Innovation Adoption Curve and Direct Pay Independent Practice 

The curve representing a continuous frequency distribution with a shape having the overall curvature of the vertical cross section of a bell; usually applied to the normal distribution. 

Bell-Shaped Curve

You are probably aware of the bell-shaped curve.  At its peak,  half the people or events or whatever you are measuring are to the left of the peak or below it and half are to the right of the peak or above it.  Half the people , for example, have an IQ below 100, and half above 100.

Well, there is something similar called the Innovation Bell Curve.  It is about the frequency of people adopting a new innovation.  

The adopters fall into these categories  as follows.

·         2.5% , Innovators – tend to be young, educated, prosperous, and risk-oriented.

·         13.5%,  Early adopters - younger, more educated, leaders , but less prosperous

·         34%, Early majority-  conservative but open to new ideas, active in community

·         34% ,  Late majority -   older, less active, fairly conservative, and less prosperous

·         16%,   Very conservative older, less active, less likely to be community leaders

Why am I telling you this?    

Because, according to Josh Umbehr, MD, and his  two partners, in the Atlas Concierge Medical Group in Wichita, Kansas,  all  three concierge physicians,  all three  in their early 30’s,  are saying  other primary care physicians , who are adopting and switching to concierge/direct pay practices independent of 3^rd parties (government and insurers),  are precisely following this innovation adoption curve.   

According to  current surveys of  primary care physicians,  and to 3 young concierge physicians in Witchita,  between 11% to  14% of physicians have switched  to direct pay practices devoid of 3^rd party involvement.     

 For whom does the bell toll?  Umbehr says the bell tolls for concierge medicine.

Based on the shape of the adoption bell  curve and the shape and speed of adoption,   Umbehr  et  al predict that 80% of primary care physicians will  be in concierge/direct pay/cash only or cash friendly practices within 5 years.

Josh Umbehr should not be taken lightly.  He and his father, are running for Lieutenant Governor and Governor of Kansas in the Libertarian ticket, the only father/son team to do so in the nation.    And Wichita, as you may know, is home of the Koch Brothers, a powerful force in conservative politics.

 Josh  and his medical partners are crisscrossing the country talking to physician groups and associations, including the American Association of Physicians and Surgeons and the American Academy of Family Physicians, about  their predictions.  They are finding receptive audiences.   They point out that direct pay practices dramatically reduce the need for staff,   cut overhead,  increase incomes,  and  enhance satisfaction of patients and participating physicians.   

Among the benefits they tout are these:  same day appointments,  unlimited time spent with patients,   wholesale medications,  whole sale lab tests,   and bundled prices included in the retainer fees for most diagnostic and therapeutic services performed in a primary care office.

If their  prediction pans out, it will come as either  a rude shock or a pleasant surprise   to many Americans, who get the predominance of their care through Medicare, Medicaid,  and  employer sponsored  plans  or individual plans.   Shock will come to those who have learned ObamaCare would lower premiums and deductibles and give them access to doctors.  The pleasure will come from personal care by personal physicians.

What are the characteristics of  concierge/direct pay/cash-only/ 3^rd party free  physicians?

The Concierge Medicine Research Collective, an independent health care research and data depository of the concierge and direct primary care industry's trade publication, Concierge Medicine Today based in Atlanta, GA released a 3-year summary of its analysis on the popularity and growth of the concierge medicine and direct primary care marketplace. They asked physicians from across the U.S. from December 2009 to December 2012 questions pertaining to their concierge medicine and direct primary care practice, patient satisfaction, business strategies, revenues and more. 

The analysis revealed the following results:

• Nearly 70% of current U.S. concierge medicine and direct primary care physicians operating practices today are internal medicine specialists.

• The second most popular medical specialty in concierge medicine is family practice.

• A surprising finding in this study was the increasing number of concierge cardiology,

dental and pediatric practices opening from February of 2010 to December 2012.

• The combined average annual income of a typical concierge medicine [and direct care] patient is between $50,000 to $200,000 per year.

• Average annual compensation/salary of concierge doctor is between $100,000 and $300,000 per year.

• The typical age of concierge doctor is between 40-59 years of age.

• 77% of a concierge [and direct primary care] patients are between the age of 40-59 years old.

• A concierge medicine doctor who provides 24/7 cell phone access receives the majority (83%) of phone calls from their patients during normal business hours, Monday thru Friday.

• 62% of direct care and concierge medical offices employ between 1-2 office employees.

• The most common reason why patients using concierge medicine call their doctor: Prescription Renewals (38%); Cold/Flu Symptoms (19%); Back Pain (14%); and Headaches (13%).

• Most concierge doctors and direct primary care physicians treat six to eight patients per day.

• More than 70% of concierge [and direct primary care] doctors will visit with their patients between 30-60 minutes per office visit, enough time to discuss case history, examination, other symptoms, treatment options and strategy for care.

• Patients using concierge medicine [and direct primary care] comply with scripts and recommendations far more due to the doctor’s routine personal follow-up with the patients and explaining the importance of compliance and other treatment options.

Tweet:    Between 11% and 14% of primary care physicians may soon switch  to direct pay/concierge/ cash only 3^rd party free practices, and this percentage could grow to 80% within five years.