Concierge Medicine vs. Protocol: What $15,000 a Year Actually Buys You
Concierge medicine vs. Protocol: what $15,000 a year actually buys you
If you’re weighing concierge medicine against Protocol, you’ve already decided that standard primary care isn’t working for you. The question is what to replace it with.
At the elite end, boutique concierge practices charge $15,000 (or a lot more) a year for what amounts to a remarkably available primary care physician. Protocol charges $695 a month for something structurally different: a coached optimization program organized around nine specific protocols and a multidisciplinary team.
Both are genuine upgrades over standard primary care. The problem is they solve different problems, and if you pick based on price alone, you’ll probably land in the wrong one.
What boutique concierge offers
Concierge medicine isn’t one category. It spans from entry-tier networks like MDVIP (typically around $2,500 a year, covered in this comparison) to elite practices charging $15,000-$30,000 (or more, some even reach 6 figures). The middle tier, roughly $10,000 to $15,000 a year, is where most high-income professionals land when they decide their PCP isn’t enough.
What you typically get at that price point:
- Very small patient panels. Elite concierge practices often carry 50-200 patients per physician, compared to 2,500+ in standard primary care and 400-600 in entry-tier concierge networks.
- 24/7 direct access. Your physician’s cell phone. Text response within hours. House calls when warranted. Travel coverage.
- Longer, unhurried visits. 60-90 minute annual exams. Same-day sick visits. No waiting-room experience.
- An enhanced annual physical. Often including additional labs, EKG, stress testing, and sometimes imaging like whole-body MRI or coronary calcium scoring.
- Specialist coordination. Your concierge physician handles referrals, acts as a single point of contact, and often has direct lines to top specialists in your region.
- Care during travel. Many practices arrange care wherever you are, including international coverage through affiliated networks.
If your main frustration with healthcare is the experience of it (long waits, rushed visits, never being able to reach your doctor), this is a real upgrade. For executives and frequent travelers who need a responsive medical concierge, it solves those logistical problems.
Where boutique concierge typically falls short
The limitation isn’t the delivery. It’s the underlying model. Boutique concierge improves the experience of primary care. It does not typically change the framework.
The same reactive playbook, delivered better
Primary care waits for symptoms. You come in when something is off. Your physician runs tests. If something flags, you get a prescription, a referral, or a recommendation. That structure is built into primary care training, reimbursement, and documentation, whether you pay a $20 copay or $25,000 a year concierge membership fee.
Boutique concierge practices are staffed by primary care physicians operating inside that same framework, just with more time and fewer patients. They’re excellent at what primary care is designed to do: catch disease when it shows up, manage chronic conditions, coordinate specialty care. Running structured optimization programs with defined longevity targets is a different job entirely, different training, different staffing, different incentive structure.
An extra 45 minutes of annual exam time discussing standard labs is still standard labs. Longer visits don’t automatically make it a different kind of medicine.
Longevity diagnostics are inconsistent
Some boutique practices include advanced testing. Most don’t, at least not as a standard part of the package. When they do, it often means coronary calcium scoring, an expanded lipid panel, or imaging add-ons. What’s typically still missing:
- ApoB as the primary cardiovascular metric. Most concierge practices still use LDL-C, which can significantly underestimate risk in patients with metabolic syndrome, insulin resistance, or elevated triglycerides, the exact population most likely to be seeking this level of care. More on ApoB here.
- Fasting insulin and HOMA-IR. Insulin resistance can develop a decade before it shows up in A1c. Without fasting insulin, you won’t see it coming.
- Lp(a). A genetic cardiovascular risk factor that changes your entire risk management strategy if elevated. Still rarely ordered as a standard test.
- DEXA body composition. Weight and BMI can’t distinguish muscle from fat, can’t detect visceral adiposity, and can’t catch age-related muscle loss.
- VO2 max testing. One of the strongest single predictors of all-cause mortality. Rarely offered outside of performance-oriented practices.
When these tests are available in concierge settings, they’re typically à la carte add-ons, not integrated into a unified dashboard with retesting cadences and coached interventions tied to the results.
No structured protocols or follow-through
A concierge physical ends the way most doctor visits end: the doctor walks you through your results, flags a few things to work on, and you leave with a summary sheet that says something like “optimize diet, increase physical activity, follow up in twelve months.”
The gap between a recommendation and a result is enormous. Research on lifestyle intervention has been clear for decades: information alone rarely changes behavior. Coached intervention with specific targets, defined timelines, and regular check-ins does.
Boutique concierge practices typically do not include:
- Health coaching with weekly or biweekly accountability
- Registered dietitian access tied to your actual lab data
- Structured exercise programming with retesting
- Protocol-based intervention programs with defined metrics and timelines
- Multi-domain care coordination beyond specialist referrals
You get a more available doctor. What happens between visits is up to you.
The price tag doesn’t change the model
A $15,000 concierge membership buys you a better experience of primary care. It doesn’t buy you a different kind of medicine. Same testing framework. Same intervention model. Same clinical training. You just get it with more time and less friction.
For many people, that’s exactly the trade they want. For others, it’s the realization that prompts the next question: what would it actually look like to optimize, instead of just monitor?
What Protocol offers
Protocol is built around a different question entirely. Nine outcome-focused protocols, each anchored to a measurable headline metric and a specific target, not “how do we improve your care experience?” but “what number are we trying to move, by when, and what happens if the first approach doesn’t work?”
Nine protocols, nine metrics
Each program is built around a headline metric and a clear target:
| Protocol | Headline Metric |
|---|---|
| Cardiovascular Risk | ApoB at risk-tier target |
| Muscle & Body Composition | DEXA lean mass + grip strength |
| Metabolic Health | HOMA-IR + glucose time-in-range |
| Physical Capacity | VO2 max |
| Sleep Health | Sleep consistency + ISI |
| Nutrient Optimization | Lab-verified nutrient status |
| Hormonal Health | Hormone panel optimization |
| Emotional Resilience | PSS-10 + cortisol pattern |
| Cancer Prevention | Risk-stratified screening |
Each protocol has a defined timeline, a retest cadence, and a team behind it. The difference in practice: you don’t get a recommendation to “improve your cardiovascular health.” You get told your ApoB is 118, that your risk-tier target is 80, here’s what we’re doing about it, here’s when we retest, and here’s the escalation pathway if lifestyle changes aren’t moving the number.
A team, not a doctor
Concierge medicine gives you better access to one physician. Protocol is physician oversight, nurse practitioner clinical execution, registered dietitians, health coaches, and healthspan directors, each with a specific job, and all of them working from the same data. Your coach handles accountability. Your dietitian builds nutrition plans off your actual lab results. Your clinical team runs protocols and makes the medication calls.
The comparison isn’t a doctor visit vs. a gym membership. It’s a solo practitioner vs. a team that actually coordinates across domains.
What the numbers actually show
Protocol members start at 27% optimal ApoB attainment and reach 69% during membership. Median member ApoB lands at 79 mg/dL, against a US population mean of roughly 95 mg/dL. That gap doesn’t happen from better access to a doctor. It happens from structured intervention, retesting, and coaching that adjusts when the numbers don’t move.
Side-by-side comparison
| Boutique Concierge | Protocol | |
|---|---|---|
| Annual cost | Typically $10,000-$25,000 | $695/month membership |
| Model | Reactive primary care, premium delivery | Outcome-focused optimization protocols |
| Primary CV metric | Typically LDL-C | ApoB |
| Fasting insulin / HOMA-IR | Variable | Included |
| Lp(a) | Variable | Included |
| DEXA body composition | Sometimes available à la carte | Included |
| VO2 max | Sometimes available à la carte | Included |
| Structured protocols with targets | No | 9 protocols |
| Health coaching | Typically not included | Included |
| Registered dietitian access | Typically not included | Included |
| Retest cadence | Typically annual | Weeks to months, based on intervention |
| Care coordination | Specialist referrals | Cross-protocol team integration |
At typical mid-tier boutique pricing of $15,000 a year, concierge medicine costs roughly twice Protocol’s $7,500 annual membership (prepaid). It includes premium access, longer visits, and 24/7 availability. It typically does not include the diagnostics, coaching, or structured intervention that Protocol provides as the core product.
Who boutique concierge is right for
Concierge medicine solves real problems. There are profiles where it’s the right call:
- Your frustration is logistical. You need 24/7 access, house calls, travel coverage, or a physician who will actually pick up the phone. That’s what concierge is designed to deliver.
- You want premium primary care. If you’re looking for a better version of the standard PCP relationship, not a different model of care, concierge delivers exactly that.
- You already have longevity specialists. If a cardiologist is tracking your ApoB, an endocrinologist is managing your metabolic health, and a trainer is programming your exercise, you may just need a great PCP at the center of it.
- Experience and amenities matter a lot to you. Home visits, concierge scheduling, coordinated specialty referrals, premium annual exams. These are real benefits.
Who Protocol is right for
Protocol solves a different problem. It’s built for people who want measurable health change, not a better doctor visit:
- You want to know your actual numbers. ApoB, HOMA-IR, VO2 max, lean mass, sleep consistency. Not the standard panel everyone gets at every price point.
- You’ve had “everything looks fine” conversations one too many times and suspect the tests being run aren’t asking the right questions.
- You want a plan, not a recommendation. Specific targets. Defined timelines. Coached accountability. Iterative retesting. Not “eat better and exercise more.”
- You want one team that sees the whole picture. Not a PCP who handles labs, a trainer who handles exercise, a nutritionist who handles diet, and none of them talking to each other.
- The measurable-outcome framing resonates. If you’d rather move ApoB from 118 to 75 than hear someone tell you your LDL-C looks fine, Protocol is the model you’re looking for.
The core difference
Boutique concierge medicine takes the standard primary care model and makes the experience excellent. Smaller panels, longer visits, 24/7 access, premium amenities. For people whose real frustration is the experience of healthcare, the waiting, the rushed visits, the inability to reach anyone, that’s a meaningful fix. It’s a real improvement and it’s priced accordingly.
Protocol starts from a different question: what specific markers predict decline, how do we measure them, and what coached intervention actually moves each one?
Panel sizes are roughly comparable. What differs is what happens between visits. A concierge physician is available when you call. A Protocol team is actively running nine programs in the background, retesting, adjusting, escalating, whether you initiated the check-in or not.
If you’re deciding between them, the question is pretty direct: do you want better access to standard care, or do you want the care itself to be different?
For how Protocol compares to other alternatives, see MDVIP and entry-tier concierge, executive physicals, and what your annual physical typically misses.
Ready to find out where you actually stand? Protocol’s Foundation Assessment covers ApoB, HOMA-IR, DEXA body composition, VO2 max, and the rest of the markers most concierge physicals don’t include. From there, we build a specific action plan with coached targets, not a summary sheet to file away.