Concierge Medicine 2.0
Monday, August 18th 2008
Concierge medicine will never be mainstream in my lifetime. Neither will functional patient-physician encounters online. The fact is that health care consumption is too concentrated in an older generation. It is concentrated in those of lower socioeconomic means. But that doesn’t mean it doesn’t have a future or a place in the delivery of health care for certain savvy, affluent, generally healthy populations.
Such appears to be the case with the very new practice, getting lots of attention online, Hello Health. This is the partial brainchild of Dr. Jay Parkinson, already an internet ‘hipster’.
An Introduction to Hello Health
This is an incredible idea and practice model which I am terribly envious of. If I lived in the Williamsburg area (and actually made use of medical care with any frequency) I would be all over this.

Those Darn, Creative Vandals
The only blip in the launch of the new practice is that their subway ads had to be pulled because the empty dialogue and thought bubbles were too enticing for vandals.
Photo via Barbarian Blog














I must disagree that concierge medicine will be mainstream in our lifetime. When I opened my concierge practice 8 years ago, there were only a few doctors in the country practicing this kind of medicine. Now there are well over 1,000.
I’ve just authored the first book on the subject, “Concierge Medicine; A New System to Get the Best Healthcare” (Greenwood/Praeger, May 2008). I would encourage young medical students and doctors to take a look. Where there is a problem, there is an opportunity. With the shortage of primary care doctors in this country, there will be great opportunities for young doctors to practice primary care medicine on their own terms, and make a living at it as well!
Steven D. Knope, M.D.
I think likely that we just have different views of what is ‘mainstream’. All I mean is that this type of medicine will never challenge traditional practice constructs as the major mode for the delivery of primary care in this country. And that the vast, vast, vast majority of patients will remain ignorant of the entire concept of concierge medicine.
Obviously the cabal of payers will never rise up and support this kind’ve model seeing as it is not ‘cost effective.’ I’m not condoning that reasoning but it remains.
‘High-attention medicine’ has a place and is a novel idea but like I described in the post, its place is with a subset of the patient population who are savvy, relatively affluent, and generally healthy.
I think you’re right about concierge medicine, as presently practiced, not becoming mainstream, but I can seem lower-costing varieties of the model emerging in the near future and possibly becoming ‘mainstream’ themselves. I think a company called MDVIP has PCPs with only 600 patients for $1500 a year. Why not 1000 patients for $750 a year, or even cheaper. It would still be more attentive care than what lots of GPs offer right now, and likely more financially sustainable for both provider and consumer. It also seems like right now that market is concentrated with well-credentialed and experienced doctors, who have the pull to switch the model of their practice and charge a premium. Eventually it should trickle down to average doctors who’d have to accept less pay for their services.
I’m not a med student or doctor, but I REALLY believe that online medical encounters will become viable in the next decade, with the technology trickling down to the average person in another decade. Perhaps that’s just because I’m somewhat of a tech geak and I’ve read a bit about coming increases in bandwidth, teleconferencing/tele-medicine, etc. We could be reaching Gb/s speeds in 10 years, which would allow for what some are calling ‘tele-presence’ vs. just telecommunication. In 10-15 years we’ve gone from computers costing thousands of dollars to having desktops sold at Wal-mart for a couple of hundred bucks. That would likely happen with this kind of tech as well. I’m hoping that within the next decade technology will make tele-commuting for lawyers more mainstream. It’s only caught on for a tiny percentage at present, because the available options really aren’t that great.
Jose,
First, I don’t often comment on others blogs but I’ve been over to Melting Pot Mind more than a few times. Congrats on starting at Harvard; I’m more than impressed…obviously.
You may be right. I will say this though. I’ve commented pretty frequently on the idea of patient expectations in healthcare and I think, even in the current model, there are some concierge medicine physicians who have found the expectations of patients too demanding. Current patients in the American health care system are not used to making payments out of pocket. If they are going to pay $750/year they expect the physician to pick up the phone and give them however long it takes to solve there problem and because of that there is a very low limit to the number of patients a concierge physician can take on board. If that number is 600 or 1000 I don’t know, but I’m not sure the number is high enough to make this type of practice relevant to most patients.
But hey, I’ve been wrong far more than once…
I been thinking about it and concierge plays a vital role for personal and business.
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