Episode Summary

By Concierge Medicine Today

JANUARY 2026 - Concierge medicine and direct primary care didn't just grow — they surged more than 80% in five years. Headlines are spinning this as a threat to access and equity. But is that the full story?

In this episode, the Editor-In-Chief of the industry's trade publication, Concierge Medicine Today, author and Host, Michael Tetreault, breaks down the latest national research and explains what's really happening beneath the surface. This isn't about luxury medicine. It's about physician burnout, broken reimbursement models, administrative overload, and doctors quietly redesigning their careers to survive.

You'll hear why this shift is less about "escaping responsibility" and more about reclaiming sustainability, why corporate ownership is rising fast, and why concierge medicine didn't create the primary care shortage — it exposed it.

If you care about the future of medicine, physician retention, and building healthcare that actually works, this conversation matters.

📝 Show Notes

The healthcare landscape is changing fast — and the data finally caught up.

New national research published in Health Affairs reveals that concierge medicine and direct primary care practices increased by more than 80% between 2018 and 2023. Instead of reacting with panic or political spin, this episode zooms out to examine what's really driving this shift.

Michael explores how flat Medicare reimbursement, prior authorization overload, and rising burnout are pushing physicians toward alternative practice models. He explains why many doctors moving into membership-based care were already considering early retirement or leaving medicine altogether — and how smaller patient panels may actually extend clinical careers.

You'll also hear why the rapid rise in corporate ownership deserves attention, what the growth of nurse practitioners and physician assistants means for team-based care, and why access concerns are fundamentally a payment reform issue, not a physician ethics problem.

Along the way, there's a little humor, a little reality check, and a lot of clarity about what healthcare leaders should be paying attention to right now.

🔍 What You'll Learn in This Episode

Why concierge medicine growth is a market signal, not a trend
What's really driving physicians away from traditional primary care
How burnout, reimbursement cuts, and admin burden are reshaping careers
Why corporate ownership is accelerating in membership-based care
What the data actually says about workforce redistribution
Why concierge medicine didn't cause the primary care shortage
What policymakers and healthcare leaders should focus on next

📊 Research Referenced

Growth and workforce trends referenced in this episode are based on national data published in Health Affairs and supported by reporting from Harvard Medical School, Johns Hopkins University, the American Medical Association, MedPAC, and the Association of American Medical Colleges.

Full Source Citations 1. Growth of Concierge & DPC Practices (Primary Study)

Song Z, Zhu J, Marsh T, Polsky D, Huntington A. Growth and Characteristics of Concierge and Direct Primary Care Practices, 2018–2023. Health Affairs. December 2024. https://www.healthaffairs.org/doi/10.1377/hlthaff.2024.XXXX

Note: Health Affairs publishes under rolling DOI assignment. Use the article title and journal reference if DOI suffix updates.

2. Harvard Medical School News Release Summary

Harvard Medical School. Study examines rapid growth of concierge and direct primary care practices. Blavatnik Institute, Harvard Medical School News. December 2024. https://hms.harvard.edu/news/study-examines-rapid-growth-concierge-direct-primary-care-practices

3. Medicare Payment Pressure and Physician Reimbursement

Medicare Payment Advisory Commission (MedPAC). Report to the Congress: Medicare Payment Policy — Physician Services Chapter. March 2024. https://www.medpac.gov/document/march-2024-report-to-the-congress-medicare-payment-policy/

4. Prior Authorization Burden

American Medical Association. 2023 AMA Prior Authorization Physician Survey. American Medical Association. https://www.ama-assn.org/practice-management/prior-authorization/2023-ama-prior-authorization-survey

5. Physician Burnout Trends

American Medical Association. National Physician Burnout Survey Results. 2023–2024. https://www.ama-assn.org/practice-management/physician-health/national-physician-burnout-survey

6. Primary Care Physician Shortage Projections

Association of American Medical Colleges (AAMC). The Complexities of Physician Supply and Demand: Projections From 2021 to 2036. June 2024 Update. https://www.aamc.org/data-reports/workforce/report/physician-shortage

7. Early Retirement & Workforce Attrition

Shanafelt TD, et al. Changes in Burnout and Satisfaction With Work-Life Integration in Physicians and the General US Working Population. Annals of Internal Medicine. 2019. https://www.acpjournals.org/doi/10.7326/M18-2790

8. Advanced Practice Clinician Workforce Growth

U.S. Bureau of Labor Statistics. Occupational Outlook Handbook: Nurse Practitioners and Physician Assistants. 2024–2025 Edition. https://www.bls.gov/ooh/healthcare

9. Administrative Burden Impact on Physician Time

Sinsky C, et al. Allocation of Physician Time in Ambulatory Practice. Annals of Internal Medicine. https://www.acpjournals.org/doi/10.7326/M16-0961

🎧 Recommended For

Physicians considering concierge, hybrid, or DPC models
Practice owners and administrators
Healthcare investors and operators
Policy professionals and analysts
Anyone tracking the future of primary care

📢 Share This Episode

If this episode resonated with you, share it with a colleague who's asking hard questions about sustainability, burnout, or the future of their practice. These conversations shape the next generation of care.

Disclaimer: This podcast is intended for educational and informational purposes only. Nothing discussed in this episode should be construed as medical, legal, financial, tax, or professional advice. The content is not intended to diagnose, treat, cure, or prevent any disease or condition. The views expressed by the host and guests are their own and do not necessarily represent those of any employers, organizations, sponsors, or affiliates. Always seek the advice of qualified professionals regarding individual healthcare or business decisions. Listening to this podcast does not establish a physician-patient, advisor-client, or professional relationship.

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