Are CONCIERGE Doctors Making Primary Care Shortage Worse?

A fundamental shift is underway in the American healthcare system, and it could determine whether you can find a doctor when you need one. As the nation grapples with a severe and worsening physician shortage, a new model of medical care is rapidly gaining traction: concierge medicine. Proponents hail it as a form of healthcare innovation that offers a solution to a broken system, providing superior patient care and a better patient experience. However, a growing body of evidence, including groundbreaking research from the Johns Hopkins Carey Business School, suggests this trend may be a double-edged sword, creating a two-tiered system that exacerbates health disparities and worsens healthcare access for the majority of Americans .

This new landscape of medical practices, which includes both concierge doctor services and direct primary care models, charges patients membership fees for enhanced access and more personalized medicine. But as more medical professionals leave the traditional insurance-based system for these greener pastures, a critical question emerges: is this trend a sustainable solution, or is it pouring fuel on the fire of the primary care crisis and hastening the very shortages it claims to solve?

The Research: A System in Flux

The alarm bells are not just anecdotal; they are backed by robust data. A pivotal study co-authored by Dan Polsky PhD, a Bloomberg Distinguished Professor of Health Economics and Health Policy at Johns Hopkins, reveals the explosive growth of these fee-based models. The research, published in Health Affairs, provides a stark statistical picture of a system in rapid transformation .

The growth of these models may benefit participating patients and clinicians, but it’s important everyone understands the potential impact these practices have on the health care system at large,” warns Dr. Polsky. We have to consider how the growth of these models may affect access to healthcare for the vast majority who can only afford the care covered by their insurance plan.

Key Findings on the Growth of Fee-Based Primary Care (2018-2023)

Metric	2018	2023	Growth Rate
Number of Practice Sites	1,658	3,036	83.1%
Number of Clinicians	3,935	7,021	78.4%
Corporate-Affiliated Practices	–	–	576%

Source: Health Affairs, December 2025

This dramatic expansion means that thousands of physicians have effectively been removed from the general patient pool, each now serving a much smaller panel of patients who can afford the annual fees, which can range from a few hundred dollars to tens of thousands . This trend directly impacts the availability of primary care physicians for the general public, a group already facing a national shortage of over 17,000 doctors in 2023—a number projected to grow

The Drivers: Why Are Doctors Fleeing Traditional Practice?

The rise of the concierge doctor is not happening in a vacuum. It is a direct response to a crisis of wellness and sustainability among medical professionals in the traditional primary care system. Many physicians are fleeing what they describe as an untenable environment, driven by a combination of “push” factors from their current jobs and “pull” factors from the concierge model.

Physician burnout has reached epidemic levels. A 2025 survey of primary care physicians in 10 high-income countries by The Commonwealth Fund found that more than two in five U.S. physicians report burnout, one of the highest rates internationally . The primary culprit? A staggering administrative burden. Researchers estimate that a U.S. primary care physician would need to work nearly 27 hours a day to complete all recommended clinical and administrative tasks, a clear impossibility that leads to emotional exhaustion and diminished job satisfaction .

This environment pushes physicians toward a model that promises a return to the core of medicine. Concierge and direct primary care practices offer:

Smaller Patient Panels: Reducing patient loads from thousands to a few hundred.
Less Administrative Burden: Many models, particularly DPC, operate outside the complex insurance billing system.
Increased Clinical Autonomy: More freedom to practice medicine without corporate or insurance-based constraints.
Improved Work-Life Balance: A more manageable workload helps combat burnout and may even extend a physician’s career longevity.

Asaf Bitton, a primary care doctor and professor at Harvard T.H. Chan School of Public Health, notes that experienced doctors are switching because traditional practices involve high workloads for relatively low pay, making the concierge model an attractive alternative .

A Tale of Two Healthcare Systems: The Patient Experience

The rapid growth of concierge medicine is creating a starkly divided patient experience. For those who can afford the membership fees, the model delivers on its promise of enhanced medical care. Patients report quicker access to appointments, significantly longer visit times, and a feeling of having a true partner in their health and wellness journey. Liz Glatzer of Providence, Rhode Island, paid $1,900 a year to join a concierge practice after her traditional doctor repeatedly failed to absorb her complex health history. Her new physician, she said, took hours to get to know her .

However, for every patient who gains this level of access, many more are left behind. When a physician transitions to a concierge model, their entire panel of thousands of patients is often forced to find a new provider in a market that is already strained. This creates a ripple effect of disruption and inequity.

“I’ve met so many patients who couldn’t afford the concierge services and needed to look for a new primary care physician,” said Yalda Jabbarpour, a practicing family physician and director of the Robert Graham Center. Separating from a doctor who’s transitioning to concierge care breaks the continuity with the provider that we know is so important for good health outcomes.”

Patients like Terri Marroquin of Midland, Texas, were told, “You had to pay the fee, or the doctor wasn’t going to see you anymore.” She eventually left her longtime physician to see a physician assistant, as finding a non-fee-based doctor in her area had become nearly impossible . Others, like Deb Gordon in Cambridge, Massachusetts, were simply told by their health plan to use urgent care for their primary care needs after their doctor switched models . This fragmentation of care leads to delayed diagnoses, missed preventive services, and reliance on more expensive and inefficient avenues for care, such as the emergency room.

The Equity Crisis: Widening the Healthcare Divide

The concierge model fundamentally transforms physician time into a scarce commodity that can be purchased by the wealthy, creating significant concerns for health equity. Adam Leive, a researcher at UC Berkeley’s Goldman School of Public Policy, puts it bluntly: “Concierge medicine potentially leads to disproportionately richer people being able to pay for the scarce resource of physician time and crowding out people who have lower incomes and are sicker” .

This trend disproportionately harms vulnerable populations and widens existing health disparities. Research has shown that concierge physicians tend to care for fewer minority patients and those with chronic conditions like diabetes . By siphoning off physicians to serve a smaller, wealthier, and often healthier patient base, the model leaves the broader public, particularly those in low-income and rural communities, to compete for a shrinking pool of providers within the traditional healthcare system . This two-tiered system directly undermines the goal of equitable healthcare access for all.

The Rise of Corporate Medicine in a Boutique World

Adding another layer of complexity is the aggressive entry of corporate medicine into the concierge space. While the model was traditionally associated with independent physicians, Dr. Polsky’s research uncovered a staggering 576% increase in corporate-affiliated practices between 2018 and 2023 . Large, for-profit companies are increasingly investing in these personalized care models, a trend that researchers warn could reintroduce the very profit-driven pressures that many physicians sought to escape.

This corporate influence threatens to alter the core appeal of concierge care. The benefits that attract both doctors and patients—such as smaller patient loads, longer visits, and reduced administrative burden—may be compromised as corporations seek to operate “at scale.” This could change the individualized nature of the care, raising new questions about healthcare quality and accountability for these rapidly growing, and often unregulated, medical practices .

The Outcomes Question: Is It Better Care or Just Better Service?

While the enhanced service and convenience of concierge medicine are clear, the impact on actual health outcomes is far less certain. A 2023 study from UC Berkeley’s Goldman School of Public Policy led by Adam Leive found no significant decrease in mortality for patients in concierge care compared to similar patients who saw non-concierge physicians . This suggests that while the patient experience is undoubtedly improved, the model may not translate to demonstrably better clinical outcomes for some of the most critical health metrics.

This raises a crucial question for the healthcare system: is the high price of concierge medicine buying superior healthcare quality, or is it primarily purchasing convenience and a more pleasant service experience? If the latter, the diversion of scarce physician resources to serve a select few becomes even more difficult to justify from a public health and health policy perspective.

The Path Forward: A Call for Thoughtful Healthcare Reform

The rapid rise of concierge medicine is less a solution to the primary care crisis and more a symptom of a deeply flawed healthcare system. While it offers an escape route for burned-out physicians and a premium experience for affluent patients, it simultaneously exacerbates the physician shortage, deepens health disparities, and threatens to leave the majority of Americans with diminished access to healthcare. The trend is not an indictment of individual doctors or patients, but rather a clear signal that the status quo of primary care is unsustainable.

Addressing this challenge requires a multi-pronged health policy approach focused on systemic healthcare reform. Rather than allowing a two-tiered system to become further entrenched, policymakers and healthcare leaders must focus on fixing the foundational problems in traditional primary care. Potential healthcare solutions include:

1.Reducing Administrative Burden: Learning from countries like Australia, the U.S. could streamline reporting requirements and create centralized, standardized platforms for billing and documentation to give doctors more time for patient care .

2.Reforming Payment Models: Shifting away from fee-for-service and toward models like capitation, as seen in Sweden, can incentivize value over volume, allowing physicians to spend more meaningful time with patients without financial penalty .

3.Investing in the Primary Care Workforce: To make traditional practice more attractive and sustainable, there must be greater investment in primary care education, training, and support systems that promote physician wellness and prevent burnout .

4.Ensuring Accountability and Transparency: As fee-based and corporate-owned practices grow, there is an urgent need for better data collection, consumer protection rules, and standards for healthcare quality to ensure all patients are receiving safe and effective care .

The concierge trend has laid bare the cracks in our healthcare foundation. The choice now is whether to patch them over for a privileged few or to rebuild a stronger, more equitable primary care system for all.