Myths abound concerning concierge medicine (CM). Unfortunately these myths prevent good doctors from converting their practices to CM.  Let’s look at those myths—maybe you need to work on yourself and your own beliefs. If you practice quality medicine your patients will value you and your work and will pay a fee to join your CM practice.  CM is a value story.  If you provide solid value, you needn’t believe these myths–value trumps myth.

The myths:

•  My patients are not wealthy/can’t afford CM.

– I have a lot of Medicare/Medicaid patients.

• My patients will not like this concierge idea.
• My patients can’t do without me.
• I have bad practice demographics.

– I am rural.

– My patients are too old.

– My patients are too young.

• 24/7 coverage sounds too hard.
• Is this legal? What are the ethics?
• The conversion process will overwhelm me.

My patients are not wealthy.  If your patients value you and your work, you can devise an affordable program.  Patients will find the money to keep you if they value you.  Be creative with pricing if necessary.  You can make it work.  Amazingly, I have patients who live in housing projects who joyfully belong to my practice because they see the value.  Conversely, all of us in CM practice have wealthy patients who say the fee is too high, do not see the value, and do not join.  Patient income generally does not predict CM success or failure.  Perceived value predicts success.  Focus on value and the rest will follow

My patients will not like this concierge idea.  Do not project onto patients negative beliefs, as those beliefs may become unnecessary self-fulfilling prophecies.  Patients’ enthusiasm will mirror your own.  Patients possess a survival instinct and will recognize your opportunity for better care, along with your belief in providing that care.  Moral:  be enthusiastic!  Believe in yourself and your patients will follow.  Above all, emphasize value and opportunity in your CM practice.

My patients can’t do without me.  Primary care doctors are famously codependent.  Get over it.  Patients not seeing the value in your practice can and will vote with their feet.  You do not decide who can live with or without you—patients decide.  Patients who truly “can’t live without me” will see the value and stay with you.  There is nothing unethical about letting patients decide who they need.   Do not project your own needs onto your patients.  Patients who do not wish to stay with you are responsible for their own lives.  Let go of your codependency.

I have bad practice demographics.  You can overcome demographic obstacles by providing great value to your patients.  Patients of all stripes, ages, and locations will stay with you if you take excellent care of them.  For example, farmers in my practice understand, respect and value hard work.  All of my farmer patients signed my contract.  The elderly do tend to value their care more that the youthful, but the health-conscious young will sign-up as well.  Meet demographic challenges by making sure your patients see value.

24/7 coverage sounds too hard.  24/7 sounds impressive, and it does demonstrate value.  Taking call has never been easier for me.  First, with fewer patients in the practice, the calls decrease in proportion to number of patients.  Second, the very patients who respect and value me enough to contract with me demonstrate discretion in calling after hours.  Mutual respect is the norm in CM.  Inappropriate calls come few and far between, so 24/7 call is not hard.

Is this legal?  What are the ethics?  Concierge medicine is legal and is ethical. In CM, you provide a service for which patients pay. If you elect to file insurance, your CM practice needs to provide a non-covered service. Some argue that by charging a fee, you limit access to patients, hence CM is not ethical.  Your response should be, “I need to see fewer patients to practice a high level of care.  I cannot take care of all patients who need a doctor.  It is not my responsibility to see all patients or attempt to cure all of society’s ills.  I just focus on my own patients.”  Explain this truth to your patients. They will understand you.  It is ethical for you to stay alive and in business by practicing concierge medicine.

Conversion process will overwhelm me.  Conversion to a concierge practice is do-able, and challenging.  You have one chance to do it right.  We do not recommend going it alone.  Conversion need not be overwhelming.  Simply ask for help.

If you know in your heart that you need a better alternative than hamster treadmill high volume medical practice, consider concierge medicine.  Do not shoot-down CM based on any of the above myths.  Focus on value.  If you can provide value to your patients and if you want a better life for your patients and yourself, bust these myths and get going.

John T. Kihm is an internal medicine physician and CEO of Concierge Medicine Direct.

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