An interview with Jessie Gruman, PhD, founder and president of the center for Advancing Health, an independent, non-profit Washington-based policy institute led to the explanation of concierge practice below.  Dr. Gruman is on the faculty of the School of Public Health and Health Services at The George Washington University and serves on the Advisory Panel on Medicare Education of the US Department of Health and Human Services and the Public Health Institute. 


Personalized/concierge practices are designed to give you extended and personalized care and greater access to your doctor — including 24/7 pager/phone access and same day and longer appointments. Patients sign a contract and pay a monthly or an annual fee, typically in addition to other charges (i.e., your normal co-payments and deductibles). These fees are highly variable depending on the level and type of service, but generally do not cover specialist visits, laboratory tests, medical procedures, prescriptions, hospitalizations or emergency room visits. The leading company in the field, Florida-based network MDVIP (, has a typical annual fee of $1,500 per adult patient and an upper limit for practice size of 600 patients per physician. In upscale communities like New York City many doctors with a concierge practice charge twice that or more… luxe boutiques in places like Miami Beach and Beverly Hills may have fees that exceed $100,000 (and include extravagant perks). Critics charge that concierge medicine is exclusionary and elitist, since not everyone can afford it, but Dr. Gruman points out that our medical system is already multi-tiered. If you can afford it and believe you would benefit from this kind of certain, focused medical attention, it is worth exploring the options available to you locally, she said.


Funny how times have changed.  Being available 24/7, 365 was the responsibility of every medical practice and you did not pay extra for it.  This was understood as being part of the job description.

Unfortunately what is viewed as avarice is merely a self-preservation technique for private physician offices to meet their expenses and exist in today’s economic climate.  Can people still afford to support this practice?