Concierge Specialty Care: When Concierge Medicine Goes Beyond Primary Care

Seeing a specialist in America now takes weeks. A new cardiology patient waits an average of 33 days for an appointment.

That is 74 percent longer than in 2004. In Washington, D.C., the cardiology wait has reached 175 days.[1] Across all six physician specialties in the same survey, from family medicine to dermatology to cardiology, the average wait is 31 days.[1]

Concierge medicine was built to fix this problem. You pay a membership fee. Your doctor keeps a small patient list. In return, you get long appointments, same-day access, and a doctor who answers.

For twenty years, that model stayed almost entirely inside primary care. When people said "concierge doctor," they meant an internist or a family physician. That is changing. The membership model is moving into the specialties, and it is bringing the same trade with it: pay a fee, skip the wait, keep the doctor.

Concierge Care Now Goes Beyond Primary Care

The evidence for the shift comes from every direction at once.

• The physician press is documenting it. A February 2026 NEJM CareerCenter report found the concierge model showing up across cardiology, endocrinology, gastroenterology, oncology, dermatology, gynecology, and, most recently, emergency medicine.[2]

• The specialists are already a quarter of the market. Concierge Medicine Today counts 8,000 to 12,000 concierge and membership practices nationwide, and its editor estimates at least a quarter of concierge physicians are now specialists. Concierge and membership practice sites grew 83.1 percent from 2018 to 2023.[3]

• The biggest network is expanding into it. MDVIP, the largest concierge company in the country with 450,000 members and 1,400 physicians, is piloting concierge cardiology and endocrinology right now, and its CEO says pediatrics is on the list.[4]

• The market data tracks it. Grand View Research values the U.S. concierge medicine market at $7.35 billion in 2024, projects $13.23 billion by 2030, and already breaks out cardiology and pediatrics as their own segments.[5]

The reasons are the same ones that created concierge primary care. Waits keep growing, as the numbers above show. Specialty care for chronic conditions is relationship work, years of small adjustments that do not fit a rushed visit. And the economics attract physicians: concierge doctors see 6 to 8 patients a day, an 80 to 90 percent reduction in volume, without earning less.[5]

So the question for patients is no longer whether membership medicine exists outside primary care. It is what each specialty version offers, what it costs, and whether it is worth it. That is the rest of this guide.

How Specialty Membership Medicine Works

The mechanics are the same in every specialty. You pay a retainer fee, monthly or annual, directly to the practice. The practice keeps its patient list small. The specialist gets time back, and you get access.

Here is the part most patients ask about first: you keep your health insurance. Most specialty concierge programs are hybrids. The membership fee buys access and time. Office visits, imaging, and procedures are still billed to your insurance or Medicare, the same as before.[6][7]

Two of the models below work differently. Destination surgery practices and membership emergency rooms are cash-pay. More on each in its section.

Concierge Orthopedics

Surgeons use the word concierge differently. There is usually no membership fee. Instead, the practice wraps high-touch service around a cash-pay operation.

Dr. John Peloza, a board-certified orthopedic spine surgeon in Chesterfield, Missouri, runs PelozaSpine this way. His practice is out-of-network and self-pay. A concierge team books travel, hotels, and pre- and post-surgery appointments, because many of his patients fly in from other states.[12] On the Becker's Healthcare Podcast this week, he described the growth of concierge spine care and the shift toward doing complex procedures in ambulatory surgery centers, which are free-standing facilities for same-day surgery.[13]

What this means for your wallet: you pay per procedure, not per year. Your out-of-network insurance benefits may cover part of it.

Concierge Cardiology

The 33-day wait covered above is only half of the access problem in heart care. The other half is geography.

• 1,454 U.S. counties have no cardiologist at all. 22 million people live in them, and the average round trip to reach a cardiologist from those counties is 87 miles.[8]

• Heart disease is the leading cause of death in America. Cardiovascular disease killed 919,032 people in 2023, one every 34 seconds.[9]

• The federal Million Hearts program calls that toll largely preventable.[10]

A concierge cardiologist sells a way around the wait. Ambulatory Cardiovascular Center in West Orange, New Jersey shows what the membership typically includes. Dr. Christoph Sossou, a board-certified cardiologist, offers members:[6]

• 60-minute new patient visits and 30-minute follow-ups

• Same-day or next-day sick visits

• His personal cell number for after-hours calls

• EKGs, echocardiograms, and stress tests done in the office

• Hospital advocacy. If you are admitted somewhere he has privileges, he manages your care himself.

His practice states the goal plainly: the best heart attack is the one that never happens.[6]

Ameli | Dadourian Medicine in Las Vegas runs cardiology inside a multi-specialty concierge practice. Its two board-certified cardiologists, Dr. Sean Ameli and Dr. Berge Dadourian, focus on prevention: coronary calcium scoring, advanced cholesterol testing, echocardiograms, and heart rhythm monitoring, with 24-hour access to a physician.[7]

Cardiology is growing fast by concierge standards. In 2015, a trade publication could find about 25 concierge cardiologists in the entire country.[11] By 2024, cardiology made up 8 percent of all concierge physicians, more than nephrology and pediatrics combined.[3]

The reason is the nature of the work. Managing blood pressure, cholesterol, arrhythmias, and heart failure takes years of small adjustments. That work does not fit in a 15-minute visit.

Membership Emergency Care

Sollis Health runs private emergency rooms in New York, California, and South Florida. A member can walk in at 2 a.m., see an emergency-trained physician in minutes, and get labs and imaging on site.

The membership starts at $4,000 a year for members under 45 and $7,000 at 45 and over. A Platinum tier runs $12,000.[14] More than 17,000 members pay for it.

You still need insurance. Sollis handles the urgent visit. Hospitalization and surgery stay on your health plan.

Concierge Pediatrics

Pediatrics is earlier in the shift, but the signals are clear.

• Sollis sells a pediatric membership in Southern California starting at $6,000 a year, and recently added pediatric immediate care to its specialty mix.[2][14]

• Pediatricians were 3 percent of concierge physicians in the 2024 poll.[3]

• MDVIP's CEO Larry Kutscher, asked in June 2026 where the network goes next: "Pediatrics is on our list. We've not done it yet."[4]

If you are weighing a membership pediatrician now, our parent's guide to concierge and direct primary care (DPC) for kids covers how the model works for families, including what stays on insurance.

Endocrinology, Rheumatology, Women's Health, and Oncology

The same model is reaching the other specialties built on long-term relationships. The NEJM CareerCenter report names working examples:[2]

• The Endocrine Center in Fairfax, Virginia, run by endocrinologist Dr. Denise Armellini

• Pacific Rheumatology Associates in San Francisco, where Dr. Molly Magnano runs a hybrid concierge model

• Ms. Medicine, a women's health network founded by Dr. Lisa Larkin, with more than 6,000 concierge patients

The same report lists oncology, gastroenterology, and dermatology as specialties where the model is appearing next.[2] MDVIP's endocrinology pilot points the same way.[4]

These conditions share one trait with heart disease. They are managed over years, not single visits. If you live with diabetes, hypertension, or heart disease, our guide to concierge medicine for chronic conditions covers what that long-term management looks like.

Hospitals Are Building Their Own

Health systems see the same demand. Atria Health Institute in New York staffs 65 specialists across 18 specialties and caps each internist at 150 patients.[2] Atrium Health, Texas A&M, and Cleveland Clinic have built concierge or premium-access programs of their own.[2] Cleveland Clinic's Executive Health program sells multi-day physicals with priority access to more than 120 of its specialists.[15]

What Concierge Specialty Care Costs

Specialty concierge pricing is less standardized than primary care, but the ranges are consistent.

In the hybrid model most specialists use, about 5 to 10 percent of an existing patient panel opts into the concierge tier. Historically that has cost $150 to $200 per month, while the practice keeps billing Medicare and insurance for the medical care itself.[11] Practices on NextMD that list cardiology and publish a fee commonly charge $200 to $350 per month (NextMD directory data).

Call it $2,000 to $4,000 a year. For comparison, concierge primary care memberships on NextMD start around $3,000 a year and run to over $40,000 at the ultra-premium end. A specialty membership is priced like entry-level concierge, for a specialist.

Fee ranges: hybrid per Cardiovascular Business and NextMD directory data;[11] primary care per NextMD directory data; Sollis per its published pricing.[14]

Five Questions to Ask Before You Pay

A specialty membership stacks on top of insurance you still need. These five questions separate a good program from an expensive one.

1. Is the physician a board-certified MD or DO? Every practice listed on NextMD is physician-led. For a specialty membership, check board certification in that specialty, plus subspecialty training where it matters, such as interventional cardiology or heart failure.

2. What does the fee actually cover? Get the split in writing: what is included in the membership, and what gets billed to insurance, Medicare, or you.[6] A good practice answers this on the first call.

3. How big is the panel? The whole value is time and access. Ask how many members the doctor carries, and what same-day access means at 7 p.m. on a Friday.

4. What happens if I end up in the hospital? Some concierge specialists follow you in, the way Dr. Sossou commits to.[6] Others hand off. Know which one you are buying.

5. Does it coordinate with my primary care doctor? A concierge specialist covers one system of the body. You still need a primary care physician who owns the whole picture and catches the problems that fall between specialties.

FAQ

What is concierge specialty care?

Concierge specialty care is a membership with a specialist instead of a primary care doctor. You pay a recurring fee to a cardiologist, endocrinologist, or other specialist. In return you get a small patient panel, long appointments, same-day access, and a direct line to the doctor. Visits and tests are still billed to your insurance.

Which specialties offer concierge memberships?

Cardiology has the most, at 8 percent of concierge physicians in a 2024 poll. Endocrinology, rheumatology, gastroenterology, women's health, oncology, dermatology, and pediatrics all have working concierge practices. Sollis Health covers emergency care, and MDVIP is piloting cardiology and endocrinology across its network.

How much does concierge cardiology cost?

Hybrid concierge cardiology has historically run $150 to $200 per month. Cardiology memberships listed on NextMD commonly run $200 to $350 per month. That is $2,000 to $4,000 a year, similar to entry-level concierge primary care.

Does insurance cover concierge specialty care?

Insurance does not pay the membership fee. Most concierge specialists stay in Medicare and insurance networks, so visits, imaging, and procedures still go through your plan. You keep your insurance for hospitalization, surgery, and everything outside the practice.

Do I still need a primary care doctor if I have a concierge specialist?

Yes. A concierge specialist manages one category of problems. A primary care doctor manages everything else and coordinates the whole picture. Many patients pair a concierge or DPC doctor with a specialty membership.

Specialty care rewards speed and attention, and the standard system is running short on both. If direct access to a physician matters to you, you can search physician-led concierge and DPC practices by city and specialty, compare published pricing, and view doctor credentials at nextmd.ai/search.

Sources

1. HealthLeaders Media. (2025). Survey: Physician Wait Times Surge 19% Since 2022. Reporting on AMN Healthcare's 2025 Survey of Physician Appointment Wait Times. Read on HealthLeaders

2. NEJM CareerCenter Resources. (2026, February 17). Concierge Medicine Making Inroads in the Specialties. Read on NEJM CareerCenter

3. Concierge Medicine Today. (2026). Media Desk: Industry Statistics (2024 physician poll; practice-site growth citing Adashi et al., Health Affairs 2025). Read the CMT media desk

4. Managed Healthcare Executive. (2026, June 25). Conversations with Perry and Friends: Larry Kutscher, MBA, CEO and Board Director, MDVIP. Read the interview

5. Grand View Research. (2025). U.S. Concierge Medicine Market Size, Share & Trends Analysis Report, 2025-2030. Read the market report

6. Ambulatory Cardiovascular Center. (2026). Concierge Cardiology. Read the practice's concierge cardiology page

7. Ameli | Dadourian Medicine. (2026). Cardiology, Concierge Medicine Services. Read the practice's cardiology page

8. American College of Cardiology. (2024, July 8). Almost Half of US Counties Have No Cardiologists Despite Higher Prevalence of CV Risk Factors, Mortality. Press release on the JACC study. Read the ACC release

9. Centers for Disease Control and Prevention. (2025). Heart Disease Facts. Read CDC heart disease facts

10. Million Hearts, U.S. Department of Health and Human Services. (2026). About Million Hearts. Read about Million Hearts

11. Cardiovascular Business. (2018, January 18). Call of Concierge: Still a Niche in Cardiology, But Growing. Read on Cardiovascular Business

12. PelozaSpine. (2026). John Peloza, M.D., Spine Surgeon, Chesterfield / St. Louis, MO. Visit PelozaSpine

13. Becker's Healthcare Podcast. (2026, July 2). Building a Patient-First Spine Practice Outside Traditional Models with Dr. John Peloza. Listen on Apple Podcasts

14. Sollis Health. (2026). Membership, Frequently Asked Questions, and Sollis Pediatrics. Sollis membership overview, Sollis FAQ, and Sollis Pediatrics

15. Cleveland Clinic. (2026). Executive Health Program. Read about Cleveland Clinic Executive Health

Source Attribution

• Inspired by: the 2026-07-02 weekly scan (Peloza Becker's episode + MDVIP specialty-expansion interview), practice primary sites (Ambulatory Cardiovascular Center, Ameli Heart Center, PelozaSpine, Sollis Health), NEJM CareerCenter, Grand View Research, Concierge Medicine Today

• Medical claims verified against: cited external sources above; canonical concierge/DPC pricing and panel numbers per pricing-tiers-and-model-comparison and panel-size-standards

Review Notes

• Opening rebuilt 2026-07-02 per Josh (4th note): the lede now starts with the specialty wait (cardiology 33 days / 175-day D.C. extreme), not the generic 31-day average, since the piece is about specialties; the 31-day figure stays as cross-specialty context ("all six physician specialties in the same survey"). Cardiology section pivots to the geography stats to avoid repeating the wait numbers.

• Restructured + rewritten 2026-07-02 per Josh (two notes): (1) "horribly written, nearly unreadable" → full prose rewrite mirroring the published NextMD voice, calibrated against the live chronic-conditions post: short declarative sentences, one idea per sentence, stat bullets instead of stat-packed paragraphs, bold lead-in lists. (2) "should be about how concierge care goes beyond primary care, then the specialties" → new thesis section ("Concierge Care Now Goes Beyond Primary Care") right after the intro, stacking the trend evidence (NEJM breadth, CMT quarter-are-specialists + 83.1% growth, MDVIP pilots, Grand View market data, and the three drivers) BEFORE the specialty-by-specialty tour. Citations renumbered to match the new order of first appearance. Same facts, sources, and links; no new claims.

• Framing decision: PelozaSpine has no membership fee; per its own site it is an out-of-network, self-pay destination practice with a travel-concierge team. The draft says so explicitly. The "concierge spine care" phrase comes from Dr. Peloza's own Becker's episode description.

• Cut per research verification: the "80% of heart disease is preventable" figure (no primary CDC/AHA page loaded carries it), replaced with Million Hearts' "largely preventable" language. Cardiology's 8% poll share stated as "more than nephrology and pediatrics combined" (osteopathic medicine polls higher, so no "largest specialty" claim).

• Pricing: ACC West Orange and Ameli|Dadourian do not publish fees, so the cost section uses the Cardiovascular Business hybrid range + NextMD directory data ($200-$350/month) without attributing a fee to either named practice. Endocrine Center / Pacific Rheumatology / Ms. Medicine facts are cited to NEJM CareerCenter (their sites were not independently loaded).

• MDVIP member count: used 450,000 (CEO's own June 2026 figure) over CMT's older "430,000+".

• Internal links (6): ambulatory-cardiovascular-center + ameli-dadourian-medicine + sollis-health-fifth-avenue-center practices, las-vegas-nv city, chronic-conditions + pediatrician-guide blogs.