While advancement of technology has undoubtedly improved the healthcare services, the medical services are also moving into a new trend, known as hybrid concierge medicine.

The increasing physician burnout and financial burden are the reasons for many physicians to start adopting concierge medicine. In the US, the shortage of physicians caused by the Affordable Care Act is the drive to more concierge medicine.

With the new model of practice, a hybrid of traditional and concierge models, concierge medicine is starting to attract more physicians to adopt the practice.

Concierge medicine allows more personalised care

Concierge medicine is essentially a system where patients pay an extra fee for more personalised care and immediate access to physicians.

The concept of concierge medicine started out in Seattle in 1996, when a doctor charged his patients with a flat fee in exchange for what he considered as “highly attentive medicine”. An example of current practice would be Sarasota Personal Medicine, a concierge internal medicine practice in Florida, that gives direct access by personal cell phone and email available 24/7 to patients and their families among other services.

In other words, physicians are able to spend more time with their patients and focus more on preventative healthcare, which is a privilege compared to the typical high volume practice.

It also allows more time for physicians to develop a closer doctor-patient relationship. Dr Steven Fineman and Dr Sean Downing, internists at Sarasota Personal Medicine, provide individualised medical care by creating and managing each patient’s treatment plan, as well as overseeing treatment programmes and researching topics and solutions for their patients.

Hybrid concierge medicine a more realistic approach

For many physicians, concierge medicine sounds like a great idea, but the reality is not as easy, as bills will go up and the reimbursement goes down, according to Steven Krems, a Californian internist.

Krems, is one of the physicians who adopted hybrid concierge medicine when he was not sure whether to shift into a concierge-style practice.

"I was afraid that most of my patients really wouldn't be able to afford it, and I really wasn't looking to be this elite type of a practice,” said Krems. With the rise of hybrid models, he could blend traditional fee-for-service reimbursement and concierge practice.

By taking up concierge clients and retaining the established patients that access care through insurance, physicians are allowed to keep their practices economically functional while transitioning away from a volume-centric model of care.

Hybrid concierge models also help to alleviate the hardship for many physicians, and patients who can afford it will have a choice to obtain more personalized care. Kurt Mosley, a senior vice president at Merritt Hawkins, a physician search and consulting firm, said, “Doctors are increasingly frustrated with paperwork. It's increasingly harder and harder for a physician to get things done."

Hybrid models to re-establish patient loyalty

For the past few years, not just primary care physicians, but cardiologists, rheumatologists and endocrinologists have also started trying concierge medicine as a result of the compressed services and overwhelming number of patients.

“It increases the productiveness economically of the physician without negatively impacting the volume of patients,” explained Wayne Lipton, founder and managing partner of Concierge Choice Physicians. “It extends professional lives, and it gives doctors greater control of their revenue stream.”

“This may be one of the simplest solutions out there that leverages relationships, and it works not just for high-end communities, but in a variety of areas. I think you're going to see it all over the place, in different variants," he added.

With the rising popularity of concierge medicine, Mosley predicts more hybrid models will be developed, including what he dubs a "hybrid-light" model, where a patient pays a lower fee and sees a physician if the doctor is available, or a nurse if they are not.

Either way, he said, the ultimate goal is to re-establish the doctor-patient relationship, which contributes to patient loyalty in a way not many approaches can replicate. MIMS

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