Membership Medicine: An Introduction to What Could Be the Future of Healthcare

Updated: Nov 21

Membership medicine may be more than the next big thing in healthcare — it might just be something you never knew you needed to get your health on track.


This post is the first in a series.
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Photo by Vitalii Pavlyshynets on Unsplash

Doctor visits are yet another thing to add to your already busy to-do list. But they don’t have to be stressful — or boring. What if visiting the doctor did not entail long wait times for quick visits where important information is still left unsaid and, instead, felt like meeting with old friends who listened to your concerns?


Unfortunately, we're so accustomed to the American healthcare system — its flaws and all — that, despite our complaints and frustrations, like a toxic relationship, we keep returning to what’s familiar. But membership medicine — or concierge medicine, as it’s also called — can be a better way to manage your health. Many patients lack access to membership medicine because they can’t afford it — while this may be true for some, others might just think they can’t. Because, when you measure the amount of time and money you can save from direct, immediate care without the wild goose chases, multiple, sometimes unnecessary prescriptions, and long wait times to see the specialists you need, diagnosing health conditions sooner and preventing others from taking place, you may just find that the membership-based model is both cost-effective and well worth it.


I’m one such person. After learning about the many benefits that membership medicine can provide, I was intrigued. Yet, I only learned about Preservation Health after my husband and I spent thousands of dollars on multiple cycles of fertility treatments, including IVF, only to receive an endometriosis diagnosis, the most common cause of infertility, at age 40. When I consider the time and money I could have saved by getting routine bloodwork at my local physician's office instead of driving to my reproductive endocrinologist’s office in New Jersey for it — over an hour each way, plus tolls / EZPass — just to ensure they get it when I need it or dealing with LabCorp or the local hospital and hoping that it gets to my doctor's office on time, I wish I had known about it sooner. In addition, had I been able to work with a primary care provider who spent time with me, perhaps, they would have been able to connect the dots much sooner. We trust our doctors to guide us in the right direction, and if this doesn’t happen, we waste so much time, energy, and money.


Many of us who suffer from chronic or acute conditions benefit from the specialized expertise that only a specialist can provide. I used to see my primary doctor first for something I thought was pretty routine. But unless you’re someone who only comes down with the typical cold, virus, or flu, the services of a typical primary care provider only go so far. In 2004, when I began getting recurring sinus infections on a regular basis at the age of 22, finding myself sick for up to 4 to 6 weeks at a time, I realized I needed more specialized care than they could provide. (Interestingly, research actually points to a potential link between endometriosis and asthma/allergies/sinusitis.) When I had insurance that did not require referrals, I started to bypass my primary care physician almost altogether in favor of reaching out directly to the specialist I needed.


However, without the support of a helpful primary care physician, I had to navigate this first medical mystery on my own. I saw one ear, nose, and throat (or ENT) physician, under whose care I did not seem to improve. After testing with another practice, I was diagnosed with asthma and allergies in addition to chronic and acute sinusitis. I continued the same pattern for quite some time: getting sick and taking, at times, multiple rounds of antibiotics, plus Prednisone, a steroid medication that can have harmful side effects with long-term use, only serving as a band-aid until the next time I got sick. One allergy and asthma practice tried to convince me I needed costly and time-consuming allergy shots when, in the end, all I needed was to take care of the root of the problem and manage my conditions over time. This is what happened after I took my brother’s advice and saw his ENT physician --- Dr. James Palmer in Otorhinolaryngology (there's a serious tongue-twister) at the University of Pennsylvania Medical Center --- who, during my first visit, found I was a serious candidate for sinus surgery. After the surgery, I had to maintain a regimen that included nasal irrigation daily of a saline solution and a steroid in liquid form. As long as I did this, I felt much better. If I slacked off, I’d get sick.


Over the years, I sadly started to think of most primary physicians as more of a middleman between me and the specialist I needed. And when I no longer needed referrals, the role that primary care providers served became unclear to me, and I began to feel they were a waste of time, at least for me and others like myself.


As the years went on, I had to manage my care on my own, communicating with each specialty physician’s office and hoping that nothing fell through the cracks. With none of them knowing what the other was doing, might this lead to more problems and confusion? I never thought much about it until I underwent multiple rounds of fertility treatments to try to conceive our first child. This process only further highlighted the many things that fall through the cracks when it comes to our health.


Fortunately, in the fall of 2022, I had the opportunity to try membership medicine before making the full commitment, enabling me to learn whether it’s for me. And my first visit was actually fun. Yes, fun. It was a Friday afternoon, and the normally bustling office was quiet. I was able to witness for myself the friendly, welcoming vibe of a medical practice that feels like family — not only because some of the staff are family, but also from the way that everyone seemed to be treated like family. It was a casual, unstuffy vibe unlike the often sterile environment of most medical practices, with their receptionists who display emotionless facial expressions.


Preservation Health is a family-run internal medical practice offering a friendly, welcoming environment where patients feel seen and heard, where they come as strangers and leave as friends. All patients work with Dr. Keith Sadel, MD, an internist with over 25 years of experience, who believes that more time with patients equals better care. As Chief of Operations, his wife, Vivi Sadel, who also runs their float therapy and wellness center, Lma Mineral Float, is the unofficial office mom who might just offer you a cup of tea — while the office manager is the doctor's sister.


By moving to a membership model that focuses on prevention, lifestyle factors, and direct access to immediate care and specialty providers, Preservation Health alleviates long delays and wait times. Through direct, immediate care — which includes access to the doctor via his cell phone number — you can get help from your doctor, whenever you need it.


While in the waiting room, I was introduced to the doctor’s brother-in-law, one of his patients, a friendly, talkative guy who filled me in on his medical issues and more. Soon, I met with the doctor. My comprehensive initial visit with Dr. Sadel felt more like a casual friendly conversation than what often ends up being a rushed appointment. When he asked about my family medical history, I told him that my oldest nephew is now a freshman at Temple University, which happens to be where the doctor attended college and medical school and where he sent both of his sons to college. During the visit, I was given an EKG, something I’ve never had before. The doctor’s reasoning: Monitoring EKG levels over time can help to indicate medical conditions that may have gone undetected. I was impressed.


Despite having been at the office for some time, I came home that afternoon feeling energized and excited, telling my family, including my in-laws who were visiting us from Florida before our family vacation to Colorado for a cousin’s wedding, all about the experience. A passionate advocate about health and wellness, my mother-in-law enjoyed hearing about the philosophy of Dr. Sadel and Preservation Health. When I arrived home that Friday afternoon, though, I had no idea I’d be back to the office so soon.

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