A Greenwich Concierge Practice Opens October 1 With 100 Patients Per Doctor. Membership Starts at $45,000 a Year.

Analysis by DPC Insider — Market Desk
#concierge medicine#panel size#membership medicine#practice economics#access to care
Sources: Concierge medical practice with $45K annual membership to open in CT — Hartford Business Journal, September 11, 2026 · Concierge Medicine Greenwich - Find Primary Care Concierge Doctors — Private Medical · Concierge Medicine in NYC — Private Medical · Concierge Medicine & Private Medical Concierge Company — Private Medical · Direct Primary Care — American Academy of Family Physicians

One physician. About 100 patients. Forty-five thousand dollars a year to be one of them.

That’s the shape of Private Medical’s seventh office, which opens October 1 at 50 Old Field Point Road in Greenwich, Connecticut. The Hartford Business Journal reported on September 11 that annual memberships start at $45,000 for adults and that the model limits each physician to 100 patients or fewer. Dr. Tiago Miguel will launch the roughly 3,000 square foot practice with a clinical and administrative team on site.

The company has been at this a while. Dr. Jordan Shlain founded it in San Francisco in 2002, and the company still lists an office there. Its locations page also names Beverly Hills, Miami, New York City, Santa Monica and Silicon Valley. Greenwich makes seven. It told HBJ it picked Greenwich because its Manhattan office was already seeing patients who live there. Membership fees aren’t billed to insurance, and members generally keep coverage for labs, imaging, procedures and specialist care.

Take the price out of that paragraph and you’ve described a DPC practice in Wichita.

What the $45,000 actually buys is a smaller number

Private Medical says the mechanism out loud on its own site. Its New York City page credits 24/7 physician access to panel size, with “each doctor only caring for around 100 members (compared to ~600 at most concierges and 2,500 in typical practices).”

Read that again as a supply claim rather than a service claim. The physician isn’t faster or more attentive by temperament. There are simply fewer people ahead of you.

Everything else in the offer follows from that one number. Same-day appointments work when the schedule has room. A text answered at 11pm works when 100 people have the number instead of 2,500. The company’s pitch is the arithmetic, and it deserves credit for stating it plainly instead of dressing it up as philosophy.

DPC pulls the same lever, several notches down

The American Academy of Family Physicians puts the average DPC panel at 413 patients and says monthly membership fees “generally range from $50 to $100.” Costs vary by practice, and each practice sets its own price.

So line up the three numbers that the two models put on the table. One physician for 100 people. One for 413. One for 2,500.

Now line up what each costs the patient. Multiply the AAFP range out and a DPC membership runs roughly $600 to $1,200 a year. Private Medical’s published floor is $45,000, which is about 37 to 75 times that range, and that’s the starting price for an adult rather than a typical one.

The panels differ by roughly four times. The prices differ by dozens. Panel size is the thing being sold in both cases, but the two models are selling it to entirely different buyers, and only one of those price points survives contact with a household budget.

Access is bought by subtraction

Both models carry the same awkward consequence, and neither one escapes it.

Neither practice creates a physician. What both do is cut the number of people one physician carries. The relief that buys is real, and the capacity behind it doesn’t move.

A doctor who moves from 2,500 patients to 413 takes roughly 2,100 people off a list. A doctor who moves to 100 takes off 2,400. Those patients don’t evaporate. They land somewhere else in a primary care system that was already short.

DPC and concierge answer that objection differently. A $75 monthly membership is priced where a working household can plausibly reach it, so the model’s defenders can argue that the people who follow their doctor out of the insurance system are ordinary patients making an ordinary trade. At $45,000 a year, the answer has to be something else, and Private Medical doesn’t pretend otherwise. Its own locations page counts 1,000 families and 30 physicians across the company. CEO Sanjay Banker told HBJ that Greenwich is “exactly the kind of community that’s outgrown the reactive, traditional healthcare system.”

That’s a market position, stated cleanly. It isn’t an access argument and it was never meant to be one.

Where DPC Fits

Private Medical’s own numbers put its practices at about 100 and describe 600 as ordinary for everyone else. So the premium at the top of this market buys a panel six times smaller than the company’s own figure for the rest of the category.

That gap leaves DPC holding a position it didn’t have to argue for. At 413 patients and $50 to $100 a month, DPC sits at the point on the curve where the panel is small enough to change how a visit feels and the price is low enough that an employer or a household can carry it. That’s a narrow place to stand, and it’s the whole reason the model is interesting to anyone who cares about volume rather than exclusivity.

None of which makes DPC the answer to a primary care shortage. It doesn’t add physicians either. But when a category starts pricing access at $45,000 and calling the buyers discerning, the gap between the two ends of “membership medicine” becomes something a reader can check with arithmetic instead of something the industry has to keep explaining.