads, writes ... "I’m always surprised at the simplicity of some of his tips and yet, they are also so critical. One of his main tips is to always keep thinking. When we stop thinking, we make bad decisions with unfortunate consequences. Raising daughters is also an adventure and we want to do things that will give us an edge. Maintaining daily focus on doing the right things makes raising daughters healthy and strong all the more likely."

Despite the article being focused on Dads and Daughters, I thought #10 on the list would strike a note among some wise and discerning Parent-Physicians.

#10. Don't be late!

I'm chronically leaving my desk later than I should. I'm sure you are as well.

We can't always accomplish what we want to each day, and it's okay!

I love how the author footnoted #10 -- "She will eagerly await your return home from work in the evenings."

Let's not be late just a little more often!

After all, it's like I repeat so often ... "It is no longer about being the best Doctor in the world anymore; it is about being the best Doctor FOR the world, FOR your Patients, and FOR your family!"

FOR YOU, FOR DOCTORS,

Editor, Concierge Medicine Today