Like Graf, the "vast majority of physicians who choose the hybrid [do so] because they don't want to say goodbye to their patients," Lipton says. "Most physicians with us opting for the full model do so because it's a way to prolong retirement. They can slow down, yet still see patients. Or, [they choose it] because they have younger families or other personal needs, and a full model gives them the time they need."
Another compelling reason physicians are seeking concierge is because they are "worried about changes in the market, and they are looking to options such as cash-only models."
Because they don't exclude patients, the hybrid models may offer more options for physicians as well as patients, he adds. It would be up to patients themselves if they want to have the concierge fee plan, or continue regular services.
As doctors divvy up their days, the concierge generally takes more time for each patient, and offers physicians a chance to see fewer patients, and have a thus less stressful practice, Lipton says. That's what Graf is starting to see. Besides offering more comprehensive care, the concierge model has convenient scheduling and shorter wait times, as well as more immediate phone access to physicians, Lipton says.
But hybrid isn't for all doctors, says Lipton. "For a hybrid to be successful, you have to be a great doctor—the kind that patients like and respect so much that they are willing to pay an additional fee in order to access your services," Lipton says.
For Graf, it was, oddly enough, his patients who first came to him and suggested he change his practice model to consider concierge a few years ago. "The thing that got me was about 10 patients over a course of a couple of years who said to me, 'you are killing yourself. You are working so hard. You should think about doing this," Graf recalls.
"When I started in solo practice [in 1987,] it was very different then. Patients were satisfied and doctors were very happy," Graf says. "Reimbursements were reasonable and things went along very nicely. But that evolved over the years, in terms of lesser reimbursements, more and more overhead, less time, more stress. I was looking around and seeing at this point, every single one of my colleagues in solo practice, or at least most of them, either had sold their practices to a hospital, or joined a big group or had given up."