What is ‘bespoke care’? What is ‘concierge’ care? Are they the same? Different?

The DocPreneur Leadership Podcast

Bespoke care and concierge care are both innovative approaches to healthcare, but they serve different purposes.

By the Editor-in-Chief, Concierge Medicine Today.

Words are my passion. While I’m not perfect at grammar (obviously!), I do manage every now and then to string a few thoughts together that resonate with some Physicians out there.

I’m also intrigued by how our culture repurposes and rebrands words to promote specific narratives and ideas. And, ever since Mrs. Nielson, my 8th-grade Advanced Language Arts teacher, told me, “You have a gift; keep writing,” I’ve loved using words. I’m smitten by the science of language and constantly on a hunt to learn the new ways our words are being reused, rebranded, refined and redefined by our culture.

One term worth revisiting is “bespoke.”

If you’re not familiar with it in the healthcare context, let me explain. The word ‘bespoke’ is probably more familiar to our European healthcare audience than our North American audience and that’s okay.

To summarize, I’ll do what you might be doing right now, ‘Googling’ it. 🙂 But, I’ll take it a few steps further and use Grammarly’s Generative AI Bot.

According to the AI Bot: “Bespoke care represents the highest level of personalized medical attention, tailored specifically to meet the individual needs, preferences, and health conditions of each patient. This customized approach ensures that every treatment plan is uniquely designed for effectiveness and empowers patients, promoting a collaborative relationship with their healthcare providers.”

Interesting, right?

Advisory Board also recently unpacked the subject here. Radio Advisory’s Abby Burns sat down with Advisory Board’s Solomon Banjo and Nick Hula to talk about a new era of innovation, where progress in diagnostics, treatments, data analysis, and ongoing management have the potential to revolutionize patient care through unprecedented customization. Download the episode for the full conversation here. In the interview they note that bespoke care is going to be complex, Hula said. “It’s going to require clinicians who are highly skilled in a clinical sense, but also in a personal sense, really knowing what’s right for their patients and being able to adjust treatment decisions based off of all the factors that we just listed,” Hula said.

For even more context, I also asked the Grammarly’s Generative A.I. Bot to contrast the words bespoke care with concierge care.

Grammarly’s Generative A.I. Bot shared that “Concierge care offers a premium healthcare model that enhances the patient experience through an annual fee or retainer. This model provides patients with exceptional access to their healthcare providers, including extended appointment times, prioritized scheduling, and often 24/7 availability. While concierge care may incorporate some elements of bespoke services, its primary focus is on improving accessibility and responsiveness.”

For perspective, over the last 20 years, many terms have emerged to describe primary care and its complex relationship with subscriptions and price transparency. Now, we can download an app on our devices and connect with a healthcare practitioner in moments for a nominal fee. Additionally, retail clinics in our neighborhoods now list their prices, which is a significant advancement compared to when we were kids.

I mention this to illustrate that in most markets, price transparency addresses a fundamental need for convenience—a new definition of luxury for today’s consumers (i.e., patients).

If you’re not well-versed in these healthcare terms, you’re not alone; they are relatively new. Concierge medicine, also known as concierge care, boutique medicine, bespoke healthcare, or private medicine, emerged in the mid-1990s, though its origins trace back several decades—an interesting story for another time. The term “bespoke care” isn’t new; like many words in healthcare, we often see familiar terms reinterpreted.

A colleague, friend, and attorney encapsulated this idea perfectly during a meeting at the American Academy of Private Physicians conference in Phoenix, Arizona, in April 2015 when he remarked, “Let’s focus on substance, not labels.”

I believe he’s absolutely right.

While many terms have fallen in and out of favor among doctors, patients, and the media, some words have emerged as central to the membership medicine landscape today. Despite their media exposure and the efforts of physicians, many still don’t fully grasp the fundamental benefits, advantages, and drawbacks of certain terms in healthcare.

Despite the various terms that have been tested in the marketplace, some physicians still struggle to understand the differences between these models. They often use terms interchangeably or promote one as a low-cost alternative while labeling concierge medicine as the expensive option.

Personally, I don’t subscribe to that philosophy. (Pun intended.)

Now, let me introduce you to a concept called “insideritis.”

This term describes a phenomenon where organizations, especially in healthcare, view themselves solely through an internal lens, neglecting the patient experience. Author, pastor, and business leadership speaker Carey Nieuwhoff highlights the issue of insideritis and the excessive use of abbreviations in professional communication. He emphasizes the importance of using accessible language to foster understanding and connection, particularly in healthcare where clear communication is essential. Nieuwhoff notes, “Perhaps the insiders know what you’re talking about, but I don’t. Nor does anyone new or not yet embedded in your culture!”

Today, patients often don’t understand the “insider jargon” that healthcare professionals use. In fact, many people today might not even know who our first president was.

Here’s on last example of how old familiar words get used and this one is something you might already be aware of: Evidence-based medicine (EBM) was first coined in the early 1990s by a group of researchers at McMaster University in Canada, particularly Dr. David Sackett and his colleagues. They aimed to enhance clinical decision-making by integrating the best available scientific evidence with clinical expertise and patient values. This approach was a response to the growing need for a more systematic and critical examination of medical literature, allowing healthcare professionals to make informed decisions based on rigorous research rather than tradition or hearsay. For a detailed source on the origins and development of EBM, you can refer to: Sackett, D. L., Rosenberg, W. M. C., Gray, J. A. M., Haynes, R. B., & Richardson, W. S. (1996). Evidence-based medicine: what it is and what it isn’t. *BMJ*, 312(7023), 71-72. DOI: 10.1136/bmj.312.7023.71.

Editor’s Note:

This article discusses the principles of EBM and provides insight into its foundational context.

To assist the writing process, these Grammarly AI prompts were used:

Prompts created by Grammarly – “Make it persuasive” – “Make it more descriptive” – “Improve it” – “Shorten it”

Prompts I wrote – “What is ‘bespoke care’? What is ‘concierge’ care? Are they the same? Different?” – “briefly describe how the term in healthcare ‘evidence based medicine’ was originally termed or…”

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