FAQ
Direct primary care is a new model in which patients pay their primary care doctor directly, rather than through their insurance company. In practice, that means patients typically pay a monthly or annual fee straight to their doctor instead of paying an insurance company premiums and co-pays.
The Direct Primary Care model also includes Concierge Medicine.
With the advent of Electronic Medical Records, many PCPs have to balance treating patients with complex insurance coding requirements as well as employer and insurance company demands. The result? In traditional fee for-service-practices, doctors spend an average of only 8 minutes per patient. Additionally, most large employers demand minimum numbers of patients seen per day and large patient panels. This results in patient’s calls not being addressed, patients routed to ER or Urgent Care, and a larger proportion of patients cared for by midlevel providers.
What has fallen by the wayside in this model? The patient-physician relationship. Our relationship. You and I.
This model does allow the focus to be back on our relationship. I have a small office, a small staff, I limit the number of patients in my practice, so I can focus on you. The office visits are often extended. Your calls will be answered, and your problems addressed. You will have access to my personal contact information. I will give you multiple modalities to receive care, including telephone, text, email and video chat. And if you need to be seen, my goal is to provide same or next-day access.
You are allowed to see a DPC physician if you have insurance, I simply will not bill your insurance. You will pay me directly for care. I am considered a non-participating provider.
No. Our practice is designed to be unencumbered by the constraints and limited reimbursement of insurance plans so that we may better serve and care for our patients. You will NOT be charged for office visits or co-pays. You only pay the membership fee.
Yes. My medical practice is NOT a health insurance program. It is very important to maintain insurance and/or Medicare to cover expensive, unusual and unpredictable events such as surgery, emergency room care, hospitalization, labs and x-rays. BUT NOT for everyday preventative primary care!
The current insurance-based healthcare system actually makes primary care MORE expensive, difficult and less effective too. Our practice does the opposite. By charging a set fee, I can spend more time with you and focus on your individual health needs to maintain and improve your health. I want you to see me as often as you need to, because my goal is healthy and happy members!
I will make courtesy visits to the hospitals where I am on staff. I will discuss your case daily with the hospitalist, review your plan of care, answer questions and make recommendations to make your stay as comfortable as possible.
In hospitals where I am not on staff I will directly communicate with the hospitalist. Hospital admissions for serious medical problems are stressful and often confusing for patients and their families. During hospital admissions, you will be assigned to a hospitalist with whom I am familiar and have established a working relationship. These physicians are available in the hospital 24 hours a day and specialize only in hospital care. I will act as your health care advocate and communicate with you and your loved ones.
This model works well for anyone desiring a personal relationship with their physician. Patients with exceptional health insurance or those paying a high monthly premium are unlikely to see a cost savings but will certainly stand to benefit from personalized care. The model works very well for healthy people who have the option of choosing a high-deductible plan, like myself, because the monthly membership allows most medical needs to be met by your
PCP without additional visit costs.
Additionally, DPC physicians typically form alliances with community services that are able to offer cash-pay pricing for labs, imaging, PT, etc. These fees are often less than insurance co-pays and can give patients the option of choosing to pay upfront to save on healthcare costs.
Yes, on a case-by-case basis, I can make arrangements to see you in your home when medically appropriate. Depending on office demands, I may be able to see you in your home at your request for an additional fee.
As your primary care physician, my extensive training allows me to handle most of your health care needs. However, in the event that you do need to see a specialist, I will find the right doctor for you and make sure you know who you are seeing. This referral process will include direct physician-to-physician consultation prior to your appointment with the specialist and direct coordination of your visit.
And after your appointment, if you have questions or concerns about your visit with your specialist, I will address these issues at an office appointment or by phone, email or video conferencing.
For problems that are not life-threatening emergencies, you can contact me 24 hours a day, 7 days a week. In most cases, I can diagnose and treat your need without a visit to the ER. In fact, concierge medicine has been shown to result in fewer ER visits for members because we can discuss your medical needs any time of the day or night.
If you have a life -threatening emergency, call 911 immediately. A family member or caregiver can call me later to alert me of your situation, so I can be in contact with the emergency room.
As a member of WholeLife DPC, you are never alone. Even when out of town, I will still be available by phone for your urgent needs. You will be notified by email prior to any vacations. If I am not available, I will have another trusted medical professional available to assist you for any urgent matters or to be seen in the office.
Yes. One of the most important aspects of private medicine is limiting the practice size to be able to devote more time and energy to each patient. Therefore, once we at WholeLife DPC have reached our ideal practice size, a waiting list will be established.
You are welcome to cancel your membership at any time as long as you give us 30 days’ notice. We will refund memberships paid for the full year at a prorated rate.
We’re so happy you are ready to become a member of our practice.
