Concierge Care

Gladstone Sellers MD, an Internist in Atlanta, Georgia, has been running a concierge practice since 2008. Prior to his current practice model, Dr. Sellers built a practice from the ground up. Noticing that more intrusion from third parties was forcing patient visits to get shorter and shorter, he wanted to spend more time with his patients to ensure the best care possible.
After a transition that took about 18 months, the concierge model was up and running. Dr. Sellers says that there are several ways to build a concierge practice, and he describes the mechanics behind the path that he and his partners took. First they looked at their patients who they had seen over the 18 months prior to starting the concierge model. They decided how many patients they could allow into their concierge practice based on the amount of time they estimated spending with each patient per year. With at least one annual physical examination per patient per year and a calculation that included the number of yearly office visits expected per year by patient age, they came up with an upper limit of patients they could enroll into the practice. Then, they sent their patients a letter describing the new practice model, and explaining what the reasoning behind it was, inviting patients to sign up. After information sessions and a FAQ page for patients, patients began signing up for the concierge practice. The group communicated with their patients' health insurance companies, and they were able to build an agreement with all but one health company.  About 9 months of the transition were nerve-wracking, with the doctors wondering if it would work, but realizing that they did not want to go on practicing with the more prevalent care model that they found inconsistent with how they wanted to take care of their patients.

The system works like this: patients pay an annual fee, which includes access to their doctors. Dr. Sellers says that he gives his patients his phone number and email address. This allows him to determine whether a patient question or problem is best handled through an in office visit (with a billing code that is paid for by the patient’s insurance) or through a phone call, email or text (which do not have a billing code.)  There is no incentive to bring patients in unnecessarily in this patient-centered practice. The most common question he gets from other doctors is, “how can you give patients your phone number?” His answer is simple. He says that using the typical healthcare model, patients treat their doctors offices like a rental car, without thought for taking care of it for the long-term. Yet, when patients use the concierge model, they treat the doctor’s office like their own care, taking good care of it. The practice grows through personal patients referrals, and that, he says, is his ideal way of meeting new patients, because they know exactly what they are signing up for.
Dr. Sellers and his partners tell their staff to treat patients, “like the family you like.” He explains that the office staff doesn’t just send patients with a referral for a lab test or a consultation, but, instead, help patients make appointments and follow through with continuity of care to ensure that the details are well taken care of.
Concierge care was still relatively new when a large national boutique medical care company, MDVIP, approached Dr. Sellers and his physician partners with a proposal to help them transition to a concierge practice model around 2004.  The agreement would have entailed that the group of physicians would be employed by MDVIP for a period of 5 years, during which MDVIP would collect 1/3 of the gross collections. The time was not right for the group, but a few years later, they hired a consulting group from Chicago to help them with the transition into concierge care, with Dr. Sellers and his partners maintaining primary control of the process and paying the consultants a fee. The transition took about 18 months, after which Dr. Sellers and his partners decided to retain the Chicago company, SpecialDocs Consultants, Inc as consultants. He says that they found the consulting group through a recommendation from another physician practice. But now Dr. Sellers explains that there are many models of transitioning into concierge care and a number of consultants on the market. While Dr. Sellers explains that it is not impossible for physicians to make the transition to concierge care independently, he does recommend hiring a professional with experience in the process. The reason, he explains, is that physicians moving into concierge care need to know how to do it and to have a plan all set out, including marketing, the financial calculations, printed materials for patients, and an understanding of how to inform patients’ insurance plans and how to continue to work with those plans.  He says that concierge care may not be right for every practice. For example, he explains that if most of the patients in your practice do not place strong value on seeing the same doctor over the long haul, then concierge care would not be a good fit for the practice.

After years in the concierge practice that he built, Dr. Sellers is sure he did the right thing. He believes that concierge practices maintain value after retirement, as physicians who are starting out are likely to want to buy into successful concierge practices because it is a good health care model that maintains doctor and patient satisfaction while providing good care.