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Concierge medicine, like most things in the health care marketplace, has many names. Perhaps a family member has recommended “boutique medicine” to you, or a patient in a waiting room brought up “direct primary care,” bragging that they have their doctor on speed dial.
However it’s been pitched, concierge care is largely the same: a model for patients, physicians, insurers and administrators looking to avoid common burdens in the health care industry — long waits, short visits and impersonal care.
“It allows for doctors and patients to interact in a way that many health care systems don’t and can’t,” says Linda Nash, founder and CEO of Richmond-based concierge venture WellcomeMD.
A concierge plan stands out because of its monthly or annual membership fee, on top of the cost of insurance or actual medical care; generally, they average between $2,000 to $4,000 a year. The fee grants patients access to nearly unlimited in-person visits with a primary doctor (as well as virtual visits) that are unconstrained by the high volume of patients that many doctors who are part of major practices see.
While there’s no industry-wide standard for how concierge practices interact with health insurance companies, many operate in-network for major providers and file claims and billing identically to how traditional health plans operate, although some employers will even cover the membership cost, Nash says.
Dr. Steven Bishop, an internal medicine doctor and director of wellness programs at PartnerMD, Richmond’s largest concierge care practice, worked for the VCU Health Department of Internal Medicine before joining PartnerMD in 2019.
“I was looking for a change, mostly because I didn’t have enough time with patients,” Bishop says. “In a standard care practice, you’re lucky if you have 10 minutes with a patient. [More time] is not just good for patients, it’s good for doctors, too.”
When focusing on preventive care for patients, as Bishop does with PartnerMD’s wellness programs, finding time to map out a patient’s path to a healthy lifestyle can be a major hurdle. With fewer appointments to attend and better knowledge of a patient’s needs, doctors can tailor a personalized health plan and follow up on the patient’s progress more frequently.
Since its modern inception in the late 1990s, concierge care has steadily attracted doctors and patients. Estimates from market research firm Grand View Research value the United States concierge care market at $6.7 billion, a growing rate that reveals many Americans are willing to pay more for convenience.
Nash originally entered the industry in 2003 as co-founder of PartnerMD, which has since grown to include 33 physicians in seven offices across the mid-Atlantic, with three locations in Richmond. She left PartnerMD in 2015 and started WellcomeMD in 2017, and it now has offices in Richmond, Atlanta, and Charlotte, North Carolina.
Dr. Olivia Mansilla (pictured at left), a practicing internist at WellcomeMD (Photo by Jay Paul)
Though the industry faces potential roadblocks in terms of growth and increasing access, including a likely shortage of primary care physicians in the near future, right now, high health costs are the focus of many trying to shape the industry’s future.
A recent study published in the Journal of Health Economics by researchers from the University of California, Berkeley and the University of Pennsylvania found that, in concierge practices that billed insurance companies, patients spent more money on average than patients without concierge care, but both patient groups had a similar mortality rate. The study also points out that putting high-quality care behind a paywall can decrease equity in health care.
It’s all about getting more personal with your doctor and stressing less about each visit.
—Linda Nash, CEO of WellcomeMD
While further investments and attention on the industry could make concierge care less expensive and more accessible, doctors stress that choosing the concierge model is about priorities. “People should have the opportunity to sit and think, ‘OK, what is my health worth?’” says Dr. Olivia Mansilla, a clinician who joined WellcomeMD in 2023.
For Nash, the relief brought to fatigued doctors and patients is worth pursuing. “It’s all about getting more personal with your doctor and stressing less about each visit,” she says.
Clean Teeth, Clear Cost
Not to be left out, a similar membership-style medical innovation is available in some Richmond-area dental offices: flat-fee dentistry. For an annual or monthly fee, patients without dental insurance receive a standardized offering of visits and services, typically two annual appointments and discounted rates for other procedures.
If flat-fee dentistry (also known as an in-house dental plan) seems similar to traditional dental insurance, it’s meant to: Benefit plans offer a more accessible way to follow a care path and increase dental health, according to researchers. Providing an affordable, insurance-free option can improve equity in health care.
“With your standard insurance plans, they cut you off at $1,500 or $1,000 per year,” says Dr. Marcel Lambrechts, a dentist with Seven Pines Dental Group in Richmond. “With these plans, they’re unlimited, so if you need $10,000 worth of work, you’re going to get a discount all the way through that. For me, that’s better.”
Seven Pines Dental Group instituted their dental membership program in 2021 and have enrolled hundreds of patients since. Similar memberships are available at many local practices, costing from $300 to $500 per year.
