What is concierge medicine and should you make the switch?

Carrie Hall, CPT

“Do you take insurance?” 

It’s one of the most common questions we get asked here at Fit Family Physical Therapy! As a concierge, direct-pay physical therapy practice, we are out of network with all insurance providers.  Today, on the blog, we are explaining a little more behind our reasoning for making the switch to a direct pay, concierge medicine model.  Pssst….sneak peak: It’s to provide better care! 

What is concierge medicine?

First, let’s start off by learning more about concierge medicine, direct primary care, or direct pay medicine.  In general, traditional concierge medicine refers to a subscription-based healthcare model, where individuals pay a monthly, bi-annual, or annual fee to see or consult with their primary care physician.  This fee covers healthcare during the subscription period for that particular provider and it is paid directly to the provider or practice and not billed through insurance.  These types of arrangements typically involve a more flexible and open communication between patient and provider. 

In similar direct pay healthcare models, a practice or provider may not require a subscription, but instead will use a fee-for-service model in which patients make payments directly to the practice for services rendered.  Often, patients can be provided with documentation to submit to their insurance for reimbursement (Fit Family Physical Therapy can do this!) if the patient’s plan has out of network service coverage. In this model, the responsibility of waiting for reimbursement shifts from the practice to the patient.  

Why is concierge medicine or direct pay practice an emerging trend in healthcare? We interviewed one of our team physical therapists, Amy Graber, to understand a little more about why Fit Family Physical Therapy made the choice to operate a direct pay and direct access practice.  Let’s check out what she said!

Interview with Amy Graber PT, DPT

Amy, why did you make the switch to a direct pay healthcare model? 

 AG: After working for 5+ years in traditional insurance- and referral-based healthcare, switching to concierge practice for physical therapy has really been about two things: 1) higher quality of care for patients and 2) flexibility without loss of profit.

What is it like being a physical therapist in the traditional healthcare model? 

AG: The demands of an insurance-based, traditional healthcare model physical therapy practice are impossibly high these days with reimbursement rates, productivity expectations, and large volume care. You can try to resist it, but the traditional style of practice eventually morphs you into an unrecognizable clinician. Burnout is prevalent, stress is high, and your patients suffer from your inevitable lack of time and creativity. There are, of course, a number of clinics that are still able to make it work and still provide quality care. But from my experience, it’s such a challenge to the provider (and clinic owner) and it really takes away from our number one priority – which is helping patients.

That’s too bad! Has transitioning to a direct pay or concierge-esque model alleviated any of that stress?

AG: Yes, definitely! Moving to concierge based practice has allowed us to deliver high quality patient care again, with one-on-one patient interactions and sufficient time to create a notable patient outcome.

We aren’t awaiting insurance authorization that limits access to quality care, we aren’t waiting on reimbursement from insurance companies months (or even years) later, and we aren’t forced to overbook appointment slots to keep the lights on.  The flexibility that comes with a consistent source of income that isn’t dictated by a third party allows for better quality of life for the practitioner.

Well, that’s great for providers! But, what do you say to patients about the benefits of stepping outside of the traditional insurance model?

AG: The benefits of concierge practice are also really apparent for the patient! We have many skeptical first time patients (who are familiar with a traditional, insurance-based model) who come to realize that this style of individual care results in fewer appointments overall, less stress, and many times even lower costs in comparison to the utilization of a healthcare plan. They are able to get one-on-one time with their care provider and their treatment can be so much more individualized in that setting, which is in everyone’s best interest.

In general, I believe concierge medicine allows the patients to have the opportunity to be heard by their provider as there are far less productivity demands and time constraints on appointments. You get to know your provider on a more personal basis, and that allows you to feel comfortable in being a partner in your own care. You have a little more of a say as to what you’d like your outcome to be. It’s such a win for patients. 

Of course, we totally recognize that some people prefer to utilize the traditional model of healthcare, and we understand! Sometimes it makes more sense financially or it’s just a comfort thing. At the end of the day, if a patient is looking for that type of interaction with a provider (from the traditional model of service), there are awesome PTs that we are happy to refer them to. We just want people to get better!

But, hands down, I do feel we’re providing an extra layer of care as concierge providers that just isn’t sustainable in traditional practice. It gives me the confidence that I can help patients long term without sacrificing quality.

Why do you feel connected to concierge medicine?

AG: I think concierge medicine recognizes that there is more than one type of patient and the traditional insurance-based model is often a “one size fits all” phenomenon. It’s nice to see medicine evolving to invest in the patient rather than the system. If providers can invest in patients early on with delivery of quality care, we can get patients to invest in their own health and well-being, and that has a significant impact on cumulative healthcare costs.

Well, there you have it! Thank you, Amy, for your perspective and reasoning on making the switch to concierge medicine with Fit Family Physical Therapy! 

Still have questions?

Want to learn more about direct pay physical therapy in the Phoenix, Arizona area? Contact us at Fit Family Physical Therapy for a free physical therapy consultation phone call. We can address your concerns and help you determine an appropriate course of action for your knee popping, clicking, and pain. Skip the line with physician and insurance wait times, talk to us, and start your path to pain- and symptom-free activity today!

About the Author

Carrie Hall is a business operations guru and fitness lover. She spent many years as Chief Operations Officer of a successful e-commerce business in Phoenix, Arizona, managing and scaling end-to-end business operations. She then decided to go after a long-time goal of becoming a Certified Personal Trainer to expand her fitness knowledge and share her passion for health and wellness with others. Carrie now enjoys being able to pursue both business and fitness (with her family!) while helping and motivating others to live a full, fit, and healthy life!