Membership Model Medical Practice - Works for Some, Not Others

March 23, 2012

Contemplating the membership model? Here are some of the key things to consider.

About six months ago, family physician Rakesh Patel transformed his solo primary-care practice in Gilbert, Ariz., into a membership practice.

“What I struggled with was the uncertainty in healthcare,” he told Physicians Practice of his decision to transition. “I really looked at this membership model as a way for me to stay independent … and that’s really important to me.”

Patel’s practice is now one of many affiliated with Medley Health, a privately held medical practice marketing and communications services company that partners with independent primary-care doctors to help them transition and thrive in membership-based practices.

Steve Wigginton, CEO of Medley Health, told Physicians Practice that company was founded around the idea that the independent physician practice was “in peril” from an economic perspective, and that the work-life balance for independent physicians was “virtually nonexistent” due to technical, financial, and regulatory pressure.

In the Medley membership model, patients pay a fee for their physicians’ services, in addition to their regular insurance premiums. In exchange for those fees, membership physicians provide patients with highly personalized care. For instance, these physicians see only about 10 to 15 patients per day, and they are heavily involved in a patient’s care throughout different healthcare sectors, says Wigginton.

For Patel, the transition to membership was a smart one. It allowed him to stay independent, yet have a fuller work-life balance; and it gave him more time to focus on a smaller number of patients, rather than on volume of services.

Sounds like a win-win, right? While it works for Patel, it may not work for every physician.

The first reason of course, is that some physicians personally oppose such models. Like in a concierge practice, patients pay monthly or annual fees for their physicians’ services. As a result, many physicians see these models as exclusive, unethical, and/or as “get-rich-quick” schemes.

But Wigginton points out that - at least in Medley’s case - the membership model is accessible and affordable to many patients, not just the wealthy. Patients pay fees of $100 per month for individuals, $150 for couples, and $200 for families. The fees can be paid monthly, quarterly, or annually.

Patel says it’s a misconception that physicians participating in this style of practice are solely doing so to experience more financial success. “Honestly, it’s a way of working smarter instead of harder,” he says. “I wasn’t going into this trying to make more money; I really wanted to just make sure that I stayed constant where I was at.” According to Patel, his practice is generating the same amount of income as it did before the transition.

Still, regardless of intent, Patel’s patients still pay that additional fee for his services. And that’s something many physicians personally oppose. 

If you are not one of them, the membership model might work for you. But there is one more factor to consider: Does it match up to your professional skills and preferences?

“It’s not right for every physician,” says Wigginton. “You need to be a physician who really enjoys and appreciates being fully engaged with your patients across the full spectrum of their health.”
Some physicians, he says, are “fantastically good as technicians” and they thrive in high-volume practices. “There’s nothing wrong with that,” he says, “but those are not likely to be physicians to whom a membership practice will be as rewarding or as successful.”

Patel says membership is simply “a different way” of practicing medicine. “For somebody who may have been [in the typical medical practice] for a long time, it could be a challenge,” he says, noting that he needs to be accessible to patients all the time. “Part of the territory is that someone can call you 24/7.”

In addition, at least for physicians who partner with Medley, membership requires tech-savvy physicians, says Patel. He relies heavily on his EHR to coordinate care and track his patients through various healthcare systems. He also texts and e-mails his patients frequently.

Still, Patel says for him, membership works. “I’m not working on charts for four hours after the office hours,” he says. “I actually have time to spend with patients in the office and work on their problems and not have to be rushed to see the next patient.”

What do you think of the membership model? Is it something you would consider or would it not be a good fit for you personally? What about professionally?