Membership-based rheumatology is a direct-care model where patients pay an annual fee for priority access to a board-certified rheumatologist — including same-week appointments, unhurried 60-minute visits, and direct access to the physician. Insurance still covers medications, imaging, and labs, but the clinical relationship is paid for directly, bypassing the 3-month waits and 10-minute visits of the insurance-driven system. Why the Membership Model Exists The traditional insurance-based rheumatology model is failing the patients who need it most. The American College of Rheumatology's workforce study projected a demand/supply gap of more than 4,700 full-time equivalent rheumatologists by 2030 — a shortage already felt as 3-to-6-month new-patient waits across most U.S. markets (Battafarano et al., Arthritis Care & Research, 2018).That structural shortage, combined with insurance reimbursement rates that pressure rheumatologists to see 25–30 patients a day, creates the experience most autoimmune patients know too well: the three-month wait, the 15-minute rushed visit, the "your labs look fine" dismissal, and the inability to reach your doctor when a flare hits.The membership model lets a rheumatologist practice medicine the way they were trained to — not the way insurance forces them to. By capping the patient panel at a fraction of a traditional practice (roughly 300–600 patients instead of 2,000–3,000), a membership rheumatologist can offer what the insurance system structurally cannot: time, access, and continuity. What Is Membership-Based Rheumatology? Membership-based rheumatology (also called direct care rheumatology or concierge rheumatology) is a private practice model where patients pay a recurring annual or quarterly fee directly to …
Membership-Based Rheumatology: Private Practice With No Wait Times
Membership-based rheumatology is a direct-care model where patients pay an annual fee for priority access to a board-certified rheumatologist — including same-week appointments, unhurried 60-minute visits, and direct access to the physician. Insurance still covers medications, imaging, and labs, but the clinical relationship is paid for directly, bypassing the 3-month waits and 10-minute visits of the insurance-driven system.
Why the Membership Model Exists
The traditional insurance-based rheumatology model is failing the patients who need it most. The American College of Rheumatology’s workforce study projected a demand/supply gap of more than 4,700 full-time equivalent rheumatologists by 2030 — a shortage already felt as 3-to-6-month new-patient waits across most U.S. markets (Battafarano et al., Arthritis Care & Research, 2018).
That structural shortage, combined with insurance reimbursement rates that pressure rheumatologists to see 25–30 patients a day, creates the experience most autoimmune patients know too well: the three-month wait, the 15-minute rushed visit, the “your labs look fine” dismissal, and the inability to reach your doctor when a flare hits.
The membership model lets a rheumatologist practice medicine the way they were trained to — not the way insurance forces them to. By capping the patient panel at a fraction of a traditional practice (roughly 300–600 patients instead of 2,000–3,000), a membership rheumatologist can offer what the insurance system structurally cannot: time, access, and continuity.
What Is Membership-Based Rheumatology?
Membership-based rheumatology (also called direct care rheumatology or concierge rheumatology) is a private practice model where patients pay a recurring annual or quarterly fee directly to the practice in exchange for enhanced access and extended time with the physician. It is not insurance, and it does not replace insurance. It is a membership for the clinical relationship itself.
Under this model, the rheumatologist’s income is aligned with patient satisfaction and long-term outcomes — not with how quickly they can cycle patients through an exam room to hit insurance-company productivity quotas. Membership practices typically limit their roster to a few hundred patients, which is why same-week appointments and direct physician access are possible.
How It Differs From Insurance-Based Rheumatology
In a traditional insurance-based practice, your rheumatologist is paid per visit by your insurance company. Reimbursement rates are low, so volume is high. The physician must average roughly 10–15 minutes per established patient to stay solvent, and administrative staff spend hours per week on prior authorization, referrals, and coding — time that does not go toward your care.
In a membership-based practice, the annual fee covers the professional relationship: the visits themselves, the time between visits, the texts and emails, the care coordination, the lab-result reviews, the after-hours calls when you’re flaring. Everything outside the professional relationship — your medications, your infusions, your MRIs and ultrasounds, your lab work — still runs through your insurance. You keep your insurance. You just no longer rely on it to purchase your rheumatologist’s attention.
| Feature | Insurance-Based Rheumatology | Membership-Based Rheumatology |
|---|---|---|
| New patient wait | 3–6 months (often longer) | Same week to next week |
| Visit length | 10–20 minutes | 45–60 minutes |
| Physician panel size | 2,000–3,000 patients | 300–600 patients |
| Direct phone/text access to doctor | Rarely | Included |
| Urgent flare access | ER or wait weeks | Same-day/next-day |
| Telemedicine | Limited, scheduled | On-demand, statewide in CA |
| Who pays the doctor | Your insurance company | You, directly |
| Meds / labs / imaging / infusions | Billed through insurance | Still billed through insurance |
| Prior authorization support | Limited staff time | Physician-led, proactive |
| Referrals & care coordination | Handed off to staff | Handled directly by the doctor |
What's Included in a Concierge Rheumatology Membership
Membership at Concierge Rheumatology is designed around the reality of living with autoimmune disease — the unpredictable flares, the medication questions at odd hours, the dread of the “quick appointment.” A typical membership includes:
- 4 comprehensive, 60-minute in-person or telemedicine visits per year — unhurried, full-chart reviews, not rushed follow-ups.
- Unlimited short-format follow-ups for medication titration, flare management, and lab-result review.
- Direct physician cell and text access for clinical questions — not a call center, not a portal queue.
- Same-week (often same-day) urgent access when a flare hits.
- Proactive lab review — Dr. Dhillon reviews your labs, calls you personally, and explains what they mean.
- Care coordination with your primary care, pain specialist, dermatologist, or nephrologist — done by the physician, not a front-desk handoff.
- Telemedicine across California — priority video visits for patients anywhere in the state, without the drive into Beverly Hills.
- Prior-authorization advocacy for biologics, DMARDs, and specialty medications your insurance tries to deny.
Looking for the speed of access specifically? See our same-week rheumatology appointment page, or read what patients say about seeing Dr. Dhillon.
What Does a Concierge Rheumatology Membership Cost?
Concierge Rheumatology memberships typically start in the low-to-mid four figures per year, with tiered options depending on visit frequency, household coverage, and telemedicine needs. Exact pricing is provided during a discovery call so we can match you to the right tier based on your diagnosis, complexity, and desired level of access.
To put that in perspective: most members report that their total annual rheumatology spend under the membership model — fee plus insurance-covered meds and labs — is comparable to, and sometimes less than, what they were paying in insurance-based care once deductibles, copays, specialist visits, and “out-of-network” surprises were totaled. The difference is what you get in return: time, access, and a rheumatologist who answers the phone.
Book a free Discovery Call to see current tier pricing and whether membership is the right fit for you.
What's NOT Included (And Why That Matters)
A transparent answer: the membership fee does not cover medications, infusions, imaging (MRI, ultrasound, X-ray), outside specialist referrals, hospitalization, emergency care, or lab draws at third-party facilities. These continue to be billed through your health insurance the way they are now. Most members keep a standard PPO or HMO plan in place specifically so those costs stay covered by insurance. The membership simply carves out and upgrades the clinical relationship itself.
Who Membership Rheumatology Is a Good Fit For
Membership-based rheumatology tends to fit best for:
- Patients with chronic autoimmune disease (RA, lupus, psoriatic arthritis, scleroderma, Sjögren’s, ankylosing spondylitis) who need frequent, thoughtful care.
- Patients who have been waiting months for a new-patient appointment and can’t afford to keep waiting.
- Patients who have felt dismissed in insurance-based practices and want a physician who has time to listen.
- Executives, professionals, and busy caregivers who need discreet, on-demand access — including private telemedicine.
- Newly diagnosed patients who need hand-holding, education, and a direct line during the first year of treatment.
Who It May Not Be a Good Fit For
Membership-based rheumatology may not be right for every patient. It is generally not the best fit for:
- Patients whose care is almost entirely infusion-based (e.g., ongoing Remicade or Rituxan infusions covered by Medicare or Medi-Cal) — you may need to stay in a practice that directly administers and bills those infusions through insurance.
- Patients whose insurance requires a specific in-network rheumatologist for coverage continuity.
- Patients who prefer a fully insurance-covered model and are comfortable with traditional wait times and visit formats.
We’re transparent about this during the discovery call. If membership isn’t the right structure for your care, we’ll tell you.
Frequently Asked Questions (FAQs)
Yes. Membership-based rheumatology is not health insurance and does not replace it. You should keep a standard health insurance plan to cover medications, imaging, labs, infusions, hospitalization, and any outside specialists. The membership fee covers the rheumatologist's time, access, and care coordination — everything else still runs through your insurance.
The fee covers your comprehensive visits, unlimited short-format follow-ups, direct cell and text access to Dr. Dhillon, priority same-week and same-day access during flares, telemedicine visits across California, proactive lab review, care coordination with your other physicians, and prior-authorization advocacy for specialty medications. It covers the clinical relationship itself.
The fee does not cover medications, biologic infusions, MRI or ultrasound imaging, X-rays, lab draws processed at third-party facilities, hospitalization, ER visits, or outside specialist consults. Those continue to be billed through your health insurance as they are today.
Often, yes — but it depends on your plan administrator and how your specific membership is structured. IRS guidance on direct-care retainers has evolved, and many HSA/FSA administrators reimburse concierge medical memberships as qualified medical expenses. We recommend confirming with your plan administrator before enrolling, and we can provide documentation to support a reimbursement request.
Direct primary care applies the same membership model to general adult primary care. Membership-based rheumatology applies it to a subspecialty — the diagnosis and long-term management of autoimmune and inflammatory disease. The structural logic is the same: the doctor is paid for the relationship, not per insurance-coded visit.
In most cases, new members are seen within one week — and often within 48 hours for urgent flares. This is only possible because the practice caps its roster. Learn more on our same-week rheumatology appointment page.
You don't have to wait three months for a 15-minute appointment, and you don't have to settle for "your labs look fine" when you know something is wrong. Concierge Rheumatology sees patients in person in Beverly Hills and offers statewide California telemedicine for patients across Long Beach, greater Los Angeles, Orange County, Newport Beach, Pasadena, and Irvine.
- Book a Discovery Call — free, 15 minutes, no obligation.
- Explore the full concierge rheumatology practice model
- Call directly: +1 323-990-1067
Every month you wait is a month your body doesn’t get back.
