Reframing Concierge Medicine as a Medical Home

Originally published in Physician’s Weekly November 2025

In today’s healthcare landscape, many patients experience primary care as a series of disjointed interactions—rushed visits, long waits, and a revolving door of unfamiliar faces. Unsurprisingly, models that promise more time, deeper relationships, and easier access are gaining traction and sparking debate.

From inside the exam room, the benefits of longer visits and consistent care are clear. Trust deepens. Prevention becomes proactive rather than reactive. Clinical decisions evolve into meaningful conversations. Yet equity concerns about affordability, continuity, and broader system impact remain valid and require thoughtful attention. It’s time to reframe the conversation. This column challenges common misconceptions about concierge medicine and proposes an ethical vision for what this model can become. Ultimately, what matters more to patients: velvet ropes or a physician who truly knows and cares for them? Is it the membership that makes the difference—or the relationship it enables?

Defining the Model: More Time, More Trust

At its core, primary concierge medicine involves a primary care model that combines a membership fee with a smaller patient panel to restore the time and continuity that often vanish in high-volume practices.

This extra time isn’t spent on bells and whistles—it’s invested in listening, coaching, prevention, and follow-through. Patients gain enhanced access and continuity; physicians gain sustainable workloads and renewed professional engagement.

While rigorous outcome studies are still emerging, early evidence suggests that this model supports greater satisfaction among both patients and physicians, as well as increased attention to preventive care and the management of chronic diseases.

Five Misconceptions—and What’s True

Misconception 1: “It’s just luxury ‘white glove’ care.”
Reality: Luxury-branded practices exist, but mainstream concierge care focuses on time, trust, and presence—not fancy waiting rooms. The model centers on relationship-driven, evidence-based medicine, not artificial hospitality.

Misconception 2: “It isn’t evidence-based.”
Reality: The payment structure doesn’t dictate clinical quality. Concierge practices adhere to the same clinical standards as traditional practices. What changes is time—time for scientific, thoughtful, and shared decision-making, as well as careful follow-up.

Misconception 3: “Only the elite can afford it.”
Reality: Costs vary widely. Affordability often depends on patient prioritization, and thoughtful practices counter exclusivity through community care and education, as well as support and flexibility for patients facing financial challenges.

Misconception 4: “It guarantees better health outcomes.”
Reality: Although patient experience and access improve, evidence for hard health outcomes remains limited. A recent review highlighted improvements in the delivery of preventive services and physician–patient communication, but it called for more rigorous comparative research. The rationale is compelling, but honesty about the data is essential.

Misconception 5: “It’s unethical.”
Reality: Professional societies, including the American Medical Association, do not deem concierge medicine inherently unethical. Instead, they flag potential concerns such as discontinuity of care when panels shrink and worsening health inequities. These concerns are legitimate, but with transparency, ethical care transitions, and a sense of community responsibility, they can be addressed thoughtfully and effectively. Moreover, concierge medical practices can help restore the ethical practice of clinical medicine and serve as laboratories for this change as our nation addresses challenges in our ailing healthcare system.

What a Concierge Medical Home Can Look Like

At my practice, we’ve worked to reimagine concierge medicine as a “concierge medical home”—a model that preserves the soul of primary care while supporting physician sustainability.

This approach rests on five essential commitments:

1. Evidence-Based Care: We adhere to clinical guidelines, draw on professional recommendations, and apply the best available evidence. Concierge care doesn’t soften standards—it creates time to uphold them.
2. Time + Trust: Our visits are intentionally longer. That time allows for conversations about what, in my opinion, matters most: sleep, nutrition, physical activity, work-life balance, and patients’ short- and long-term health goals. When physicians have time, they don’t just assess—they listen, teach, and connect.
3. Whole-Person Lens: Health is complex. We consider not only physical symptoms but also mental, emotional, and spiritual well-being. Patients are multidimensional beings who deserve care that considers them in their entirety.
4. Team-Based Care: Our care team includes staff, consultants, and the patient. Roles are defined, communication prioritized, and genuine compassion expected.
5. Access with Responsibility: We offer same- or next-day appointments and after-hours support. However, access alone isn’t enough—we also invest in teaching medical students, partnering with community organizations, and ensuring ethical transitions when patients transition to new care.

In a fragmented system, our goal is to make care feel personal, continuous, and complete—the way being “welcomed home” should feel.

A Rubric for Ethical, Patient-Centered Concierge Care

Those creating a concierge medical home carry a responsibility to design a model that serves people rather than one that parallels selling a commodity. This means employing evidence-based medicine instead of fads, pseudoscience, or unproven therapies; prioritizing relationships, access, and whole-person care over luxury or exclusivity; and offering transparent pricing and explicit service scopes, rather than hidden costs. Safeguards for continuity and community engagement must remain central, ensuring that no patient feels abandoned or unsupported.

Reclaiming the Heart of Primary Care

The short-sighted question is, “Is concierge medicine bad?” Perhaps the better question is, “Does this practice earn trust, deliver evidence-based care, and support the purpose and meaning of medicine for those involved in its delivery?”

Why not retire caricatures and embrace nuance? With thoughtful design, safeguards, and values, concierge medical homes can move beyond niche appeal to help reclaim the heart of primary care—anchored in access, prevention, and enduring relationships. Not a privilege for the few, but a renewed promise of what medicine can—and should—be.