In May 2023, Dr. Joanna Loewenstein MD opened a concierge internal medicine practice in New York City, marking the first of its kind at Weill Cornell. Growing up with a gastroenterologist father who was highly regarded in their community, Dr. Loewenstein felt overwhelmed after ten years as an internist due to the limited time available to thoroughly address complex health issues in the typical 15-minute clinic appointments. As a solution, her practice charges a $5,000 yearly fee, in addition to billing insurance for labs, imaging, and follow-up visits, with the aim of providing more comprehensive care to patients.
Meanwhile, Dr. Samuel Ganz, an internal medicine physician in South Florida, started a concierge practice in 2021 after feeling burnt out by the managed care model that hindered his ability to adequately care for patients. Charging an annual membership fee of $15,000 and eliminating insurance, Dr. Ganz prioritizes direct access and personalized care for his patients, particularly those with limited time or severe medical conditions. He recently launched Med2Uinc, a concierge practice offering immediate access to a range of medical services beyond primary care, addressing patient dissatisfaction with the current healthcare system.
Dr. Lara Briseno Kenney, a specialist in hematology oncology and hospice palliative care, opened a rural Missouri “Direct Care” practice in 2019, introducing the first hematology oncology direct specialty care practice in the U.S. While direct care differs from concierge care, as it excludes contracts with commercial insurance companies, Dr. Kenney’s model focuses on providing unlimited services through a flat monthly fee. With average patients being middle-aged, rural, working-class individuals, Dr. Kenney emphasizes affordability, transparency, and stronger patient-doctor relationships as key attractions for her practice.
Despite the assumption that patients in direct care practices do not have insurance, the majority of Dr. Kenney’s patients are insured but opt to pay out of pocket for medical care to access personalized services and transparent pricing. By offering accessible rates for services such as mammograms and labs, Dr. Kenney aims to simplify the billing process and provide a more cost-effective alternative to traditional insurance systems, where patients face multiple fees and unclear billing statements. This transparency and affordability are reshaping the healthcare experience for patients, as they have a clearer understanding of the costs and appreciate the enhanced doctor-patient relationships.
Charging $1200 annually for unrestricted access to Dr. Kenney’s care, patients recovering from breast cancer, for instance, can benefit from ongoing support, education, medications, and screenings at affordable rates. Dr. Kenney’s model offers a range of services for a flat fee, reducing the potential financial burden for patients while enhancing the overall care experience. This approach resonates with patients seeking value in their medical care, as the direct care model continues to gain traction for its patient-centered approach and cost-effective practices.
Dr. Kenney’s advocacy for the direct care model reflects a growing trend in healthcare, where patients are increasingly seeking transparent pricing, improved access to care, and stronger doctor-patient relationships. The shift towards concierge and direct care practices signals a broader movement within the industry to address patient dissatisfaction with traditional healthcare systems and prioritize comprehensive, personalized care. As these alternative models continue to evolve and expand, they offer a promising solution for patients seeking quality care, affordability, and accessibility in a rapidly changing healthcare landscape.
