Price shaming? DPC vs. Concierge Medicine.

By Sonja Horner, Healthcare Business Innovator | Outcomes Advocate | DPC Journal/Concierge Medicine Today Contributor

If you are a pet owner, you may have seen images on Facebook that show pictures of animals that have behaved in a way that causes their owner’s to shame them. Often times, the shame includes a piece of poster board with a brief description of the “crime” placed around the animal’s neck. The signs generally declare that the pet has chewed a hole in their owner’s sweater or eaten their owner’s favorite shoes or sometimes relieved themselves in the house.

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I own two dogs, who we have affectionately renamed the “Bumpuses” from A Christmas Story, so I find humor in these images. But lately, I have found myself referencing these “shaming” images when I participate in conversations that discuss the differences between Direct Primary Care (DPC) and Concierge Medicine.

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Here’s a Q&A exercise that may help us establish the differences:

Q: Which model allows physicians to restore the doctor/ patient relationship?

A: DPC & Concierge Medicine

Q:Which model allows patients to communicate with their physician via telephone, email and text?

A: DPC & Concierge Medicine

Q:Which model asks patients to commit to their practice for a monthly fee?

A: DPC & Concierge Medicine

Q: Which model charges fees up to $100 a month for services?

A: DPC & Concierge Medicine (exceptions in both models)

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Now for three of the major differences between the models:

The Role of Insurance: The perception that all concierge medical practices accept insurance is not accurate. In fact, there is a dynamic practice in the San Francisco Bay Area that fits this example and there are others. I don’t know of a concierge medicine practice in the country who enjoys the headaches of dealing with the third party payor system, but they do so as a convenience to their members. If you see the revenue collected vs. the cost to collect scenarios you may be surprised.

The Preventive Services: Both models offer services that can be deemed preventive. However, advanced labs and technology found their way into the Concierge Medicine model more than five years ago. These advances answered the questions for physicians who were interested in measuring improved patient outcomes and a value proposition that was more than 24/7 access.

The Price: It appears that the DPC model ranges in price from $35 – $100 a month, annual discounts are offered, I will apologize in advance if there are practices that charge more. Concierge Medical practices range in price from $50 – $300 a month, annual discounts are offered. There are practices that charge as much as $25,000 a year and there may be practices that charge even more, but they are the exception not the rule.

So where does the line exist between charging too much vs. not charging enough?

Shouldn’t the line be drawn between how many practices stay open to deliver this this type of care and those that don’t? If we “zoom out” from this discussion and think about the long-term value of these models, the conversation needs to be broadened. Both models will benefit from continuous transparency, but think about the benefit to consumers if DPC & Concierge Medicine broaden the conversation to include measured disease regression.

Original Post: OCTOBER 28, 2014