While there are many flaws in the American healthcare system, no one can argue that it is not innovative. Part of that has to do with the sheer amount that Americans spend on healthcare. When it comes to per capita spending on healthcare, the US ranks second in the world with 10,624 USD spent per capita per year on healthcare. For comparison’s sake, Germany is fifth on that list with 6646 USD spent per year. Another EU country, Hungary, is fourty-fifth in the world with 2115 USD spent annually. This increased expenditure has its many downsides, but it also allows for more market striations. That is, because of the higher spend, there is room for a true premium sector. Enter concierge medicine.
“Concierge medicine” does not have a single definition because there are many different versions of it. That said, most concierge medicine models have a core set of features. First, doctors at concierge practices offer enhanced customer service: same-day or next-day appointments, highly personalised care, access to doctors at all hours, and phone/virtual consultations. The more expensive plans include most covered services, so the client is not charged additional fees for doctor visits and basic lab test, x-rays, etc. Expanded services often include in-home visits, worldwide access to doctors, and expedited emergency room care. Second, concierge doctors see far, far fewer patients per year. While a typical doctor sees between 1900 and 2500 patients per year, concierge doctors see between 50 and 1000, so they can better remember their patients and their personal needs and devote more time and energy per patient. To access a concierge practice, the patient pays an out-of-pocket fee, often annual. The average annual fee is between 1500 and 5000 USD a year (125 to 420 USD a month). Some offices charge more than 10000 USD!
The COVID Acceleration
This model has grown considerably in recent years, and the pandemic only accelerated that change. The extreme doctor burnout that affected most practices did not affect concierge medicine; doctors could focus on fewer patients and not feel so overwhelmed and defeated by the pandemic’s ancillary effects. Additionally, more “ideal” patients (young, healthy people that require fewer resources) are signing up for concierge services. COVID has led these people to prioritise healthier lifestyles. Increasingly, more specialists, like OB/GYNs, are taking part in concierge models, not just primary care physicians.
With growth comes criticism, and the critiques around concierge medicine are valid. The main issue people have with concierge medicine is that it is yet another brick in the wall between rich and poor. In the US, the rich already have drastically better healthcare outcomes than poor. In that same vein, critics of concierge medicine point out that healthcare is a zero-sum game. Because of a nationwide shortage of doctors and healthcare workers that is only growing worse by the month as the pandemic drags on, fewer doctors are available to treat patients in the general population. If doctors continue to abandon practices that are accessible to most in favour of concierge practices that can only be afforded by few, then that shortage will only worsen.
Despite all these criticisms, concierge medicine has grown in the last decade, and it shows no signs of slowing down. This model is already being replicated on other continents, even in countries like Germany with robust public healthcare models and strong patient outcomes. This trend shows that people, especially rich people, have higher expectations when it comes to medical services, but they are willing to pay a pretty penny to have those expectations fulfilled!