Guide to Building a Sustainable Concierge Longevity Practice

After leaving a stressful hospitalist role that nearly gave her a heart attack while pregnant, Dr. Stubs was determined not to recreate the same overwork in her own practice. She structured her concierge service so that patients know she is not accessible 24/7 for emergencies; they must go to the ER. However, she offers a significant advantage over typical primary care: same-day appointments. She blocks online slots that are reserved for concierge members, so they can be seen quickly for urgent but non-life-threatening issues like suspected infections before travel. This model relies on her physical office and a team of staff to manage scheduling, prescriptions, and follow-ups, allowing her to maintain a full patient schedule within defined office hours (9:30-4:00 with a 30-minute lunch). She emphasizes that this structure, combined with clear messaging, has allowed her to avoid the burnout that drove her from hospital medicine.

Dr. Stubs initially used Quest for low-cost baseline labs but found it chaotic to mix insurance billing, client-bill options, and add-on functional tests. As her clientele grew and demanded more functional insights, she adopted Vibrant's America panel. She sets a fixed panel for all patients—extended hormones, a lipid/inflammatory mix, vitamins, magnesium, etc.—and repeats it at six months. The same panel at both time points creates a clean before-and-after picture, which she finds motivating for patients and clinically useful. For any follow-up on a specific abnormality (like thyroid), she uses Quest for single-marker, frequent testing because it's more cost-effective than re-running the entire Vibrant panel. The $225 minimum is covered within the concierge tier, making the offering seamless.

Dr. Stubs is adding a DEXA scanner to her practice as a tool to elevate her concierge offering. She has a large medical weight loss segment and wants to ensure that patients do not lose lean muscle mass while shedding fat. For women entering perimenopause, when sarcopenia risk increases, having a DEXA on hand enables her to monitor muscle mass and intervene early with resistance training or nutritional adjustments. By embedding the scan into a higher-priced tier, she creates a turnkey metric that patients can follow alongside their lab work, making the membership more tangible and results-oriented.

Dr. Stubs created the Rooted Retreat to bring women together in a positive, healthy environment. The event features expert talks on health and mindset, a sound bath, meditation, yoga, breathwork, cupping, ear seeding, and a vendor marketplace. All proceeds go to local charities such as those supporting homeless women and children. The first year they also donated to a national fertility charity. Despite the workload, she finds it incredibly rewarding and has started hosting smaller office forums (e.g., on perimenopause) to maintain community connection throughout the year. This model not only gives back but also strengthens her brand and patient retention.

Dr. Stubs emphasizes that a common fear among new concierge practitioners is that nobody will pay their rates, prompting them to discount. She fell into this trap early on and now advises against it. Instead, she urges clinicians to do 'reverse engineering': decide the target annual salary and the number of patient-facing hours per week, then divide to find the necessary revenue per patient. The price then reflects the value of the time and service. Over the past few years, she's been gradually raising her fees and sees that the market accepts it. The key is patience; even if the practice fills slowly, consistent pricing attracts patients who truly value the care. She notes that having a physical location and relying on word-of-mouth further validates the premium pricing.

Dr. Stubs started with Quest for its low per-test costs and no minimum order, which helped when she was undercharging for her services. However, as her practice grew and she wanted to include functional markers like inflammatory lipids, magnesium, vitamin D, B12, and folate, Quest became expensive and administratively messy. Vibrant's America panel let her pick and choose a broad array of tests for a single draw, with a $225 minimum that fits neatly into her concierge fee structure. Now every patient receives the same panel at intake and at six months, creating a consistent baseline and trend analysis. She notes that patients appreciate getting more than what their insurance-covered primary care offers, and the uniform billing reduces front-desk questions. For targeted, frequent monitoring (e.g., thyroid), she still uses Quest separately, but the bulk of functional screening is done via Vibrant.

Dr. Stubs explains that many of her patients are in the early 40s or postpartum phase and often seek medical weight loss. She wants to ensure their muscle mass is maintained and even increased during weight loss, especially as women approach perimenopause and menopause when muscle loss accelerates. The DEXA scan provides precise body composition data, allowing her to show patients tangible changes beyond the scale. By embedding it as part of a higher-tier concierge package, she creates an added value that doesn't require her time for every scan—staff can run it. She sees this as part of a 'turnkey' approach where patients can follow their body metrics alongside lab work and see the impact of lifestyle changes.