One of my favorite inspirational videos is “How to start a movement” by Derek Sivers.
In 1998, Sivers created a movement with CD Baby, a way for independent musicians to sell “direct” to fans. CD Baby made around $70 million for independent artists before Sivers sold the business in 2008 for $22 million (most of which he donated into a musician’s trust).
Direct to Patient – A Growing Movement
There is a growing movement in primary care to new retainer-based practice models attracting doctors, patients, investors, and developers. These new, more affordable membership practices provide a “direct” doctor-to-patient relationship – some are concierge medicine, others a hybrid model, direct primary care or cash only practices.
The idea for most is to minimize the need for insurance, except for emergency and catastrophic care and, thereby, eliminate or minimize the high administrative costs for a practice. By having a “direct” relationship with patients, these doctors can also see fewer patients, have more time for patients, and get more meaning from their work. New healthcare and mobile technologies are streamlining processes and providing better realtime communications to foster connectivity between doctors and patients.
“The average primary care physician practice serves 2,000 to 4,000 patients. Retainer-based practices typically serve 100 to 500 patients.” – American Medical News
Concierge medicine was once an elite-only model where patients who paid a high annual fee costing thousands of dollars could have 24/7 access to their physicians and longer, more quality visits. “Today, 60% of concierge practices charge less than $135 per month, and many charge month to month,” according to Michael Tetreault, Editor-in-Chief of Concierge Medicine Today.
Google Ventures Invests $30 Million
Although One Medical Group does not consider itself “concierge” medicine, it is a retainer model whose patients pay $150 to $200 for an annual membership. One Medical still accepts most insurance plans, but says it can cut administrative costs from 4 people per practice to 1.5 through the use of digital technologies. It recently attracted $30 million in investment from Google Ventures raising a total of $77 million.
Direct Primary Care Affordable Even for the Uninsured
Dr. Josh Umbehr of Atlas MD enjoys connecting with patients via social media. He says Atlas MD is affordable for most people, and uninsured patients are saving money. “I have a patient who now pays $17 per month less than she did for her treatment alone, and that now also includes covering her entire family of four.” (More from my interview with Dr. Umbehr in Part 2 on Monday.)
One in 10 Doctors Looking to Concierge Medicine
In “The Connected Concierge”, Travis Good, MD, editor of HIStalkConnect, cites that one out of ten doctors is looking to concierge medicine in the next one to three years. An MD and MBA with a wife in medical school, Dr. Good asks:
What is it to practice medicine today? What is it going to be in 10 or 20 years? Would you tell your kids to go to medical school?
According to a recent study by the Mayo Clinic, one of of every two doctors reports suffering from burnout, a finding that stunned even the researchers. The idea of switching to the freedom of an “independent” practice, via concierge medicine or direct primary care, has a lot of physicians asking questions, according to Michael Tetreault.
Technology Drivers for New Models in Primary Care
Some social and technology trends supporting this movement include:
- More people are self-tracking, using sensors and mobile health apps, and collecting “little data.”
- More mobile health apps are being prescribed – especially for chronic conditions.
- Concierge doctors are more likely to prescribe mobile health apps.
- 70 percent of physicians report that at least one of their patients is sharing health measurement data with them. Nearly three-quarters of physicians agree that self-tracking leads to better patient outcomes.
- Doctors using social media, email, texting and real-time communications are connected clinicians who are looking for more connectivity with patients.
- Prescriptions and treatments in retainer models offer price transparency. Price transparency can lead to better adherence, and, better patients.
- New patient-relationship management systems are empowering patients for connected health.
- Trends for preventative medicine and wellness care models.
- Desire for portability of health data.
Future Trends: Interview with Travis Good, MD
I spoke with Good about his perspective on the future trends for health and mobile technologies for concierge medicine and direct primary care, and also about his new venture, Catalyze.io – a backend solution for those who want to innovate and develop in the healthcare space.
Although Good does not see concierge becoming the majority of primary care, he thinks technology can bump up the 10 percent already interested through connected health technologies.
It’s exciting to see technology as enabling more direct connectivity between provider and patient. It enables providers to practice their trade directly with patients, instead of through lot and lots of layers. It opens doors to transparency and more direct accountability. It also has the potential of significantly lowering costs.
It’s a very exciting time in healthcare! Healthcare is great industry. It’s incredibly huge, fragmented and frustrating at times, but those challenges are also really just incredibly massive opportunities. And I am not talking about it from a financial perspective, but from an impact perspective.
Look for Part Two of “Technology Driving New Models for Concierge Medicine and Direct Primary Care” at HL7standards.com on Monday, April 22.
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