Different concierge practices offer widely varying services. Where some practice owners view anything beyond core primary care services as a distraction, others see opportunity in expanding their offerings. 

There isn’t a right or wrong view. Choosing what’s best for your practice is more nuanced than that.

ROAMD has members across the spectrum. Some practices look more like first-class medical spas than typical primary care offices. Dr. Carrie Bordinko’s clinic Benessair Health in Scottsdale, Arizona, for example, houses a state-of-the-art Olympic gym and several hyperbaric oxygen chambers. Members receive primary care but can also get everything from personal training to physical therapy to rehab and more. It’s precisely what Dr. Bordinko wants her clinic to be — a destination for people seeking that type of treatment and therapy.

Other successful ROAMD members run straightforward primary care practices with a more traditional look and feel — exam rooms, a lab space, a physician’s office, a staff lounge, and a modestly sized reception area.

Is one of these right and the other wrong? Not at all. As business owners, you decide what sort of practice you want to run and what services you want to offer. 

In the spirit of learning and growing together, we simply want to share what’s possible and what kinds of services ROAMD members are offering. You can give it some critical thought as an exercise to consider whether you should or shouldn’t expand your scope. Is your practice still serving your members well? Would new offerings improve patient care? Would they improve the perceived value of membership, or generate new revenue?

The point is, you have options, and only you can decide what fits your patients and your practice. Let’s start by looking at some potential benefits of expanded offerings, which you can evaluate in the context of your unique situation.

Potential Benefits of Non-Core Services

There’s a lot of variation in what practices can offer as far as ancillary services. It’s important to note that many of these services don’t necessarily have to be carried out by the physician(s) of the practice. We’re not suggesting you get certified in massage therapy. But if massage is something a lot of your members use, or if you often refer patients for another service, perhaps you and your patients would benefit from bringing it in-house.

Enhance Member Experience

As a consumer, it’s always nice to have comprehensive services all under one roof.

Patients come to us because they trust us, feel comfortable with us, and prefer the concierge model of care. We understand them and know them better than anyone else. But often when they need additional services, we have to send them back out into the conventional, run-of-the-mill medical world.

If members are going to need additional services anyway, why not provide the opportunity to get those from us — in a space that’s comfortable with people they trust?

This creates a much better member experience and can even help retain members at renewal time, especially if you’re able to roll some services into their membership dues. The services become a really nice perk that creates some stickiness to your practice. For example, if a patient receives two free acupuncture treatments and a massage every few months, they’re perhaps more likely to renew.

Improve Impact on Health

Some extended offerings may seem to walk a fine line between primary care and specialized medicine. For example, is oncology screening part of primary care? We certainly perform some basic screening ourselves, and we recommend regular screenings like colonoscopies and mammograms. Does everyone go get them? It’s hard to say.

New technologies like the GRAIL Galleri Test offer an opportunity to screen for far more cancers and find them at very early stages. It’s not yet part of regular oncology diagnostics, but the potential health impact is astronomical.

The Galleri Test catches things like pancreatic cancer at stage 1. Traditional means normally catch pancreatic cancer at stage 4, after symptoms are present and it’s far too late. As a consumer, I would love my provider to offer me access to a test like that, even for an added fee. It could literally save my life.

Mental health care is another offering that could make a huge health impact. Many patients struggle to come forward with mental health issues due to their intensely personal nature and because of the social stigma. 

Bringing a mental health concern up with a trusted primary care physician is a big step, but then having to go see a stranger in an office with “psychiatrist” on the door can lead to patients not getting help at all. Offering this service in a place where they’re comfortable and in a practice they trust could make the difference.

Attract New Members

In concierge medicine, you may find that many members of your target audience are searching for something specific besides primary care. These ancillary or non-core services have the potential to become big attractors for your practice.

When you invest in a new technology or service and incorporate it into your marketing and SEO, there’s a good chance people will find your office when they search for that offering in your area. For example, someone might search for “BOTOX in Indianapolis.” They find your office and realize they also need a great primary care provider.

Ancillary services also set your practice apart from other primary care clinics because, depending on your geography, not many have offerings like in-office medical and cosmetic BOTOX treatments.

Raise Perception of Your Clinic 

Even if your clinic isn’t actively looking to add new members, it’s still good to be known in the community. No one talks about how their doctor weighed them and checked their cholesterol. But they will tell their friends about ice baths and hyperbaric chambers.

Just imagine someone on the golf course or at a cocktail party who mentions the steam room at your clinic. “Your primary care doctor offers what?” These kinds of conversations differentiate your practice from the traditional primary care model that has disappointed so many consumers. Members will spread the word about your practice if you’re impacting their health and improving their experience with non-core offerings.

Generate Revenue

It can be tricky to decide which of these additional services should come as part of your core package, which to include in various membership tiers, and which warrant additional fees.

Some tests and services may not appreciably increase the demand on your time and resources, giving you more freedom with how you incorporate them. Maybe you simply roll them into membership dues or use them as the basis for creating membership tiers.

Other services, like interpreting a 20-page genomic test report, will require more. You should be compensated for your time spent reviewing and communicating complicated test results. Patients know this; they’ll even expect to pay for it.

Non-Core Services ROAMD Members Currently Offer 

To give you some ideas, below is a list of some non-core services ROAMD members offer in their practices right now. This isn’t a comprehensive list, and it’s not a recommendation to offer all of them. It’s just a list to show what’s possible:

• Hyperbaric chambers
• Photomodulator
• Physical therapy
• Personal training
• Massage therapy
• Acupuncture
• Cosmetic treatments
• Ozone therapy
• Standalone executive physicals  
• Surgical suites
• Branded and non-branded supplements
• Travel reciprocity / referrals / travel assurance
• Dietary services
• Psychiatry / psychology / counseling
• Advanced pharmacy offerings
• Advanced screenings and diagnostics
• Urgent care services
• FotoFinder (skin imaging)
• InBody (body composition)

Evaluate Patient Impact and Potential Revenue

As you contemplate what services you might offer, it can be helpful to build a matrix to evaluate the worth and feasibility of potential offerings. I love using a 2×2 grid with high versus low patient impact (quality of life, health outcomes, cost of care) on one side and high versus low revenue potential on the other side.

Some things might have a low patient impact, but won’t cost you much, so you make a judgment call based on that information. Other offerings might have low revenue potential but high patient impact, and you might decide to offer them regardless of direct revenue generation.

Thinking along this methodology can help you evaluate possible offerings in terms of both patient impact and revenue.

Evaluate the Impact on the Practice

Adding services will probably affect your staff in one way or another. They’re the ones who will be picking up the slack to facilitate these services, learning new technologies, scheduling appointments, and reconfiguring the space as needed.

Will you need to bring in someone who’s certified for dietary counseling or for staffing hyperbaric chambers? Or can you implement creative solutions to minimize impact on staff? 

Griffin Concierge Medical in Tampa, Florida, has an impressive setup for their InBody body composition testing. Members can come in through a side door to use the machine without ever talking to someone in the office. Their results automatically go into the EMR, the physician is notified, and everyone goes on with their day.

But in most cases, factors like increased foot traffic through the office, varying appointment lengths for different services, scheduling exam rooms, and even how many parking spots are available for your building need to be thought through carefully.

Will increased foot traffic put patient experience or patient privacy at risk? If so, some practices mitigate this by scheduling 45-minute visits on one-hour blocks to leave a 15-minute buffer for patients to come and go before the next person arrives.

Another big consideration is cost to the practice. Hyperbaric oxygen chambers, for example, come with an enormous price tag and the associated costs of finding the space to house them and operating them. But there is arguably no better way to become a true destination for care than adding such a service.

Consider What’s Right for Your Practice

All of these factors underscore the importance of evaluating what’s best for your practice. No two practices are alike. Certain non-core services might make sense for one, but not for another.

As we investigate new possibilities, it’s helpful to learn from one another’s experiences. Have you added ancillary services in your practice? Which ones, and what has your experience been?