What Is a Concierge Doctor? A Cardiologist Who Switched Explains

You know the routine. You book the appointment, you sit in a waiting room full of people who also do not feel well, and when your name is called the doctor has a few minutes and one eye on the clock. You leave with a prescription and most of the questions you walked in with.

So you start asking: what is a concierge doctor, and are the people who have one getting better care or only a shorter wait?

Two Live Well and Thrive episodes answer from the inside. In episode 40, Mike Torchia sat down with Dr. Ilan Kedan, a Beverly Hills cardiologist who left an insurance-based job to run a concierge practice. In episode 109, Dr. Eli Gabayan and his associate Hana Ayoub of Beverly Hills Concierge Medicine described how a membership works. This post puts the two together: what the model is, what it changes about a visit, what a membership includes, and how to judge whether it is worth it. Neither episode names a price, so this post does not either.

What is a concierge doctor? A physician who left volume medicine

Dr. Kedan did not start out this way. He told Mike he spent the first 17 and a half years of his career as an employed physician.

I worked for a company, and the company essentially dictated who I saw, and it was all insurance-based.

He called that the standard way of doing it. Then he wanted a change, for reasons he summed up as life and lifestyle, and today his practice is, in his words, 100 percent concierge.

His account of the difference is arithmetic. In a volume-based business, he said, you have to do volume, and volume requires less time with each patient to make up the margin. That is the regular-doctor visit you already know. The short appointment is how the model pays for itself. A concierge doctor, as he describes his own practice, is a physician who no longer has a limited time slot for a patient encounter.

So if you are asking what is concierge medicine, the working answer from these two episodes is a practice that is not built on insurance volume and gives the time back to the patient. Dr. Kedan is a concierge cardiologist, one specialist working that way. Dr. Gabayan’s center is the larger version: a group of physicians behind one membership. Some people call the same arrangement a private doctor.

A first visit runs at least an hour, and the doctor comes to you

Mike asked the practical question. If someone is a first-time patient who wants a general scan, how long is the consult? The answer was a minimum of one hour.

We go through everything head to toe, and if it takes longer, it takes longer.

The second change is where it happens. Mike introduced Dr. Kedan as a cardiologist who comes to people’s homes and offices, and the tool that makes that possible fits in a pocket: a handheld wireless ultrasound that displays on a smartphone. Dr. Kedan said a pocket-sized device became commercially available in 2011, that he has scanned every patient since, and that he is now 40,000 exams in. He starts with the heart, and because the stomach, pancreas, liver and gallbladder sit right next to it, he taught himself what normal and abnormal look like there too. What that scan can and cannot show about your arteries is covered in the post on signs of heart problems, along with Mike’s own reason for wanting the doctor in the room when an image is read.

Mike named the third change himself: privacy. His own clients want the convenience, he said, and they also do not want to sit in a room with 10 to 15 other people when they are not feeling well. A doctor who comes to you removes the waiting room entirely.

Your images go home with you, and the next scan has a baseline

In the old setup Dr. Kedan trained on, the pictures lived on a tape in a hospital. Now they are files.

They’re digital images that I can capture and I can store and I can share with patients. They could take it with them.

Mike asked whether they can be emailed. They can be emailed, AirDropped or sent by text, he said. That sounds like a small convenience. Dr. Kedan made it the center of how he works.

Most people who see a heart doctor already have a diagnosis, he explained, and the job from there is managing a chronic condition over time. His point was that when you treat people, the images change. Store the earlier scan, compare it with the new one, and you can see whether the treatment is doing anything. He compared it to the gym, where you measure a 400-meter session or the weight on the bar instead of guessing whether you are stronger.

This is what the extra time buys, and it is a large part of the answer to what is a concierge doctor. A doctor with an hour can scan you, show you the picture and keep it for next time. A doctor on a volume schedule orders the test somewhere else and reads the report later.

What a concierge medicine membership buys

The second episode shows the model at the scale of a whole center. Mike opened it by describing medical services available 24/7 and a doctor who will come to your home. Dr. Gabayan told him the concierge service has been running for a few years and keeps expanding into more services for its patients.

Mike asked the question a parent would ask. Say it is a husband, a wife and three kids, and they no longer want to book a separate appointment for every sore throat. Can a family take an annual membership? Yes, Hana Ayoub said, and the center has a pediatric concierge physician on staff, so the children are covered under the same plan as the adults.

Then the mechanics, which are less tidy than a brochure would make them. There are different tiers of membership. Some services are included and some are not. For the ones that are not, such as a house call, someone coming out to do testing, or a place near the front of the line for imaging, Hana said a member gets better rates. And one person stays on your case.

There’s always a handler with you the entire time, in the entire process.

Virtual consults are part of it as well. Mike asked whether a patient who cannot come in can do a consult over FaceTime, and the answer was yes, including for international patients in China and Saudi Arabia. Members can also book outside normal hours. Hana described the after-hours work as cash pay, and said the center takes most insurance for some testing when there is a physician’s order, so call first. No dollar figure came up anywhere in the conversation. The lab, the imaging and the argument for testing early are in the precision medicine post.

Is concierge medicine worth it? Start with the Sunday-night call

Mike made the case in one picture. A father with three kids knows that if his wife or his son needs something, he can call on a Sunday night and get a physician on FaceTime. If a child has a 104 temperature, a nurse practitioner can come to the house and judge whether this is a hospital visit. Ask a member what is a concierge doctor and this is the answer you will get. You are paying to have a medical professional within reach when the office is closed.

He also said what most of those calls turn out to be.

A lot of times people just need someone to say you’re going to be okay.

In his experience arranging doctors for clients, many of the urgent requests were people having a panic attack who believed it was a heart attack. Hana added that sometimes it is indigestion. Mike’s point was that the caller does not know the difference, so a professional has to evaluate what is going on, and Hana said her team can bring an EKG to the home. The person on the couch cannot tell. One sentence of general context, not from the episode: chest pain or trouble breathing is a call to emergency services, with or without a membership.

Dr. Kedan’s version of the answer is quieter. He spends a lot of time with people, he said, and he called that the beauty of a concierge practice.

Now the other side of the ledger. Neither physician quoted a fee. Neither claimed that concierge patients live longer. Mike said plainly that a practice like Dr. Kedan’s suits people who are not relying on insurance to cover it. So the test is yours to run. Count what waiting costs you now, in weeks before a scan and in questions you never got to ask. Count how often you would use a doctor who answers. If the answer is rarely, a membership you do not use is only a bill.

Mike runs a concierge model too, and the medical side is not his

Mike told Dr. Kedan on the show that he has a concierge service himself, and his old tagline for it still describes the idea: “Private services for the very public person.” He calls himself the concierge of health and fitness. Behind that phrase is a team: trainers, chefs who travel, chiropractors and massage therapists, because one man cannot be everywhere his clients are.

The line he draws matters. In episode 109 he told Dr. Gabayan’s team that he arranges the trainers and the specialists, and that they can handle the medical side. Mike is not a physician and does not diagnose or treat. Physicians test and treat; Mike designs the program around what they find. That is what tested, not guessed means in practice.

He uses his own word for the role: architect. Every Operation Fitness program is designed by Mike and delivered by his team, with the same promise a good concierge doctor makes, which is time and attention on one person. See how the programs are built.

Where to go from here

Watch both conversations on YouTube: Ep. 40 with Dr. Ilan Kedan and Ep. 109 with Dr. Eli Gabayan and Hana Ayoub.

See how testing comes first in every Operation Fitness program at /programs.

If you want to talk through what a program built around your own results would look like, request a consultation. Mike replies to every message.