Meet the Hybrid Concierge Medical Practice Model

"You are killing yourself. You're working too hard." Surprisingly, those were the admonishments from patients, advising their doctor. It was the reverse scenario from medicine-as-usual.

Indeed, Jeffrey H. Graf, MD, FACC, a Manhattan cardiologist and internists, had been struggling with the push and pull of his practice over the last few years. Like many doctors, the 57-year-old physician found his reimbursements were going down, and expenses were going up.

Consequently, his hours were extremely long, and the fun of being in practice was disappearing. Still, he loved his patients and wanted to keep helping them.

Graf thought about going into a full concierge model, where patients pay a flat fee per year.  His conclusion: "I looked into the faces of people I knew for a long time and thought: 'I can't do this; it isn't right. So many of my patients would have to leave me, especially those who couldn't afford the program. It isn't the way I want to practice; I can't go [concierge] full-time," he says.

Instead, Graf opted for the middle ground.  He is among a growing number of physicians who are dipping into concierge while maintaining a full-time practice, in a scenario that is aptly named "hybrid concierge." A hybrid model allows doctors to merge traditional and concierge programs. This gives them the option to care for patients who rely on Medicare or other government or private insurance programs.