Residents of La Mesa, Mt. Helix, Rancho San Diego, and nearby East County communities now have access to a new healthcare option focused on access, continuity, and personalized attention.
Dr. Thomas Ence, 40, a board-certified emergency medicine physician, recently joined Coastal Concierge Physicians, a concierge medical service offering 24/7 telehealth and in-home visits for a wide range of acute and everyday medical needs. He leads the practice’s East County expansion, where he has built his own patient panel.
Ence said the practice grew out of his years working in emergency departments, where he often saw patients seeking care not because they required emergency intervention, but because they had few timely alternatives.
“Patients want fast, personalized care from a well-trained doctor—without the chaos of the emergency room or the delays of traditional clinics,” he said. “This is for anyone who wants a physician who makes house calls, knows them as an individual, and is well trained in handling any acute needs that arise.”
Coastal Concierge Physicians provide around-the-clock care for injuries, ear and throat infections, bladder infections, migraines, abscesses, strep throat, sports injuries, and seasonal illnesses. Services also include physicals, laboratory testing, imaging coordination, allergy care, medication refills, and COVID and flu testing.
“We’re here for essentially anything a patient may need in an acute setting,” Dr. Ence said.
Unlike traditional primary care practices, Coastal Concierge Physicians does not accept insurance. Patients instead enroll in a monthly membership that provides direct access to their physician. Ence said this approach allows him to spend more time with patients while avoiding administrative barriers that can slow care.
“I work directly for you—not the insurance company,” he said. “That means faster care, longer visits, and no surprise bills. Patients should still keep regular health insurance for hospitalizations, specialists, or major testing, but for day-to-day care, this approach is much more streamlined.”
Membership pricing is published and straightforward. Individual plans cost $300 per month, while family plans cost $600 per month. Membership includes same-day or next-day care and direct phone and text access.
Ence said transparency around pricing is intentional and addresses a common frustration among patients.
“People often don’t know what their care will cost until they receive a bill,” he said. “We wanted everything to be upfront, so patients know exactly what they’re paying and what they’re getting.”
House calls are a core part of the practice. Patients typically begin care with a call or text, then work with Ence to determine whether a telehealth visit or an in-home visit is the best next step.
“I actually find great pleasure in stepping into a patient’s home and caring for them there,” he said. “You see their environment, their support system, and you’re able to deliver care in a way that feels unrushed.”
Concierge medicine has gained traction in recent years as patients and physicians look for alternatives to increasingly strained healthcare systems.
Ence said insurance-driven medicine has placed growing demands on physicians while reducing time spent with patients.
By contrast, the concierge model allows him to maintain a smaller patient panel while offering more direct access. He continues to work in emergency medicine, which he said strengthens his concierge practice rather than detracting from it.
“Maintaining those emergency skills is important,” he said. “It would almost be a disservice to my concierge patients if I didn’t stay sharp in that setting.”
Dr. Ence serves East County communities, including La Mesa, Mt. Helix, Rancho San Diego, and surrounding neighborhoods. He said focusing locally allows him to provide timely in-person care while building long-term relationships.
“We’re building relationships and providing care that fits each patient’s life.”
More information about Coastal Concierge Physicians is available at www.coastalconciergephysicians.com. Dr. Ence can also be reached at drence@ccphysician.com or (801) 592-0342.
