Boutique Care: Is It Really Better Than Private Practice?

Boutique medicine has been a buzzword for a few years. It’s also known as concierge care and retainer medicine. It allows physicians to charge their patients a yearly retainer—similar to that of an attorney—in exchange for VIP treatment. That retainer can run anywhere from $1,200 – $6,000 and is paid out-of-pocket over and above traditional healthcare premiums. To date, insurance does not cover boutique retainer fees.

So what perks do patients receive? Same-day appointments, extended physician access and longer, more personalized patient consultations, to name a few. Some practices even offer house calls, 24-hour access and patient transportation. Physicians don’t have to rely on fees-for-services regulated by insurance companies and can have fewer patients on their dockets. An average private physician in a metro area spends only 10 minutes on average with any one of his 1,800-2,000 patients. With a boutique practice, patients average 500 or so. Sound like a no-brainer? Perhaps. But before you abandon your private practice in favor of one that appears to be a win-win situation, be aware of its pros and cons.

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PROS

  1. Fewer patients from your private practice will be able to afford boutique fees. Your schedule will likely decrease from its private practice levels. The return for you is more time to devote to each of your retainer-paying patients to develop meaningful connections and long-term relationships based on trust. Another plus: you won’t have to spend as much time dealing with insurance paperwork.
  2. You have two sources of income: The retainer and insurance reimbursements for visits and procedures. Unlike with traditional private practices, you won’t spend as much time dealing with insurance companies. However, if you accept Medicare patients or ones with nondiscrimination caveats in their contracts, you’ll still be expected to abide by governmental regulations.

CONS

  1. You could have a waiting list of patients who might grow tired of waiting. Whether they come from referrals via your old practice or Internet searches, new patients are potential assets to your practice or its worst enemies. If they can’t get in to see you—either because of a new patient waitlist or if they can’t afford concierge fees—you can count on a mention in social media. One that could go viral in a bad way.
  2. 2. Concierge practices must stay true to their menu services. If you offer 24/7 access or patient transportation, you must be prepared-and properly staffed-to handle those offerings. You can’t just add them as perks to garner new patients without being able to back them up. Some of these perks will require additional staff or staff with specialized training.

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Boutique practices don’t automatically mean a life of riches. The decision to move from private practice to a concierge model is one that will take a good deal of due diligence. The initial patient loss could cripple your practice. If you make a hasty decision based on hopes of owning a beach house in Malibu, recouping lost patients could be virtually impossible, especially if they’ve already found new doctors. This risk is one reason why some physicians choose to blend a traditional practice model with the boutique. It’s a huge recordkeeping challenge but gives you a trial period to see if the full concierge model would work for your practice.

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Shelley Moench-Kelly, MBA, is a New England-based writer. Her freelance clients include Google, MedEsthetics magazine, and The Week.

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