If you've decided concierge medicine fits your situation, the practical question is how to actually make the switch without creating gaps in your care. It's not complicated, but a few steps done in the right order make the transition smooth rather than chaotic. Here's a step-by-step framework.
Step 1: Know what the model actually is
Before switching, understand what you're changing and what you're not. Concierge medicine means a direct relationship with your physician rather than episodic care through a revolving door of providers.
In my practice, the switch typically means:
- Same-day or next-day visits become standard rather than rare
- Direct cell-phone access to me for medical questions
- Appointments of 30 to 60 minutes
- Comprehensive annual exams with detailed labs and preventive planning
- Specialist coordination I handle directly
- Hospital involvement if you're admitted
What you're leaving: a traditional practice where the physician is responsible for 2,000 to 3,000 patients and structurally cannot provide this level of attention.
Step 2: Evaluate the specific physician
Not all concierge practices are the same. The questions that separate them:
Panel size. How many patients does the physician actually carry? Below 400 is meaningful; above 600 and you may not see much improvement over traditional care. Mine caps at 50.
What's included in the membership. Look for annual comprehensive exams, direct access, same-day sick visits, coordination, preventive planning, and house calls if relevant. These should be the standard offering, not premium tiers.
Billing model. Does the practice bill insurance for services in addition to the membership, or is it private-pay? Neither is wrong; the answer matters for how the relationship works.
Credentials and experience. Board certification in Internal Medicine, active unrestricted license, verifiable record through state board.
Meet before committing. Any reputable concierge practice offers a consultation where you can meet the physician, ask questions, and assess fit before signing.
Step 3: Understand how insurance fits
Concierge medicine works alongside your health insurance, not instead of it. Your insurance still covers specialist visits, hospitalizations, lab work, imaging, and prescriptions. The membership covers what the physician delivers personally.
In my practice specifically, which is private-pay, I don't bill insurance at all. You keep your insurance for everything that happens outside my office. For patients on high-deductible plans specifically, this structure often works well; the membership replaces fragmented out-of-pocket primary care while the HDHP handles catastrophic events.
For seasonal residents, the value compounds. A Florida physician who actually knows you beats urgent care visits with strangers every time something comes up during the winter months.
Step 4: Transfer your medical records
Before your first appointment, request records from your current primary care physician: recent labs, imaging reports, medication lists, notes from specialists. Under HIPAA, your current practice must provide these within 30 days. Many offices can send electronically, which is faster.
Useful to bring to the first visit:
- Complete medication list including supplements and over-the-counter products
- Pharmacy information
- Contact details for every specialist you see regularly
- Recent hospital discharge summaries, if any
- Family history updates
- A list of questions or concerns you want to cover
If this feels overwhelming, practice staff at most concierge practices can help coordinate record transfers.
Step 5: Schedule the initial comprehensive visit
A first concierge visit shouldn't look like a standard office appointment. In my practice, initial visits run 60 to 90 minutes and cover the complete medical history, family history, lifestyle, health goals, and concerns.
This isn't a rushed encounter. It's the foundation for the relationship. Patients often use this visit to surface things that previously got glossed over: symptoms they never had time to mention, family history details, questions they'd been sitting on for years.
Step 6: Notify your current physician
This step feels awkward, but it's worth doing. Let your current primary care physician know you're transitioning. You don't owe an explanation, but a clean handoff ensures good records flow and maintains the relationship in case you need anything from that office later.
Most physicians understand. The traditional system's structural problems aren't the individual doctor's fault, and they know it as well as patients do.
Timing the switch
The best time to switch is before you urgently need to, not during a health crisis. Establishing the relationship when you're well lets the physician build a baseline, allows records to transfer without time pressure, and means you have the access in place when something does come up.
For patients considering this, I usually recommend scheduling the initial visit at least a few weeks before any anticipated travel, elective procedure, or expected medical event, so we have time to establish things properly.
If you want to talk through specifics
If you're considering making the switch to concierge medicine and want to talk through whether my practice fits your situation, reach out. I'll answer questions directly and tell you honestly whether this is the right fit or whether a different option would work better for you.
