Optimal wellness (aka thriving not surviving) is officially part of the cultural zeitgeist, and not just for devoted health junkies. And, as people seek more integrative and personalized forms of healthcare, the conventional primary care model that seemingly worked for so many years, is now falling short for some. This is why the membership-based concierge medical model has grown in popularity in recent years, featuring individualized care, comprehensive treatments, and long-term wellness planning.
Also referred to as boutique, personalized, and direct-practice medicine, the buzzy new model allows patients to keep doctors available on-call while making integrative and functional therapies more readily available for patients.
"Concierge medicine allows for on-demand medical care, advanced functional testing, and personal access to a physician," explains Dr. Shan Siddiqi, medical director and concierge physician at Integrative Aesthetics in Miami, Florida. Concierge medical practices are essentially fee-based, ranging in price from hundreds to thousands of dollars annually. Because physicians are paid on retainer, practices can limit the number of members to ensure that doctors have time to provide individualized, time-intensive care to each patient. In exchange, patients have access to their medical providers 24/7, and the ease of follow-up is ideal for the treatment of complex and chronic health concerns.
These practices also often offer diverse therapies that go beyond a singular specialty; for instance, Dr. Siddiqi works alongside naturopathic doctor Nadia Musavvir, who treats a variety of concerns including digestive disorders, anxiety and mood issues, PCOS, and hormone imbalances — to name a few. Because of the range in scope, concierge practices can often (but not always) replace the need for a primary care physician entirely, and are often able to perform the functions of an urgent care facility. Most patients still keep their insurance, however, to cover hospital stays, in-network referrals, not to mention emergency care while traveling.
"Since COVID-19 hit the US, concierge medicine has gained significant popularity," says Dr. Ehsan Ali of the Beverly Hills Concierge Doctor. He notes that his practice’s membership doubled in size during the pandemic with patients appreciating that quick access to treatment. If you have ever waited for hours in a waiting room, or called the doctor and had to wait weeks for an appointment — or even months for a specialist — the beauty of concierge medicine is that it facilitates care in a matter of hours, and can even help move patients to the top of waitlists — but with the pros come the cons. Learn more about the rising healthcare trend below.
How Is Concierge Medicine Different From Primary Care?
There are several elements that set concierge practices apart from their traditional counterparts. The goal for both is to prioritize the patient’s access to healthcare and to facilitate ongoing care between patient and doctor. However, concierge practices do so by keeping doctors’ caseloads (i.e., the number of patients they meet with) smaller. This yields more time spent with patients at appointments, where they have the opportunity to provide broader and more in-depth counseling. More frequent communication between appointments facilitates seamless ongoing care, while also permitting the doctor more time to research and create long-term, comprehensive treatment plans. This type of personalized healthcare also often includes luxury facility amenities and the options for house calls (more on that later).
Concierge practices typically follow an annual, fee-based membership model to keep caseloads small with different tiers of coverage. The Spring Center in Orange County, California preceded the concierge trend with a model that included tiered benefits like telehealth calls and discounts on supplements. Every patient at the center goes through an in-depth intake process with the integrative doctor, Kelly McCann, MD who spends extensive time with her patients and incorporates diverse therapies — from vitamin IVs, to dietary counseling, to custom supplement regimens — into her treatment planning. Patients also have the option of booking with her physician associate (if she’s unavailable) and she has a list of recommended specialist providers that she regularly refers to.
True concierge practices emphasize minimal wait-times. Sollis Health, which requires no appointments and boasts no wait times, is a chain of private concierge practices with locations in New York City, the Hamptons, Los Angeles, Miami, Palm Beach, and soon, San Francisco. The membership fee includes "unlimited visits to the doctor with no co-pay; round-the-clock telemedicine; patient advocacy; care coordination; VIP services at leading hospitals; and expedited access to an exclusive network of specialists."
24/7 Access, 365 Days a Year
"Essentially, each individual patient has direct access, 24/7, to guidance from an MD, including during weekends, evenings, and holidays," says Chicago-based Dr. Marcie Claybon, medical director at BIÂN health center. Their patients typically reach out via e-mail, phone calls, or text message, and receive expedited medical advice. Due to smaller caseloads, the practice is also able to take appointments in-office within 24 hours, or to schedule telehealth appointments.
Immediate Emergency Treatment
"Sollis was founded with one goal in mind: to offer high-quality care for any medical issue at any time, with no waits or appointments," says Sabine Heller, chief commercial officer of Sollis Health. "We can handle 90% to 95% of what an ER can, and if a member prefers to have a physician come to their house, we can arrange for that, too." In instances when you need to see a specialist, a Sollis professional will handle the paperwork and referral process for you, acting as your patient advocate should you be admitted to the hospital.
Concierge doctors can also schedule at-home visits. Dr. Ali points out that traditional doctor's office visits can be cumbersome — making appointments, driving to the office, and waiting with other patients that might be symptomatic. As Dr. Siddiqi points out, home visits are ideal for discretion and for convenience when you're not feeling well. In-home offerings are more popular than you might think, ranging from treatment for colds and ailments, but also including blood draws, testing and evaluation (such as for COVID), custom vitamin IV's and injections, and more. That being said, to make the appeal of coming to the office worth it, concierge doctors often make their offices luxe and spa-like.
Functional, Integrative, & Holistic Offerings
"There is definitely a growing trend toward embracing medical care that supersedes the 'checkbox' approach [to diagnostics and treatment]," says Dr. Claybon. "Patients want to feel great, rather than fine, and the current traditional medical model often stops at 'fine.'" To achieve optimal health, concierge care might lean on multiple therapies that go beyond what you would expect from your primary care doctor — vitamin IV’s, allergy and food sensitivity testing, hormone testing, and more.
What is particularly exciting for wellness enthusiasts is that buzzy holistic health practices — think infrared saunas, ice baths, cupping, or even hyperbaric oxygen therapy, to name a few — can also be part of your personalized treatment plan. Dr. McCann regularly works with her patients to modify their diets and recommends (and even compounds her own) supplement blends, in addition to the medications she prescribes. As Dr. Claybon points out, BIÂN patients are typically "interested in holistic medicine, or an East-meets-West approach." So, in addition to performing all the functions of a primary care physician, patients at BIÂN may be referred to modalities that include acupuncture, naturopathic nutrition, ayurvedic medicine, massage therapy, chiropractic therapy, fitness training, meditation, and more, all under one roof.
Individualized Treatment Planning
"We offer an ultra-personalized treatment plan for each guest, from our high-tech full body scanner, to singing bowl therapy," says Nils Behrens, CMO of Lanserhof Group, which serves Europe. Lanserhof guests are assessed by a doctor and prescribed a unique combination of therapies from the Lanserhof Concept — from cryotherapy to psychological therapy; from fasting to nutrition. "Our team of physicians and therapists is constantly [working to incorporate] the latest scientific findings [from] naturopathy, energy medicine, psychology, chronomedicine, and Western medicine."
Sollis Health emphasizes their desire to help their patients navigate the healthcare system, and to be their advocate. "We act as your sherpa, guiding you through the medical system and doing all the heavy lifting,” says Heller. "We have relationships with the best [doctors] worldwide and can get you expedited appointments with the best practitioners, from cardiology to dermatology to psychiatry. Instead of waiting weeks, we'll get you in within a matter of days." This is why most patients keep their primary health insurance, in the case of outside referrals or emergency care.
Concierge doctors are aware that their patients are paying extra, so they seek to make it a luxury experience. "We are not a traditional dental office. A visit with us feels more like a spa. We feature all the luxury amenities you could imagine — TV's in the ceiling, noise-cancelling headphones, CBD gummies, nitrous oxide," says Dr. Ben Reyhani, aesthetic dentist and partner at Apa Aesthetic LA.
Meanwhile, a membership at BIÂN is akin to a Soho House for health-lovers: guests have access to a luxury facility with a gym, spa, restaurant, medical office, and beauty services, as well as the on-site lab and medical services. A stay at a Lanserhof location is nothing short of a health-minded vacation at a five-star European resort, with seven-day stays starting at 7,000 euros.
Who Benefits From Concierge Medicine?
Both patients and doctors benefit from the rapport-building concierge medicine facilitates to the elevated standard of care received. Patients with chronic health conditions that require ongoing treatment appreciate more one-on-one time and consistent care from their doctors.
Those with lifestyle constraints or overactive schedules that make it difficult to work wellness visits and doctor's appointments into their routines could benefit from this type of health care model. Lanserhof often treats high-powered executives that come for stays annually to receive all of their testing and check-ups in one place in lieu of having a primary care doctor.
Plus, doctors genuinely want to help improve the lives of their patients and to expand their knowledge by treating complex, interdisciplinary cases. "During residency, I often only had fifteen minutes to spend with patients with complex, chronic diseases," says Dr. Siddiqi. "I had enough time to address their diseases according to the standard care model [but] there was rarely ever time to discuss the importance of sleep, diet, exercise [without] drastically increasing the wait time of other patients."
Heller points out that spending more time with their patients also humanizes medicine, stating, "That goes a very long way towards the recovery and well-being of a patient, and intrinsically allows for preventative care."
Is Concierge Medicine for You?
If you are wondering whether concierge medicine might be for you, Dr Siddiqi sums up some main differences between conventional and concierge patients. "Concierge patients tend to put more of a priority on health management rather than symptom control," he continues. "They are often focused on optimizing performance in a specific domain, and they want better access. They don't want to wait one-to-two weeks for an acute concern."
The prerequisite ability to pay is perhaps the only downside. In a country where not everyone has access to healthcare, the privilege to pay for an elevated standard of care is unfortunately available only to some. But for those that can pay and want to prioritize their health and wellness, concierge medicine is the future. "When someone needs medical attention, the convenience of having a doctor to call directly 24/7 is priceless," says Dr. Ali. And the fact is, those that can afford it are more interested than ever in being proactive in their medical care. "This is something which has changed in the last 10 years," Behrens says. He notices that their guests are much more motivated to optimize their health, oftentimes coming after receiving treatment in the interest of detoxifying the body and feeling better holistically. "In general, I would say that [the pandemic has spurred] increased awareness of physical, mental, and spiritual health," he says.