Concierge and Hybrid Models Offer Physicians Practice Options

Are you looking for a change, a different way to run your medical practice? Patrick Hennesssy, MD, was. The medical director and founder of Orlando Executive Health says he believed there was still a role for high touch, quality, relationship-based medicine. “But I also knew that if I played by insurance company rules, there was no way I could survive as a primary care physician.”

Instead, Hennessey opened a practice that he says was purpose-built as a concierge, relationship-based, primary care, internal medicine practice. He hired staff with a background in customer service, designed an office that “looks more like a gentleman’s club than a doctor’s office,” and never looked back.

The right mindset

Hennessey says the key to making a concierge practice work is that both the physician and the staff should not be running away from what he calls “managed care, churn and earn practice,” but instead running toward relationship-based, high-touch healthcare.

“One of my patients described my practice as having your own corporate medical director on a time share, rather than staying at a Motel 6,” Hennessey says. He relishes when patients call at 8:30 in the morning with a problem, not really expecting to be able to see him that day, and his assistant asks them, “When can you be here?” They can arrive by 9, leave by 10, and be back to work with the problem taken care of. “I’m working directly for my patients, not the insurance company,” Hennessey explains.

But success depends on more than just having the right mindset, he cautions. For a younger physician, it’s important to make sure you’re sufficiently capitalized so you can set the practice up the right way.

“And preserve your capital so that you don’t get halfway up and running and then get panicked because you feel like you have to get patients in, so you start accepting insurance contracts. You’ll lose your momentum, and lose your way in the financial uncertainty.”

The hybrid approach

Susan Wilder, MD, was also tired of what she calls “a diseased payment system.” She opened her Scottsdale, Arizona practice six years ago, but it was just over two years ago that she decided it was time for a change.

“Both patients and providers are increasingly disenchanted with the system that doesn’t reward patient-centered care,” Wilder says. Her hybrid concierge medical practice, LifeScape Medical Associates, PC offers the best of both worlds.

“We didn’t give patients the all or nothing option,” says Wilder, explaining that patients have the choice to invest in the concierge model, or remain in traditional primary care practice mode. “I looked at it like adding first class to the airline. Not only did it offer those patients who wanted first class that opportunity, it also subsidized coach.”

As a result, Wilder and her associates are able to spend more time with their regular patients. “We can lose a little money on the primary care side, but we can do that because we have a way to be creative financially. It’s a win-win for the patients and the practice.”

But Wilder cautions that transitioning from traditional medical practice to a hybrid concierge model was a scary undertaking. It was a softer step as opposed to a giant leap into a straight concierge practice, but just as she and her associates began the transition, the recession hit. And in Arizona, it hit hard.

“We were ground zero,” Wilder recalls. “But having the hybrid allowed me not to have all me eggs in one basket. Patients had the option of still remaining with me as their provider even when they could no longer afford to be in the concierge model. And many of them want to come back to that model as soon as they can afford to. So, they have a choice.”

Additional considerations

Hennessey suggests that physicians who are considering a change to a concierge model should try, whenever possible, to control their overhead, and have it grow as much as possible proportionate to their patient base. Beyond that he says that all the good sense practice management principles still apply, “minus anything that has to do with insurance contracts.”

Wilder, who is also the medical director for Concierge Choice Physicians, says that the hybrid model allows physicians to take a gentler step to see if the model is right for them, because “simply labeling your practice as a concierge practice and charging a lot of money does not make you a good provider. I think when physicians go into concierge medicine because they really believe in the service and that personal relationships with their patients, those are the physicians who are going to succeed.”