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Concierge medicine is a term used to describe a relationship with a primary care physician in which the patient pays an annual fee or retainer. This may or may not be in addition to other charges. In exchange for the retainer, doctors provide enhanced care.

Concierge physicians care for fewer patients than in a conventional practice, ranging from 100 patients per doctor to 1,000, instead of the 3,000 to 4,000 that the average physician now sees every year. All generally claim to be accessible via cell phone or email at any time of day or night. The annual fees vary widely, from $60 to $15,000 per year for an individual, with the lower annual fees being in addition to the usual fees for each service and the higher annual fees including most services. Some concierge practices do not accept insurance of any kind.

Mostly concentrated on the East and West Coasts, in 2004 the Government Accountability Office counted 146 such practices. The American Medical Association does not track the number of concierge practices because the concept is still so new.

The concept of concierge medicine has been accused of promoting a two-tiered health system that favors the wealthy, limits the number of physicians to care for those who cannot afford it, and burdens the middle and lower class with a higher cost of insurance. Detractors contend that while this approach is more lucrative for some physicians and makes care more convenient for their patients, it makes care less accessible for other patients who cannot afford (or choose not) to pay the required membership fees. (IHP keeps fees low so that it is affordable to all of their residents in the communities that we serve.)

One physician in a CNN.com article noted that he might not be treating patients at all if he hadn’t made the switch to concierge medicine: "…many doctors are becoming so disillusioned with primary care that they are quitting altogether."

Some say that concierge medicine is not the solution to the healthcare system’s woes, but is a symptom of "too much emphasis being placed on cost control and too little emphasis on the patient." (This is why IHP developed its model of consumer owned and driven clinics. Since the association owns the clinic in conjunction with IHP it allows the association to be a part of the directional team of the Clinic thereby providing enhanced patient emphasis in all areas of clinic operations and care.)