Cash-based Private Practice. Concierge Care. VIP PT.
These buzzwords have become all the rage in the rehab community in recent years, particularly as the popularity of concierge medicine continues to rise among physicians.
Along with all the hype about the benefits of these practice models, however, there comes substantial confusion about what exactly concierge rehab is and how it works.
Let’s break down the details together.
What It Is and What It Ain’t:
Characteristics of Concierge Care
In the classical model of concierge medicine, patients pay a monthly or annual membership fee to their provider, essentially as a retainer. (1)
In return for this fee, the patient enjoys more direct and frequent access to their provider — including phone and email, as well as more readily available appointments.
Because concierge providers tend to cap their practice membership at a maximum number, they are able to see patients on short notice with decreased wait times, and they have more time to spend with each patient. (2) Rehabilitation clinicians in concierge practice are able to offer their patients similar benefits.
In the physical therapy space, some concierge PTs charge a practice membership fee, much like their physician colleagues. As part of the membership, these providers may offer a yearly musculoskeletal exam, much like an annual physical. (3, 4)
This exam is an opportunity to provide a thorough head-to-toe screening of the neuromusculoskeletal system, with the goal of identifying potential impairments and compensation patterns before they become bigger problems.
This approach helps highlight the role of physical therapists as primary care providers. In much the same way that biannual dental visits allow dentists to assess your oral health, an annual PT screening offers a way to monitor musculoskeletal wellness year over year.
Some rehab professionals practicing in concierge models opt for a different approach: rather than charging a regular fee, they offer bundles or packages of visits and/or treatment types.
In addition to advertising what they can offer clients, is equally critical that concierge therapists be extremely clear about what they cannot do.
For example, concierge therapy cannot replace a patient’s usual primary care physician. While an annual screening of a patient’s movement system is valuable, it is not the same as an annual physical with a medical doctor.
Rehab professionals in concierge practice must be cautious to avoid providing services outside their scope of practice, particularly in states that do not permit unrestricted direct access to PT or OT.(5)
Finally, concierge rehab should not be viewed by patients as an “all-you-can-eat” buffet of endless treatment options. Providers must be mindful to encourage their concierge patients to take ownership of their own rehab journey rather than relying on frequent access to their therapist as an “easy fix.”(6)
Who Benefits from a Concierge Care Model?
Concierge care isn’t for every patient or every provider. However, certain subsets of these populations are likely to thrive in the intimacy of the concierge environment.
Patients who are most likely to flourish under concierge care:
- Deeply value a one-on-one connection with their providers: They want a close relationship with a therapist they trust.
- Are willing to invest both time and money in their health and wellness. They need to be willing to pay out-of-pocket for premium services.
- May be busy professionals and/or new parents who value the convenience of a therapist who can come to them on their schedule.
- May be home-bound individuals or facing other transportation difficulties – again, convenience is king.
When considering concierge care as a next career step, you can’t only think about the patients; you have to consider if the setting is a good fit for your personality and practice style.
You are likely to excel as a therapist in a concierge setting if you:
- Are confident in your skills and your ability to provide best-in-class care. Your patients are paying you directly for a premium experience: Make sure you can deliver.
- Are prepared for an intimate connection with your patients. It can be quite unsettling to transition from a busy clinic where you are treating 2-3 patients per hour to a setting in which you have an hour or more of face time with one person. Be sure you are mentally and emotionally ready for the challenges that come with this environment.
- Are flexible with your schedule and are willing to be contacted frequently and at odd hours. If you’re seeking a 9-to-5 schedule, this might not be the setting for you. However, if you’re happy to work evenings, weekends, or split shifts in exchange for more freedom to control your own schedule, concierge care could be a great fit.
- Are a niche practitioner looking to hone your practice to fit your “ideal clients.” Perhaps you provide early post-partum rehab, specialize in helping active retirees, or offer early intervention pediatric care: these patient populations may all flock to the flexibility and personalization of a concierge model.
What To Consider Before Committing to a Concierge Model of Care?
We’ve discussed the pros and cons of the concierge practice model as a whole. Now, let’s consider a few other key points before you dive in:
- Can you manage a business — not just a practice?
- Do you know the legal requirements?
- Are you willing to be more available than 9-5?
Concierge Consideration #1:
Are you ready to start and manage your own small business?
Setting your own subscription and/or package prices means you should be able to see many fewer patients than you might in a typical insurance-based practice.
However, the time you aren’t spending on insurance documentation or treating your 14th patient of the day will be allocated to the basics of running a business: Accounting, marketing, website development, and the like.
Do you enjoy these aspects of business management? If you don’t, are you willing to sacrifice some of your income to pay someone else to manage them for you?
Concierge Consideration #2:
Are you clear on the legal restrictions on your practice?
We already touched on the importance of understanding your state’s practice act: Can you legally provide direct access PT/OT in your state, or will you need to coordinate with local physicians for referrals? Can you provide wellness services without a referral?
As usual, Medicare makes everything more complicated. While the details require their own article, suffice it to say that you cannot charge Medicare beneficiaries out-of-pocket for concierge physical therapy services. (7)
Concierge Consideration #3:
Are you willing to offer your clients more direct and frequent access to you?
In a concierge model, patients are paying for the ability to consult with you more often and more quickly than with providers in traditional settings. This is a great way to foster patient engagement and better outcomes!
However, you need to be ready to answer questions via text, email, or phone outside of regular business hours.
You will also need to set clear boundaries to ensure that your professional life doesn’t run over into your personal life and lead to burnout. After all, if you’re interested in concierge care, you’re probably looking for ways to make your practice more sustainable and enjoyable for the long term.
Defining these types of boundaries from the beginning will set you up for a successful therapeutic relationship with your patients for years to come!
