How to Choose a Concierge Doctor in Seattle: 7 Questions to Ask

The most useful thing to know when choosing a concierge doctor is that the fee tells you almost nothing. Two Seattle practices can charge the same amount and deliver completely different medicine. What separates them is panel size, what is genuinely included, and who answers at 9pm on a Saturday.

Here are the seven questions we would ask if we were the ones shopping. Ask them of us too.

1. How many patients or families does each physician carry?

This is the first question and the most important one. Everything else follows from it.

A typical insurance-based primary care physician carries 1,900 to 2,500 patients. Concierge practices range from around 600 at the entry level down to 50 families at the most exclusive. Below roughly 200, same-day appointments and two-hour visits become structurally possible rather than aspirational. Above roughly 400, you are mostly buying a shorter wait.

Be specific when you ask. “Small panel” is not an answer. Ask for the number, and ask whether it is per physician or across the practice.

At Kosmos, each of our three physicians holds 100 families.

2. What is included, and what generates a separate bill?

Concierge practices differ enormously here, and the difference can be worth more than the membership fee.

Ask directly: is the annual physical included? Labs? Imaging? If the practice advertises advanced diagnostics, are those inside the membership or referred out and billed to you or your insurer?

A $6,000 membership that includes $8,000 of testing is a different proposition from a $6,000 membership that includes a longer conversation. Both can be worth it. They are not the same product.

3. What actually happens after hours?

“24/7 access” appears on nearly every concierge website. It means very different things.

Ask what happens at 9pm on a Saturday. Do you text your physician’s mobile, or reach a call service that pages whoever is on? Is it your doctor or a covering doctor? What is the realistic response time?

Then ask the follow-up that matters: what happens when you need to be seen, not just advised? Some practices can meet you at the office. Some will meet you at the emergency department. Some will tell you to go and follow up Monday.

4. Who covers when your physician is on vacation?

A solo concierge practice has a structural weakness. If your physician is the entire practice, then two weeks a year you effectively do not have one.

Ask who covers, whether that person has access to your chart, and whether you have ever met them. Practices with two or more physicians who share coverage handle this better, and it is worth asking how they handle handoffs.

5. Is the practice independent, or part of a national network?

Both models exist and both can work, but they behave differently.

National networks such as MDVIP affiliate independent physicians under a shared brand. That brings standardized programs and a recognizable name. It also means the fee is often set by the individual physician rather than published centrally, so you have to ask each doctor what they charge, and program decisions may be made above the practice level.

Independent practices set their own terms and can change them faster, in either direction. Ask who owns the practice and who decides what is included.

6. What is the physician’s actual background?

Concierge medicine attracts physicians for different reasons, and the training matters for what they can handle.

Ask about board certification and where they trained. Ask specifically whether anyone in the practice has emergency medicine experience, because that experience changes how confidently a practice handles the 9pm call. It is the difference between a physician who can assess a situation over the phone and one whose safest answer is always “go to the ER.”

Our practice has three physicians. Dr. Chris Dodd is board certified in internal medicine. Dr. James Bhaskar practiced emergency medicine for more than 18 years alongside family medicine. Dr. Carolan Constantine is board certified in both internal and emergency medicine, with a focus on women’s health.

7. What happens when I need a specialist or a hospital?

Concierge medicine is primary care. It does not cover surgery, hospitalization, or specialist treatment, and any practice that implies otherwise should worry you.

The right question is what the practice does when you need those things. Does your physician make the referral personally and speak to the specialist, or hand you a name? Do they stay involved during a hospitalization? Do they review the specialist’s findings with you afterward?

The coordination is frequently the most valuable thing a concierge practice does, and it is rarely on the website.

Two more things worth knowing

Directories are not neutral. Several concierge directory sites that rank well on Google are paid listings. A practice’s placement reflects what it paid, not how good it is. Use directories to build a list, then research each practice directly.

Almost everyone offers a free introductory call. Use it, and use it on more than one practice. A 30-minute conversation with the physician tells you more than any amount of website reading. Bring the seven questions above.

If you want to ask us

We offer a 30-minute call with one of our physicians, not an intake coordinator, and there is no obligation attached to it. If we are not the right fit for what you need, we will tell you, and we can usually point you somewhere better.

Schedule a call, or read more about how concierge medicine works at Kosmos, what every Seattle practice charges, and what membership includes.