Four ways to build your practice, side by side. Then what changed in medicine, what your members are actually buying, where to start, and the tools that already exist to run it.
All four are real concierge practices, and all four belong to you. Each step adds more of you in the room, more equipment and more cost. Each step also opens up insurance billing for the care you give in person.
Talk, don’t drive.
Video and phone visits from anywhere: your home, the golf course, the pickleball court. Your members keep their own doctor and come to you for access and a second opinion.
Insurance: membership only. Keep it simple.
The doctor comes to you.
Most care happens by video. When a patient needs to be seen, you go to them. Your laptop and phone run the practice, and testing you can’t do in a home goes to people who have the equipment.
Insurance: bill the house calls.
A home base, on your schedule.
Video for most things, plus an exam room for in-person visits. Rent part-time space in another doctor’s office a day or two a week, or take a full-time office when you’re ready.
Insurance: bill the office visits.
The senior doctor goes concierge.
Works best in a practice that is already staffed and running. The senior doctor sees the concierge members, who pay for more of his time. Nurse practitioners and the rest of the team handle everyday care. No one has to give up a 2,000-patient panel. How it works ↓
Insurance: the whole practice bills it.
Flip the switch to see each practice with insurance billing and without it.
About insurance and telemedicine. Medicare does pay for many telemedicine visits today, but those rules are temporary (Congress has extended them through December 31, 2027) and billing them adds a whole layer of insurance work. So on our standard plan, a telemedicine-only practice stays membership-only. A doctor who really wants to bill for telemedicine can. When we say “insurance” on this page we mean traditional Medicare and PPO plans. HMOs are not part of the plan.
The full-time office works best when the practice already exists: staffed, billing insurance and running. Nobody throws away a 2,000-patient panel to keep 300. Instead, the practice adds a concierge tier at the top. Patients who want the senior doctor pay extra for more of his time. Everyone else keeps getting great care from the team.
Members pay for more of his time.
The recurring care every patient needs.
Trained and mentored by the senior doctor.
Nurse practitioners came up through nursing. That means years of hands-on patient care before they ever took on advanced training. Most became nurses because they care about people, and it shows at the bedside.
Many practices today are run by nurse practitioners, and they do excellent work. Medicine is learned by doing. After years of practice, experience counts for far more than where the training started.
The senior doctor’s time is the scarce thing. A strong team protects it, so he can give it to the people paying for it.
The same pattern repeats. Each turn adds a doctor and builds the practice’s worth.
Doctors we met at the Concierge Medicine Forum in Atlanta who run their practices this way put it at about 300 concierge members for each clinician, doctor or nurse practitioner.
Every one of those members pays the membership, and their covered care is still billed to insurance. That is two kinds of income from the same patient, on top of the insurance patients the practice already serves.
An example, not a projection. Your team, your town and your patients set the real numbers.
What a nurse practitioner may do without a doctor’s supervision depends on the state. Billing rules for visits by nurse practitioners and physician assistants also differ from visits by doctors. Your own health care attorney and billing professional should review how your team is set up.
Insurance pays for a lot of what a doctor does all year, and leaving that money on the table makes no sense. But the visit that tells you the most about a patient is the one insurance barely touches.
Swipe the table sideways to see B and C →
| Compare | AThe concierge onboarding physical | BThe Medicare wellness visit | CA traditional physical |
|---|---|---|---|
| What it is | A full workup to learn the patient’s whole health picture from day one | A yearly review and prevention plan | A yearly hands-on checkup |
| Hands-on exam | Yes, head to toe | Not required. Mostly questions, vitals and a checklist | Yes, a standard exam |
| Time with the doctor | One to two hours, often over two visits: one for the exam and labs, one to go over the results | Short. Set by the office’s schedule | Usually 20 to 30 minutes |
| Blood work | Extensive: the basic panels plus advanced cholesterol, inflammation, full thyroid, hormones, vitamins and diabetes risk | None required | Basic: blood count, metabolic panel, cholesterol |
| Other tests | Urinalysis, often an EKG, and more as the doctor chooses | Memory check, fall risk, mood, a screening schedule | Sometimes a urinalysis; screenings by age |
| What the patient walks away with | A written plan for health, healthspan and longevity, with follow-up all year | A list of screenings that are due | “You’re fine,” or a referral |
| Who pays | The patient. An onboarding fee the doctor sets, often around $2,500, sometimes credited back over the first year | Medicare: about $138 (2026 national average) | Not original Medicare. Many Medicare Advantage plans and most employer plans cover a basic one |
The short version: B is a conversation and a checklist. C is a quick look. A is a deep dive with a plan.
Original Medicare does not pay for a full physical, so a doctor can charge a Medicare patient for it directly, even if he takes Medicare. The covered pieces are different. If he also does the wellness visit, or orders labs for a condition the patient already has, he bills those to insurance and leaves them out of the fee, or leaves them off the bill entirely. Never both. If a patient’s Medicare Advantage plan already covers a physical, check the plan’s rules before charging that patient for one. Have your own health care attorney review your membership agreement before you open.
Most concierge firms start with a doctor who already has 2,000 or 3,000 patients. They sell that panel on paying a couple of hundred dollars a month. A few hundred sign up. The rest are let go.
That wastes a valuable asset: the practice the doctor spent years building.
You start a new practice at your own pace, often while you keep the job you have. We help you find members from scratch.
If you already own a practice, you don’t have to throw it away. Keep it, and let the senior doctor go concierge while the team carries the rest. Or sell it to a new doctor, get paid for what you built, and grow a concierge practice beside it.
Over the last decade, corporations and private-equity roll-ups bought up independent practices. The doctor who used to own the practice became an employee inside it — handed a patient panel too large to know, a schedule set by someone else, and productivity targets that reward volume over care.
You didn't lose your judgment or your skill. You lost the room to use them. Prior authorizations, RVU quotas, a chart that takes longer than the visit, and a compensation model tied to throughput rather than outcomes. The relationship that drew you to medicine — knowing a patient over time — is the first thing the model squeezes out.
Concierge medicine keeps everything you trained for and changes what surrounds it: your panel size, your calendar, and who the practice answers to.
Ask most physicians what their practice is worth and they have never run the numbers. It is the question a CPA is built for, and it does not fit in a paragraph — so what it costs to leave, what the practice earns and spends once it is running, and what it is worth when you are finished with it now live together on one page.
You own the practice and the decisions inside it — the model, the panel, the schedule, the standard of care.
Fewer patients, real visits. The time to think, to listen, and to practice the medicine you trained for.
A predictable membership base instead of the insurance treadmill — and the upside of the practice is yours.
Knowing your patients again — continuity, trust, and the reason most of us went into medicine in the first place.
Most physicians don't stay where they are because they love it — they stay because the change feels unknowable. It isn't. Whether you start by video on your days off or turn your own practice concierge, it's a sequence, and it's been walked before.
Model your panel, your membership revenue, your overhead, and the runway you'd need — before you commit to anything.
Timing, your patients, your contract and non-compete, and the concierge or direct-care model that fits your specialty.
Entity, agreements, compliance, billing, and tax — the business scaffolding, handled with the right professionals.
Launch the practice that's yours, with the systems to run it lean and the support to keep it steady.
Apps and telemedicine platforms handle access — and they handle it well. What no app can do is the thing a concierge physician does naturally: know the whole family, not just the patient in the bed. When one trusted doctor looks after the parents, the kids, and the grandparent down the hall in a facility, care stops being a string of disconnected visits and becomes something a family can actually feel.
A concierge panel is small enough that one physician can truly know an entire family — and catch the problems of an aging parent that a fifteen-minute visit never would.
Part of how we help you build the practice is a posture the system trains out of doctors: reach out first — especially for the ones who can't always advocate for themselves.
A parent in a facility should never feel out of sight. A shared photo, a two-minute call, a hello passed along — connection, even when the family can't be in the room.
You don't need us to invent anything. Plenty of trusted apps already keep families in touch — we help you fold that into the care you give, and we widen what we recommend as we vet more.
A wave from a grandfather in his room, reaching his family at dinner that night — and their hello coming back.
Nobody has to invent that moment. It only has to be encouraged — by a doctor who knows the whole family and the everyday tools that already connect them. That's what a concierge practice makes room for, and it costs nothing to add.
Your members are not leaving their primary care physician, and they are not dropping their health plan. This does not replace either one — and we say so plainly, because it is true.
What they are buying is the one thing insurance does not sell: a doctor who answers. Someone who already knows their history and will take the call. Someone who will give them a second opinion on what they have just been told. Someone who will tell them about the things their plan will not pay for — because those things exist, and nobody inside a fifteen-minute visit has the time to mention them.
That is why the panel stays small and the fee is monthly. They are not paying you for visits. They are paying to be known.
It is worth knowing what the current arrangement values that relationship at. Of everything spent on an insured family in a year, roughly four percent goes to primary care — on the order of $295 a year for a commercially insured adult, and closer to $580 a year under Medicare. That is what the system pays a physician to carry someone’s primary care for twelve months. Your members are not being asked to replace it. They are paying separately, and directly, for the part it does not include.
Primary care’s share of spending: Health Care Cost Institute (2022 data, published 2024). Per-person figures are that share applied to average annual spending and are illustrative.
A telemedicine concierge practice needs four things working together: a way for patients to reach you, a way to see them on video, a medical record that holds the visit, and a way to collect the membership every month. Below are four platforms that do all of that today — real companies, real products, in daily use by independent practices, each one signing a Business Associate Agreement. You could open on any of them this quarter.
We publish the prices. Every figure here comes from the company's own pricing page, checked in August 2026, including the add-ons that don't appear in the headline number. Nobody on this page pays us anything, and we don't take a referral fee from any of them.
The least expensive real all-in-one.
$49–$129 per month
Charting, video visits, secure messaging, patient portal, scheduling and card payments in a single login. Built for virtual-first practices, which is exactly what you would be starting.
Best fit: a solo physician who wants one login and the lowest monthly cost to open the doors.
Built around the membership itself.
from $290 per month
The only one here designed around the thing that actually makes concierge work — recurring membership billing — with a clinical record, member onboarding and self-scheduling built around it.
Best fit: the physician who wants the money side handled properly from the first member.
The concierge-native clinical record.
$281 per month, plus setup
Built by MD HQ specifically for direct-care and concierge practices, and the deepest clinical tool on this list. Read the add-ons before you compare it to the others on headline price.
Best fit: a physician who wants the strongest clinical record and will pay for it. Add the portal and video and the real figure is nearer $390 a month.
Flat, unlimited, written by a practising doctor.
$300 per doctor, per month
Built by the founder of AtlasMD for his own direct-care practice. One flat price, unlimited patients, with billing and dispensing designed in rather than bolted on afterwards.
Watch this one: video visits are not in the published feature list. For a telemedicine practice you would pair it with a video tool.
If all you need this month is the conversation. You can start smaller than any of the above. Spruce Health is $24 per user per month for HIPAA-covered phone, text, video, fax and a shared inbox, with the BAA included and a one-time $19.50 SMS registration; the $49 tier adds call routing and after-hours triage. Doximity Dialer is free for verified physicians and gives you calls and browser-based video showing your practice number instead of your cell. Neither is a medical record — you would add one of the four above when you are ready. Plenty of physicians begin exactly here.
This is the CPA talking, and it is the one piece of arithmetic on this page I would not want you to skip. Software runs somewhere between $50 and $400 a month, and it stops there. Payment processing does not stop — it grows with every member you add.
Take the suggested $200 monthly membership. A 3% card rate costs you $6 of it, every month, for as long as that patient stays. At three hundred members that is roughly $1,800 a month, which is more than any platform fee on this page — several of them put together. The same payment taken by bank transfer, on a plan that charges 1% capped at $5, costs a fraction of that.
So ask every vendor one question before you sign: what does it cost me when a member pays by bank transfer rather than card, and can I make that the default? It is a dull question. Over a few hundred members and a few years it is worth more than most of the features you will be shown in the demo.
An illustration using the suggested membership price, not a projection of your revenue, your panel, or your costs. Processing rates vary by plan, by card type and by negotiation.
And eventually, ours — but we are not going to put a date on it.
We are building our own, designed around this practice specifically. It could be three months. It could be three years. You can never tell. So until it exists, this page is the honest answer: these are real products you can buy today, and any of them will let you open. When ours is ready, you will hear it from us. Until then we would rather you started than waited.
These are independent, third-party companies, described from their own published materials and pricing pages as checked in August 2026 — not endorsements or paid placements. We are not affiliated with any of them, we receive no commission or referral fee from any of them, and none of them has any relationship with us. Software pricing, feature sets and Business Associate Agreement terms change frequently and often are not what a headline number suggests; confirm current pricing, the current BAA, and what is included versus billed as an add-on directly with the vendor before you rely on any of it. Our role is to help you compare and set up the right fit for how you want to practise.
Software is only half of what is available today. The other half is firms — some that will convert your whole practice and bring you members, others that will simply run the marketing while you keep everything. You don't have to do this with us. Here are the main players, shown honestly, with what they charge where they publish it.
They convert your practice and market it to bring members — a hands-off path where an established firm handles the switch and the patient acquisition for you. These are independent companies, listed for comparison. Most of them work by converting the patients you already have, which usually means keeping a few hundred and letting the rest go — read them with that in mind.
Franchise / revenue share
The largest membership-primary-care network — reported 1,400+ affiliated physicians across about 45 states. Handles the conversion, national and local marketing, and member acquisition; panels are capped around 600.
Pricing: partnership model; MDVIP shares in membership revenue. Patient fee reported ~$1,800–$5,000/yr by market. Visit →
Royalty share
Helps independent physicians add a membership tier while continuing to bill insurance. Provides marketing, technology, and training to launch and grow the panel.
Pricing: takes a royalty share of membership revenue; patient fee ~$1,500–$2,000/yr. Visit →
Custom engagement
Practice-management consultants offering a turnkey conversion playbook plus ongoing operational and marketing support for independent physicians going membership-based.
Pricing: custom per-physician engagement; not published. Visit →
Custom engagement
Positions itself as a physician-equity conversion specialist — you own and build equity in a concierge practice, with launch support and marketing.
Pricing: custom per-physician engagement; not published. Visit →
Unlike the turnkey partners above, these firms don't convert or take a share of your practice — you keep and own it, and they run the marketing for a fee. A straightforward snapshot of agencies operating in this space today; pricing is shown where a company publishes it.
Custom proposal
Full-service concierge and membership-medicine marketing: brand strategy, web design, SEO, paid media, content, and analytics.
Pricing: custom — request a proposal. Visit →
From ~$999 / month
Digital marketing for DPC and concierge practices: AI-driven patient engagement, local SEO, Google and Facebook advertising, reputation management, and texting/chat tools.
Pricing: advertised from ~$999/month; tiered. Visit →
Custom
Concierge-focused SEO, PPC, AI-search visibility, and website design; reporting built around consultation requests and enrollments rather than just clicks.
Pricing: custom — book a consultation. Visit →
Custom
A DPC platform — membership billing and EHR — paired with DPC-specific marketing services to help practices grow their membership.
Pricing: custom — contact for a quote. Visit →
These are independent, third-party companies, listed for comparison from their own public materials — not endorsements, and we are not affiliated with any of them. Pricing shown is what the company advertises or what public sources report, and it varies widely by market, specialty, and package; confirm current pricing, terms, and business-model details directly with each company before relying on them.