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Panel Size: What the Evidence Says About How Many Patients a Physician Can Serve Well
Most physicians pick a concierge panel target by feel, or by a consultant’s rule of thumb. Two decades of time studies offer a sturdier starting point. This brief sets out the hours that recommended primary care takes and how much of that a team can absorb, then gives you a calculator to test your own number.
New in October 2026. A planning companion to Brief No. 29 (fees) and Brief No. 4 (growth).
Start here: the questions this brief answers
Tap a question for the short answer, then jump to the evidence.
No study has measured the right panel size for a concierge practice. What the research does measure is time. Modeling studies from Duke University and, more recently, the University of Chicago estimate that guideline-recommended care for a typical panel of 2,500 adults would take 21.7 to 26.7 hours of physician time per day when no team shares the work. Scaled to an 8-hour day, that points to a panel of roughly 750 to 1,000 patients for a physician who does everything personally, and closer to 2,000 when staff take on much of the preventive and chronic care. Family physicians’ own reported panels fell from an average of 2,362 in 2013 to 1,760 in 2021. Concierge panels are far smaller: a 2005 national survey found 898 patients per retainer physician, and CMT observes typical concierge panels of about 225 to 550 today, an estimate whose method is not published. The gap between those numbers is, in large part, the time a membership fee buys. The calculator in Part 4 turns your own assumptions about visits and the work between them into a panel ceiling. Leave room under it for the weeks that do not go to plan.
Is there a research-backed number for concierge panel size?
No. CMT found no study that measured the panel a concierge physician can serve well. The evidence measures physician time in conventional primary care, and you can translate that into your own ceiling.
Go to the full answer ↓How much time does recommended primary care take?
For a panel of 2,500 adults, the most recent estimate is 26.7 hours a day without team support and 9.3 hours with it (Porter and colleagues, published 2022). Earlier Duke studies put the total at 21.7 hours.
Go to the full answer ↓How much does a care team change the math?
A great deal. One model found a reasonable panel of 983 patients when the physician does everything, rising to 1,947 when staff take on 77% of preventive care and 47% of chronic care.
Go to the full answer ↓How big are concierge panels in practice?
Published figures are old. A 2005 national survey found a mean of 898 patients per retainer physician, against 2,303 in traditional practice. CMT’s own observation is about 225 to 550, method not published.
Go to the full answer ↓How do I set my own target?
Decide how many physician minutes each member should get in a year, counting the work between visits, then divide your clinical time by that figure. The calculator in Part 4 does the arithmetic and flags a ceiling with no slack.
Go to the full answer ↓Two decades of time studies, and the hours they keep finding
The figure of 2,500 patients per physician still turns up in workforce plans and recruiting conversations. Its pedigree is thin. Researchers at the Robert Graham Center traced it to an article from 2000 and concluded that it “was not based on data or a review of actual physician panel sizes.”1 Practice Insight
Starting in 2003, a team at Duke University asked a narrower question. How long would it take one physician to deliver the care that guidelines recommend to a panel of that size? For preventive services alone, the answer was 1,773 hours a year, or 7.4 hours of every working day.2 Population Data
Chronic disease added more. Covering 10 common conditions, stable patients needed 3.5 hours a day. Once the authors allowed for patients whose disease was not under control, the figure climbed to 10.6 hours, more than the time a physician has for all patient care.3 In 2009 the group put the pieces together with acute care and arrived at 21.7 hours a day.4 Population Data
The newest estimate runs higher still. Porter and colleagues at the University of Chicago rebuilt the model with real patient data from a national health survey and current guidelines, and they counted the documentation and inbox work the Duke studies left out. Their total for 2,500 adults was 26.7 hours a day. With team-based care modeled on the federal Comprehensive Primary Care Plus program, it fell to 9.3 hours.5,
Scale those totals to an 8-hour day and the implied panel for a physician who does all the work is about 920 patients on the 2009 Duke total and about 750 on the Chicago total. With the Chicago team model it is about 2,150. This is CMT’s arithmetic, not a finding of either study, and it inherits their assumption that every patient receives every recommended service.
These are models, not stopwatch measurements. The Duke authors used the shortest published time estimate for each service and called their figures conservative.2 A physician who drops low-value services would need less time than the models say. One whose patients are older or sicker than the national average would need more. Concierge panels tend to carry many Medicare patients: in the GAO survey, they averaged 185 of the 491 patients per physician.7
What a care team takes off the physician’s day
Each of these studies ends in the same place. The physician cannot do it all, so someone else has to do part of it. Altschuler and colleagues put numbers on that trade in 2012.
Their per-patient figures make a handy yardstick. When the physician does everything, recommended care works out to about 2.06 hours, or 124 minutes, of physician time per patient per year, with chronic care the largest share at 0.99 hours.8 Population Data The calculator in Part 4 measures your assumptions against that number.
The Duke group drew the conventional conclusion: two full-time nurse practitioners or physician assistants working with one supervising physician could meet the time needs of a 2,500-patient panel, with the physician focused on the sickest patients.4 Many concierge practices are built the other way. A lean office of one physician and a small staff, selling direct access to that physician, has less to delegate. Its panel has to shrink to match. CMT Research Brief No. 40 looks at staffing choices in detail.
List the tasks your members are paying you, personally, to do. Then list the ones a nurse or medical assistant could do as well. The first list sets your panel size. The second sets your staffing.
Reported panels, traditional and concierge
Time studies say what panels should be. Surveys say what they are. The two have been moving toward each other in conventional practice, while concierge panels sit far below both.
| Source | Who was counted | Panel figure | Read it with this in mind | Evidence type |
|---|---|---|---|---|
| Bazemore and colleagues, 2024 | U.S. family physicians on the board certification questionnaire; 29,463 of 55,605 could estimate their panel | Mean of 2,362 in 2013, falling to a low of 1,760 in 2021 | Self-reported; a decline of about 25% in a decade9 | Population Data |
| Raffoul and colleagues, 2016 | Studies of practices in the U.S. and abroad | 1,200 to 1,900 per physician | The authors say it is unknown whether even these panels are small enough for optimal care1 | Practice Insight |
| Murray and colleagues, 2007 | A worked example in an AAFP journal | 1,400 (20 visits a day, 210 days, 3 visits per patient a year) | Illustrative, not a benchmark10 | Practice Insight |
| Alexander and colleagues, 2005 | 144 retainer physicians and 463 nonretainer physicians, by mail survey | Mean of 898 retainer vs. 2,303 nonretainer | Two decades old; response rates of 58% and 50%11 | Practice Insight |
| U.S. GAO, 2005 | 112 concierge physicians surveyed in fall 2004 | Average of 491 patients in October 2004, vs. 2,716 the year before converting | The 491 includes an average of 166 patients outside the membership; many practices were new7 | Practice Insight |
| MDVIP website | A national concierge network | Over 1,400 physicians and more than 400,000 patients, or roughly 300 per physician (CMT arithmetic) | Company-reported network average, including physicians still building panels12 | Industry Research |
| CMT Media Desk | Concierge practices CMT follows | About 225 to 550 patients | CMT observation; method not published13 | Industry Research |
Two national figures fill in the other side of the equation. Americans made 320.7 physician office visits per 100 people in 2019, and 50.3% of those visits were to primary care physicians.14 That works out to about 1.6 primary care visits per person per year, though the average includes people who saw no doctor at all (CMT arithmetic). A typical primary care exam lasted 18.0 minutes across 21 million visits in 2017, measured from EHR timestamps.15 Population Data
Then there is the work between visits. In one Wisconsin health system, primary care physicians spent 5.9 hours of an 11.4-hour workday in the EHR, 1.4 hours of it after clinic closed. Inbox management alone took 23.7% of that EHR time.16 Practice Insight Membership practices that promise direct messaging should expect this share to grow, not shrink. That is CMT’s reading, not a measured result.
CMT’s editor, Michael Tetreault, has argued that fewer patients “doesn’t mean less care; it means more intentional care.”13 The research supports the premise that time per patient falls as panels grow. It has not tested whether a 300-member panel produces better results than a 600-member one.
A smaller panel has a cost, and patients outside it bear much of it. When a physician goes from 2,300 patients to 500, most of the old panel must find care elsewhere. A 2023 study in the Journal of Health Economics found stronger evidence that concierge patients were selected by income than by health. Spending rose sharply for patients affected by the switch, with no average effect on mortality.17 Population Data CMT examines that study in Brief No. 26 and the duty to departing patients in Brief No. 32. Plan for those patients when you set the number, not after.
The concierge figures above are either two decades old or company-reported. A short CMT survey of concierge physicians (not DPC) asking current panel size, target panel size, member visits per year, typical visit length and years since opening would give planners a current benchmark. Report hybrid practices separately, and publish the sample size, dates, recruitment method and response rate.
Editor: replace this box with CMT survey results (with sample size, dates and recruitment method) before publishing, or delete it.
Find your panel ceiling
The calculator uses the supply-and-demand identity from Family Practice Management: panel size times visits per patient per year equals visits a physician can offer per year.10 CMT adds the work between visits and a reserve for unplanned demand. It counts physician time only. Treat the result as a ceiling for planning, not a target, and not as financial or staffing advice.
Panel ceiling calculator
The examples are illustrative. The traditional example uses the 18-minute exam from national EHR data15 and the 210 days and 3 visits a year from the Family Practice Management worked example.10 The concierge example and the 124-minute yardstick’s use here are CMT assumptions; the yardstick itself comes from Altschuler and colleagues.8
Setting a panel target you can keep
A panel number is a promise to members about time. These steps turn the evidence above into a target and a date to check it. They reflect CMT’s editorial reasoning, not a published standard.
Price your time per member
Decide how many physician minutes each member should get in a year, visits and between-visit work together. The 124-minute yardstick covers guideline care with no delegation; longer visits and direct access mean more.
Count real clinical time
Start from 52 weeks and subtract vacation, CME, holidays and the hours you spend running the business. Many physicians overestimate this number.
Hold back a reserve
Same-day visits and a hard flu season arrive unannounced. A practice that books to 100% of capacity will break its access promise first.
Decide what the team carries
Every task a nurse or medical assistant takes on frees physician minutes. Write down which ones, because members will notice if the list changes.
Set a trigger, then check it
Pick the number at which you close enrollment or add a clinician. After six to 12 months, compare it with your actual visit and message counts, then pair the result with your fee using Brief No. 29 and your growth plan using Brief No. 4.
Read the time studies
Know where 21.7 and 26.7 hours a day come from, and what those models assume.
Run your own numbers
Use the calculator with your real calendar and your real visit length, then revisit it with a year of data.
Publish your panel promise
Tell members how large the practice will grow and what happens when it is full. A stated cap is easier to keep.
How this brief was built
CMT opened and read each time study cited here in October 2026: Yarnall and colleagues (2003) on preventive care, Ostbye and colleagues (2005) on chronic care, the combined Duke estimate (2009), Porter and colleagues (published 2022, print 2023) and Altschuler and colleagues (2012) on delegation. For the Porter study only the abstract and a university summary were available, so its detailed workday assumptions are not reported. Traditional panel figures come from peer-reviewed sources and a federal survey. Concierge panel figures come from a 2005 peer-reviewed survey, the 2005 GAO report, one company website and CMT’s own Media Desk; the last two are labeled Industry Research.
The time studies are simulation models built on national population data (Census, NHANES). CMT labels them Population Data because of that base, but they estimate time rather than measure it. Every “implied panel” figure in this brief that does not appear in a study is CMT arithmetic and is labeled that way. No direct primary care figures are used; DPC panel data appear separately in Briefs No. 29 and 30. The calculator is a planning aid that counts physician time only. It is not financial or staffing advice.
How to read the evidence types
Every key finding is labeled by evidence type. Labels describe the type of evidence, not its value. Each type answers different questions. Funding is disclosed on every source.
Randomized trials and systematic reviews.Best for cause and effect.
Large observational studies and government data.Best for trends at scale.
Surveys, smaller studies and expert consensus.Best for real-world experience.
Company-sponsored or company-reported data that is not peer-reviewed.Best for early signals and operating data.
Statutes, regulation and official guidance.Best for what is required.
What we don't know
- The panel size at which concierge patients’ access or outcomes start to slip. No peer-reviewed study has measured it.
- How many visits and messages concierge members actually generate in a year. No public dataset reports this for concierge practices separately from DPC.
- Current concierge panel sizes from a sample with a published method. The newest peer-reviewed figure dates from a survey published in 2005.
- How much of the modeled documentation burden ambient AI scribes and inbox tools now remove. Early studies (see Brief No. 24) measure documentation time and burnout, not panel capacity.
How to cite this brief
External review: this brief has not yet been reviewed by an outside expert. When review is complete, the reviewer is credited by name above with any conflicts of interest, and the version number is updated. Reviewers check accuracy and fairness; CMT is responsible for the final content.
Corrections policy: when an error is identified, CMT corrects it in the open and updates the version number above. Send corrections to the editor through conciergemedicinetoday.net.
Related CMT Research Briefs
References
- Raffoul M, Moore M, Kamerow D, Bazemore A. A primary care panel size of 2500 is neither accurate nor reasonable. Journal of the American Board of Family Medicine. 2016;29(4):496-499. doi:10.3122/jabfm.2016.04.150317. www.jabfm.orgFunding: none reported
- Yarnall KSH, Pollak KI, Ostbye T, Krause KM, Michener JL. Primary care: is there enough time for prevention? American Journal of Public Health. 2003;93(4):635-641. doi:10.2105/AJPH.93.4.635. ajph.aphapublications.orgFunding: federal (National Cancer Institute grants CA14236 and P01-CA72099; National Institute of Mental Health grant 5 R01 MH56846-03 with the Group Health Cooperative of Puget Sound)
- Ostbye T, Yarnall KSH, Krause KM, Pollak KI, Gradison M, Michener JL. Is there time for management of patients with chronic diseases in primary care? Annals of Family Medicine. 2005;3(3):209-214. doi:10.1370/afm.310. www.annfammed.orgFunding: not stated (no funding statement on the journal page; authors report no conflicts of interest)
- Yarnall KSH, Ostbye T, Krause KM, Pollak KI, Gradison M, Michener JL. Family physicians as team leaders: "time" to share the care. Preventing Chronic Disease. 2009;6(2):A59. www.cdc.govFunding: not stated (no funding statement in the article; published in a CDC journal with the standard disclaimer)
- Porter J, Boyd C, Skandari MR, Laiteerapong N. Revisiting the time needed to provide adult primary care. Journal of General Internal Medicine. 2023;38(1):147-155. Published online July 1, 2022. doi:10.1007/s11606-022-07707-x. link.springer.comFunding: not stated for the study; author disclosures list federal support for two authors (NIA K24AG056578; NIDDK P30 DK092949)
- McPhee D. Primary care doctors would need more than 24 hours per day to provide recommended care. UChicago Medicine Forefront. August 3, 2022. Summary via university news release. www.uchicagomedicine.orgFunding: not stated (university news release)
- U.S. GAO. Physician Services: Concierge Care Characteristics and Considerations for Medicare (GAO-05-929). August 2005. Survey of concierge physicians, fall 2004; panel figures on pages 14 and 24. www.gao.govFunding: federal (U.S. GAO; study required by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003)
- Altschuler J, Margolius D, Bodenheimer T, Grumbach K. Estimating a reasonable patient panel size for primary care physicians with team-based task delegation. Annals of Family Medicine. 2012;10(5):396-400. doi:10.1370/afm.1400. www.annfammed.orgFunding: not stated (no funding statement on the journal page; authors report no conflicts of interest)
- Bazemore A, Morgan ZJ, Grumbach K. Self-reported panel size among family physicians declined by over 25% over a decade (2013-2022). Journal of the American Board of Family Medicine. 2024;37(3):504-505. doi:10.3122/jabfm.2023.230421R1. www.jabfm.orgFunding: none reported
- Murray M, Davies M, Boushon B. Panel size: how many patients can one doctor manage? Family Practice Management. 2007;14(4):44-51. www.aafp.orgFunding: not stated (author disclosure: nothing to disclose)
- Alexander GC, Kurlander J, Wynia MK. Physicians in retainer ("concierge") practice: a national survey of physician, patient, and practice characteristics. Journal of General Internal Medicine. 2005;20(12):1079-1083. pure.johnshopkins.eduFunding: mixed: professional society (AMA Institute for Ethics), foundation (Robert Wood Johnson Clinical Scholars Program) and academic (MacLean Center for Clinical Medical Ethics)
- MDVIP. About MDVIP (company website). Accessed October 2026. www.mdvip.comFunding: industry (MDVIP company website)
- Concierge Medicine Today. Media Desk: quotes from the Editor-in-Chief, FAQs and data. Accessed October 2026. conciergemedicinetoday.netFunding: Concierge Medicine Today (self-published; no outside funder) CMT original
- National Center for Health Statistics, Centers for Disease Control and Prevention. FastStats: Ambulatory care use and physician office visits (National Ambulatory Medical Care Survey: 2019 National Summary Tables, table 1). Last reviewed September 1, 2026. www.cdc.govFunding: federal (CDC National Center for Health Statistics)
- Neprash HT, Everhart A, McAlpine D, Smith LB, Sheridan B, Cross DA. Measuring primary care exam length using electronic health record data. Medical Care. 2021;59(1):62-66. doi:10.1097/MLR.0000000000001450. experts.umn.eduFunding: foundation (Robert Wood Johnson Foundation, Grant No. 41978, in part)
- Arndt BG, Beasley JW, Watkinson MD, et al. Tethered to the EHR: primary care physician workload assessment using EHR event log data and time-motion observations. Annals of Family Medicine. 2017;15(5):419-426. doi:10.1370/afm.2121. www.annfammed.orgFunding: academic (University of Wisconsin Department of Family Medicine and Community Health, SSRCA program funds for the observation validation)
- Leive A, David G, Candon M. On resource allocation in health care: the case of concierge medicine. Journal of Health Economics. 2023;90:102776. doi:10.1016/j.jhealeco.2023.102776. ideas.repec.orgFunding: not stated
Educational and informational only. This CMT Research Brief does not constitute medical, legal, tax, financial, accounting or other professional advice, and it does not create a professional relationship of any kind. Statements about laws, regulations, tax rules and payer policies are general, may not reflect the rules in your state, and can change after publication. Consult a qualified attorney, accountant, tax adviser, compliance professional or licensed clinician before acting on anything here.
Independence. Concierge Medicine Today is an independent publication. It does not accept payment for favorable coverage, and it does not favor one practice model over another. Company names and products are mentioned for context only and are not endorsements. Funding is disclosed for every source in the reference list.
Accuracy. CMT verifies figures against their original or best available sources at the time of publication. Where a figure is an estimate, an inference or a company-reported number, the brief says so. This content is not without possible error or omission.
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