Understanding the model
What is concierge medicine?
Written by a physician who practises it, rather than by a directory that sells listings.
Concierge medicine is primary care funded by a membership fee paid directly to the practice, instead of by the volume of visits billed to insurance. Because the practice is not paid per visit, it can keep a deliberately small patient panel, which is what makes longer appointments, same-day access and direct contact with your own physician possible.
How it works
The mechanism, in one paragraph.
Panel size is the variable. Everything patients notice follows from it.
In insurance-funded primary care, a practice earns per encounter. The rational response to that incentive is a large panel and short appointments, and that is what most practices end up with, regardless of how any individual physician feels about it. A membership fee decouples the practice’s income from the number of appointments it runs. Once that link is cut, a small panel becomes financially survivable, and everything patients associate with concierge care follows from the small panel.
So the fee is not buying luxury. It is buying a smaller denominator.
Definitions
The terms you will see.
Concierge, direct primary care and boutique get used interchangeably and do not mean the same thing.
- Concierge medicine
- Primary care funded by a membership fee. The practice usually still expects you to carry insurance for care delivered outside it, such as specialists, imaging and hospital stays.
- Direct primary care (DPC)
- A closely related model, also membership-funded. The distinction is not standardised across the industry and the two terms are often used interchangeably.
- Panel
- The number of patients one physician is responsible for. This is the number that determines everything else. My Choice Primary Care caps its panel at 150.
- Membership fee
- What you pay the practice directly, monthly or annually. At My Choice Primary Care it is set by a formula weighing age and the complexity of your care.
Cost
What it costs.
Most practices will not say what a fee is or how it is decided, which is why the question keeps getting asked.
Fees vary widely across the country, and many practices will not discuss theirs at all, which is why the question is asked so often. At My Choice Primary Care the fee is set by a consistent formula weighing age and the complexity of your care, and discussed at the consultation. How that works is set out on the membership page.
Insurance
How it works with insurance.
Insurance and Medicare do not cover the membership fee. However, many members find that their HSA or FSA funds can be used to pay for concierge services; please consult your tax advisor to confirm.
Yes, you still need insurance. We do not participate in any insurance networks, including HMOs, Tricare Prime, or Medicaid. Your membership covers your care with Dr. Sisodia, and it does not pay for care delivered anywhere else. You will need insurance for emergency care, routine bloodwork and laboratory tests, imaging, hospital stays, surgery, and specialist visits and procedures.
Fit
Who it does not suit.
Someone who sees a physician rarely, has no ongoing conditions and is content with their current practice is unlikely to get a membership fee back in value. The model earns its keep for people who want time, continuity and direct access, and for people managing something ongoing where having one physician who knows the whole history genuinely changes the care.
We would rather say that plainly than sell a membership that does not fit. There is a fuller version of this argument on whether concierge medicine is worth it.
Common questions
People often ask.
- What is the difference between a concierge doctor and a regular doctor?
- The clinical training is the same. The difference is the size of the practice. A concierge physician deliberately keeps a small panel, which is what makes extended visits, same-day appointments and direct phone access possible. In a traditional practice the panel size makes those things impractical regardless of intent.
- How much does concierge medicine cost at My Choice Primary Care?
- Membership fees are set by a consistent formula that considers both age and the complexity of care. Pricing is discussed during the consultation, with monthly or annual payment options available. The fee covers your relationship with Dr. Sisodia: extended visits, direct phone and text access, and coordination of your wider care. It does not replace health insurance.
- Does insurance or Medicare cover the membership fee?
- Insurance and Medicare do not cover the membership fee. However, many members find that their HSA or FSA funds can be used to pay for concierge services; please consult your tax advisor to confirm.
- What is the downside of a concierge doctor?
- You pay a membership fee that insurance does not reimburse, and you still need insurance for specialists, imaging and hospital care. If you rarely see a physician, or your care is already well managed by a practice you like, the membership may not be worth it. It is worth most to people who want time and direct access.
Next step
See what it costs here.
How the fee is set is published, rather than kept until a sales call.