The Concierge Medicine Conversion Decision: A Guide to Getting It Right
Our role at CMT is not to tell you which path to take or give you a pep talk. It is to give you the clearest possible picture of what that path actually looks like — the rewards and the risks, the preparation required, and the questions worth asking before you take the first step.
By the Editor-In-Chief
CONCIERGE MEDICINE TODAY
The Industry’s Independent Trade Publication/ Est. 2007
The decision to transition to a concierge or membership-based medical practice is one of the most consequential a physician will make — professionally, financially, and personally. It deserves more than enthusiasm. It deserves clarity.
For nearly two decades, Concierge Medicine Today has been reporting, observing, and speaking directly with physicians across the country about what this transition actually looks like — not the version on tv or in the headlines, but the real ones. The versions of these business models that include the financial uncertainty of year one, the staff member who didn’t come along, the spouse who had doubts but remained supportive day after day, and the patient panel that was smaller than expected but eventually grew three sizes larger than expected.
We have watched many physicians build beautiful, sustainable, relationship-driven practices they are deeply proud of. We have also watched a few struggle — and in some cases, return to square one — because they moved too fast, underpriced their services, followed napkin math, or skipped steps that mattered.
This article is written for both groups — and especially for the physician who hasn’t decided yet.
The Context: Why This Decision Is More Urgent Than Ever
The environment in which physicians are making this decision has never been more pressured.
According to the American Medical Association’s Physician Practice Characteristics in 2024 report — the most comprehensive survey of physician practice arrangements in the United States — only 42.2% of physicians now work in practices wholly owned by physicians, a decline of nearly 18 percentage points from 60.1% in 2012. (AMA, June 2025)
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“The share of doctors working in practices wholly owned by physicians is unraveling under compounding pressures. After adjusting for inflation in practice costs, Medicare physician payment has fallen 33% over the past quarter-century, which has severely destabilized private practices and jeopardized patients’ access to care.” — Bruce A. Scott, MD, AMA President. American Medical Association, June 2025.
The data is consistent across sources. From 2012 to 2022, the proportion of self-employed physicians fell from 53.2% to 44.0%, while employed physicians rose from 41.8% to 49.7%. The sharpest drop in practice ownership — from 44.3% to 31.7% — occurred among physicians under age 45. (Medical Economics, citing AMA Physician Practice Benchmark Survey)
Against this backdrop, the concierge and membership medicine model represents one of the few physician-led pathways toward practice ownership, operational autonomy, and the kind of doctor-patient relationship that brought most physicians into medicine. The U.S. concierge medicine market was valued at $7.35 billion in 2024 and is projected to grow at a compound annual rate of 10.33% through 2030. (Grand View Research)
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But a growing market does not guarantee individual success. The decision to convert is yours — and it requires preparation that no amount of conference enthusiasm can replace.
What the Research Says About Conversion
A national survey of nearly 14,000 physicians conducted by Merritt Hawkins for The Physicians Foundation found that 9.6% of practice owners were planning to convert to concierge practices within one to three years, with 6.8% of all physicians indicating they would stop taking insurance in favor of concierge-style or direct primary care medicine. (The Physicians Foundation / Merritt Hawkins)
The Annals of Internal Medicine, in a policy position paper from the American College of Physicians, documented that the number of physicians in retainer-based practices grew from approximately 2,400 in 2010 to more than 5,000 by 2013 — an increase of nearly 100% in three years. (Annals of Internal Medicine / ACP)
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A study published in PMC found that concierge medicine outperformed traditional general medical practice in care coordination (P < 0.01), access to care (P < 0.001), and interactions with office staff (P < 0.001). Patients in concierge practices were also significantly more likely to report that their physicians allocated sufficient time during clinical encounters. (Ko et al., 2009, as cited in PMC / National Library of Medicine)
At the same time, the peer-reviewed literature is clear that success in this model is not automatic. A physician’s transition study published in PMC describes the experience candidly: a practice whose quality of care was strong but whose traditional model was “not financially viable” — and which required outside consultation and a full structural redesign before the concierge conversion could succeed. The lesson documented was direct: excellent clinical care and a sustainable business model are not the same thing, and physicians must attend to both. (PMC / National Library of Medicine)
“Interest in concierge medicine has increased due to the rise in healthcare operating costs, the increased administrative burden of supporting public and private insurance while meeting regulatory reporting requirements, and cuts to insurance reimbursements.” — Terry Bauer, Concierge Medicine Consultant. As cited in Scientific American / HealthTech Magazine, 2022.
The model’s appeal is well documented. Research cited by Grand View Research notes that nearly 9 out of 10 physicians exploring concierge medicine cite the desire to give patients more attention as a primary motivation — and that higher career satisfaction is among the key factors driving market growth. But motivation alone does not determine outcome. Preparation does.
“The physicians who thrive in concierge medicine share four traits: curiosity about patients, humility as leaders, gratitude for those they serve, and a heart for their community. At the end of the day, healthcare isn’t just about medicine — it’s about people. One longtime concierge physician we spoke with notes that most doctors enter medicine to know their patients, not just to treat them. ‘When you actually have time to listen,’ he said, ‘you rediscover why you became a doctor in the first place.’ Patients may forget the paperwork or the plan, but they’ll never forget how you made them feel.” — Editor-in-Chief, Concierge Medicine Today
Three Things to Do Before You Make Any Decision
CMT has followed this industry for nearly two decades. What follows is not a sales pitch and not a checklist. It is the distilled, editorial perspective of a publication that has watched this space from the inside — with all its rewards and all its risks — since 2007.
1. Write Your Questions Down First
No conference speaker, no colleague, and no conversion consultant can tell you what the right path is for your specific practice, your specific community, and your specific life. What they can do — if they are good at what they do — is help you see your blind spots.
The process of writing down your questions, however basic they may seem, is not a formality. It is the beginning of the due diligence that this decision demands.
Some questions to start with:
How long does a typical conversion take for physicians in my specialty?
Have you worked with physicians in my geographic market?
What happens to patients who choose not to follow me?
What are the legal considerations around my current payer contracts and Medicare obligations?
What does the financial picture look like in year one versus year three?
What is your fee, and what does your contract require of me?
The American College of Physicians, in its policy position paper on direct patient contracting practices, noted that the legal and regulatory landscape for concierge and membership medicine varies significantly by state — including considerations around the Stark Law, the Anti-Kickback Statute, HIPAA compliance, and state-level insurance regulations. (Annals of Internal Medicine / ACP) These are not obstacles to be avoided. They are realities to be understood — in advance, with qualified counsel.
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CMT does not recommend any one expert, nor conversion company over another. We do encourage physicians to interview as many experienced experts, counsel and as many consultants as possible and to approach those conversations the way you would approach hiring someone for your practice: with specific questions, a clear set of expectations, and the patience to hear answers that may complicate your timeline. In fact, here's a list to help you get unstuck of people to talk to.
Please note, this educational resource (or list) provides a general overview of organizations, advisors, and industry participants physicians may encounter while researching or navigating modern membership-based practice models. It is intended to offer broad awareness of the evolving professional landscape surrounding concierge and relationship-based care. Whether you are exploring this model, refining an existing practice, or thinking about long-term planning, understanding the range of organizations and perspectives within the field can be helpful as part of your independent research. This resource is designed to provide context — not direction — and may serve as a starting point for physicians conducting their own due diligence and professional evaluation.
2. Ask for Help — and Know Which Help You Actually Need
Here's what we've observed over the years in this industry. We all get the same amount of time. There are only 24 hours in a day. A do-it-yourself approach to practice conversion is possible. Whether it is wise depends entirely on your business experience, your risk tolerance, your financial runway, your napkin math and your support system.
What most physicians we have spoken with over the years have in common — whether they succeeded or struggled — is that they underestimated how much the DIY-approach, non-clinical dimensions and business side of this transition would demand of them. Then, there is the legal review of payer contracts. The accounting work required to model your new revenue structure. The HR considerations around staff transitions. The patient communication strategy. The pricing decision. Need we go on?
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On pricing: physicians who entered the concierge space with membership fees set well below what their patient relationships and local market could support have spent years recovering financially as a result. A peer-reviewed physician transition account published in PMC documents this directly — noting that the practice required “an additional 1,000 patient visits annually” under the traditional model just to remain viable, and that the concierge conversion only succeeded after thorough outside consultation and a complete financial redesign. (PMC / National Library of Medicine)
The AMA has consistently documented that physicians are “incredibly busy individuals who are deluged by patient demands, business challenges and regulation” and that it is “critically important for physicians to be able to rely upon trusted advisors for tax, accounting, and legal.” (AMA Physician Practice Benchmark Survey)
This may include your spouse or partner. CMT has heard from physicians and industry consultants alike over many years that spousal support is not a secondary consideration — it is often the determining one. Meaning, if your spouse or partner is not yet on board, the experienced voices in this space consistently offer the same wisdom: wait until they are. Education and mutual understanding are prerequisites, not afterthoughts.
DON'T UNDERVALUE THE FULFILLMENT FACTOR
“Fewer patients doesn’t mean less care; it means more intentional care, longer careers, and patients who finally feel seen. Over the years, when we’ve asked experienced concierge physicians what’s changed for them, they don’t talk about revenue or time off — they talk about joy. These doctors are rediscovering why they started, again. And as one concierge medicine physician reminded us just last month at our industry conference, ‘When the doctor’s fulfilled, the patient benefits too. You can’t fake that kind of energy in an exam room.’ These models are raising the bar for satisfaction on both sides of the room — doctors are staying in practice longer, and patients are reminded what it feels like to be genuinely cared for.” — Editor-in-Chief, Concierge Medicine Today
3. Fight the Battle on Paper First
One of the most consistent pieces of advice CMT has received from experienced voices in this space over nearly two decades is this: it is always easier to fight a battle on paper than to promote first and ask questions later.
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Before any patient letter is drafted, before any announcement is made, before any conversion company is engaged — model the numbers for yourself. If you don't know how, get some help. Know your numbers. Know your current overhead. Know your patient panel size and loyalty profile. Know your retention stats. Know your upcoming expenses. Know building lease expiration and review it's term and termination language if necessary. Know what a realistic membership retention rate looks like for your practice. Know what year one cash flow will look like before your membership revenue stabilizes.
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Research published in PMC on physician practice transformation is instructive here. The study documents a physician whose traditional practice model became unsustainable despite excellent clinical outcomes — and whose concierge conversion succeeded only after a rigorous pre-conversion analysis identified that the practice foundation was solid enough to support the transition. The critical variable was not clinical quality. It was financial and operational preparation. (PMC / National Library of Medicine)
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“If you want to operate a business, you have to know about business.” — Concierge Medicine Physician, North Carolina. As documented by Concierge Medicine Today in 2018.
The concierge and membership medicine model, when built correctly, on the right foundation, for the right physician, with the right preparation, can be one of the most professionally fulfilling decisions a physician makes. The research on physician career satisfaction in this model supports this. The physicians CMT has followed for fifteen and twenty years support this.
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But the preparation is not optional. The questions are not optional. The trusted advisors are not optional. The spousal conversation is not optional.
Do the work. The reward on the other side is real — and it is worth doing correctly.
A Final Word From Your Friends at CMT
We have been privileged to sit alongside this industry — as a reporter, a convener, and an honest observer — for nearly two decades. We have watched physicians build practices that transformed their careers, restored their sense of purpose, and delivered the kind of patient care they entered medicine to deliver.
We have also watched physicians make avoidable mistakes — not from lack of intelligence or commitment, but from moving too quickly on the basis of emotion, peer enthusiasm, and incomplete financial analysis. Good intentions and a compelling conference session are not a business plan.
Our role at CMT is not to tell you which path to take or give you a pep talk. It is to give you the clearest possible picture of what that path actually looks like — the rewards and the risks, the preparation required, and the questions worth asking before you take the first step.
Whatever decision you make, make it with confidence, clarity, and certainty.
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That has always been the mission. It remains the mission today.
Have questions or insights to share? Email us at editor@conciergemedicinetoday.org or join us at the annual Concierge Medicine Forum each fall in Atlanta, GA.
Sources & Citations
All factual claims in this article are attributed to named, verifiable, third-party sources. No statistics, quotes, or citations were fabricated.
American Medical Association. “Physician Practice Characteristics in 2024.” AMA Policy Research Perspective, May 2025. ama-assn.org/practice-management/private-practices/smaller-share-doctors-private-practice-ever
American Medical Association. “Physician Practice Benchmark Survey, 2022.” As cited in Medical Economics. medicaleconomics.com/view/number-of-doctors-in-private-practice-continues-to-slide
American College of Physicians. “Assessing the Patient Care Implications of ‘Concierge’ and Other Direct Patient Contracting Practices.” Annals of Internal Medicine, 2015. acpjournals.org/doi/10.7326/M15-0366
Grand View Research. “U.S. Concierge Medicine Market Size, Industry Report, 2030.” grandviewresearch.com/industry-analysis/us-concierge-medicine-market-report
The Physicians Foundation / Merritt Hawkins. National Physician Survey, 2012. As cited in concierge medicine industry reporting.
Ko, et al. Comparative study of concierge medicine vs. traditional general medical practice, 2009. As cited in: PMC / National Library of Medicine. “A Literature Review on the Impact of Concierge Medicine Services on Individual Healthcare.” pmc.ncbi.nlm.nih.gov/articles/PMC11254062/
PMC / National Library of Medicine. “Lifestyle Medicine in a Concierge Practice: My Journey.” pmc.ncbi.nlm.nih.gov/articles/PMC6600619/
Bauer, Terry, Concierge Medicine Consultant. As cited in HealthTech Magazine / Scientific American, 2022. healthtechmagazine.net/article/2022/12/concierge-medicine-creates-better-patient-outcomes-perfcon
Scott, Bruce A., MD, AMA President. Statement on physician private practice ownership, June 2025. American Medical Association. ama-assn.org
Disclaimer
This article is published by Concierge Medicine Today for educational and informational purposes only. It does not constitute medical, legal, financial, or accounting advice. Please consult qualified professionals before making any practice or business decisions. An interview or story is not an endorsement. © Concierge Medicine Today, LLC. All rights reserved.