An inside look at the growing field of concierge medicine

With health front and center in the age of COVID-19, some local doctors are turning to a new trend to keep afloat. But it comes at a price.

Gone are the days of doctors making house calls.

As some health insurance companies posted big gains in 2020, doctors we spoke with say their profits are being squeezed; that’s also making medicine less personalized.

And that’s one reason doctors are turning to the “concierge medicine model.”

“The concierge model is a membership-based practice where someone pays an annual membership fee, sometimes billed monthly depending on the practice, and what that does is it allows the physician to dedicate more time to an individual,” explained Dr. Kimberly Parks, a partner and medical director at Synergy Private Health, a concierge practice in Chestnut Hill. “Rather than taking on 3,000 patients, a physician is able to take on a few hundred patients,” she said.

“There have been times in my career where I’ve overseen thousands of patients, and it’s difficult to have that depth of relationship,” said Dr. Janine Pardo, a partner with Parks at Synergy.

According to the Concierge Medicine Research Collective, concierge doctors only see, on average, between 6 to 8 patients a day. Synergy caps the number of patients on a doctor’s caseload at 300, which Synergy’s doctors say enables them to spend an hour and a half with patients for an annual visit. And they can address areas most primary physicians don’t have time for, like prevention and lifestyle.

“Close to two-thirds of Americans have two or more chronic illnesses that they manage and lifestyle is a huge underlying factor that contributes to those kinds of illnesses and at least here in our practice at Synergy, using the concierge model allows us to spend the time working on lifestyle medicine and really a strong emphasis on prevention-care that can lead to much better outcomes for these patients,” said Pardo.

Cooking classes, stress management and health coaching are included in the Synergy fee. Other perks may be same-day appointments or no wait times, waiting in a waiting room.

Insurance is billed for visits and labs, but Synergy charges patients an additional membership fee of $5,000 a year.

Some concierge doctors charge more.

“Pricier practices you’re gonna see in NYC as high as $50,000 a year; we have colleagues in Boston that are charging anywhere from $25,000 to $40,000,” said Parks.

It sounds great, but the reality is that not everyone can afford this kind of service. Boston 25 asked the doctors how we can prevent quality healthcare from becoming something that is only accessible to people who can afford it.

The doctors’ response is the upfront costs pale in comparison to the long-term savings. “There can be a misconception about concierge medicine. I think when people and even health systems think about just how much money goes to sick care and even severe illness care and we compare that to the cost of an even more upfront investment that really enables us to prevent some of that. I think you can look at it from a cost-savings perspective,” Pardo said.

Dr. Pat Hopkins, a functional integrative rheumatologist, runs the Greater Boston Functional Medicine Group in Weymouth. She, too, accepts insurance, but asks patients for a $20 monthly fee, which pays for a nurse nutritionist to join doctors’ visits.

“I tried to figure out what was slightly less than two cups of coffee and a manicure and it really was in order to give us a little cushion going forward to bring information, education and therapies that you’re not getting anywhere else,” said Hopkins.

“Medicine traditionally takes care of illness, and Concierge Medicine represents people who are interested in taking care of your health. And that’s a different paradigm. And what draws people into going into concierge medicine is unfortunately most of our insurance companies don’t want to pay for wellness,” she said.

According to a new poll from NPR, the Robert Wood Johnson Foundation, and the Harvard T.H. Chan School of Public Health, more than 1 in 5 wealthy people pay an extra fee for direct access to their doctor, but for low and middle-income people, the rates are less than half that (5% and 9%, respectively). The average age of patients who pay for concierge health care is between 40 and 59 years old.