Thinking of Converting to Concierge? Don’t Give Away Your Practice

By Glenn Sabin
Thinking of Converting to Concierge? Don't Give Away Your Practice.

You started your practice with a mix of capital, sweat, excitement, and risk.

You knew you were a skilled clinician and placed faith in your business acumen and those advising you.

You believed you would soon be serving patients and earning enough to make a comfortable living that would also support a good life/work balance contributing to a good quality of life—and, one day, a comfortable retirement.

As you operated under your respected medical professional name and solid reputation, there were likely personal and professional challenges that included turnover in administrators and support staff, insurance denials and slow-pay reimbursements, reduced reimbursements especially from Medicare, adaptation to new technology, and changing legal and regulatory issues surrounding the practice of medicine. You know, the usual stuff.

Along the way, you experienced the feeling of being on a treadmill with no kill switch … trying desperately to stay on schedule, while hoping your patients didn’t notice you were a bit harried and rushed, as if their 30-minute wait in reception, and a further delay in the examination room, went unnoticed.

All the while, your service and dedication to patients remained unwavering.

The Shifting of Consideration

As time permitted, you became aware of the paths some of your colleagues took, and you were able to take a little time to explore their practice business models.

You started to give more thought about how yours was performing: for you as a physician and business owner, sure, and the care and outcomes you were able to deliver as you hustled from patient to patient.


While the task of reimagining your practice can appear daunting, requiring a deep dive across numerous areas, it can also be an empowering and highly manageable process when addressed one core area at a time.

Reimagining your medical practice business model requires a meaningful, comprehensive ideation process that starts with asking yourself: “What does an ideal practice look like to me (and my partners)? What will that ideal encompass?”

Change incorporates the following core pieces:

  • financial modeling of the practice with forecasting, informed by:
  • various business model options tailored for you (and your partners), e.g., direct cash-based, hybrid insurance and membership, episodes of care ‘programs’, and opting out of Medicare;
  • patient pricing and featured benefits;
  • clinical care delivery approach including discussion of shared or group medical appointments and inclusion of scribes;
  • consideration of inclusion of mid-tier practitioners, and health coaches;
  • deployment of new technology for business and clinical care delivery processes, e.g., EMR/EHR/CRM, automated billing, capture of patient outcomes data, marketing and patient engagement;
  • strategic development of communications and processes specific to converting existing patients to your new business model, and engaging new prospects alike;
  • development of core set of patient legal documents and forms;
  • timeline for a thorough, phased-in practice conversion and/or new program offerings.

The above is only a partial list of what goes into a successful custom practice conversion. The comprehensive list is longer than, well, a CVS receipt. You get the point: a significant amount of work and planning goes into a high-quality practice conversion.

[Related content: Time to Rethink Your Practice Business Model]

If and when you are ready to consider a concierge or direct primary (or specialty) care practice and business model, the first question you should ask yourself is this:

“Do I have to engage a national franchisor to ride my coattails and have their hands in my pocket?

No. No, you do not. Be assured of this: the success of your new clinic business model does not require you to give away your future earnings in perpetuity by attaching your professional name and medical practice to a branded franchise conversion company.

Let’s go a little further.

Give Away Control … or Control Your Own Destiny?

The national franchise concierge brands are not the only ones capable of designing and implementing these practice conversions. Which means you need not give away a significant piece of future revenue to an outsider organization.

A conversion executed at the highest level does not have to involve a cookie-cutter approach. Processes and best practices, yes.  Cookie-cutter, instead of capturing your unique, nuanced, personal and professional medical brand? No.

Your concierge-style practice should and can be customized exactly the way you envision delivering care and generating value—for your business and your patients. These two things are not mutually exclusive.

The big-branded licensors of concierge care franchises such as MDVIP, Castle Connolly and SignatureMD, have a buttoned-up process that determines if a prospective partner clinic meets their financial criteria.  Their decision to do business with you is based largely on the demographics, geography, and size of your current patient panel.

These franchise conversion companies specialize in converting existing practices, not launching new ones. The truth is, they are risk-averse; they want to best ensure their financial success upfront, mitigating most of the risk at the get-go. Otherwise, they will ‘pass’ on ‘investing’ in your clinic.

There’s no question that the national concierge medicine franchisors have well-established brands. They have templated every aspect of practice conversion processes, including patient communications and engagement (e.g., form letters, phone bank scripts, patient ‘town hall’ presentation content), membership benefits, and guidelines for adherence to their organization’s brand and standard operating procedures.

But, with these ease-of-transition processes and relatively smaller upfront fees also come ongoing franchise licensing fees that exist for as long as you are partnering with the franchised brand.

These fees really add up over time.

You will need to decide if the ends justify the means. Will the concierge franchisor campaigners allow you the total freedom and control to create a new practice paradigm? Will that model be customized for you and your practice partners—and designed with your unique patients and their quality outcomes in mind, or might it feel too generic?

The Sweet Spot for Big National Concierge Franchisors and Practices

The national concierge practice franchisors can be an excellent match for their target internal medicine / primary care physician partner. Typically, it’s the mid- to late-career doctor who: 1) has an active patient panel exceeding 1200, 2) has a practice located in a relatively affluent area, 3) has a practice which has been active for several years, 4) is overworked and burnt out.

[Related content: Physician Specialists and Emerging Practice Business Models: Choosing Forward]

These ideal (for franchisors) prospective practices and physicians have been on the hamster wheel of commercial insurance and CMS for many years, dealing with the administrative challenges and mid-level practitioner turnover all along the way.

They know they should be doing better by their patients than 30-minute new patient consults and 10-15-minute follow-up appointments, but their waiting rooms are packed, fueled by a shortage of new primary care physicians and the added burden of a continued trajectory of the unhealthy, comorbid American human condition.

These practitioners are excited about the prospect of going from more than a thousand active patients to 300-400 paying $1200—$1800 for an annual membership, plus hanging on to commercial payers and CMS—a popular hybrid model.

There Is a Difference

The typical primary care physician may have an active interest in lifestyle factors as core determinants of health. They may espouse this during patient encounters or incorporate sensible wellness activities for their own health. Whether they do or do not, they’ve obviously recognized that they need to improve their own quality of life by making a significant change in their practice model.

Intellectually they know that a concierge model can allow them to slow down and spend more ‘quality’ time with their reduced patient panel, while enjoying a better life-flow.

Customization is key. Some practitioners will find becoming part of a licensed franchise model, while still owning their business, a reasonable option. Others will find it best to turn everything over and entrust a franchisor, as it works as the path of least resistance with less overall effort, based on a reduced level of collaborative process in developing a truly customized conversion.

The Sweet Spot for Integrative Health Providers

Integrative, functional, and lifestyle medicine physicians, or mid-level practitioners leading a clinic that is true to their training and certification, may be reaching for, and needing, something more. Something different.  Something more nuanced to accurately capture the specific way they deliver, or aspire to deliver, care.

What about designing your dream practice conversion?

This means a conversion which is customized for how and to whom, and from where, you deliver care, and how you wish to be remunerated for it. It allows for the deep dive to be led by responsive professionals steeped in the integrative health field. They operate as independent consultants who thoroughly understand the industry and have witnessed many practice model pivots. They streamline the process. They tailor every aspect of your practice conversion in direct alignment with your aspirations and needs—professionally and financially—but not through a franchise process.

Thinking about converting your practice and not sure which direction to go? Get in touch to schedule a 30-min complimentary consultation.

About FON

FON is a leading integrative health and medicine business development and strategy consulting firm. FON specializes in custom solutions for growing patient volume, developing programs, and increasing product sales. Our practical business models are driven by innovative marketing, clear messaging, and customer engagement via branded storytelling.

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Image of Glenn Sabin
Author: Glenn Sabin
FON’s founder, Glenn Sabin, is a nationally recognized thought leader with a reputation for successfully positioning integrative health organizations for sustainable growth. Combining media, marketing and business development expertise with an extensive professional and personal integrative health and medicine narrative, Glenn is deeply passionate about advancing the field as the new standard of care—accessible to all.
Read Glenn’s story.


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