Chris Maslin 00:00:00 Doctors spend twice as much time on administration than they do on actual care. So if you think about that, do you think that that is not sustainable?

Austin Luttrell 00:00:21 Welcome to Off the Chart, A Business of Medicine podcast featuring lively and informative conversations with healthcare experts, opinion leaders and practicing physicians about the challenges facing doctors and medical practices. My name is Austin Luttrell. I'm the assistant editor of Medical Economics, and I'd like to thank you for joining us today. Today's episode is brought to you by Special Tax Consultants. And our topic today is the growing popularity of concierge medicine. As physician burnout, payer pressures and patient expectations reached new inflection points. Many doctors are rethinking how they practice medicine. For this episode, Medical Economics Content Vice President Chris Maslin sat down with Greg Grant, the chief operating officer of Special Docs to explore by 2020 6th May be a pivotal year for physicians considering that transition to membership based care from financial models and patient demand to technology and lifestyle balance. Greg uncovers what's driving the next wave of concierge medicine and what it could mean for your future in practice.

Austin Luttrell 00:01:10 Greg, thank you for joining us. Let's get into the episode.

Greg Grant 00:01:22 Greg Grant with Special Docs. Thanks so much for joining me today. I appreciate it.

Chris Maslin 00:01:26 Chris, great to join you. I really am grateful to be on the show and I'm looking forward to this conversation.

Greg Grant 00:01:32 So we're talking concierge medicine today. It is December 11th, the day we're recording this, about to flip the calendar into 2026. So I'm curious, Greg, what you see as the biggest macro trends that are shaping the concierge medicine market as we head into the new year?

Chris Maslin 00:01:49 Yeah. Thanks, Chris. 2026 is going to be a pivotal year for concierge medicine and what we also refer to as membership medicine. and the question is why there is such a disconnect now between how doctors want to practice medicine and how it's being reimbursed. this sort of relentless treadmill of a fee for service model is fundamentally broken, and doctors have had enough. they don't want these unjust appointments. They want the ability to do proactive care and do medicine that produces the outcomes that they were trained to do.

Chris Maslin 00:02:24 And so that's come to this, place in time where more and more doctors are going. No more. And we've seen a tidal wave shifted already started in 2025. And it's going into 2026, where doctors are saying, this is not why I signed up for practicing medicine. I signed up to be a doctor, that I could help my patients and not be shoved into a 7 to 12 minute appointment, hoping that I can change this person's behavior or fix what's actually wrong with them. at the same time, a big shift is that consumers patience are going. I cannot work within a system that takes three weeks to four months to get an appointment. When I'm sick, I want to have a doctor that knows me, that understands me, that listens to me, and that is available when I want to see them. And so that's going to be a continued shift as patients are becoming more discerning and more demanding, because health care is becoming more and more important to people. And then lastly, this is less about for the concierge space, boutique or luxury medicine.

Chris Maslin 00:03:27 It's becoming much more mainstream. I'm sure if you have conversations at home or you bump it to your friends, there's the conversation is loud. I've got a concierge doctor. People are saying this more and more, and that's because they are wanting to have a doctor that they can call their own. And concierge is what's allowing that to happen. And it's becoming more commonplace. So big trends. Doctors have had enough. Patients have had enough. The health care system is fundamentally broken to deliver the care that we need. And so this boutique model is now becoming more mainstream, and it's going to become even more mainstream as we look at the growth for 2026.

Greg Grant 00:04:06 So, Greg, you mentioned, you know, how healthcare in some ways fundamentally broken. And I'm thinking about some of the trends in addition to what you mentioned, such as inflation, dealing with payers and the pressure that dealing with payers in the traditional model, what that puts on physicians, there's a physician shortage, there's rising overhead costs, which are, you know, tied to inflation.

Greg Grant 00:04:32 You know, how do you see these economic factors shaping the concierge sector's growth trajectory? And what do you see that could potentially shift in 2026?

Chris Maslin 00:04:43 Yeah, I think if you look at any of the economic sort of reports in the industry today, just general macro trends, it's not a really pretty picture. You know, some people say, it's great. Everything is well, but you speak to the people that might be in the grocery store. You speak to people on the ground. And if especially we speak to a lot of our physicians. Costs continue to rise. And there's not like there's going to be a downward, movement on these. So overheads in running their practices are going up. Inflation continues to rise. So things that might have cost, you know, $0.10 for a swab might cost $0.14. staffing is harder to get. So more and more people are trying to hold on to their jobs because the market is not very clear on what's going on. And so to find new staff members, it becomes more and more difficult.

Chris Maslin 00:05:30 and then the thing that's so frustrating is reimbursement from the payers is becoming more and more difficult for doctors to get their hands on. And the big health systems are making it more and more difficult for doctors to do it. So doctors are spending they the statues. Doctors spend twice as much time on administration than they do on actual care. So if you think about that, do you think that that is not sustainable? And so if you talk about sort of inflation, peer pressure, shortages of stuff and increasing overheads, it becomes more and more indicative that the way to solve this is to have a practice that's sustainable and to have a medical practice that's sustainable. And for a patient to say, I'm prepared to pay the money to get the care I need, this is a path that can actually try and solve that. but if you look at the macro numbers, Eve at the economic pressures is one thing. But because of the demands of patients and doctors, you know, from 2018 to 2023, the number of what we what we term as membership medicine, two camps, direct primary care because people might have heard of that or concierge medicine.

Chris Maslin 00:06:43 It's grown by 83%. And that is speaking to patients who are fed up. They've had enough. And doctors are going, I need to find another way to deliver Cairns. So they've gone into this membership type models. And this is indicative of I mean, how many of us have got memberships that we pay for on a monthly basis? It's become commonplace. We pay for the services that we want. So why would you pay for medical care that you want? So that's the one thing. But then if you, you know, peel back the argument and say what's happened in the concierge space, you know, the industry is not a small industry anymore. It's over $7 billion. That's what the latest trends are. And they estimate that it's going to grow at a compounded growth rate of like 10% a year. And if you, you know, push that forward till 2035, you're looking at almost a $20 billion industry. So this is going to continue to grow. and it's going to continue to grow because the macro forces and also the sort of patient and doctor needs are moving in that direction, and I think it's not going to slow down.

Greg Grant 00:07:48 I'm curious, Greg, what types of physicians do you see showing the strongest interest in transitioning to, you know, a concierge or a membership model and how you see that mix evolving in 2026?

Chris Maslin 00:08:02 Yeah. So traditionally, primary care internal medicine is sort of the the sort of main contingent for concierge care. and we've seen over years, though, that there are a number of key specialties that are popping up and having tremendous growth rates, and there are reasons for that. So let me let me touch on a few. Cardiology, you know, there's a there's a, there's an increased need to have my own cardiologist, especially as a larger portion of the population are getting elderly. So the baby boomers have moved. You know, they're much older now, and they want to make sure that they have their heart taken care of, especially if they've got a pre-existing conditions. And so that is one. They love the idea that they can have availability. Because again, if you've got a health issue that's heart related, it's a high stress condition and so they want to have their doctor available.

Chris Maslin 00:08:54 and there's just ongoing tests and bloodwork that they need to make sure that they get and remain on top of their care. So that's cardiology. We've seen at least a 10% growth year on year in that space. The next one is endocrinology. So think of chronic diseases in the diabetic space. where there's a lot of medication management that's needed. So obesity, thyroid, lots of touch points are needed to make sure that your, getting the care that you need and you're getting the touch points that you need with your doctor. So that's a growth area for us. And then of course, as I mentioned, this big baby boom shift. geriatric. So elderly care, high complexity, multiple comorbidities or the language that we will use for that is, in the layman's terms, as multiple medical issues. they need a lot of care coordination. and they need direct availability. So those are three, specialty areas that we've seen tremendous growth in. But it is interesting. We started to see growth in pediatrics OBJ we've started to see those growth sectors because as you can see, a lot of doctors are saying actually I want my children to have good quality access to care because they can't get it today.

Chris Maslin 00:10:07 and then you could start to see for OBJ where they're saying, I want a woman's health focused physician, that I can check in at any time, that I can ask them questions, they could partner with me and when I might have a baby, they will also be there for me. So we're starting to see growth in those sectors, too. then the last shift, Chris, that we're seeing is multiple specialty practices starting to offer concierge care. So think about it would traditionally have started with internal medicine or primary care. They bring in an endocrinologist as part of their practice because a lot of their patients might already be needing care in the diabetic or weight management area or bringing in a cardiologist. And so these practices offer almost a one stop shop for most of the patients. And you might pay a membership, but it gives you access to both cardiology and internal medicine. And we're starting to see a very strong growth in that. and so patients are going, wow, if I could pay a monthly fee, but I get access to a mix of care.

Chris Maslin 00:11:15 That is the sweet spot for me. And they are really excited about that. We're seeing good growth in that as well.

Greg Grant 00:11:22 Earlier in our conversation, you had mentioned changing patient expectations. And I'm wondering how, you know, do you see a willingness to pay for personalized and available care changing among patient populations and sort of a second part? What does that mean for physicians who are right now, you know, on the fence, considering potentially transitioning to concierge medicine?

Chris Maslin 00:11:46 Yeah. So I was mentioning it briefly. I think we've been trained that subscriptions are part everyday course. You know, gym memberships is the first one. You pay a monthly fee for a gym membership. And that's a lot of what a lot of concierge and direct primary care doctors are saying. In the same way that you've got a gym membership, why wouldn't you have a health care membership? I mean, think about it that way. you use your insurance if you've had a car accident, but you go to a general shop to change your tires, do your oil, that's what you should be using a concierge doctor for.

Chris Maslin 00:12:18 They are doing a lot of the care for you, but if there's a dramatic situation, then you use your insurance to go to the hospital. So we've seen more and more people are getting trained on this idea of a membership. We've also seen a big movement, and you guys have probably commented on this, but keywords like longevity medicine, optimizing your health, biohacking, peptides, all this talk, people are willing to pay a lot of money to have a doctor that can talk that language and help them to have optimal health. And we've seen a lot of concierge practices actually double down on that. And providing those services as part of their services they provide. But what's unique about membership medicine is that you get longer patient doctor interactions. And that leads to, I always say, more time equals better care. Because once I understand Chris's background or Greg's background and why these things are happening to him or her, I can actually help course correct what they're doing. Additionally, and it goes into proactive health planning, it's this idea of we can sit down and plan the next year what you need to do to improve your health outcomes.

Chris Maslin 00:13:30 and the thing that makes membership medicine and, you know, your your question is patient expectations. Patients expect to be able to speak to their doctor. And they're wanting to say, you know, I've got a question I want after hours that I can call my doctor or my doctor if something's urgent and I speak to my doctor, not to a number or to a health system that puts me into an E.R. straight away. And I'm not and I'm not really seen as a as a relationship with somebody. So it takes away that stress of the unknown because you have somebody on call that kind of ask and be your partner in your care. We call it The Advocate, which helps navigate a health system in case you do need care. The concierge doctor comes alongside you as a patient and knows you and knows what's best for you, and can help you connect the dots between what tests I should have, what medications I should have, what lifestyle adjustments I could have. So patient expectations are increasing. They are becoming much more discerning and demanding.

Chris Maslin 00:14:30 And it's because there's a general groundswell of, oh, I can optimize my health, I can get wellness checkups, I can have hormone stuff taken care of. And that's what a lot of concierge practices are able to do for a patient, because they have the time to do that.

Greg Grant 00:14:45 So you and me, we both know that physicians are very detail oriented. Yeah. And so for, you know, our physicians who may be checking out this conversation, let's let's give them some details. So what does a modern concierge practice look like today here on the cusp of 2026? So I'm thinking of, you know, things like panel size, what the communication between a physician and patient is like, how long a typical visit is, availability, any of the special offerings or sort of care coordination? Well, you know, can you detail that out for us a little bit?

Chris Maslin 00:15:21 Yeah definitely can. So we've touched on a few things already, but it's really a built around time with the patient. So that's really what it's built around.

Chris Maslin 00:15:31 But there's also got to do with a lot of coordination and helping you as a patient not feel stranded in your care journey. patient visits are longer. The care plan is proactive. communication is much more frequent and clear because you know. You know your doctor. The doctor knows you. there's a lot of pre planning. specialist collaboration on your behalf. So a lot of our internal medicine. Concierge practices, they reach out to. Specialists on the patient's behalf. Hey, Specialist cardiologists. I'm dealing with this patient. he's exhibiting these conditions. Can you give me some advice or thoughts about what I should be doing, or what prescriptions I should be thinking about? I'm thinking of this. Does this make sense? And the primary care doctor could go straight back to me and say, I've already spoken to a couple of specialists, and we've got a game plan for you versus you as a patient trying to find a a cardiologist takes you four months to find the doctor. The doctor never. The cardiologist never speaks to the primary care doctor.

Chris Maslin 00:16:31 Because do you know why? This is an interesting thing. Concierge doctors aren't compensated by insurance companies to speak to another doctor, Which seems crazy because that's the best way to deliver coordinated care for a patient. So you'll see more of that and you'll see more, in clinic, lab taking and readouts so that it's immediate. You don't have to go to another, lab to go get your blood work. so it's also structured. So a lot of our concierge practices, and this is how they built this very secure messaging that happens real time. So you can almost text your doctor. there are easy ways to schedule appointments and check in. So there's virtual care to supplement very quick appointments. And also you can come in. So that's definitely part of the practice. there's also clear expectations that are set between patient and doctor regarding after hours availability. And concierge. Doctors say look you can contact me anytime, but really after hours contact me with something's urgent and patients respect that. It's quite funny. A lot of concierge doctors think I will not sleep at night.

Chris Maslin 00:17:38 My patients are going to call me all, all hours. They're going to be super demanding because they're paying a lot of money. And the reality is so different to that. The reality is no patients actually respect the doctor's time. And when it's urgent, the doctor knows it's urgent, the patient knows and they can speak after times. So there actually is a really good work life balance for the doctor. Although for a concierge doctor is thinking about this right now. Chris. And that's your question. The market going, I'm going to go and, you know, be available 24 over seven. How's that going to work? That is not really how it actually plays out. Real day. So the typical pedal sizes range from 300 to 600 patients. in comparison to a typical fee for service doctor, that could be two and a half to 3000 patients. So if you're in that sort of situation with 3000 patients as a doctor, I don't know how you deliver good care. And if you're a patient, I don't know how you get in to get good care.

Chris Maslin 00:18:35 And that's why this model reduces the panel size. We call it the panel, and in that 3600 range, and the average membership fees for the patient ranged from about 2200 to to around $3,000. That's the average. And that depends on the market and also the sort of service that you're providing as a concierge doctor.

Greg Grant 00:18:57 So, you know, we talked to macro trends at the beginning. And one of those macro trends is, you know, greater consolidation among health care providers. You know, more physicians are working for health systems and hospitals. and so I was curious about, you know, sort of hospital systems incorporating concierge medicine as an offering. So what do you see as the challenges and the rewards, potentially for the hospital systems that may want to, you know, incorporate a concierge style offering? And what does a successful integration of such a thing look like?

Chris Maslin 00:19:33 Yeah. I mean, this is a really complex area, so I'll just state that because no health system is equal, and some health systems have embraced the idea that their best doctors are going to form a concierge practice, and they either they either support that and they could support that by saying to the doctor, when you leave, we're going to support you.

Chris Maslin 00:19:53 We're going to make sure that you can still keep your patients, but please refer them back into the health system so we don't lose that revenue. So that's the sort of perfect scenario where the prac the hospital system feels like they haven't really lost the doctor because they're still referring precious income streams into that. But then you've got the other health systems which are very controlling. And they say these are our patients. If you leave, we're going to make it incredibly difficult for you, and we're going to make sure that you can't practice with a certain radius. And that's where companies like us come and partner with both the physicians and the health systems to work on a way that all three parties can benefit through that journey. But talking about the challenges, designing it the right way to ensure membership covers appropriate non-COVID services like enhanced care planning, coordination and wellness oriented touchpoints, and that clinical services are built correctly. So that's some of the challenges that we have to work with the health system and the doctors. you know, successful integration requires clear service definitions, the right staffing, consistent standards, workflow, service delivery, making it complement, not cannibalizing the health system.

Chris Maslin 00:21:02 and so if we can work with the doctor and the health system, there is a way that we can make this work. Now, what we've seen is, multiple models, but the ones that are most common is either the patient, the doctor leaves and just sets up their own practice and they do their own thing. The other one is where the health system says, we want to support concierge medicine. We are going to make aware that it's a concierge practice, but we'll get a partner like special docs to make sure all the services that are needed to run the practice effectively are done, and that the doctors deliver quality care. And then there's another one where within the health system, the doctors stay within the health system. They both in the health system. But the health system says you still are employed by us. So for that it gives the doctor some security. And so they get the security. They get their pensions, they keep going on, but they have their panels reduced, and they have somebody like special docs that manages the day to day.

Chris Maslin 00:21:58 So, that's what we're seeing in the industry today from a health system perspective.

Greg Grant 00:22:03 That's interesting. I wanted to talk a little bit about your company. You know, Special Docs has been a pioneer in the concierge medicine space for, I think it's 20 years now. so from your vantage point as a chief operating officer, you know, what do you see that's allowed special docs to remain? You know, one of the trusted leaders throughout so many shifts in health care, all of these trends that we've talked about, all of these challenges, you know, what aspect do you see about Special docs model that sets it apart from the other concierge transition or management firms that are out there.

Chris Maslin 00:22:41 Yeah, Chris, there are actually quite a lot of things that make special docs special. And the way that we we think about it, I've coined the phrase from one of our cardiologists. He said special docs provides concierge services for concierge doctors. And so what we do is our mission has remained the same since we started 20 years ago to help physicians build the concierge practice that they own.

Chris Maslin 00:23:06 It's theirs. It's their vision versus other groups where they control the experience for the doctor, and they become an affiliate as part of a broader group, we help concierge doctors build their practice that they want. They manage the patients as their growth. And when we just come alongside them and build a practice of their dreams with them, and we to provide, we give them expert support. The name of our company, special docks consultant. So we provide consulting services, provide them support, guidance in and enable them to practice the best medicine that they can. some of our differentiators are, we are competitively priced. So imagine that as you as a doctor, you're considering concierge care. We make sure that it's affordable to work with us versus some of our competitors, which take a very large percentage of your monthly earnings. So that's the one difference that we're competitively priced. We make sure that the doctor and the physician or the physicians group, they have control and visibility over their patient membership at all times versus other groups where they're contract to control their patient memberships.

Chris Maslin 00:24:16 It's really controlled by the sort of broader company that owns that relationship. we also have shorter contracts with our physician groups. And the reason for that is because we believe that after five or so years, we have helped establish the doctor. We've set up the practice. They are running it well. We've grown their panels for them. we've taken care of all the billing for all of them, and they typically stay with us. We. But we don't ban them to stay with us versus other, consulting firms. They ban the doctor to stay with them, with contracts that actually are more like handcuffs than they are. giving the doctor the option to go in a different direction should they choose. And in a weird way, because we're given that flexibility, they stay with us because they don't feel like we have done them. A dirty is the expression where we've locked them into something that they can't get out of. we let them shape their brand. It becomes their brand. It becomes their identity. and the patient experience they control, and we work with them on that.

Chris Maslin 00:25:19 And then we let them work with other doctors in our network. So we have this thing called a physicians lounge, where all our doctors join, and they can ask questions with the other doctors if they want advice from other doctors. We connect other doctors. We have a physicians advisory board, which we share knowledge and insights across our network. So they have access to other doctors in that. I really am proud of what one of our clients said. the doctor said she said some companies want to control how you practice as a concierge physician, but not special docs. You know, you allow us to be autonomous, make decisions that we feel are best for our practice and for our patients, and you just come alongside and support us, and that's what we do. it's not it's not flashy bells and whistles. It's really genuine relationships built over years and years. Doctors trust us because we fight for them, we work with them, we grow their practices, and we treat them like we want to be treated ourselves as patients.

Chris Maslin 00:26:19 Thinks about it in a way that it's that personal touch. That's what we do.

Greg Grant 00:26:24 You and I have spoken before about concierge medicine and some of this stuff, and I know that you've spent, you know, the past year, you know, really engaging with the physicians across the special docs neck, neck network. so what have you heard from them about, you know, all this stuff, the pressures and the frustrations that that they were facing before conversion and, you know, sort of the sunny side of that, you know, how things have improved, you know, since their conversion. Can you share some of those?

Chris Maslin 00:26:52 Yeah, yeah, I can definitely. I've already spent a lot of time on the road and speaking to doctors and going to conferences. And man, burnout is a very real thing. and the latest data shows that we've returned to pre-pandemic levels. You know, the in September 2025, a report came out from the Survey of American Physicians that showing that anxiety and stress levels are reported by 57%.

Chris Maslin 00:27:19 And then they say, with debilitating stress reported at 55%. So more than every, you know, more than every second doctor is going. This is just so stressful. I'm so, It's actually debilitating stress. I don't feel like I could continue going. So, you know, doctors are saying to me that they feel that their care is being compromised by the volume of patients that they have. This is a very real thing. Doctors were trained to care for their patients. And we've got this thing called a moral dilemma, where you as a physician and a lot of our clients and prospective clients that you speak to are facing this dilemma where I want to care for my patients. But the way that the the system is set up, I'm unable to do that. And they've got this moral wrestling match that they're having that's causing them to have undue stress. And so, we're trying to help them relieve relief, release that burden. take care of that for them. help them. We say to them that it's better to care well for 500 patients than it is to care poorly for 3000.

Chris Maslin 00:28:33 And so that's what we're doing. And so they've got this fear that they're having. but the what I'm hearing the most is I can't keep practicing as I am today. That's what I'm hearing across the board.

Greg Grant 00:28:47 I know you have a background in hospitality. how does that shape the way you support the physicians? in exceeding, you know, rising expectations that that concierge patients have. So how does that hospitality lens, you know, sort of affect the way that you look at the health care market?

Chris Maslin 00:29:08 Yeah, I come back from a health in a sort of hospitality background. And the way that I see concierge medicine is the intersection between hospitality and healthcare. And that's what really drew me to special docs in this industry is that's what concierge medicine really is. It's a place where patients can come and that the experience is not accidental. It's designed. You walk in. It's not a waiting room because a waiting room feels like there are hundreds of people waiting. You come in the front desk says, hey, Chris, we've been waiting for you.

Chris Maslin 00:29:47 Please come in. The doctor's, ready to see you. healthcare often relies on that, and that's unsustainable. Going above and beyond, staying late, squeezing one more call. and so when I think about hospitality, there's so many touchpoints that concierge doctors do now, they follow up with you in the health care systems, that people don't get follow up calls. They might send thank you notes to say thank you for coming in today. they might send a Christmas card to you. They might ask about your pet. And because they know that that's important to you, They might ask about the wedding that you're trying to get to, but because you're struggling with cancer, they're going to walk that road with you. So that's what hospitality is. I often say to people, what is hospitality and what is service? What's the difference? And they say to me, I'm not quite sure that I can explain what the difference is between service and hospitality. And so I said, that's the difference. I said, service is what the doctor will do.

Chris Maslin 00:30:51 When you go in there. They will meet you, they will weigh you. They will, maybe do some, they will measure your heart rate and all that and that the service that you will have, hospitality is not what was delivered, but how you felt. So when you leave a concierge practice, you felt heard, you felt seen, you felt taken care of. You felt surprised. You felt delighted. These things that you hear of in hospitality, language, but you don't hear of them in health care because they seem so disconnected. And that's why concierge medicine really is that intersection between hospitality and healthcare. And more and more of our physicians are going talk to us about hospitality. Talk to us about that, because I want to infuse that language into my clinic. So, they would have quality toilet paper, small things, things that would delight a patient in going, wow, I feel like, you know, my money is going for this membership care, but it's worth it. It is worth it because this experience is something that I've been missing for years and years, and I love that somebody is caring for my health as much as I do.

Greg Grant 00:32:08 So for those physicians who are out there and they are considering, you know, right now there's they're stuck in the traditional model and they're considering a concierge practice. You know, what does a realistic timeline look like. And the other part is what are the signs in a practice or in a physician that suggests that they're ready to make the leap to concierge medicine?

Chris Maslin 00:32:35 Yeah. So typically the concierge conversion process is a 3 to 6 month process. There are there are a lot of things that go into that. And we come alongside our physicians. And it's thing it's it's it's a lot of things from creating a logo and an identity and building a website, getting credentialed if you need to. and, you know, a lot of the lift is making sure that we work with the physician to get their patients on board. It, reach out to their patients, explain to them what concierge medicine. So it really is about managing the membership enrollment, the billing, the fee collection processes. Because as you can imagine, as a doctor, you don't want to have to think about that stuff.

Chris Maslin 00:33:20 You would like somebody else to take care of it, and then staying in compliance with regulations relating to billable services. So some of our physicians want to continue billing through insurance. So making sure that they're in compliance, insurance coverage, patient privacy, websites security, all those things we provide as a service and we provide that to the doctor. messaging to patients. So, setting up systems to make sure that, let's say the physician says I'm going away this weekend. Or just as a heads up, this is the latest research on vaccinations. We provide that to the to the doctors. they've got to think about things like hiring staff, training staff, getting all small things like prescription pads, ordered, all that sort of stuff, and make sure that the practice can run smoothly. And then working with them on this, the flow of care, making sure that we, we help them think about the front desk. How does that work? How does it support them? What are the tools? What EMR should they use to make sure that they capture patient notes? We work a lot with AI, and we advise our concierge doctors on what our tools are helpful for them right now to be able to deliver care and infused with some technology.

Chris Maslin 00:34:35 and then we work a lot with them on online reputation. It's this idea, Chris, when you're a patient and you're looking for a doctor, you type in quality doctor, primary care doctor in a market or exceptional cardiologist in Reston. And we make sure that your your reviews on Google are very, very good and they come front and center. We make sure that all your gradings in terms of the different medical publications are good. We make sure that your practice gets featured on the right hand side of Google. And even now we're working on how do we get indexed in things like ChatGPT and that sort of stuff. But your online presence and reputation work hard to make sure that when a patient. So let's say you leave a health system. Patients are still looking for you. The health system. We need to make sure that if they search online, they find you. Now that you're not in the health system anymore, you're actually at a concierge practice.

Greg Grant 00:35:31 So what misconceptions do physicians most commonly have when it comes to the financial realities of the concierge model? And sort of a larger question? Secondary question is, you know, what does that economics picture look like as we head into 2026?

Chris Maslin 00:35:48 Yeah, there are a couple of big misconceptions here, Krista.

Chris Maslin 00:35:51 The first one is that this is going to be an automatic financial windfall. I'm going to wake up. I'm going to leave the health system that I'm in, and I'm going to start my practice in month one. I'm going to be so rich. It's just going to be incredible. The reality is it just takes time to build a sustainable practice. it depends, of course, on your existing panel size right now and converting that into your practice. But you've got to do staffing and pricing and services that you commit to deliver. It does take a little bit of time to get there. So and that's what we work with the doctors closely on, like coming alongside them to grow their panel very quickly. but it doesn't happen overnight. That's the first thing. The second thing is, concierge medicine only is successful in wealthy markets. You know, where people are very rich and they can afford concierge. We've we've seen clients with full, thriving practices in almost every type of geography, from urban to suburban, small towns, rural locations.

Chris Maslin 00:36:52 and it's because there is a demand for good quality care. It doesn't matter where you are. and this trend is going to continue in 2026 as physician shortages are very real. And actually in remote towns and villages, there's even a bigger shortage of doctors. and so concierge practices are getting full in those markets. Then the other one is that if I become a concierge doctors, I have to cut my relationship with insurance. That's not. That's a misconception. We have a majority of our clients of track are doing both concierge medicine and also billing through insurance. and we help them set it up, and we make sure that they stay in compliance with how that works about what they can offer the concierge services and what's included in there and what's not included that they can build through insurance. So, so be aware that in 2026, the force is driving dissatisfaction. Dissatisfaction, like rush visits pay a friction. Admin burdens. They're not resolving themselves quickly. none of those things are getting fixed overnight. And so, more physicians will continue to look for concierge options, you know, how do I do this? making it workable that I could practice in the way that I wanted to do.

Greg Grant 00:38:11 Yeah, I think the, you know, it's the future is uncertain, but the one certainty is that the challenges in health care, you know, are not going to be going away. So. Correct. All right. A couple more questions for you, Greg. if a physician, you know, who's listening right now, it's like, this sounds great, but also, maybe they're hesitant, maybe they're nervous, you know, like, and they just, like, need a bit more info, like, so what would you want that physician to consider as they look ahead and explore their options in 2026?

Chris Maslin 00:38:44 Yeah, we've mentioned a lot of them already. But maybe just I'll I'll answer it in a different way. concierge medicine does represent the future as we shift from about tech model to a mainstream model. so if you're a physician thinking, oh, this is going to be an anomaly, this is out of the box. It's high risk. It's no, this is becoming this is already mainstream.

Chris Maslin 00:39:08 It's not becoming mainstream. It is already mainstream. and further proof is more hospital groups and systems are exploring membership models to keep their good physicians because. More and more physicians have left health systems. Their health systems are going. Hang on. We have to work out how to solve this deal. So that's the one. So it reinforces that this is really a successful model. And many patients are more interested in receiving personal care. It's not about luxury. They just want a better doctor that really cares for them. Proactive care. and so especially for a big part of the population, most patients in concierge practices today are above the age of 55. And so this is not getting smaller. If you look at the bar graph of what's happened with the demographic breakdowns of the country, more and more baby boomers are, you know, in their 60s, 65. And they that segment is massive and that is going to be fueling concierge practices because those are the people that want and can afford good quality care.

Greg Grant 00:40:14 So last question what excites you the most about the future of concierge medicine in the coming years?

Chris Maslin 00:40:22 It's going to continue to grow. so that's happening. We'll see more sophisticated models being developed. we're going to see lots more. I mean, I even spoke to a psychiatrist who said, I've started a concierge practice. You're going to see a lot more specialties going. You know what? I know that there's a demand for this service, and I think membership is a way to pay for my services and means that I can have the lifestyle that I want and deliver the care that I want. So, you know, doctors, so many of our clients come to us and go, I cannot continue anymore. I just can't anymore. I want to stop medicine. I want to get out of this thing in totality. And I'm excited about 2026 because there is solutions for these physicians. There is a way out of this desperate situation, and that excites me more than anything, because we know we have a path for them that is sustainable and hugely successful and massively satisfying.

Chris Maslin 00:41:26 And so that makes me, excited. Just a side note on DPC, because we mentioned it right in the beginning under the umbrella of Membership Medicine, we've got two lines that you could think of direct primary care and concierge medicine. Direct primary care is also going to continue to accelerate massively. So the big beautiful bill passed a law that a lot of, direct primary care can be paid for on a membership basis using your HSA funds. And so that's a big shift. And this is further fueling this idea that I could pay a monthly fee for my doctor. So with the growth of membership members in both DPC and concierge, the future looks incredibly bright for those models, and we're very well positioned to help doctors on that journey. we are confident that we can do it well, but in a way that the doctor feels listened to and supported. So concierge medicine, as a industry is thriving, it's going to continue to thrive for the reasons that we've mentioned. And we're looking forward to a release, good year for better care.

Chris Maslin 00:42:34 and better lifestyle for doctors delivering patient patient care in a way that they were trained to deliver.

Greg Grant 00:42:41 Greg Grant, special Docs Consultants, thanks so much for joining me today and sharing your insights. I really appreciate it.

Chris Maslin 00:42:47 Chris, the time has been really well spent with you. Thank you for the insightful questions. And all the best to you guys.

Austin Luttrell 00:43:06 Once again, that was the conversation between medical economics content Vice President Chris Mussolini, and Greg Graham, chief operating officer of Special Docs. My name is Alison Luttrell, and on behalf of the whole Medical Economics and Physicians practice teams and today's sponsor, Special Docs Consultants, I'd like to thank you for listening to the show and ask that you please subscribe so you don't miss the next episode. Be sure to check back on Monday and Thursday mornings for the latest conversations with experts sharing strategies, stories, and solutions for your practice. You can find us by searching off the chart wherever you get your podcasts. Also, if you'd like the best stories that Medical Economics and Physicians Practice published delivered straight to your email six days of the week, subscribe to our newsletters at Medical Economics, Comm and Physician's Practice.

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