Innovative Model of Care

Dr. Obayedur Khan March 2, 2020 boutique medicine, Concierge medicine, Direct primary care (DPC)
Concierge medicine

Concierge medicine, boutique medicine, or direct primary care (DPC) are terms used interchangeably to describe a new concept in medical care, which is gaining popularity among doctors as well as patients. Those who are unaware of what concierge medicine entails, here is a brief explanation about how it works. In a concierge setting, a doctor limits his patient population to a couple of hundred to several hundred in some cases up to 600 depending on what model he or she follows. Due to a low number of patients, a doctor only sees 3-8 patients a day. As a result, patients are allowed extra time during their visits, and there is usually no wait time in the office. Additionally, when called by a patient, the doctor can see them on the same day or next day. Due to the nature of the practice, doctors make themselves available 24/7 via their cell phone. Many doctors allow telemedicine. 

Most concierge doctors follow their patients in the hospital. Some follow their patients in nursing homes and also make home visits. In contrast, a general practitioner has thousands of patient in his or her practice, sees 20-30 or more patients a day, cannot see a patient on a timely fashion, has a long wait time in the office, does not go to hospital or follow patients outside office setting, does not usually answer calls from a patient. Due to the nature of the practice, a traditional general practitioner also cannot accommodate same-day appointments and sees a patient for only 5-10 minutes. The growing dissatisfaction is making concierge medicine popular.

Now let’s discuss how the payment works for concierge medicine, boutique medicine or direct primary care. There are several models of practice. It depends on where your practice is and which model you follow. In one model, a doctor takes a lump sum once a year fee, and that’s all. In this model, most do not seek reimbursement from insurance, reducing administrative burden. This, in turn, reduces overhead expenses. In another model, a practitioner charges monthly fees and also charges a patient’s insurance provider. In another model of care, a doctor may take a higher number of patients and can charge less fees. In this model that is followed by MDVIP, a Johnson and Johnson company, doctors are allowed to take up to 600 patients. Patients are charged a yearly fee and their insurance company is also billed for their visits. A copayment is also collected. Due to their nationwide network, MDVIP patients are able to see a doctor anywhere in the country if they are vacationing or visiting outside their primary area. Since a third party is involved, overhead costs may be more than usual concierge practice.

In contrast to general wisdom, most concierge patients are not from the highest income group. In fact, the top most earners are less likely to sign up for concierge care. Instead, middle class and upper-middle-class families are the customers of concierge care. Patient satisfaction in concierge care remains exceptionally high. As a result, retention is also high. In my experience, none of my concierge patients went back to traditional practice.

I started my concierge medical practice 4 years ago and I am satisfied in terms of providing care and following my lifestyle. Most importantly, my patients are satisfied. I invite you to visit my website: www.conciergemedicalofnaples.com

Obayedur Khan, MD, FACP

Dr. Obayedur Khan, a double board certified internist and fellowship trained geriatrician, has been practicing in Naples since 2005. A graduate of Salimullah Medical College, Dhaka, Bangladesh, Dr. Khan is a fellow of American College of Physician and affiliated with Naples Community Hospital. Dr. Khan is a Castle Connolly and Gulfshore Life Top Doctor.

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