The Patient: Patient-Centered Outcomes Research

, Volume 2, Issue 2, pp 95–103

Paying for Enhanced Service

Comparing Patients’ Experiences in a Concierge and General Medicine Practice

Authors

    • Department of MedicineTufts University School of Medicine
  • Hector P. Rodriguez
    • Department of Health Services, School of Public Health and Community MedicineUniversity of Washington
  • David G. Fairchild
    • Department of MedicineTufts University School of Medicine
  • Angie Mae C. Rodday
    • The Health Institute, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center
  • Dana G. Safran
    • Department of MedicineTufts University School of Medicine
    • The Health Institute, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center
    • Blue Cross Blue Shield of Massachusetts
Original Research Article

DOI: 10.2165/01312067-200902020-00005

Cite this article as:
Ko, J.M., Rodriguez, H.P., Fairchild, D.G. et al. Patient-Patient-Centered-Outcome-Res (2009) 2: 95. doi:10.2165/01312067-200902020-00005

Abstract

Background: Concierge medical practice is a relatively new and somewhat controversial development in primary-care practice. These practices promise patients more personalized care and dedicated service, in exchange for an annual membership fee paid by patients. The experiences of patients using these practices remain largely undocumented.

Objective: To assess the experiences of patients in a concierge medicine practice compared with those in a general medicine practice.

Methods: Stratified random samples of patients empanelled to each of the four doctors who practice at both a general medicine and a concierge medicine practice separately situated at an academic medical center were drawn. Patients were eligible for the study if they had a visit with the physician between January and May 2006. The study questionnaire (Consumer Assessment of Healthcare Providers and Systems Clinician and Group Survey, supplemented with items from the Ambulatory Care Experiences Survey) was administered by mail to 100 general medicine patients per physician (n = 400) and all eligible concierge medicine patients (n = 201). Patients who completed the survey and affirmed the study physician as their primary-care physician formed the analytic sample (n = 344) that was used to compare the experiences of concierge medicine and general medicine patients. Models controlled for respondent characteristics and accounted for patient clustering within physicians using physician fixed effects.

Results: Patients’ experiences with organizational features of care, comprising care co-ordination (p < 0.01), access to care (p < 0.001) and interactions with office staff (p < 0.001), favored concierge medicine over general medicine practice. The quality of physician-patient interactions did not differ significantly between the two groups. However, the patients of the concierge medicine practice were more likely to report that their physician spends sufficient time in clinical encounters than patients of the general medicine practice (p < 0.003).

Conclusion: The results suggest patients of the concierge medicine practice experienced and reported enhanced service, greater access to care, and better care co-ordination than those of the general medicine practice. This suggests that further study to understand the etiology of these differences may be beneficial in enhancing patients’ experience in traditional primary-care practices.

Supplementary material

40271_2012_2020095_MOESM1_ESM.pdf (117 kb)
Supplementary material, approximately 120 KB.

Copyright information

© Adis Data Information BV 2009