In May 2023, Dr. Joanna Loewenstein opened a concierge internal medicine practice in New York City, inspired by her father’s compassionate care as a gastroenterologist. She felt overwhelmed with the lack of time to provide thorough care to her patients under the standard 15-minute appointment model. Despite charging a $5,000 yearly fee and billing insurance for additional services, Dr. Loewenstein acknowledges the criticism that such practices exclude those who cannot afford it but believes it is necessary for her to practice medicine in the way she desires.
Dr. Samuel Ganz, an internal medicine physician in South Florida, also transitioned to a concierge practice, charging an annual fee of $15,000 and not accepting insurance. He emphasizes the value of direct access for his patients, especially those who are limited in time or are in critical health conditions. Dr. Ganz recently expanded his practice to offer a range of medical care beyond primary care, providing immediate expert consultations for urgent cases.
Dr. Lara Briseno Kenney, specializing in hematology oncology and palliative care, established a “Direct Care” practice in rural Missouri, offering services without contracting with commercial insurance companies. She charges monthly membership fees of $100 for hematology oncology patients and $60 for internal medicine patients, catering to middle-aged, rural, working-class individuals. Dr. Kenney’s model prioritizes building relationships with patients and providing transparent and affordable healthcare services, even for serious diagnoses like cancer.
Despite misconceptions, Dr. Kenney notes that most of her patients have insurance but choose to pay out of pocket for the benefits of a direct care model. This approach offers cost transparency, affordability, and comprehensive care under a single membership fee, eliminating additional copays, facility fees, and multiple charges common in insurance-based clinics. Patients appreciate the value of having a personal relationship with their doctor and the stress-free experience of knowing the costs upfront for their medical care.
Patients in direct care practices value the accessibility, personal connection, and cost-effective services compared to traditional insurance-based models. Dr. Kenney emphasizes the benefits of practicing medicine with improved work-life balance and flexibility in the direct care model, enabling her to focus on building relationships with patients, providing comprehensive care, and promoting overall well-being. The growth of concierge and direct care practices reflects a shift in patient preferences towards personalized, transparent, and affordable healthcare services that prioritize quality over quantity.
