Concierge Medicine

Abstract

A model of retainer-based medicine, commonly called concierge medicine, whereby some patients pay a retainer for physician access, demonstrates that all patients can benefit from this arrangement. Implemented mostly by primary care physicians (e.g., internists and family medicine practices), the system reduces the pressure on physicians to see as many patients as possible and allows patients for whom waiting is a concern to gain quicker access to medical care. Using a stylized queuing model, this study addresses the effects on physicians, “elite” patients, and those who are not paying a retainer. A key finding is that, if implemented properly, concierge medicine can be beneficial for all the patients and the service provider by reducing patient wait times and increasing providers’ income. For two sample ZIP codes, the analysis shows estimates of improved wait times and provider revenue based on a particular level of retainer payment. An examination of 251 U.S. ZIP codes where concierge medicine has been adopted shows that retainer-based health care is more likely to be adopted in locations with relatively high average age and income.