Concierge medicine is a care delivery model, originally focused on primary care but since applied to other specialties, in which practices charge patients an annual fee, ranging from $2K to $100K (but usually below $10K), in exchange for smaller panel sizes, greater access and availability, and more personalized services. Direct primary care (DPC) takes this idea one step further by charging a larger fee and operating entirely outside insurance. Together, they offer an answer to many clinicians’ and patients’ complaints about the underfunded, overburdened status quo of primary care delivery, but only for those who can afford it. 
 
From 2018 to 2023, the number of medical practices offering concierge or DPC services grew 83 percent, and the corresponding clinician count grew 78 percent, but from a very small starting point. In 2023, 7K primary care clinicians (including both physicians and advanced practice providers) worked in concierge or DPC practices. Using a conservative estimate that there are 350K primary care clinicians practicing in the US, approximately two percent of them are in concierge models. This is not to dismiss concierge care as insignificant, as the economics of this model at the practice level can be incredibly impactful, but rather that it can only serve a certain slice of the healthcare market. This slice has been growing thanks to Baby Boomers reaching retirement age, which increases both its demand and supply (concierge works as a great bridge to physician retirement). The recent growth of concierge care instead prompts the question: what is its natural ceiling? How many Americans would pay even more upfront for highly personalized care, and how many practices could that support?