Diabetes Self-Management Blog

As health-care costs continue to rise in the United States, some doctors are adopting a payment model that makes costs even higher for their patients — and many of those patients willingly and even enthusiastically participate.

In what has come to be called concierge medicine, primary-care doctors charge their patients an up-front annual fee for what they promise will be an exceptional level of personal attention. Privileges of membership may include guaranteed same-day appointments, house calls, and visits by the primary-care doctor in the emergency room if such a situation arises. The doctors also emphasize that due to the membership fee, they can shrink the number of patients they see and spend more time with each patient. They also note that with fewer patients to keep track of, coordination of care with specialists and paying close attention to lab results and other data becomes much easier.

In a recent segment on PBS Newshour, correspondent Betty Ann Bowser interviews two doctors with concierge practices in the Houston, Texas, area. Both are members of a nationwide network called MDVIP, which helps doctors convert their existing practices to a concierge format. Practices affiliated with MDVIP charge around $150 per month for membership, and they are allowed to have no more than 600 patients. One of the doctors interviewed noted that before he joined MDVIP, his practice saw about 3,000 primary-care patients; it now sees about 400. MDVIP claims that its format boosts preventive care and helps reduce hospitalization rates by more than 70%. One critic, however — a professor at the University of Texas School of Public Health — suggests that serving affluent patients who care about their health in the first place is the most likely reason for MDVIP’s lower hospitalization rate.

And while individual patients may benefit from membership in a concierge-style practice, whether they get their money’s worth is an open, and subjective, question. What is not in question, however, is that concierge medicine offers few answers to problems that vex the greater health-care system, such as high costs and a shortage of primary-care doctors.

What do you think — does the idea of concierge medicine appeal to you personally? Do you feel that your current primary-care experience is too rushed and impersonal, and could benefit from more time dedicated to each patient? How much would you be willing to pay for membership in a concierge practice? Are you comfortable with the idea of doctors limiting their practices to well-paying clients? Leave a comment below!


  1. These MDVIP practices are rip offs. In general, the preventive care side of madicine has become a rip off as well. I am all for doctors being well paid, but do the math on the program you referenced. 600 patients x $150 per month x 12 months = 1.08 million $ per year. Even with malpractice insurance I doubt it costs a doctor anywhere near that much to maintain an office. And, this $150 appears only to keep the doctors on retainer and does not cover fees for services.

    Posted by Bill |
  2. Concierge medicine, or “Personalized Care” has been around for over a decade now and has grown significantly in the past five years. There are several companies which offer the expertise to help physicians “convert” their practices. MDVIP is just the largest, albeit “most-expensive” option out there.

    I work with a consulting group that is one of the oldest and most reputable in the industry. Our fees are less than half what MDVIP charges their physicians…and thus, their patients. We also work with Endocrinologists as well as IM/FP physicians and most of our clients enjoy thriving, growing practices as well as satisfied patients.

    Posted by Bret |
  3. The American Academy of Private Physicians (AAPP) is the professional group for doctors in concierge medicine. The nationwide network called MDVIP may be okay for some doctors, but in talking with two doctors that have a concierge practice, they feel that MDVIP is a little too over the top in their demands.

    I would suggest reading my blog http://bobsdiabetes.blogspot.com/2012/05/concierge-medicine-is-not-understood.html in which the four main types of concierge practices are discussed.

    In my research, I have seen fees range from $50 per month to an much as $500 or more per month. The majority have monthly fees of less than $150 per month. There is too much information that is not revealed about individual concierge practices to make accusations. They are in need and fill a niche, or they would not continue to exist. Some people are actually reducing their costs by using concierge practices, paying the monthly fee, and substituting major medical or hospitalization insurance instead of standard medical insurance. The largest hole I have found here is high cost prescriptions for those with chronic diseases.

    As a patient, I say stop criticizing and let this find its place. Many of the primary care physicians have found this route in order to survive and continue practicing medicine. Many are being forced out because of decreases in reimbursement and hospital monopolies.

    Posted by Bob Fenton |

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