The annual membership used to start at $25,000. That bought you a doctor who answered your calls, appointments that started on time, and the luxury of not sitting in a waiting room flipping through magazines from 2019. Concierge medicine was explicitly for people with family offices, and the price point kept everyone else out.
That is changing. Practices are now launching with memberships between $2,000 and $5,000 annually, which means this is no longer a question of whether you are wealthy enough. The question is whether you are willing to treat your health like the executive function it actually is. You already pay $250 a month for things that matter less than being able to see a doctor when something feels wrong, and you know it.
What You Actually Get
Here is what you are actually buying. Same-day or next-day appointments, which means when you wake up with a fever and a board meeting in three days, you do not spend the morning calling six offices to see who can fit you in next Thursday. Thirty-minute to hour-long visits instead of the standard seven minutes, which means the doctor has time to ask follow-up questions and you have time to mention the thing you almost forgot to bring up. Direct access to your physician via text or email, which means you are not calling the front desk and waiting two days for a callback that comes during your next meeting. No insurance billing, which means no prior authorizations for the test your doctor already said you need, and no surprise bill three months later because the lab your doctor sent you to was out of network even though the office is in network.
Some practices include comprehensive annual physicals with bloodwork most insurance will not cover until you are symptomatic. Others offer minor procedures in-office that would otherwise require a specialist referral and a six-week wait. The specifics vary, but the structure is the same: you are paying to remove friction from a system that treats your time as if it has no value.
The Math You Have Already Done
You have already done this math in other parts of your life. You pay for TSA PreCheck because twenty minutes in a security line is twenty minutes you do not get back. You pay for the good car service because coordinating ride shares when you are trying to make a flight is a tax on your attention you cannot afford. You pay for someone to manage your schedule because your calendar is the architecture of your life and amateurs are expensive in ways that do not show up on invoices. The logic is identical. The only difference is that we have been conditioned to think healthcare is supposed to be hard to access, and paying to make it easier feels like admitting defeat.
What It Costs When You Wait
But here is what actually happens when you do not have a doctor you can reach. The weird pain you noticed three weeks ago becomes the thing you are finally addressing after it has been going on for three months. The prescription that needs refilling turns into a half-day project of phone tag and pharmacy transfers. The referral you need sits in a queue somewhere while you refresh the patient portal hoping someone has responded. Every one of these inefficiencies costs you time, energy, and the cognitive load of managing a system that was never designed to prioritize your life over its own bureaucracy.
The Actual Calculus
The $3,000 annual membership is less than you spend on the gym you use twice a month, or the subscription services you forgot to cancel, or the handbag you bought because it was on sale and you might need it someday. The question is not whether you can afford it. The question is whether you have decided that being able to address your health without friction is worth prioritizing over things you care about less, and whether you are willing to admit that the healthcare system you have been navigating is not going to fix itself while you wait for it to get better.
What This Actually Is
This is still not accessible to most people, and pretending otherwise would be dishonest. But if you are reading this, you are probably someone who has started to ask whether the thing keeping you in the traditional system is principle or just inertia. The price point has dropped to where this is now a choice you can actually make, and the practices offering it are betting that enough people like you will decide it is worth it.
This is not healthcare getting better. This is you deciding that paying to opt out of a broken system is a better use of resources than continuing to lose hours of your life to a process that does not value your time. Whether that feels like progress or just a more efficient way to stratify access is something you will have to reconcile on your own. But the option is there now, and it is priced for people who are tired of pretending that waiting three months for an appointment is an acceptable cost of participating in the system everyone else uses.
