Each month, the bills arrive for the Netflix accounts, the Amazon Prime memberships … and, of course, the subscriptions that get you in the door of the local physician’s office.
In an age of myriad subscription services, more local physicians are being convinced that patients are willing to pay a regular fee — outside of insurance — for personalized, accessible care. So, they’re embracing membership-based models at their practices that offer heightened levels of service — at a cost.
That’s the crux of what’s sometimes referred to as direct primary care or the concierge medicine model. Of the latter, MDVIP is one of the national leaders. The organization, acquired in a private equity deal that included Goldman Sachs Asset Management in 2021, has grown significantly since its founding in 2000.
There are 46 physicians that have decided to fly the MDVIP flag in the Garden State. Bret Jorgensen, chairman and CEO of the Florida-based company, said its market spans about 45 states today, a network of more than 1,200 affiliated physicians.
“New Jersey has always been an attractive market for us,” he said. “We’ve recently added several doctors in South Jersey, and in Central Jersey as well. We’re growing across the state. And that story is true for us in all markets. We think the model makes sense everywhere.”
Each of these MDVIP-affiliated physicians, who care for a maximum of 600 patients (and not the thousands a traditional primary-care physician might see), is asking patients to supplement typical insurance reimbursements with an annual out-of-pocket fee of around $2,000 annually.
“The idea that (these patients) now pay to see a doctor they were seeing for free, or just with an insurance copay before, you’d think it would be a tough pill to swallow,” Jorgensen said. “But, the fact is, many of them try it. And, when they try it, they stick around.”
According to the company, the patient yearly renewal rate that its physicians experience crosses over 90%. Patients respond with high sanctification rates in surveys as well, Jorgensen said.
So, what are these patients getting that they wouldn’t otherwise? A comprehensive wellness exam, a more personalized relationship with doctors and less barriers to access, Jorgensen claims.
“So, in our view, it’s an incredible investment into affordable, personalized health care,” he added. “And the model is basically the same as a cable bill or a Starbucks coffee each day. It’s a reasonable price point for what it is.”
These arrangements might be gaining new prominence, but their existence — as well as questions over the precedent it sets and whether it has the potential to pull doctors away from a larger pool of patients in need of services — spans several decades.
Burned out and stretched thin by the pandemic, physicians over the past few years have found the motivation to experiment with new approaches to primary care services.
Dr. Teresa Lovins, member of the board of directors of the American Academy of Family Physicians, appreciates what the direct primary care model has done for her practice since she started using it in 2020.
“I have consistent income each month, because I always know exactly the amount of memberships sold,” she said. “At the start of the pandemic, physicians’ offices had difficulty making payroll. Mine stayed the same at that time, because I was being paid, whether patients saw me or not.”
Besides that, she counts less fussing with insurance companies as a perk for physicians under a direct primary care model.
“But the biggest benefit is that I can take patients in a more holistic manner,” she said. “For example, I’m less likely to refer patients out for something like a (dermatological) procedure I can do here, because I have the luxury of time with them.”
Despite an increased level of interest in it each year, particularly from young physicians-in-training in residency programs, Lovins said the model has actually only been adopted by 3-5% of members at the American Academy of Family Physicians.
“And what I’ve heard from (physicians) who feel they can’t do it: It’s about the fear of running a business and the financial side of getting started,” she said. “Running a business is something we’re not trained for in medical school. And you have to put money into the practice to develop it, because you’re often not starting with a huge membership. That can scare physicians off.”
Companies such as MDVIP do offer physicians support with marketing and branding. They also help a physician’s existing patient base into their program and establishes with physicians a continuity of care plan for those who don’t want to continue seeing their doctor if it means paying for a membership.
From Jorgensen’s perspective, it’s becoming easier over time to persuade people of the value in these different models of care — especially with the new emphasis on health introduced by the pandemic.
“For so many, investing in health has become a priority,” he said. “We think that at this time, and for the foreseeable future, this model is really resonating.”
It’s not exactly a medical dictionary term. But Dr. Jeffrey Lederman, a primary care and internal medicine specialist in Eatontown, finds it’s the best way to describe his first dozen years of work, after finishing his residency, in a traditional primary care setting.
“We were seeing 40 patients a day on top of doing hospital rounds,” he said. “It was quite a grind.”
In 2014, he was among some of the first doctors in his area to gamble on the new structure MDVIP was offering. He’s a convert.
“Honestly, this has been the best 10 years of my career,” he said. “I couldn’t speak higher of this model of care. … And, for patients, I think they love it as well. Because it feels close to them to what old-school medicine was like.”
Lederman sees a dozen or less patients a day, which he believes affords him enough time with each that he feels he can take more of a proactive approach to their health care than he’d be able to in a traditional arrangement. He said that’s true for a patient base that’s both young and old.
“I have patients in great health who just want to make sure they’re getting yearly physicals done and have up-to-date screening tests,” he said. “And, in case they need me for something else … this model allows for them to have an acute care visit the same day they call. They don’t have to go to a walk-in center and see a different doctor every time something comes up.”