Direct Primary Care, Direct Care and Concierge Medicine Defined

What is does Direct Care Group do and how is it different from concierge medicine? Or, more generally, what is direct care/direct primary care and how is it different from concierge medicine?

We receive this question frequently. Since we are operating in a relatively new niche within a growing industry there are many terms used to reference our business. A century or so ago, the automotive industry was in a similar stage of development and their products carried many different names. Automobile. Wagon. Cab. Motorcar. Jalopy. It's generally understood that each of these terms is synonymous with "private, personal, internal combustion transportation machine."

In the medical industry, references to concierge medicine include: direct primary care, celebrity medicine, private doctors, personalized medicine, private medicine, elitist-sounding phrases, or direct care (as we prefer). Direct primary care (or simply direct care) is just another term for concierge medicine.

A broad definition of concierge medicine includes several key attributes. By any name, it is a format in which: doctors see fewer patients; patient access to a doctor in person, by phone or email is enhanced; an 'executive physical' is included; and patients are charged an annual or monthly fee. Benefits to patients consist of a better relationship with their doctor, more preventative medicine including wellness and nutrition, and overall enhanced wellbeing as demonstrated by fewer trips to the hospital. Physicians see an improved lifestyle, ability to focus on their craft, and stability of income.

Within the current discussion and nomenclature surrounding the product, there is little to no differentiation or coherent brand identity. There is no standard for a "premium" concierge offering nor is there a clear "entry level" version. In fact, there is little product development or marketing outside of broad, generic themes. As the industry grows, however, these types of distinctions will become more and more apparent and dichotomies will evolve.

At present, the most easily identifiable differentiator is price. Independent doctors charge from $1,000-$6,000 per year per patient, MDVIP doctors charge $1,500-$2,000, and at the high end, MD Squared charges about $50,000 per year per family. Features and benefits generally trend with the expenditure to some degree. But... these practices are indiscriminately referred to as concierge medicine, direct primary care, and etc. regardless of price or offering.

Upon close inspection two major distinctions emerge. Surprisingly (or not) they are rarely identified by how a practice is referenced and neither is clearly explained or promoted.

First: Hybrid vs. Pure (Patient Conversion)

In most cases, a doctor will complete a process whereby his patient base is solicited to join a new concierge arrangement. In a pure practice, patients' options are to either continue on with their current doctor in the new program with 24/7 access, same or next day scheduling, longer appointments, wellness and nutrition, and more or to find a new doctor. In the hybrid model, the doctor retains those patients which do not wish to convert to the new format. While the ratio of hybrid to pure concierge practices is unclear, the differences are not.

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