So, you’re thinking about launching a concierge practice. This isn’t just a small career change; it’s a complete rethinking of how you want to practice medicine. You’re moving away from the chaotic, high-volume world of traditional healthcare and toward a model built on real relationships and proactive, meaningful care.
Before you get lost in the spreadsheets and legal forms, the very first step is to get crystal clear on what you truly want.
Define Your Vision: Why Are You Really Doing This?
This is your chance to rediscover why you went to medical school in the first place. Are you trying to escape the burnout that comes with 15-minute appointments and endless paperwork? Do you want the time to truly dive into complex cases, focusing on prevention instead of just putting out fires?
Nailing down your personal and professional goals is non-negotiable. This vision becomes your North Star, guiding every single decision you make from here on out.
Why a Clear Vision Is Everything
Without a solid vision, it’s dangerously easy to build a new practice that just recreates the same frustrations you’re trying to leave behind, only with a different payment model. Your vision will dictate your business model, shape your marketing, and define the entire culture of your clinic.
Start by asking yourself some tough questions:
- What does the ideal doctor-patient relationship look like to you? How much direct access are you comfortable with? 24/7 cell phone calls? Secure messaging only?
- What is your perfect work-life balance? Sketch out an ideal week. How many patients do you see each day? How much time is for deep clinical work versus administrative tasks?
- What will make your practice unique? Beyond just longer appointments, what specific services, technologies, or medical philosophies will set you apart?
You’re not alone in seeking a better way. The concierge medicine market is booming because patients are just as fed up as physicians. The global market was valued at around USD 21.83 billion in 2025 and is on track to hit USD 42.29 billion by 2032. This isn’t a niche trend; it’s a powerful shift toward personalized care, and it signals a massive opportunity for doctors ready to build a practice that aligns with their values.
This initial phase is all about getting the foundation right.
As you can see, a powerful vision is the launchpad. It leads directly to smart research and helps you choose the business model that will actually work for you.
Choosing Your Concierge Practice Model
Your vision will immediately point you toward the right operational model. While you can customize things later, most concierge practices fit into one of three main categories. Each has huge implications for your patient panel size, how you generate revenue, and your relationship with insurance companies. If you’re new to the concept, you might want to read more about what concierge medicine is and how it works to get a better feel for these structures.
Here’s a practical breakdown to help you decide which path is right for your practice.
| Model Type | Patient Panel Size | Insurance Billing | Best For Physicians Who… |
|---|---|---|---|
| Full-Retainer | Small (200-400) | None for primary care | Want complete autonomy and to fully exit the insurance game. |
| Hybrid | Mixed (traditional + concierge) | Yes (for non-concierge & covered services) | Want to transition gradually, test the market, or keep a larger patient base. |
| Direct Primary Care (DPC) | Small to Medium (300-800) | None for primary care | Are focused on affordability, accessibility, and serving a broader community. |
The model you pick is a huge strategic decision, not just a financial one. A full-retainer practice maximizes your time and deepens relationships, but a hybrid model gives you a lower-risk runway to get started.
Do Your Homework: Initial Market Research
Once you have a vision and a potential model, it’s time for a reality check. Is there actually a market for this in your community?
Start by analyzing your local demographics. Look for affluent neighborhoods, clusters of busy executives, or active retiree communities—these are often the people who most value the convenience and personalized attention you’ll be offering.
Next, scope out the competition. Are there other concierge doctors nearby? Don’t be discouraged if there are. Study their websites, their pricing, and the services they highlight. The goal isn’t to copy them, but to find the gaps. What aren’t they offering? Where can your unique vision shine? This early research ensures you’re building your dream practice on solid ground, ready to attract the exact patients who need you most.
Laying the Legal and Financial Groundwork
When you shift to a concierge model, your role expands. You’re no longer just a physician; you’re a business owner. This means building a solid legal and financial framework from the very beginning is non-negotiable. Getting this right protects you, your practice, and your patients, preventing massive headaches down the road and setting you up for long-term success.
Your first big decision is choosing a business structure. This isn’t just paperwork—it has major implications for your personal liability, how you’re taxed, and your day-to-day administrative burden. While a sole proprietorship is the simplest path, it offers zero liability protection, leaving your personal assets completely exposed.
That’s why most physicians launching a concierge practice choose a more formal entity. It creates a critical legal shield between your personal finances and the business.
Selecting Your Business Entity
For new medical practices, the decision usually comes down to two common structures: the Limited Liability Company (LLC) and the S Corporation (S-Corp).
- Limited Liability Company (LLC): An LLC is a popular starting point because of its flexibility and relative simplicity. It protects your personal assets from business debts and lawsuits. It also allows for “pass-through” taxation, which means business profits are taxed on your personal return, neatly avoiding the dreaded double taxation.
- S Corporation (S-Corp): The S-Corp also provides that crucial liability protection and pass-through taxation. Its main advantage can be in the tax department. By paying yourself a “reasonable salary” and taking the rest of the profits as distributions, you can potentially lower your self-employment tax bill.
This is a decision you shouldn’t make alone. Consulting with a healthcare attorney and a CPA is essential. They’ll dig into your specific financial situation and your state’s laws to help you pick the structure that best aligns with your goals.
A critical mistake I see is physicians treating the legal setup as a mere formality. Your patient contract is arguably your most important risk management tool. It must be crystal clear about what the membership fee covers—and what it doesn’t—to prevent misunderstandings that could lead to legal claims.
Drafting Ironclad Patient Contracts
Your patient membership agreement is the absolute cornerstone of your practice. This is a legally binding document that manages expectations, defines responsibilities, and ensures you’re compliant with regulations. This is not the time for a generic template downloaded from the internet. It needs to be drafted by an attorney who understands retainer-based medicine and your state’s specific laws.
A well-drafted contract must clearly specify:
- Scope of Services: Spell out exactly which services are included in the membership fee (like extended appointments, 24/7 direct access, and care coordination) and which services are not (lab work, specialist visits, hospital care).
- Fee Structure: Be transparent about the membership fee, payment schedule, and your policies for late payments or cancellations.
- Communication Policies: Define the methods and expected response times for communication. This is key for setting realistic boundaries around your after-hours access.
- Termination Clause: Outline how either you or the patient can terminate the agreement, including required notice periods and any refund policies.
This clarity is vital, especially if you plan to accept insurance for certain services or if you see Medicare patients. Your contract has to prevent any hint of “double-billing”—charging a membership fee for services that are already covered by insurance or Medicare. The penalties for this are severe. While some models like Direct Primary Care often bypass insurance entirely, it’s critical to know the difference. You can get a deeper understanding by reading about Direct Primary Care vs. Concierge Medicine explained on Haute Living.
Building Your Financial Plan
With your legal structure in place, it’s time to map out the money. A detailed business plan and a startup budget are must-haves, particularly if you’re looking to secure a loan.
Your budget needs to cover both the one-time startup costs and your ongoing monthly expenses.
Typical Startup & Operational Costs
| Category | Example Expenses |
|---|---|
| Legal & Administrative | Business formation fees, attorney consultations, licensing fees |
| Office & Equipment | Rent/lease deposit, medical equipment, office furniture, EMR software |
| Staffing | Salaries for a small team (e.g., nurse, administrative assistant) |
| Insurance | Malpractice, general liability, cyber liability insurance |
| Marketing | Website development, branding, initial promotional materials |
You’ll want to project your expenses for at least the first 12-24 months. And here’s a pro tip: build a cash reserve to cover a minimum of six months of operating costs. This financial cushion is your safety net, giving you peace of mind as you build your patient panel and establish a steady revenue stream from memberships.
Crafting Your Membership Model and Setting Your Price
Your membership model is the financial engine of your entire practice. Get this right, and you’ll have a sustainable business built on predictable revenue. Get it wrong, and you’ll struggle, no matter how great your clinical skills are. This isn’t about picking a number out of thin air; it’s about strategically packaging your value in a way that makes perfect sense to your ideal patient.
The goal is to create a structure where patients don’t just see a fee. They see a clear, tangible investment in their long-term health, a partnership that feels both exclusive and invaluable.
Single Retainer vs. Tiered Memberships
One of your first big decisions is how to structure the fee itself. You’ll generally choose between two paths: a single, all-inclusive fee or a tiered structure with different levels of service.
- Single Retainer: This approach is beautifully simple. One fee, whether paid annually or monthly, gives every patient the exact same access to all your services. It’s clean, easy to explain, and fosters a strong sense of a single, unified community within your practice. Everyone is on the same level.
- Tiered Memberships: This model gives you more flexibility to serve a wider range of patients with different needs and budgets. For example, you might design a core tier with all the essential concierge services and then add a premium tier that includes things like advanced health coaching, in-depth genetic testing, or more frequent deep-dive health planning sessions.
A word of caution on the tiered model: it requires very careful design. You absolutely must ensure that your base tier still delivers exceptional value. No patient should ever feel like they are receiving a “lesser” standard of care; the tiers should be about adding more services, not delivering a compromised version of your core promise.
How to Define and Articulate Your Value
Here’s a hard truth: patients will not pay a premium for benefits they don’t understand. It’s your job to translate the abstract idea of “better care” into concrete, compelling features. Don’t just say “better access”—spell out exactly what that means in their day-to-day life.
Your membership agreement should clearly outline benefits like:
- Direct Physician Access: Specify the methods. Does it include your personal cell for texts? A secure patient portal with guaranteed response times? Make it explicit.
- Unhurried Appointments: Guarantee appointments that are 30-60 minutes long. This is a powerful contrast to the 7-15 minute appointments that have become the frustrating norm in traditional primary care.
- Proactive Health Planning: Frame your service as a fundamental shift away from reactive sick care. You’re not just there when they’re ill; you’re their strategic partner in prevention and longevity.
- Expert Care Coordination: Emphasize your role as their healthcare “quarterback.” You’re the one who will navigate the labyrinthine healthcare system for them, from getting them into top specialists to coordinating hospital care.
These are just a handful of the many top benefits of concierge medicine that justify the fee. When you communicate these advantages clearly, prospective patients stop seeing a cost and start seeing immense value.
Your membership agreement isn’t just a legal document; it’s a value proposition. It should make a patient feel confident and excited about the level of personalized care they are about to receive.
Setting Your Price Point
Pricing is equal parts art and science. Your fee needs to reflect your deep expertise, the unique value you’re offering, and the simple financial realities of running a business. Start by doing some market research to see what other concierge practices in your geographic area are charging, but don’t just copy their numbers blindly.
You need to factor in your specific overhead, your personal income goals, and, most importantly, the maximum patient panel size you’re willing to accept. A physician building an exclusive practice with a panel of just 200 patients will naturally need to set a higher fee than one who is comfortable managing 500 patients.
Use your financial projections to work backward. This will help you land on a fee that ensures your practice is not just profitable, but truly thriving.
To give you a clearer picture, here’s a common way physicians structure their membership tiers.
Example Membership Tier Options
| Tier Level | Annual Fee Range | Key Included Services | Ideal Patient Profile |
|---|---|---|---|
| Essential Care | $2,000 – $3,500 | 24/7 direct physician access, same/next-day appointments, care coordination | Individuals and families looking for dramatically improved access to their primary care physician. |
| Wellness Plus | $4,000 – $6,000 | All Essential services plus a comprehensive annual wellness plan, basic nutritional counseling, and fitness guidance. | Patients who are highly focused on proactive health, prevention, and optimizing their well-being. |
| Executive Health | $7,000 – $12,000+ | All Wellness services plus advanced diagnostics (like CAC scoring), executive-style physicals, and personalized health coaching. | Busy professionals and executives who need comprehensive, highly efficient, and data-driven healthcare management. |
This table illustrates a framework, but you’ll need to tailor the specifics to your practice, your skills, and your target market.
Finally, you must be confident when you discuss your fees. When you’ve thoughtfully designed a membership model that you believe in and can clearly articulate its immense value, the conversation changes. You’re no longer “selling” something. You’re inviting patients to join a new and far superior healthcare experience.
Building Your Practice’s Operational Backbone
Exceptional patient care isn’t magic. It’s built on a foundation of seamless operations and the right technology. This is the blueprint for the infrastructure that makes your high-touch service model possible—designing systems that eliminate administrative drag so you can maximize your most valuable asset: time with patients.
Your Electronic Health Record (EHR) system is the central nervous system of your practice. Be warned: a generic EHR designed for high-volume, fee-for-service clinics will actively work against you, creating friction where you need flow. When you’re evaluating options, you have to prioritize features that directly support a relationship-based model.
Choosing a Concierge-Friendly EHR
The right EHR should feel less like a billing tool and more like a communication hub. It needs to enhance the patient experience, not just document it.
Look for a system with these non-negotiable features:
- A Robust Patient Portal: This is your digital front door. Patients should be able to easily schedule appointments, view lab results, and access their health records without having to call your office.
- Secure Messaging: Direct, HIPAA-compliant messaging is a cornerstone of the concierge promise. This feature allows for quick check-ins and follow-ups, reinforcing the value of your direct-access model.
- Customizable Templates: You need the ability to create detailed, personalized notes that aren’t constrained by rigid, billing-focused templates. Your notes should tell a patient’s story, not just list codes.
An EHR that constantly gets in your way is a recipe for burnout. The goal is to find a platform that feels intuitive and lets you focus on the patient in front of you, not the screen. Think of it as your digital co-pilot, not your taskmaster.
Integrating Telehealth Thoughtfully
Telehealth is no longer an optional add-on; it’s a core component of modern concierge care. It offers incredible convenience for your patients, perfect for follow-ups, reviewing lab results, or managing minor issues without forcing an office visit.
The key, however, is balance. Your practice is built on personal connection, so telehealth should complement, not replace, in-person visits. Use it strategically to enhance access and efficiency while preserving the deep, personal relationships that define your practice.
Insights into operational success confirm that blending telehealth with in-person care is a key trend for sustainability, especially for managing chronic conditions. The most successful practices masterfully weave virtual and in-person care to maintain quality while managing costs. You can discover more insights about concierge medicine market trends on GlobeNewswire.
Hiring Your Small, Dedicated Team
As you grow, you can’t do it all alone. But a concierge practice doesn’t need a large staff—it needs the right staff. Your first hires, likely a nurse and an administrative professional, are extensions of you and your brand. They must embody your patient-first philosophy in every single interaction.
When hiring, look beyond clinical skills. Prioritize candidates with exceptional emotional intelligence, impeccable communication abilities, and a genuine passion for personalized service. A team member who is abrupt on the phone or dismissive of a patient’s concern can undo all the trust you’ve worked so hard to build.
This small, cohesive team is your greatest operational asset. They will know your patients by name and understand the nuances of their care, creating the seamless, welcoming experience that sets your practice apart.
Designing Efficient Clinical Workflows
Finally, you must meticulously design your clinical workflows. This means creating clear, repeatable protocols for every common task in your practice. When everyone knows the process, the practice runs smoothly, and patients receive consistent, high-quality service every time.
Map out the entire patient journey from start to finish:
- New Patient Onboarding: What are the exact steps from the first inquiry to their initial comprehensive visit?
- Appointment Scheduling: How are same-day requests handled? What’s the protocol for scheduling in-person versus telehealth visits?
- Communication Protocols: When is a text message appropriate versus a phone call or a formal portal message? What are the expected response times for each?
- Prescription Refills: Create a simple, reliable process that eliminates patient frustration and pharmacy callbacks.
These workflows are the invisible architecture of your practice. By intentionally designing them, you create an operational backbone that is efficient, professional, and perfectly aligned with the premium quality of care you promise to deliver.
Attracting Your First Patients and Marketing Your Practice
With your practice legally and operationally sound, it’s time to focus on the heart of the business: the people you’ll serve. Marketing a concierge practice is nothing like marketing a traditional clinic. You’re not just trying to fill appointment slots; you’re building trust and explaining the profound value of a genuine healthcare partnership.
Your marketing shouldn’t feel like advertising at all. It should be a natural extension of the patient-first philosophy your practice is built on. It’s about educating potential patients about a better model of care, one they might not even know is an option.
Create Your Digital Front Door
Today, your website is your practice. Long before someone picks up the phone to call you, they will vet you online. Your website has to be professional, polished, and immediately convey what makes you different.
Within seconds, a visitor should be able to answer these questions:
- What is concierge medicine? Explain the model in simple, direct language. No jargon.
- What specific benefits do I get? Don’t just say “better access.” Detail the 30-60 minute appointments, direct physician access via cell, and unhurried visits.
- Who is the doctor? Patients are choosing you, not just a business model. Your bio and photo should be warm, professional, and confidence-inspiring.
- How do I join? Make the next step obvious, whether that’s scheduling a complimentary meet-and-greet or filling out a simple inquiry form.
This digital presence is your foundation for building credibility and the central hub for every other marketing effort you undertake.
Master Local SEO and Online Visibility
A beautiful website is useless if no one finds it. This is where local Search Engine Optimization (SEO) becomes absolutely essential. When a busy executive or a health-conscious retiree in your city searches for “best primary care doctor near me” or “personalized medicine,” you need to be at the top of that list.
This doesn’t require a six-figure marketing budget. Start with the fundamentals: claim and meticulously optimize your Google Business Profile. Add high-quality photos of your office, ensure your address and phone number are correct, and write detailed descriptions of your unique services.
As you onboard your first few members, encourage them to leave honest reviews. Those testimonials are pure gold, providing the social proof that new patients need to feel confident. Consistently using keywords related to concierge medicine and your specific location throughout your website signals to Google that you are a relevant authority in the area.
The market is already looking for you. The U.S. concierge medicine market was valued at USD 7.35 billion this year and is projected to grow at a CAGR of 10.33% over the next five years. With the primary care segment alone holding a 26.72% market share, it’s undeniable that patients are actively seeking the personalized, high-touch care you provide. You can read the full research about concierge medicine market growth to grasp the scale of the opportunity.
Build Relationships and Word-of-Mouth Referrals
While your digital footprint is critical, the most powerful marketing for a concierge doctor happens offline, through genuine human connection. The lifeblood of your practice, especially in the early days, will be word-of-mouth.
The most effective marketing strategy is to deliver an unparalleled patient experience. When a patient feels truly heard, cared for, and respected, they become your most passionate advocate.
Consider these relationship-focused strategies:
- Host Small Health Talks: Organize intimate, educational events on relevant topics like “Navigating Menopause” or “Optimizing Brain Health.” Don’t rent a huge hall; use a local library, a high-end community center, or even partner with a local business. This positions you as a trusted expert and lets potential patients meet you in a low-pressure setting.
- Build a Professional Referral Network: Get to know other trusted professionals who serve the same type of client. This includes specialists, financial advisors, estate attorneys, and even high-end real estate agents. Once they understand the immense value you provide, they can become a fantastic source of qualified referrals.
- Engage with Your Community: Become a visible health resource in your town. Write a column for a local magazine, offer to speak at a Rotary Club or Chamber of Commerce meeting, or volunteer at a community health fair. These activities build a reputation that no paid ad can buy.
Ultimately, attracting your first patients isn’t a numbers game. It’s about demonstrating your value and building real trust, one relationship at a time.
Common Questions About Starting a Concierge Practice
Making the leap into concierge medicine is a thrilling prospect, but it’s completely normal to have a long list of questions. Let’s tackle some of the most common queries and sticking points that come up when physicians are mapping out this rewarding career transition.
How Do I Transition Existing Patients to a New Concierge Model?
Handling this transition is all about early, transparent, and empathetic communication. You absolutely cannot just flip a switch one day. The key is giving your current patients plenty of lead time—I always recommend a runway of three to six months before the new model goes live.
This window gives them the space to absorb the information, ask questions, and decide what’s best for them without feeling cornered or rushed. Be proactive and personal in your approach.
- Host Informational Sessions: Set up small group meetings, both in your office and virtually. Use this time to personally walk them through the new model, what it means for their care, and the value behind the membership fee. This is your chance to articulate the benefits they’ll experience, like unhurried appointments and direct access to you.
- Provide a Gracious Off-Ramp: For those patients who can’t or choose not to join, your job is to ensure a seamless and respectful handoff. Have a list of trusted colleagues ready for referrals and make sure their medical records are transferred smoothly. Protecting these relationships is critical for your professional reputation in the local medical community.
Can My Concierge Practice Still Accept Insurance?
This is easily one of the most frequent questions, and the answer comes down entirely to the business model you choose. There is no one-size-fits-all solution here.
A hybrid model is specifically designed to accommodate insurance. In this setup, you charge a membership fee for non-covered perks (like wellness coaching, advanced screenings, and 24/7 access) but continue to bill insurance for standard office visits.
On the other hand, a full-retainer or Direct Primary Care (DPC) model typically sidesteps the insurance system altogether. The membership fee covers the vast majority of primary care services, and patients use their insurance for specialist care, imaging, and hospitalizations.
Consulting a healthcare attorney on this point is non-negotiable. They are essential for structuring your patient agreements to avoid any compliance minefields, particularly with Medicare regulations and the severe penalties associated with “double-billing.”
What Is a Realistic Patient Panel Size?
The dramatically smaller patient panel is one of the most profound benefits of this model. While a traditional primary care doctor is often drowning under a panel of over 2,000 patients, a concierge physician typically cares for between 200 and 600.
Finding the right number for your practice is a balance between your desired service level and your financial targets.
- A panel of 200-300 patients allows for an incredibly high-touch, deeply personal level of care.
- A panel of 400-600 patients can make the model more financially accessible to a wider community while still delivering an exceptional standard of care.
To find your sweet spot, you’ll need to run the numbers. Model your projected revenue based on your planned membership fee. This simple calculation will help you land on the target that ensures your practice’s long-term sustainability and gives you the work-life balance you’re seeking.
What Are the Biggest Unforeseen Challenges?
Physicians consistently underestimate two major hurdles: the sheer demands of entrepreneurship and the emotional toll of patient transitions. You’re no longer just a clinician—you’re now the CEO, head of marketing, and chief brand strategist. This requires a completely different skillset you must be prepared to learn on the fly.
Secondly, don’t underestimate how emotionally taxing the conversations with long-time patients who can’t join the new practice will be. It’s a real and difficult part of the process that many doctors aren’t ready for.
Another common pitfall is failing to manage patient expectations around your availability. Because they have direct access, you must set clear, firm boundaries from day one. This is vital to preventing your own burnout and ensuring the concierge model remains sustainable for you in the long run.
Are you a top physician looking to elevate your practice and connect with patients who value premier care? Haute MD offers an exclusive network that provides the visibility and credibility needed to build a thriving concierge practice. Learn more about joining our curated network of leading medical experts.