The Physician Entrepreneur’s Playbook:
To start a concierge medical practice, consider important business, financial, and legal aspects associated with membership-based healthcare.
Key Takeaways
If you’re a physician who’s thinking of switching your practice to the concierge medicine model, you’re not alone. As demands on doctors increase, many seek alternative ways to practice medicine — enabling them to prioritize patients' needs and personalize care.
But where do you start? Here are some of the most important business, financial, and legal aspects to consider when building a resilient and profitable concierge medical practice.
The Foundation: A Business Plan for Physicians
Before you take significant actions to open your own concierge medical practice, you first need to plan.
Do Competitive Research
If you’re new to the concierge care model, start with basic research. Read about concierge medicine, review potential competitor profiles, and speak with other concierge doctors.
A market assessment can give you an idea if there are other similar practices in your area. How do they operate? Who do they primarily serve? What services do they offer? Understanding your competition can inspire you to build your practice and ensure that you’re meeting the needs in your community.
Define Your Goals
Next, think about why you’d like to be a concierge doctor. What goals do you have for your practice? Write down mission, vision, and values statements, which can serve as guideposts as you build your business plan. Defined goals also help you prioritize your decision-making.
Make Decisions to Build Your Business Plan
A complete business plan includes a lot of information, but here are a few initial questions to answer to get you started:
- Prospective patients: Who do you plan to serve? What are the demographics of patients in your area? What do they need from a health care provider?
- Practice size: How many patients will you see? A smaller practice gives you more time to build patient relationships, but a larger practice may mean more resources and services.
- Services: What will you provide to your patients? You might offer unlimited primary care visits, a wellness program, chronic disease management, or other services.
- Fees: What will members pay? Will it be a flat fee or a tiered approach? Will you serve as direct primary care or accept insurance?
- Availability: How and when will you be available to your patients? Will you provide telehealth services? Who is your backup if you’re away? How many staff members do you need?
- Marketing: How will you attract new patients and advertise your services?
The Finances: Pricing and Service Models
As a doctor, you must follow all legal and ethical guidelines related to practicing medicine. There are also many federal and state regulations that agencies, such as OSHA and CMS, enforce. Many concierge doctors work with a local health care legal expert, since it can be overwhelming to understand all areas of compliance. The following sections provide a few examples of what you’ll need to review.
Employment Contract
Before you transition to a concierge-style practice model, review your existing employment contract. Your current practice or hospital may require you to give your leave notice within a specific timeframe. Your contract also may include non-compete and non-solicit clauses, keeping you from recruiting your own patients.
HIPPA and Patient Privacy
As part of your practice, you must follow HIPAA and patient privacy laws. That includes protecting patient confidentiality and making records accessible but secure. You must also ensure the security of all communication channels, including calls, text, and video chat.
Medicare
A big decision to make as you start your practice is whether you’ll opt out of Medicare and commercial insurance. If you don’t accept Medicare payments, you have more flexibility with the fees you set and services you offer. The downside is that your patients won’t be able to submit claims to Medicare for covered services. You cannot charge a fee for services usually covered by Medicare unless you opt out of Medicare. For some patient demographics, access to Medicare is important. Whatever your approach, make sure you understand the possible consequences.
Commercial Insurance
You’ll also need to decide if you want to join health insurance networks for some services or stay independent. Your choice affects how you conduct billing, submit reimbursements, and follow regulatory requirements.
Not accepting commercial insurance means less administrative burden, but it can also make it harder as you start your practice, since in-network insurance may appeal to more patients and give you more financial stability.
Your patients should be aware that, whether you accept it or not, they should keep their traditional health insurance, which covers major medical expenses, emergencies, and specialty care.
Additional Resources for Private Practice Setup
If you’re ready to start practicing a different kind of medicine, but are feeling overwhelmed, that’s OK. The good news is that you don’t have to open your practice by yourself. There are resources to help. Many doctors interested in concierge medicine choose to join an alternative like MDVIP.
With MDVIP, you receive benefits and support services, including, but not limited to:
- Training, education and online resources
- Legal expertise
- Access to a patient portal
- A practice development manager
- An electronic health records (EHR) support team
Learn how MDVIP can help you navigate the transition and build a thriving practice. MDVIP’s model also works with commercial insurance
people Also Ask
Direct primary care is a payment model in health care where patients pay their primary care provider for a specific set of services. The provider doesn’t bill the patient’s insurance plan.
Note that if you choose to be a concierge doctor, you don’t have to use the direct primary care model. Many concierge medical practices continue to accept commercial medical insurance and Medicare. But there are significant regulatory hurdles to operating a concierge model while accepting Medicare.
There are many ways to attract patients to your new practice, using physician marketing techniques, such as:
- Creating a memorable business name
- Reaching out to existing patients to explain the transition and value
- Setting up a professional, accessible website
- Marketing your services on social media
- Building patient trust to get referrals
- Networking with other providers and at events
At MDVIP, our affiliated physicians have a dedicated practice development manager who customizes a practice development plan focused on attracting new patients.
While you can try to convert your traditional volume practice to a membership-based health care model by yourself, it’s often challenging. Many physicians work with consulting organizations that help them switch to a concierge-type medical practice.
If you're interested in starting an MDVIP-affiliated practice, you receive a thorough evaluation to make sure you can achieve the practice experience you want for your patients and succeed as a business. An affiliation with MDVIP gives you a network of resources, including continuous legal, financial, and practice management support.