What Is Concierge Medicine — And Why It Changes Everything

Most people don't realize how broken their relationship with their doctor actually is — until they experience something different.

The average primary care visit in the United States lasts less than 18 minutes. Getting a same-day appointment often means seeing whoever is available. Reaching your physician directly — by phone, by text, in a moment that actually matters — is, for most people, not an option.

That's not a personal failing of any individual doctor. It's the predictable result of a system built around insurance reimbursement, not patient care. Physicians are incentivized to see volume. Patients are processed, not known.

Concierge medicine was built to solve exactly this.

What Concierge Medicine Actually Is

Concierge medicine is a membership-based model in which you pay a direct annual or monthly fee for a fundamentally different kind of physician relationship. In exchange, your physician limits their patient panel to a small number of members — which changes everything about how care is delivered.

At Makena Health, Dr. Josh Starbuck maintains a deliberately small panel of patients. Not because it limits growth, but because it is the only model that allows him to practice medicine the way medicine should actually be practiced — with depth, continuity, and genuine personalization.

This is not a luxury add-on to the healthcare system. It is a replacement for the part of the system that was never working.

What Makena Health Concierge Membership Includes

Membership at Makena Health is built around something most people have never experienced from a physician: genuine continuity, unhurried access, and a care model designed to understand your biology deeply — and intervene before problems develop.

At the core is precision medicine. Rather than waiting for symptoms or reacting to abnormal lab values, Dr. Starbuck uses advanced diagnostics to identify where your health is heading years before standard medicine would take notice. Multi-omic biomarker analysis, genomic profiling, body composition, metabolic testing, VO₂ max assessment, and longitudinal tracking of dozens of markers create a living picture of your physiology — one that evolves with you and informs every clinical decision.

This is preventative medicine practiced at its highest level. Not a yearly physical and a handshake. A comprehensive, data-driven strategy for extending healthspan, preserving cognitive and physical function, and catching the earliest signals of disease long before they become diagnoses.

In practice, membership includes:

• Same-day or next-day appointments — always, without exception

• Extended appointment times — never rushed, never processed

• Direct access to Dr. Starbuck by phone and text — a real physician, available when it matters

• Unlimited office visits — as many as your health requires

• Telehealth from anywhere in the world — continuity regardless of where you are

• Physician house calls to your home, estate, or hotel

• Deeply personalized care plans built around your specific biology, history, risk factors, and goals — not a generic protocol

• Advanced biomarker tracking with longitudinal analysis across key cardiometabolic, hormonal, inflammatory, and metabolic markers

• Genomic analysis to understand your inherited risk, drug metabolism, and precision supplementation needs

• Care coordination with world-class specialists — locally and across the mainland, through Dr. Starbuck's network via Longevity Docs and the Private Physician Alliance

• Integration of targeted longevity therapies — peptide therapy, hormone optimization, hyperbaric oxygen therapy, red light therapy, EBOO, IV nutrient therapy, VO₂ max testing, and more — each selected based on your data, not a menu

Every element of this model is built around a single principle: manage trajectory, not just diagnosis. Most medicine waits for something to go wrong. Makena Health is designed to ensure it doesn't.

This is medicine that knows you. Not your chart — you.

How This Differs From What Most People Experience

Dr. Starbuck practiced as an Internal Medicine Hospitalist at Maui Memorial Medical Center for five years before founding Makena Health. He has seen, from the inside, what happens to patients inside a volume-driven system — and he built Makena Health as a deliberate departure from it.

His perspective on medicine is also shaped by something more personal. During his residency, he was hospitalized with acute renal failure, diagnosed with IgA nephropathy, and ultimately required a kidney transplant — donated by his sister. Having navigated serious illness as a patient, Dr. Starbuck understands the vulnerability, confusion, and need for a physician who is genuinely present.

That experience is not a footnote. It is the foundation of how he practices.

Who Concierge Medicine Is For

Makena Health's concierge members share a common orientation. They are proactive, not reactive. They don't wait for symptoms to prompt action. They view health as their most important asset and make decisions accordingly.

They include:

• Executives and entrepreneurs who cannot afford to be reactive about their health

• Families on Maui who want a physician who knows every member, not just a file

• High-performers seeking to optimize cognitive and physical function, not just avoid disease

• Individuals who have watched a parent decline and are determined to intervene earlier

• Visitors who spend significant time on Maui and want a physician relationship here that matches the standard they hold everywhere else in their lives

What they have in common is this: they have experienced conventional medicine and found it insufficient. Not because their doctors weren't good physicians — but because the system those physicians operate within was not built to serve people like them.

The Executive Physical as a Starting Point

Many of our concierge members began with an Executive Physical — Makena Health's comprehensive diagnostic program that includes advanced cancer screening with Galleri, cardiac imaging with Cleerly, genomic analysis, VO₂ max and metabolic testing, full biomarker panel, and a personalized action plan from Dr. Starbuck.

It is the most thorough health assessment available in Hawaii. And for many patients, it is the moment they realize what medicine can actually look like when it is done without shortcuts.

From that foundation, concierge membership becomes the logical next step — the ongoing relationship that turns a diagnostic snapshot into a longitudinal strategy.

Why Maui

Makena Health is located in Wailea, on Maui's south shore — one of the most restorative environments on earth. For residents, this is their medical home. For those who visit regularly or seasonally, it is an opportunity to establish a physician relationship in a place that already serves as a sanctuary.

We work with patients from across the country and internationally. Many travel specifically to access this level of care. All leave with a physician who knows them, a care plan built around their biology, and a direct line to Dr. Starbuck when they need it.

If You're Considering Membership

The first step is a conversation. We're happy to answer questions about what membership looks like, what it includes, and whether Makena Health is the right fit for you and your family.

We don't practice transactional medicine. If you're looking for the same, we'd like to meet you.