Concierge medicine companies registering more physicians

The number of physicians signing on with concierge practice companies has increased, according to statements issued in September and October by two large organizations offering these services. Concierge practices, however, remain a small part of the health system.

"I don't envision that it is going to be 20% to 30% of health care," said Wayne Lipton, managing partner of Concierge Choice Physicians, based in Rockville Centre, N.Y. "A couple percent is probably more realistic. It's not for every doctor."

The company offers physicians a hybrid concierge program. A member practice continues to take insurance and see a significant proportion of patients in the usual way. Patients have the option of choosing to pay a monthly fee for additional services, such as 24-hour direct phone and e-mail access to their physician. About 50 to 150 patients usually do so.

A total of 172 practices signed on with Concierge Choice Physicians as of October, an increase from the 120 that enlisted at the beginning of the year.

MDVIP, which is based in Boca Raton, Fla., also reported growth. Practices that signed on with MDVIP, which was purchased by Procter & Gamble in December 2009, restrict the patient population to no more than 600. All the company's patients pay fees for additional services such as longer appointments.

MDVIP had 430 practices as of October. A year ago, 330 were signed on. Many of these practices continue to take insurance, including Medicare, but physicians need to ensure that the additional fees are not used for any covered services.

Doctors who sign on with these companies say establishing some form of concierge practice can be an alternative for physicians in solo or small practices. The companies provide management services and resources for concierge practices.

"The doctors own and control their own practice and remain independent," said Mark Murrison, MDVIP's president.

Although these companies reported growth, a Sept. 13 study found that concierge or retainer practices did not become a significant part of the health system or have much of an impact on access to care. This was a significant concern when the model emerged more than a decade ago.

The impact of retainer practices on Medicare beneficiaries could not be quantified, according to the study by the National Opinion Research Center at the University of Chicago and Georgetown University in Washington, D.C. Only 756 physicians operated these kinds of practices in 2009, an increase from the 146 that the Government Accountability Office found in 2005.

Researchers noted that most retainer practices have one or two physicians and operate in large metropolitan areas. Most are in primary care, although a few specialists such as cardiologists and endocrinologists work this way.