African Economic Development

Many physicians with whom we speak are expressing angst regarding converting to a concierge medicine model in today’s economic climate. Is it economic suicide to make this change today? We think not, if the change is made intelligently. Across the board consumers are reducing spending on goods and services. This is not only affecting discretionary purchases like Botox injections and laser eye surgery, but is also affecting primary care services. Some consumers would rather suffer through a cold for an extra few days than pay a co-pay to see their doctors.

“How,” you may ask “could converting to a concierge medical practice model help me in these economic times?” If done correctly, converting to a concierge or retainer-based practice model could help you offset your losses in fee-for-service revenue by “segmenting your market”. It may also enhance the level of care that you are able to deliver to patients, your own career satisfaction, and your lifestyle.

“Market Segmentation” is the process of developing two or more distinct marketing propositions to address the differing perceived needs of customers, or potential customers, in a market, with each marketing proposition addressing the members of a group, or segment, who have similar views regarding needs or interests.

In our world, market segmentation is accomplished by: 1) providing to patients who value highly personalized preventative care, immediate physician availability, and an ongoing relationship with a trusted doctor the ability to access unprecedented levels of care and service; and 2) continuing to provide standard levels of care and service to patients who place more importance on price than on service. Market segmentation enables your practice to give patients what they desire. While we believe that one physician cannot successfully offer two distinct levels of care to different patient groups, there are a number of means by which you can segment your patient population and deliver the levels of service that your patients desire; you can hire a physician’s assistant or nurse practitioner to serve as the principal interface with non-concierge patient, or you can hire an associate MD to treat those patients in the broader context of your practice. We describe this program in greater detail on our website:

So, back to the original question. We believe that segmenting your market to deliver the care that your patients desire not only does not constitute economic suicide, but rather represents an excellent risk mitigation strategy. Unless you have the “perfect practice”, undertaking an all or nothing conversion (terminating your relationship with any patient who chooses not to join your retainer practice) to concierge medicine could entail additional risks in today’s economic climate.