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For concierge medicine

Growth systems
for membership-model medicine.

Parker Medical (Las Vegas) has been a Macbach client since 2013. The Architect book includes concierge and membership-model practices. We know the math, member acquisition, retention, referral velocity, the brand surfaces that decide whether a prospect even enters the consideration set.

The three operating realities

What we actually understand.

Members, not patients.

Concierge practices don’t scale by adding appointments, they scale by adding members. The funnel is longer, the consideration set is smaller, and the word-of-mouth signal is louder than any paid channel.

Brand is operational.

When a practice charges $2,000-$10,000+ per year for membership, the website, the waiting room, and the follow-up email are all brand artifacts. One weak surface undermines the rest of the offering.

Retention is the business.

Annual churn is the quiet killer. A ten-point retention improvement matters more than a ten-point acquisition improvement at the membership-model math. We treat retention as a marketing discipline, not just a clinical one.

Model by model

Same methodology.
different levers.

Hybrid / lower-tier concierge

Still insurance-accepting, membership as add-on. Local search and GBP carry a large part of the acquisition load; paid needs tight targeting to avoid bringing in patients who won’t pay for the membership.

Classic concierge internal medicine

$2K-$5K membership, hundreds of members per physician. Organic search, trust content, physician-authored material, and reputation management do the heavy lifting.

Luxury / executive concierge

$10K+ membership, small cap, waitlist. Brand, referral pathways, and a site that reads like a luxury service, not a clinic, are the make-or-break factors.

Direct primary care overlap

DPC shares mechanics with concierge but at a different price point. Content strategy is similar; paid economics are very different. We run both playbooks.

Questions

Answers specific to
membership practices.

What panel sizes do you grow?
Under 600 members we optimize acquisition. Between 600 and 1,000 we shift weight to retention, referral mechanics, and waitlist management. At capacity we work brand, physician authority, and quiet expansion.
Does local SEO actually matter for a membership practice?
Yes, but differently than for a transactional practice. Prospective members search the physician by name, the practice by brand, and the model by vocabulary (concierge, membership medicine, direct care) more than generic service terms. GBP health, review velocity, and physician authority pages are the foundations.
How much should a concierge practice spend on marketing?
Three to five percent of collections combined acquisition and retention, skewed higher at launch and lower at steady-state. A 400-member practice at $3,500 annual membership ($1.4M collections) typically runs $40K to $70K annually on marketing.
How long does paid media take to pay back?
Six months to positive contribution. Twelve to eighteen months to see the full compounding effect. Concierge purchase cycles are long; the first touch is rarely the conversion.
Do you work with solo-physician concierge practices?
Most of the concierge book is solo or two-physician. The brand and retention disciplines are the same at one physician or ten.
What's different about concierge versus DPC growth?
Price point and audience frame. DPC is category-first education (most prospects don't know the model exists). Concierge is physician-first trust building (prospects know the model and are evaluating physicians). Same channels, different sequencing.
Markets we serve

Concierge medicine
by market.

Each city has its own competitive field, submarket geography, and maturity curve. The pages below carry the honest version of the concierge playbook for that market.

Tampa Bay
FL · 3.1M
Recommended · Growth
Read the Tampa Bay page →
Dallas
TX · 7.9M
Recommended · Growth
Read the Dallas page →
Houston
TX · 7.3M
Recommended · Dominance
Read the Houston page →
Austin
TX · 2.4M
Recommended · Foundation
Read the Austin page →
Atlanta
GA · 6.2M
Recommended · Growth
Read the Atlanta page →
Charlotte
NC · 2.8M
Recommended · Foundation
Read the Charlotte page →
Nashville
TN · 2.0M
Recommended · Growth
Read the Nashville page →
Scottsdale
AZ · 5.0M
Recommended · Dominance
Read the Scottsdale page →
Miami
FL · 6.2M
Recommended · Dominance
Read the Miami page →
Chicago
IL · 9.4M
Recommended · Growth
Read the Chicago page →
Denver
CO · 2.9M
Recommended · Growth
Read the Denver page →
Los Angeles
CA · 12.8M
Recommended · Dominance
Read the Los Angeles page →
New York
NY · 19.5M
Recommended · Dominance
Read the New York page →
Washington, DC
DC · 6.3M
Recommended · Dominance
Read the Washington, DC page →
Seattle
WA · 4.0M
Recommended · Growth
Read the Seattle page →
San Diego
CA · 3.3M
Recommended · Growth
Read the San Diego page →
San Francisco
CA · 4.7M
Recommended · Dominance
Read the San Francisco page →
Boston
MA · 4.9M
Recommended · Growth
Read the Boston page →
Phoenix
AZ · 5.0M
Recommended · Growth
Read the Phoenix page →
Philadelphia
PA · 6.2M
Recommended · Growth
Read the Philadelphia page →
San Antonio
TX · 2.6M
Recommended · Foundation
Read the San Antonio page →
Jacksonville
FL · 1.6M
Recommended · Growth
Read the Jacksonville page →
Fort Worth
TX · 7.9M
Recommended · Growth
Read the Fort Worth page →
San Jose
CA · 2.0M
Recommended · Dominance
Read the San Jose page →
Columbus
OH · 2.2M
Recommended · Foundation
Read the Columbus page →
Indianapolis
IN · 2.1M
Recommended · Growth
Read the Indianapolis page →
Oklahoma City
OK · 1.5M
Recommended · Foundation
Read the Oklahoma City page →
El Paso
TX · 870K
Recommended · Foundation
Read the El Paso page →
Las Vegas
NV · 2.3M
Recommended · Growth
Read the Las Vegas page →
Detroit
MI · 4.3M
Recommended · Growth
Read the Detroit page →
Louisville
KY · 1.4M
Recommended · Foundation
Read the Louisville page →
Portland
OR · 2.5M
Recommended · Growth
Read the Portland page →
Memphis
TN · 1.3M
Recommended · Foundation
Read the Memphis page →
Baltimore
MD · 2.8M
Recommended · Growth
Read the Baltimore page →
Milwaukee
WI · 1.6M
Recommended · Foundation
Read the Milwaukee page →
Albuquerque
NM · 920K
Recommended · Foundation
Read the Albuquerque page →
Tucson
AZ · 1.0M
Recommended · Foundation
Read the Tucson page →
Fresno
CA · 1.1M
Recommended · Foundation
Read the Fresno page →
Sacramento
CA · 2.4M
Recommended · Growth
Read the Sacramento page →
Mesa
AZ · 5.0M
Recommended · Foundation
Read the Mesa page →
Kansas City
MO · 2.2M
Recommended · Growth
Read the Kansas City page →
Raleigh
NC · 2.1M
Recommended · Growth
Read the Raleigh page →
Omaha
NE · 970K
Recommended · Foundation
Read the Omaha page →
Virginia Beach
VA · 1.8M
Recommended · Foundation
Read the Virginia Beach page →
Long Beach
CA · 12.8M
Recommended · Foundation
Read the Long Beach page →
Oakland
CA · 4.7M
Recommended · Growth
Read the Oakland page →
Minneapolis
MN · 3.7M
Recommended · Growth
Read the Minneapolis page →
Bakersfield
CA · 920K
Recommended · Foundation
Read the Bakersfield page →
Tulsa
OK · 1.0M
Recommended · Foundation
Read the Tulsa page →
Arlington
TX · 7.9M
Recommended · Foundation
Read the Arlington page →
Cleveland
OH · 2.1M
Recommended · Growth
Read the Cleveland page →
Start here

Read Parker Medical,
then run the audit.

A twelve-year concierge engagement, in Dr. Parker’s own words. It’s the closest thing we publish to a straight answer about what a long Macbach partnership actually looks like.