Concierge Care is NOT Direct Primary Care

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A new article about concierge care came out in Newsday. It’s called Doctor retainer fees: LI patients pay extra to get better personal care, quicker access. It’s behind a paywall but I was able to read it using GetPocket where I saved it.

Right off the rip, I do not like the term “retainer fees”. The definition of a retainer is: a fee paid in advance to someone, especially an attorney, in order to secure or keep their services when required. Please do NOT associate doctors with attornies. Let’s use membership fees.

The article is long but garners no sympathy for the doctors doing it. The cheapest physician has a $1800 annual fee while he still bills insurance. The rest are stuffing their pockets as fast as they can.

Here are some highlights of the article with my thoughts after them:

But the spread of concierge care has raised concerns for some health policy experts. This style of medicine tends to draw wealthier patients, and research shows it may not lead to better health outcomes. By reserving some physicians for a select number of patients, concierge care limits the number of doctors in the remaining primary care system and increases the workload for its already-strained physicians, said Dr. David Podwall, president of the Nassau County Medical Society, a trade group.

Cherry picking is TRUE for concierge care and not DPC. And the part about not leading to better health outcomes is propaganda.

 Mount Sinai’s Hudson Yards clinic was set up to cater to nearby businesses by offering extended hours and on-site mental health, physical therapy and other specialty care, according to its medical director Dr. Louis DePalo. The site then developed a membership program for executives with demanding schedules, homes in multiple locales or otherwise unconventional lifestyles, DePalo said. Annual retainer fees start at $16,000, which covers all care provided on-site. This includes unlimited in-person and digital consultations, imaging and tests, care coordination and an array of personal services, such as DePalo’s daily meeting with a patient on a weight loss program.

$16,000. Yeah, this is not DPC. This is greed.

Dr. Asma Rashid, a concierge doctor, serves celebrities and the ultra-rich, for whom privacy is very important. She is shown near her home in Water Mill on June 6. Credit: John Roca

Dr. Asma Rashid, of Water Mill, says she is glad bigger systems are exploring concierge care, though they may have a harder time personalizing physicians’ approach. 

“We finally get to pay off our loans and provide very satisfying medical care,” she said of her team. “But it’s sad for me to see that it’s not easily accessible to the masses.”

Rashid said her practice, Hamptons Boutique Medicine, has an annual retainer “way above” the more typical $5,000 to $10,000 rate because she serves celebrities, high-profile executives and politicians. She will travel — sometimes internationally — to treat clientele focused on privacy, and sew up wounds and perform other minor surgeries in their homes.

Wait, you’re sad that it’s not accessible to the masses but you still charge way above the typical $5k-$10k rate (which is 5 to 10x more than DPC does already)? Oh, and you serve celebrities, high-profile executives and politicians? Those crocodile tears must hurt.

This is where I preach a little. We cannot fix a broken system by catering to the rich. We cannot break the insurance model if we still charge insurance. That’s what concierge care does. DPC is the opposite. We are affordable to most of the community and do not deal with insurance. DPC is scalable but only by independent doctors.

This journalist never heard of Direct Primary Care because there are only one or two in all of Long Island!! It just proves that the area is ripe for the DPC picking.

About Douglas Farrago, MD

Dr. Farrago is a retired family physician based in Forest, Virginia. Since 2021, he has run DPCnews.com, a leading resource for the Direct Primary Care (DPC) movement. He is the author of three best-selling books on Direct Primary Care: The Official Guide to Starting Your Own Direct Primary Care Practice The Direct Primary Care Doctor’s Daily Motivational Journal Slowing the Churn in Direct Primary Care (While Also Keeping Your Sanity) In 2016, Dr. Farrago conceived the idea for the Direct Primary Care Alliance and co-founded the organization alongside other pioneering DPC physicians. He is widely recognized as a leading expert in the DPC model and frequently lectures to medical students, residents, and practicing physicians on how to successfully start and run their own DPC practices.Dr. Farrago sold his Direct Primary Care practice in October 2020 but continues to receive care there as a patient.