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    Concierge medicine becomes an option in reform era


    One of the most challenging aspects of transitioning to concierge care is marketing your new practice model to patients, says Tokarz, who recently retired from Northern Virginia Family Practice in Alexandria, Virginia. Established practices with experienced physicians have a distinct advantage. 

    “My finances improved as soon as we transitioned, but I had 25 years of experience practicing in the same location with long-term patient relationships,” says Tokarz. “It would be extremely difficult to start a concierge practice from scratch.”

    Almost 40% of Glenville Medical’s patients joined the new concierge practice, higher than the average retention rate of  15% to 35%, according to data compiled by SpecialDocs Consultants. Puglisi attributes his success to being in an established practice serving a relatively wealthy demographic. Still, losing the other 60% was tough. “You realize that once you put a price tag on your services not every patient will be able to afford it,” he says. 

    Puglisi also cautions against transitioning too abruptly. He and his partners started informing patients about the change six months in advance of their official transition, giving them time to educate patients, sign up members, and find new medical homes for those patients who opted to leave.

    The practice worked with a team of consultants to set up a dedicated phone line for patients to ask questions about concierge care and its cost implications. The physicians also advertised the change in local publications and revised the practice’s website.

    In the months leading up to his official transition, LaGrelius made a point of speaking personally to each patient at the end of every visit. He also invited them to talk to one of his staff in a private room to ask questions and get additional details.

    “Any physician planning to make this change needs a clearly delineated timeline as to how they will implement it,” says Puglisi. “If patients are clearly educated about why you’re transitioning, you’re more likely to have a full practice at the end of the day.”

    Financial implications

    For many physicians, the biggest fear about changing to a concierge practice is losing revenue during the startup period. They worry that their existing patients will balk at the membership fee and that the practice will struggle financially as it tries to attract new patients.


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