Concierge Medicine — Should You Offer It?

By John Lombardo, M.D., F.A.C.S., Chief Medical Officer, MLMIC, and repurposed from The Scope, First Quarter 2026

In 2025, patients more frequently sought a different model of medical practice called the “concierge physician.” These physicians, almost always internists or family practitioners, contract with patients to provide specific services in exchange for a yearly fee paid by the patient directly to the physician.

The Concierge Medicine Practice Model, Explained

There are a great many ways in which concierge medicine is practiced, but, in general, in exchange for a yearly fee, which can range from $500 to $10,000 or more per patient, the physician agrees to provide 24/7 access for the patient, by cell phone or other means, as well as same-day or next-day appointments, which are typically longer than the average visit. The physician treats a variety of relatively minor ailments, while patients in need of a specialist are referred appropriately, and the appointment is expedited by the concierge doctor. (As the specialist does not participate in the same arrangement, their usual fees prevail.) The concierge doctor does not accept any insurance, but laboratory and other tests are billed to the patient’s medical insurance.

This practice model has evolved for a variety of reasons. For the physician, inadequate reimbursements from insurance companies, as well as difficulty and red tape in collecting from them at all, are prevalent. As a result of these and other factors, many medical practices have trouble breaking even. In the concierge medicine model, if a doctor, for example, charges a $2,000 annual fee for their services, 250 patients would guarantee an income of $500,000 per year, plus whatever other sources of income are available. In addition, concierge medicine allows the physician to spend much-needed time with each patient. Typically, office visits often include only five or 10 minutes with the doctor, which can be barely enough to cover the essentials.

For the patient, concierge medicine addresses what has become a major concern for most patients, namely, speaking with their doctor or securing an appointment, even with a specialist. Being told that a doctor can’t see you for four or five months has become a common experience, whether the doctor is a private practitioner or an employed physician in a health system. While critics of the concierge physician model (and there are many) claim that one is paying the doctor to “simply pick up the phone,” one can’t emphasize enough how important this is to a patient in need. Others claim that this system is a way to marginalize the poor, who can’t afford the necessary fee.

Risk Management Considerations and Recommendations

MLMICcurrently has little basis to evaluate the frequency of medical malpractice or specific loss drivers unique to concierge medicine, as claims loss data primarily focuses on medical specialty and geographic region. Practice organization structure is not an insurance pricing consideration, and the growth of concierge practices is a fairly recent phenomenon. However, as those offering concierge medicine are largely family practitioners and internists (with some pediatricians), and because concierge practices are largely located in New York’s urban areas, MLMIC’scollected data on malpractice lawsuits does provide guidance in likely loss scenarios and areas in which to focus risk management resources.

In both family medicine and internal medicine, most malpractice cases involve allegations of a delay or failure to diagnose injury or disease (most often cancer), and, consistent with the concierge model, most cases stem from the ambulatory care and office/clinic settings. The situations driving these lawsuits, in order of frequency, include:

• Errors in clinical judgment
• Poor communication among providers and between family members and providers
• Coordination of care, including failure or delay in ordering tests and reporting findings
• The failure of follow-up systems.

The concierge medicine model is designed to fill these gaps in communication and treatment. In theory, a concierge patient is afforded more time with his or her doctor, allowing more active patient engagement, leading to better preventative care, earlier identification of illness, and enhanced care coordination. However, if additional time spent with you is offered as part of your concierge practice model, your documentation should reflect the time spent with your patient. In a malpractice suit, the plaintiff’s counsel will scrutinize your documentation of representations of time spent with patients, and electronic health record metadata may be used to identify the length of the patient’s encounter.

A common benefit offered by concierge medicine is 24/7 access to a physician. However, it is still important to manage the expectations of your concierge patients. This includes a clear understanding of how quickly a call can be addressed, what care can be provided by the practice, and how quickly a patient can be provided an appointment or a referral, especially in light of the concierge physician not having control over the specialist’s schedule.

Likewise, as in any practice model, when medical advice or direction is provided in a telephone call, it is important that calls be documented in the patient’s medical record as quickly as possible. Such encounters are often scrutinized in claims of malpractice, and a lack of adequate documentation of these calls can be difficult to defend.

Ultimately, not all concierge practice models are created equal, and quality of care is dependent on the quality and judgment of the practitioner and the quality of communication. MLMICoffers practice survey services and education programs to assess a practice’s structure and address identified gaps.

Malpractice Case Concerns

As stated, and on the bright side, concierge medicine should reduce the frequency of losses related to access, care coordination, and communication. On the negative side, the severity or value of an injury will likely be higher for concierge patients. Compensation for a patient injured through negligence is made up of both economic and non-economic damage. In theory, non-economic damages, or pain and suffering, should ignore a patient’s economic status and class. Economic damages, on the other hand, which include lost wages and loss of earning capacity, are likely much higher for the patient of a concierge practice, as economic damage to a high-wage earner can easily be in the millions.

As to the concierge medicine business arrangement, as in patient care, poor outcomes can result from poor communication and lack of understanding. It is vital that the concierge patient/ practice agreement includes a detailed description of what services are included. For example, a patient must be made aware that the concierge service does not include coverage for hospital stays, lab tests, specialist visits, emergency care, and more.

While MLMIChas yet to see any volume of claims associated with concierge medicine, one thing that will need to be considered should a case come to trial is the jury pool’s perception of the concierge model.

Will potential jurors look negatively at the doctor for offering an enhanced level of care that plaintiffs are likely locked out from due to the associated costs, or will the jurors be critical of plaintiffs who are alleging that the level of service they expected was not met? In essence, will jurors be critical of a person who might be alleging that they could not get an appointment the next day, when it can take months for other patients to get an appointment? How will jurors scrutinize a telephone call between the parties, when they likewise feel they themselves are unable to talk to a doctor without an appointment?

In any case, the plaintiff’s counsel will likely hold that the concierge patient was entitled to something more than the requisite standard of care, based upon representations made to the patient when contracting for concierge medical services. As part of this approach, the care provided to the plaintiff in a suit will be contrasted to any advertisements, representations, or promises made to the patient when they joined the practice. It can be difficult to defend care that did not meet the representations made about the level of care the patient was expecting to receive based on such representations.

Out-of-State Considerations

Concierge medicine physicians should also consider whether their patient population spends a considerable amount of time outside of New York State, as patients currently out of state who are in need of care may expect telehealth visits or to have prescriptions sent to local pharmacies. As most states consider the location of the patient to be the site where the medicine is being practiced, physicians offering concierge services may wish to consider licensure and liability coverage in those states where their concierge patients are often located.

Going Forward

We can see, then, that there are advantages and disadvantages to the practice of concierge medicine for both doctor and patient. If reimbursements to physicians were fairer and made promptly without hours spent on the phone by staff, concierge medicine would probably not be growing as much as it is. In the end, doctors and patients want the same thing, namely, enough time to spend together to best address the patient’s needs.

MLMICpolicyholders can reach out to our healthcare attorneys for questions about concierge medicine or any other healthcare law inquiries by calling (877) 426-9555 Monday-Friday, 8 a.m.-6 p.m. or by email here.

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This document is for general purposes only and should not be construed as medical, dental or legal advice. This document is not comprehensive and does not cover all possible factual circumstances. Because the facts applicable to your situation may vary, or the laws applicable in your jurisdiction may differ, please contact your attorney or other professional advisors for any questions related to legal, medical, dental or professional obligations, the applicable state or federal laws or other professional questions.