Wall Street Journal Shares Pros and Cons of Concierge Medicine

Jen Wieczner of the Wall Street Journal stitched together a piece about the benefits and the doubts of concierge medicine. It did successfully clarify the outdated definition of concierge medicine, the personal medicine for jet setters. She also properly incorporated the term “direct primary care” as affordable, non-insurance based care, explaining that on one hand there still are “lavish, celebrity-type treatment” centers, but also a newly emerging option like our Atlas MD-model. She writes that “pared-down clinics charge roughly $50 to $100 a month for basic primary-care medicine, more accessible doctors, and yes, money savings for those looking to reduce their health spending.”

Not bad. That sounds like what we’re up to here at Atlas MD.

She also included this relevant stat. According to Concierge Medicine Today, “Of the estimated 5,500 concierge practices nationwide, about two-thirds charge less than $135 a month on average, up from 49% three years ago.” It’s believed our lower cost practices are driving growth in concierge medicine. Offices are being added at a rate of about 25% a year, says the American Academy of Private Physicians.

Also not bad. This is becoming the free market reaction we were hoping for.


Wieczner points out the irony of the Affordable Care Act, which mandates insurance, actually encouraging the growth of our insurance-free industry.

As Dr. Qamar of MedLion says, after Obamacare, “All of a sudden our market went from the uninsured to everybody.”

This is another one of those counter intuitive outcomes. And although we were never behind the red tape solution, we’re not going to complain about our growing popularity. Our attitude is that MORE docs need to take the leap and get into our model of care. And its primary care physicians who need to take the lead, if only for the simple logic pointed out here–the main flaw in our current system is the needless inclusion of insurance to pay for things WE KNOW WE ARE GOING TO PAY FOR. Whereas an oncologist isn’t someone a patient KNOWS they will need the service of, we are. And that’s why our fight should be for a primary care future that is insurance free. If other specialists can incorporate less red tape, that will be powerful, although the unexpected nature of say, cancer, does make the cash-only part a little more challenging.

The WSJ article is worth a read if only to identify with your potential patients, and see the situation from their perspective. Here’s some questions you could likely face if you open a cash-only clinic.

Wait, if the ACA already requires me to buy health insurance, why would I need direct care too?
Remember that many of the new health plans have high deductibles. If they are too high, members will never hit them, meaning patients will be paying thousands of dollars out-of-pocket anyway. There’s no reason they can’t just use this money smarter, on more affordable services like yours.

I like direct care, but I still need insurance. What do I do?
A patient’s best bet will be to choose a high-deductible policy that has minimal premiums for emergencies. Then, put the money they save on this plan towards the direct care subscription. Although high-deductible plans are often paired with health savings accounts, the IRS won’t automatically qualify direct care as eligible for HSA expenses. Hopefully this changes in upcoming years. (Read more about the criteria for HSA-eligibilty here.)

I feel like I am double paying now. How can direct care save me money?
When fee-for-service doctors charge for each treatment and test, patients can rack up bills of hundreds of dollars. Direct care charges flat fees that include basic checkups, treatment of minor ailments and electrocardiograms, or EKGs. Yes, services like blood work, X-rays and vaccines do cost a little more, but it’s our new job to cut red tape, and negotiate with specialists and labs to secure discounts for patients. The WSJ cites stories of Brian Forrest (he has a $39-a-month Access Healthcare clinic in Apex, N.C.) who has gotten prostate-cancer tests for $5 from a lab charging a Medicare patient at least $175. He’s arranged for $350 mammograms for $80, and colonoscopies for $400 when the going rate is $2,000. We’ve got plenty of cost-saving stories of our own, too.

If the concierge medicine is cheaper, do I still get VIP treatment?
Because we aren’t at insurance companies’ whim, we do take on fewer patients and spend more time with each of them. This is an added value to our model, something you don’t find anywhere else really. With things like our Atlas.md EMR, patients don’t even have to come in to pay, or get service. We could help someone who had a run in with poison ivy, or a bad spider bite by using “tech visits” (Twitter, smartphones). Patients can pay us online with a credit card.

This is cool, too, and worth bringing to new subscribers attention. According to the WSJ, “Students at North Carolina State University who studied Dr. Forrest’s practice found that his patients with normal insurance spent 12% less out-of-pocket than had they gone to a regular doctor—partly because the longer visits kept them healthier.” So in a nutshell, what are they playing you for? Affordable care, better service, and improved health.

Again, not bad, direct care. Not bad.