Critics of concierge medicine argue it's worsening physician shortages and expanding inequity

Primary care doctors are converting into membership-based concierge practices

Subscription-based practices sometimes don't accept insurance and they also require annual membership fees which can add up to thousands of dollars per year. In return, patients are promised more personalized care and round-the-clock access to medical providers. As doctors transition to concierge care, this retainer-based medicine model is forcing people to choose between searching for new primary care providers or paying hefty fees.

Doctors report wanting more time to plan, provide care for patients

Many physicians experience aspects of burnout, and concierge medicine provides a slower, more relational approach to medicine, including consistent follow-up care for a smaller pool of patients. A concierge medicine clinician may talk with each patient frequently, perhaps every few weeks, instead of just once a year.

By 2036, the US may face tens of thousands of primary care physician shortages

That's the estimate of the Association of American Medical Colleges, which contends that whenever physicians switch to concierge medical practices it exacerbates this projected shortage since each of those clinicians will see fewer patients and those patients must be able to afford that pricey care.

Roughly 45% of clinicians in 2023 reported at least one symptom of burnout

With that kind of statistic as a backdrop, proponents of concierge medicine practices argue that concierge services could help keep doctors in medicine and thus help to address physician shortages.

US concierge and direct primary care practices surged 83.1% between 2018 and 2023

Research published in December 2025 in the journal Health Affairs indicates that these retainer-fee care models are expanding across the country. Concierge medicine charges monthly or annual fees, as does direct primary care (which doesn't take insurance).

Concierge care may account for more than 10% of primary care physicians

That's the rough estimate from Zirui Song, a Harvard Medical School professor who focuses on health care policy and studies the growth of concierge medicine. He and other researchers found that between 2018 and 2023 the number of concierge and direct primary care practices (concierge care without accepting insurance) grew by 83% and the number of clinicians in those practices increased by 78%.

Concierge medicine practices typically have hundreds of patients, instead of thousands

A clinician describes how he's "one call away" from his patients in the concierge medicine system. His patients pay about $150 per month to be members in his practice on top of normal care visit costs. Doctors like him may only have hundreds of patients in their practice—instead of thousands.

Annual memberships for concierge medicine can be $1,000 or as much as $50,000

Concierge medicine practices offer more opportunities for same-day visits and longer meeting times with doctors in exchange for annual membership fees on top of typical insurance payments, copays, and deductibles.

Concierge medicine offerings are growing on college campuses, catering to students

Parents are interested in concierge and direct primary care services for their kids, including offerings with dorm visits, guaranteed same-day appointments, and medication access, so new practices have sprung up catering to college settings. (Some users may encounter a paywall.)

Virtual care—telehealth—is a significant component of concierge medicine

Telehealth—a central plank of concierge medicine—can widen the gap between the rich and the poor since lower-resource individuals may have less access to technology and encounter other access issues.

Amazon's One Medical, MDVIP, and SignatureMD are examples of concierge practices

Annual fees for concierge practices can range widely. At the lower end, Amazon's One Medical costs $199 (which can drop to $99 if you're a Prime member) and four figures for MDVIP and SignatureMD. Annual fees jump to $10,000 or more for options like Massachusetts General Hospital's concierge practice.

Concierge medicine officially began in 1996, with the first concierge practice

MD2 International, a concierge medical office that opened in Seattle, Washington, was founded based on the idea of unrushed, no-wait-time visits and personalized care offerings with strong relationships between patients and their providers.

Older, medically complex patients are a high proportion of concierge practices, a membership-based model which is sometimes referred to as retainer medicine or VIP medicine.

Concierge services are one of the top medical costs retirees fail to factor into their planning

One of the unexpected medical costs retirees are facing is thousands of dollars a year for concierge care membership fees. A typical annual fee can average $3,500. Concierge care is an option that's particularly popular among older adults with more complex health needs and in some areas of the country doctors are increasingly turning away Medicare patients and only accepting new patients willing to pay annual fees for concierge medicine. (Some users may experience a paywall.)

The Government Accountability Office in 2005 concluded concierge medicine didn't threaten Medicare

This congressionally mandated analysis concluded that the number of concierge physicians nationwide was too small for concierge practices to undermine Medicare patients' access to affordable health care and it was "unlikely that the approach has contributed to widespread access problems." Medicare is the federal health insurance program for the aged and some disabled individuals.

One estimate values concierge services at $38.9B by 2032

Data Horizons Research put the value of this global market at $18.9B in 2021, but anticipates massive growth by 2032, with North America comprising the majority of the market. Chronic health conditions, their analysis suggests, will be a contributing factor to this growth as medically complex individuals seek more personalized care.

The rise of telemedicine: A post-pandemic analysis

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There may be a surplus of nearly 8,000 emergency room doctors by 2030

That was the 2021 prediction of the American College of Emergency Physicians, which led to a sudden steep decline in the field among medical students and residents. (Some users may encounter a paywall.)

Urgent care is one step up from primary care

If a patient needs to see a provider today, urgent care can be a good solution. It has shorter wait times and a more affordable price tag than heading to the emergency room. Typically, an emergency department will have more specialists available for a serious and complicated issue, as well as advanced testing capabilities.

Patients are messaging their doctors online more than ever—recent research suggests portal messages have risen by 157% since 2020.

Flexible spending accounts can't be used to pay for concierge membership fees

FSAs, used by roughly half of Americans, can only cover qualified medical services—so actual care—and cannot be used to cover membership fees for a concierge medicine practice. These fees must be paid out of pocket by clients.

Private equity's expansion into healthcare has been criticized for raising patient medical costs

Between 2000 and 2018, PE's total investment in healthcare ballooned from $5B to $100B. While healthcare systems originally began consolidating as a solution to navigating complex regulations (and to make working with insurance companies easier), research suggests that private equity has both increased patient costs and decreased the quality of care in hospitals and doctors' offices.

The lack of diversity in clinical trials is undermining the future of precision medicine

Medicine works better when the treatments are tailored to fit each individual person’s biology and history. Homogeneous patient selection in clinical trials means treatments and care are being refined based on only a small range of variables, some of which may not apply to you. This 40-minute podcast episode discusses the historical and current reasons for the lack of clinical trial diversity and what this means for the future of personalized medicine.

Telehealth demand for GLP-1s is on the rise as people seek it out for myriad reasons—the proportion of non-obesity and non-diabetes-related prescriptions for the drug soared from 4.5% in 2018 to 17% in 2023.

Modernizing health data privacy: A call for comprehensive reform

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Men are flocking to hundreds of new online testosterone clinics for low T prescriptions.

Doctors are prescribing social activities—and seeing good results

Physicians, especially in the UK, are asking patients what they enjoy and then prescribing a consistent regimen of doing that type of activity to improve fitness and overall health, including community exercise classes, volunteering, and spending time in nature. This approach may provide better incentives to stick with an activity.

White patients waited 374 days for a kidney—Black patients waited 727 days

A 2022 congressionally mandated report highlighted racial inequities in the US organ transplant system, including disparities that made it more likely white people will be placed on organ wait lists than Black people. It spotlighted inequities such as racial differences in median kidney wait times identified in earlier research. The report, from the National Academies of Sciences, Engineering, and Medicine, recommended fixes including that the Department of Health and Human Services develop national performance goals for the system and achieve equity in the system in the next five years.

Read what it's like working in emergency medicine

A board-certified emergency medicine physician working in the Bronx writes about what her workweeks look like and what attracted her to this fast-paced medical specialty, including being able to help suffering patients quickly, treating a wide range of ailments, and tending to disadvantaged communities.

Digital healthcare is helping emerging economies

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USA Television Network fictional series Royal Pains spotlights concierge medicine

This fictional television series, that aired from 2009-16, chronicles the adventures of a doctor who transitioned into offering concierge medicine for a big-spender clientele. As a private physician-for-hire he is on call to provide care 24/7.

Patient portals offer a good opportunity to track your healthcare records and communicate with doctors, but they also allow patients to see test results without context, which can cause unnecessary concern.

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Emergency room evaluations may be improved with AI algorithms

Emergency room care teams must make fast and crucial decisions. They must determine if patients need to be admitted or discharged and when to order more tests or not. Researchers have been exploring how often patients died in the week after they were sent home and evaluating how this and other aspects of emergency care decision-making could be improved with AI algorithms to assist decision-makers.

Rural emergency rooms are sometimes operating without any physicians on-site

These facilities may not have an on-site doctor at all, with norms varying widely by state. In North and South Dakota, more than half of their emergency departments were running without 24/7 attending physician staffing, according to recent research. Instead, they're staffed by physician assistants and nurses.

Congress didn't renew temporary enhanced Affordable Care Act federal subsidies that expired at the end of 2025, a move that substantially raised ACA health insurance premiums.

Dozens of US women in labor turned away from hospital between 2022 and 2024

An Associated Press analysis of federal hospital investigation data concluded that more than 100 pregnant women in medical distress were turned away from emergency rooms or treated negligently since 2022.

The potential promises and pitfalls of AI in medicine

Artificial intelligence (AI) is increasingly being integrated into healthcare, offering the potential to aid in diagnoses, answer patient queries, and streamline administrative processes. In a recent PBS interview, Dr. Isaac Kohane, editor-in-chief of the New England Journal of Medicine AI and chair of Harvard’s department of biomedical informatics, discusses the current state and future of AI in medicine.

Most Americans are now dying at home, reversing 20th century trends

For most of the 21st and 20th centuries most Americans died in hospital settings. But in 2016, home-based deaths overtook hospitals; most Americans are now dying at home, likely fueled by individual preferences to die at home or to receive at-home palliative care.

Learn how Hollywood tries to get mental health portrayals right

"Entertainment is always the first priority," the director of medical research for "Grey's Anatomy" and "Private Practice" explained in this Newsweek article. But, medical consultants and dedicated groups like the University of Southern California's Hollywood, Health, and Society program, can help inform shows' characters, actions, and sensitivities on subjects like mental illness.

HBO Max's 'The Pitt' aims to be the most accurate representation of medicine on TV by using real doctors as consultants.

Some argue that America is too dependent on consulting

Many major companies in America—not to mention the federal government—spend thousands of dollars a month paying to contract major consulting firms.

The 15-minute city lets residents meet their daily needs within 15 minutes on foot

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How Korea’s beauty industry is impacting its healthcare system

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Visualize the global supply chain of medicine, which may begin with basic research in the US, but outsource intermediate steps.

See this ranking of the top 10 medical shows on television

The Hollywood Reporter created this 2025 ranking of 10 television shows from around the world that focus on medicine. Candidates included "Grey's Anatomy," "The Pitt," "New Amsterdam," "ER," and more. The publication warns that its ranking is a living document that may change with time—and that its explanations include show spoilers.

Some researchers have pushed for 'food deserts' to be rebranded as 'healthy food priority areas.'

Read the Surgeon General's 2023 loneliness report claiming loneliness is an epidemic

This report details the specific health threats linked with loneliness, including that loneliness and social isolation can increase the risk of premature death by nearly 30%. Loneliness lowers our capability to mount an effective immune response to viruses and respiratory illness, can cause chronic inflammation on par with physical inactivity, and increases the risks for anxiety, depression, dementia, heart disease and stroke.

Insurance denials prevent lifesaving care for patients with eating disorders, according to an investigation from The Seattle Times.

HSAs are frequently criticized for exacerbating inequality in healthcare access

Health savings accounts offer large tax advantages, but require personal contributions. Some argue that the tax advantages benefit wealthy individuals more than anyone else and that HSAs don't do much to help people who can't afford to regularly contribute to one. As a result, HSAs only decrease costs for those who can comfortably invest in them, and health inequalities between high-income and low-income individuals are exacerbated.