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Yesterday28 min
Why Nurse Practitioners and Physician Assistants Are Finding Their Place in Concierge and Membership Medicine
The evidence doesn't say nurse practitioners and physician assistants are simply interchangeable with physicians. It says something more specific, and honestly more useful. It says that for the visit types that make up most of what primary care and concierge medicine actually deliver day to day, prevention, chronic disease management, education, relationship, the research consistently finds NP and PA led care landing on par with physician led care, and on the measures patients say they care about most, time and feeling heard, often landing ahead. Sources referenced in this episode Association of American Medical Colleges, physician workforce shortage projections (March 2024). Health Resources and Services Administration workforce projections, as reviewed in Journal of General Internal Medicine (2025). U.S. Bureau of Labor Statistics, Occupational Outlook Handbook, Nurse Practitioners and Physician Assistants entries. Neprash HT, et al., Medical Care (January 2021), EHR-based analysis of primary care visit duration. Swan M, et al., "Quality of Primary Care by Advanced Practice Nurses: A Systematic Review," International Journal for Quality in Health Care (2015). National survey study on NP patient satisfaction outcomes, Nursing Outlook (2019). Nice Healthcare literature summary on nurse practitioner outcomes and patient satisfaction. Health Affairs (2025) national study of concierge and direct primary care practice and clinician growth, 2018-2023. American Association of Nurse Practitioners, State Practice Environment data. American Academy of PAs, "PA Education: Preparation for Excellence." Note: The practice example(s) described in this episode are a composite illustration drawn from patterns commonly reported across the concierge and direct primary care industry, not an account of a specific, verified individual or practice. This article is intended for educational and informational purposes for physicians and healthcare leaders. It does not constitute medical, legal, financial, or accounting advice. Workforce projections and state scope-of-practice laws change over time; readers should confirm current figures with the primary sources cited before relying on them for practice or policy decisions.
5 days ago54 min
(Sneak Preview) CMF 2026 Keynote, Dr. Kyra Bobinet
In this conversation, Dr. Kyra Bobinet and Michael Tetreault sit down to discuss the habenula and its role in motivation and setbacks, why the traditional compliance model works against how the brain actually changes, the Iterative Mindset as an alternative framework for physicians and patients, and how this thinking should shape the physician-patient relationship in concierge and membership-based practices. They also preview Fresh Tri Pro, ahead of Dr. Bobinet's appearance at the Concierge Medicine Forum this October. Dr. Bobinet earned her MD from UCSF and her MPH from Harvard, teaches health behavior change at the Stanford Medicine AIM Lab, and is CEO and founder of Fresh Tri, a clinician-facing behavior-change platform built on the neuroscience of habit formation. She is the author of the bestselling Well-Designed Life and the newly released Unstoppable Brain, and co-developed the Iterative Mindset Inventory with mindset researcher Dr. Jeni Burnette of NC State University. She is an enrolled member of the Leech Lake Band of Ojibwe. The Story Your Patients Keep Telling Themselves (and How to Rewrite It) with Dr. Kyra Bobinet Why do patients who genuinely want to get healthier so often fail to follow through? On this episode of the DocPreneur Leadership Podcast, host Michael Tetreault talks with Kyra Bobinet, MD, MPH, about the "know-do gap" and the neuroscience behind it. This episode is educational and informational. It is not medical, legal, or financial advice. Links: Fresh Tri: https://freshtri.com Iterative Mindset Quiz: https://freshtri.com/iterative-mindset-quiz/ Dr. Kyra Bobinet: https://drkyrabobinet.com Contact Dr. Kyra Bobinet: https://drkyrabobinet.com/contact/ Unstoppable Brain Podcast (YouTube): https://www.youtube.com/@unstoppablebrainpod Fresh Tri on LinkedIn: https://www.linkedin.com/company/freshtri/posts/?feedView=all Fresh Tri on Instagram: https://www.instagram.com/fresh_tri/
5 days ago29 min
Your Patients Aren't One Audience. They're Four.
We didn't stop at finding this pattern once. We checked it against 1,149 patients across the full archive, 416 from the early years of our data (2013 to 2018) and 733 from the recent years (2019 to 2024), asking the exact same question both times: what matters most to you? By Michael Tetreault, Editor-in-Chief, Concierge Medicine Today You know your medicine. Do you really know your practice? Most physicians can explain their care in one sentence. Far fewer can say, honestly, whether their patients trust them, whether their marketing is actually reaching the people it's meant for, or whether someone quietly unhappy is about to leave without ever telling you why. For eleven years, Concierge Medicine Today has been asking the people who matter most: the patients themselves. Why are you searching for a new doctor. Why are you leaving your last one. What matters most to you when you're choosing who to trust with your care. Over seven thousand patient conversations later, collected between 2013 and 2024, a pattern emerged that we didn't expect, and it's reshaping how we think this industry should market, welcome, and retain the patients it serves. Concierge and membership medicine patients aren't one audience. They're four (LEARN MORE). The Two Questions That Actually Matter We tested a long list of variables against the data: age, income signals, geography, how patients found us, even how much they cared about the physical office space. Almost none of it mattered as much as we assumed. Hospitality and service, for instance, turned out to matter to nearly everyone, which means it isn't a dividing line at all. It's table stakes. Two questions, and only two, consistently separated patients into meaningfully different groups: How do they already feel about their current doctor? Happy, or ready for something new? What do they want from insurance? Do they want their next doctor to still work with insurance and Medicare, or do they want independence from that system entirely? Plot patients on those two questions, and four distinct groups appear, drawn from 561 patients who answered every question behind this model. The Four Types Level-Uppers, 29% of patients. These patients trust and like their current doctor (4.23 and 4.19 out of 5) but still want full independence from insurance (2.21 out of 5). They aren't fleeing a bad relationship. They're confidently reaching for something better before anything breaks. This group skews Baby Boomer and Gen X, with a meaningful Millennial presence, the youngest-skewing of the four. Coverage Keepers, 27% of patients. The most loyal group in the data, with trust and like scores of 4.38 and 4.40, and the single highest insurance-importance score of any group we measured, 4.67. They aren't leaving anyone. They want the concierge experience added to a relationship they already trust, not traded away for it. The oldest-skewing group, heavily Baby Boomer. Fresh-Starters, 27% of patients. Low trust and connection with their current doctor (2.65 and 2.56) and little interest in insurance compatibility (2.34). They're done compromising with the relationship and the system at the same time. This group spans every generation fairly evenly, and they are the most likely of the four to say, in their own words, that they're leaving because they feel like a number. Careful Movers, 16% of patients, the smallest group. Unhappy with their current doctor (2.60 and 2.60) but still needing Medicare or insurance to work, 4.64, nearly the highest score in the entire dataset. This is a patient solving two problems at once: a doctor who isn't working, and a financial reality that has to keep working. That's a harder position than any other group faces, which is likely why they tend to be the most time-pressured to find a fit. Ten Years of Proof, Not a Guess We didn't stop at finding this pattern once. We checked it against 1,149 patients across the full archive, 416 from the early years of our data (2013 to 2018) and 733 from the recent years (2019 to 2024), asking the exact same question both times: what matters most to you? The answer: 74.3% in the early years. 74.5% in the recent years. Virtually unchanged. For eleven straight years, roughly three out of every four patients who came looking for a concierge or membership doctor were looking for a relationship first, not a perk, not a discount. That wa
2 weeks ago42 min
The Lexus Lesson for DPC: You Can't Discount Your Way to a Full Panel
Toyota didn't beat Mercedes by getting cheaper. It beat Mercedes by getting closer to the customer first. Here's the six-year research obsession behind the Lexus LS 400, and why undercutting your way to a full panel is a strategy that has already failed in a dozen other industries, and what Harvard's own pricing research says to do instead. By Michael Tetreault, Editor-In-Chief, Concierge Medicine Today "I'm a car guy, so bear with me on this one. There will be some good points [in this article], I promise. I know enough about engines to self-diagnose and wrench on them myself. Driving an old car with lifter problems through North Dakota and southern Canada in the '90s will teach you that." ~Michael Tetreault Today's article isn't about concierge medicine directly. It's about a distant cousin in the subscription-based healthcare world, direct primary care, or DPC. Over the past two decades, I've noticed more and more that there is a moment almost every DPC or low-cost, membership-based practice hits around year two or three, when the patient panel quietly stalls (catch the car pun). Growth that used to feel automatic starts to flatten out, and you notice it before you can quite explain it. That's usually right about when a competitor down the road launches at $59 to $93 a month, and a quiet voice in your head says: just drop the price. Fill the seats. Worry about margin later. That instinct is understandable. It is also, according to decades of business research and a growing body of data inside concierge and membership medicine itself, one of the fastest ways to damage the very practice you built to serve patients better. This is not a scolding. It is a strategy conversation, grounded in evidence, for low-cost subscription-based physicians who left, or are considering leaving, the insurance-driven system specifically to build something sustainable that has a low cost for the patients because you feel your altruistic nature pulling you to do so. But, if the goal is sustainability, the tactic matters. What "racing to the bottom" actually means Let's zoom out for a moment. A price war is what happens when competitors inside the same market repeatedly cut prices to undercut one another, creating a cycle where each side matches or beats the last cut. This "price-cutting momentum" pulls in competitors who feel forced to follow the initial price cut, and while it can create short-term benefits for the buyer, it erodes the profit margins of everyone competing. Harvard Business School researchers Akshay Rao and Mark Bergen, writing in Harvard Business Review, built a career studying exactly this dynamic across industries. Their conclusion, echoed by strategists since, is blunt: most price wars are avoidable, and the businesses that start them or get pulled into them rarely come out ahead. The Kinsta business blog, summarizing HBR's own internal analysis of the question, put it plainly: when businesses were asked whether they should engage in a price war, the overwhelming answer was "no." Instead, the research points toward differentiation as the more durable response to a low-cost competitor. There is a second, quieter finding in that same research that some physicians should sit with. Price itself shapes how a buyer perceives value, and a price set too low signals that the product is cheap, in the way a price set too high can signal it is a ripoff. In other words, the discount that was supposed to win the patient can be the very thing that tells the patient your care is not worth much. It's indeed, a delicate balance and it's different for every practice and every doctor. Why? Because of who you work for and serve: the patient. Every patient is different. Every practice is different. That makes this topic challenging but it's a conversation worth having because I want to see your practice thrive and more importantly, survive in your community. The framework underneath the instinct <img class= "alignright size-medium wp-image-100680" style="float: right;" src= "https://conciergemedicinetoday.org/wp-content/uploads/2026/02/shop-concierge-medicine-books-reviewed-library-14-300x300.png" alt= "Dire
3 weeks ago58 min
She Named Her Practice After Her Son. Then Built It Around Everyone Else's.
She left academic medicine to build the practice her own family needed. Here's how, and why. Dr. Priyanka Chopra spent years as an academic hospitalist watching a fragmented healthcare system fail the people who needed it most, including, eventually, her own family. That experience became the reason she left. Alongside her husband, she founded Nivaan Health, a mobile, in-home concierge practice in Miami built on a simple premise: patients deserve time, trust, and genuine care, not rushed visits and disconnected specialists. In this episode, Dr. Chopra talks with Michael Tetreault about what it actually took to make the leap: the role her spouse played as both partner and support system, how she's used AI to handle the operational and branding work most physicians never trained for, and why she measures success by restored patient functionality rather than traditional volume metrics. It's a candid look at what "unreasonable hospitality" means in practice, and a practical guide for any physician quietly wondering if there's a better way to build a career in medicine. Learn more about Nivaan Health: https://nivaan.health/our-story
4 weeks ago31 min
What GLP-1 marketing built that most concierge practices haven't.
"Patients have already told the market what they're willing to pay for a health outcome," CMT Editor-in-Chief Michael Tetreault said in an interview for this article. "A GLP-1 subscription and a concierge medicine membership now cost about the same, roughly $3,000 a year. The question isn't whether patients will invest in their health. It's who earns that investment." By Editorial Staff, Concierge Medicine Today, August 2026 (See full list of citations and sources and disclaimers at end of article) Please note, this is market and editorial analysis, not medical, legal, financial, or accounting advice, and it does not evaluate the clinical merits of GLP-1 medications, which is a conversation between a patient and their physician. Concierge medicine is not, and should never be marketed as, a treatment alternative to any prescription medication, including GLP-1s. That distinction matters enough that we're stating it plainly here, before we go any further, and readers should keep it in mind throughout. That said, let's unpack the topic. FULL ARTICLE: https://conciergemedicinetoday.org/2026/08/24/what-glp-1-marketing-reveals-about-concierge-medicines-opportunity/ A patient on a compounded GLP-1 and a patient enrolled in a concierge medicine practice are now spending almost exactly the same amount each year. Roughly $3,000. We put the real numbers next to each other: GLP-1 telehealth pricing, our own 2026 concierge medicine benchmark survey, direct primary care spend, urgent care, etc. The overlap doesn't stop at price. The age group spending the most on GLP-1s, 50 to 64, is also the core of the concierge medicine patient base. Patients have already decided they'll pay out of pocket for a health outcome. That part isn't up for debate anymore. What's still open is who earns that trust, and why. To be clear about what we're saying and what we're not: concierge medicine is not a substitute for any medication a patient and their physician decide is right for them. What it can be is the unhurried relationship where that conversation actually happens, something a fifteen-minute visit rarely allows. Full research, sourcing, and what this means for how practices market themselves are in the article. Disclaimer: This article is for informational and editorial purposes. It does not constitute medical, legal, financial, or accounting advice, and it takes no position on the clinical use, safety, or efficacy of GLP-1 medications or any other prescription treatment. Concierge medicine as described here, is a healthcare membership business model. It is not a treatment, and it should not be marketed or described as an alternative or substitute for any medication a patient and their physician have determined is appropriate. Physicians and practices using any messaging from this article in their own marketing are responsible for ensuring compliance with FTC truth-in-advertising standards and their state medical board's advertising rules, including avoiding any claim, direct or implied, that concierge membership treats, replaces, or competes with a specific medication or clinical intervention. Figures labeled as estimates reflect Concierge Medicine Today's own analysis of published per-unit data and are identified as such throughout. Readers should consult a licensed physician, attorney, or financial advisor for guidance specific to their situation. Sources glpchart.com. "GLP-1 Telehealth Price Report 2026." 2026. GLP-1 Telemedicine. "The Real Cost of Telehealth GLP-1 Programs in 2026: Subscription Fees, Hidden Charges, and What You're Actually Paying For." 2026. Chronos Body Health & Wellness. "The Real Cost of GLP-1 Weight Loss Medications in 2026: What You Should Know Before You Start." April 14, 2026. Concierge Medicine Today. 2026 Industry Pricing Benchmark. 2026. (cited via Concierge MD Finder, "How Concierge Medicine Pricing Works in 2026: A Real Cost Breakdown," May 30, 2026) Connectedly Health. "DPC Pricing Index by State (2026): Direct Primary Care Costs." February 15, 2026. Medical Economics. "Five surprising findings about the state of direct primary care," citing the Direct Primary Care Alliance 2026 physician survey. 2026. Mira Health (talktomira.com). "Urgent Care Visit Cost With and Without Insurance (2026 Update)." July 8, 2026. ClinicAds. "Telehealth Marketing in 2026: The Complete Guide to Compliant, Profitable Patient Acquisition." July 17, 2026. EMARKETER. "GLP-1 drugs dominate prescription TV ad spend," citing iSpot.tv data. 2025. EMARKETER. "Pharma linear TV ad decline in H1 driven by steep GLP-1 spending cuts." July 16, 2026.</
Aug 17, 202654 min
Unstoppable: Dr. Kyra Bobinet on the Brain, Failure, and Falling in Love with Trying Again
How Are You Iterating? Dr. Kyra Bobinet on the Brain Science of Behavior Change Why do patients who genuinely want to get healthier so often fail to follow through? On this episode of the DocPreneur Leadership Podcast, host Michael Tetreault talks with Kyra Bobinet, MD, MPH, about the "know-do gap" and the neuroscience behind it. Dr. Bobinet earned her MD from UCSF and her MPH from Harvard, teaches health behavior change at the Stanford Medicine AIM Lab, and is CEO and founder of Fresh Tri, a clinician-facing behavior-change platform built on the neuroscience of habit formation. She is the author of the bestselling Well-Designed Life and the newly released Unstoppable Brain, and co-developed the Iterative Mindset Inventory with mindset researcher Dr. Jeni Burnette of NC State University. She is an enrolled member of the Leech Lake Band of Ojibwe. In this conversation, Dr. Bobinet and Michael discuss the habenula and its role in motivation and setbacks, why the traditional compliance model works against how the brain actually changes, the Iterative Mindset as an alternative framework for physicians and patients, and how this thinking should shape the physician-patient relationship in concierge and membership-based practices. They also preview Fresh Tri Pro, ahead of Dr. Bobinet's appearance at the Concierge Medicine Forum this October. This episode is educational and informational. It is not medical, legal, or financial advice. Links: Fresh Tri: https://freshtri.com Iterative Mindset Quiz: https://freshtri.com/iterative-mindset-quiz/ Dr. Kyra Bobinet: https://drkyrabobinet.com Contact Dr. Kyra Bobinet: https://drkyrabobinet.com/contact/ Unstoppable Brain Podcast (YouTube): https://www.youtube.com/@unstoppablebrainpod Fresh Tri on LinkedIn: https://www.linkedin.com/company/freshtri/posts/?feedView=all Fresh Tri on Instagram: https://www.instagram.com/fresh_tri/
Aug 7, 20261h 0m
A New Category in Cancer Care, Built by the People Who Saw It Fail
Moving Cancer Upstream: Dr. Jose Barreau on Prevention, Prime Time, and the Fight to Detect Cancer Earlier Dr. Jose Barreau spent decades on the wrong side of a timeline every oncologist knows too well, treating cancer after it was found, often at a stage when the window for real intervention had already closed. That experience became the founding premise behind PreOncology, the company he built to move cancer care upstream from treatment to prevention. Barreau's work recently reached a much bigger audience. He's featured in The Chase: Inside the Race to Cure Cancer, a documentary now streaming on Amazon Prime Video that follows real patient experiences and the healthcare teams navigating one of life's hardest journeys. In this conversation, we talk about what it was like being part of that project, why the film's message about early detection lines up so closely with PreOncology's mission, and what he wants viewers to take away from it. We also get into the founding story behind PreOncology itself: why conventional screening was never built for the individual, why the technology to detect cancer earlier already exists but has never been properly integrated, and how an oncologist-led model is trying to close that gap. Barreau also shares lessons from his earlier work founding Doc Halo and Halo Health, healthcare communication platforms used by over 300,000 physicians nationwide. Dr. Barreau will be speaking live at the 2026 Concierge Medicine Forum this October in Atlanta, GA, where he'll go deeper into what personalized cancer surveillance actually looks like in practice. If this conversation resonates, that session is one worth planning your schedule around. Learn more about Dr. Barreau and PreOncology: https://preoncology.com/our-story/ Watch The Chase: Inside the Race to Cure Cancer on Amazon Prime Video. This episode is educational and informational. Nothing discussed should be considered medical advice.

About The DocPreneur Leadership Podcast

Concierge Medicine Today's "DocPreneur Leadership Podcast" has become a trusted voice and is a recorded history of membership medicine in all it's various forms. From Concierge Medicine to Direct Primary Care (DPC) and everything in between it unpacks unique entrepreneurial insights in healthcare ranging from hospitality in healthcare from a patient perspective to interviewing healthcare leaders, Physicians, PAs, NPs, insurance and payor connections, attorneys, interior designers and more. This Podcast Is Recorded, Produced and Hosted by Concierge Medicine Today, LLC. Concierge Medicine Today, LLC is the industry trade publication reporting and highlighting news, trends and happenings in the Concierge Medicine space. Each year they host the industry's largest medical conference. To learn more, visit: www.ConciergeMedicineToday.net. Topics include but are not limited to: Precision Medicine; Concierge Medicine; Whole Genome Sequencing; Pharacogenomics; Membership Medicine; Direct Pri

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Latest Episodes

Why Nurse Practitioners and Physician Assistants Are Finding Their Place in Concierge and Membership Medicine

(Sneak Preview) CMF 2026 Keynote, Dr. Kyra Bobinet

Your Patients Aren't One Audience. They're Four.

The Lexus Lesson for DPC: You Can't Discount Your Way to a Full Panel

She Named Her Practice After Her Son. Then Built It Around Everyone Else's.

What GLP-1 marketing built that most concierge practices haven't.

Unstoppable: Dr. Kyra Bobinet on the Brain, Failure, and Falling in Love with Trying Again

A New Category in Cancer Care, Built by the People Who Saw It Fail