Whither, Direct Care?

By Steve Barrett
Tuesday, November 12, 2019

Supporters of direct or concierge care argue that it lets providers offer more individualized attention, and that by contracting directly with patients — not insurers and government programs — direct care providers keep down overhead.

Skeptics, however, suggest that the smaller patient loads direct care providers typically take on reduce healthcare access in a time of physician shortages.

Whatever direct care’s overall effects on medicine, it remains an open question exactly how prevalent the model will become.

“A growing number of physicians have indicated they plan to adopt this model in the next several years,” recruitment firm Merritt Hawkins states in its 2019 Review of Physician and Advanced Practitioner Recruiting Incentives.

However, the level of interest has not been on a steady upward track. Surveys by The Physicians Foundation/Merritt Hawkins found physician intentions to practice direct or concierge care in the ensuing three years have varied considerably the past nine years:

  • 2012: 6.8%
  • 2014: 6.2%
  • 2016: 8.8%
  • 2018: 4.5%

“While most of the solo physician practice searches Merritt Hawkins conducted in the 2019 Review period were for direct pay/concierge settings, this model has not yet become more than a niche,” according to Merritt Hawkins. “Physicians may be less sanguine about moving to concierge/direct pay than they once were.”