What is DPC (Direct Primary Care)?

DPC is a newer model of medicine that blends old-fashioned care via a direct relationship with your physician, and the technology of today (email, text, telemedicine, video chats). It is personalized, accessible care. This includes longer clinic visits (usually 30 to 60 minutes) as often as needed, without copays or additional fees. It means speaking to your doctor when you have questions, not a phone tree. It means not waiting weeks or months for anappointment.

This is comprehensive primary care for an affordable, flat monthly fee. Wellness care, chronic disease management, many acute issues such as injury or illness, and some in-office procedures (strep swab, UA, abscess drainage, stitches/glue, etc.) are all part of Direct Primary Care.

DPC is NOT insurance – hospitalizations, surgeries, emergencies, and specialists are not covered by DPC. Labs, imaging, medications, and pathology are available at a discount for out of pocket payments (or you can use your usual insurance if you prefer). Occasional additional costs may be incurred for in-office medications or supplies (crutches, splints, etc.). These costs will be discussed up front. No surprises. We are all about transparency.

What is not part of DPC at Vineyard Health?

DPC is certainly comprehensive care, but obstetrics and pediatrics are not included. I also do not do chronic pain management (with controlled medications) except in palliative/hospice/end of life patients. I may offer flu vaccines, depending upon the volume of requests. I will advise on other recommended vaccinations, but am not be able to offer them in the office. Please also see the Direct Primary Care tab to see what services are covered and not covered, or available at a discounted rate.

Out-of-office care, such as emergencies, hospitalization, surgery, and specialist care, is not covered in DPC. Any care provided by other healthcare professionals outside of Vineyard Health is also not covered.

What about insurance?

I do not bill insurance. My only commitment is to you, the patient. Because DPC physicians eliminate the significant bureaucratic burden of participating in insurance or Medicare, we can pass the savings on to you – and provide compassionate, attentive, and timely care at an affordable cost. Your medical records are private, and never shared with a third party unless you request it (or as required by law). Insurance is not required for my services.

Direct Primary Care is NOT insurance and does not replace insurance. Insurance or alternative cost-sharing plans are encouraged in case of emergencies, surgery, hospitalization, or specialist care. You can always use your insurance for medications, labs, and imaging if you prefer. In the event of hospitalization or specialty referral, I will work closely with your hospitalist or specialist to help inform your care and for your transition out of the hospital. I do not admit to the hospital. If you are unsure about what kind of insurance you need, I can recommend an insurance broker to guide you.

Do you take Medicare patients?

I do not bill Medicare, nor can my services be billed to/reimbursed by Medicare. I see Medicare and Medicare-eligible patients for direct pay/cash pay (same as for all patients). Medicare patients can chose to participate in the DPC membership or use my consultation services, but will need to sign a waiver that neither you nor your doctor (me) will bill Medicare for my services.

As with other private insurances, Medicare will still cover outside services as usual if prefered (labs, medications, imaging, etc.). Participating in DPC does not in any way affect your Medicare coverage for other outside costs, and I am still able to make referrals or order tests and medications to be covered by Medicare.

What if I’m healthy? Will I still benefit from DPC?

Absolutely! Rather than reactionary medical care, DPC allows you to be proactive in your care, making plans to stay healthy. This is healthcare that is tailored to the individual. You can call and ask questions, use email, or make a visit to discuss concerns before they become medical problems. This is preventative care at its best, reducing risk of disease in the future. And, of course, we are there for acute illnesses, like a sore throat or UTI, as well injuries like sprains, strains, and small laceration repairs.

What if I have chronic medical issues and/or complicated health problems?

DPC is a great way to manage or control chronic conditions and complex medical issues. This is high quality, customized care. We can have more frequent visits and follow up by phone, email, or video chat. I am happy to offer education and support to help you be as healthy as possible, and with nutrition and lifestyle education, some patients are able to control, improve, or even reverse some of their conditions. Because we have more time, we can address important issues as often as needed. Remember, 80-90% of healthcare is manageable by primary care.

What if I am out of town/traveling?

We can stay in communication by phone, email, or video chat. Medications can be called in (if in state) or mailed. If you need urgent care or hospitalization while out of town, I will happily speak with your treating physician(s).

Are the monthly fees tax deductible or eligible for HSA/FSA reimbursement?

Please consult with your tax advisor for guidance. The monthly membership fee is not currently tax deductible, although legislation is in the works.

Do you do pain management?

I treat pain with lifestyle changes, supplements, OMT, and sometimes, medications.

I do NOT prescribe chronic controlled substances (opioids, stimulants, sedatives) except in palliative/hospice patients for cancer or end-of-life symptoms.

If you are on chronic controlled substances, I will see you as a patient for your other medical conditions and deliver great primary care, and will communicate with your pain specialist. We do not keep opioids or other controlled substances in the office.

What if I decide to cancel?

This is a relationship built on trust and respect. There is a 3-month commitment upon enrollment. To cancel, I ask for a 30-day notice. If you decide to rejoin at a later date, you may be charged a re-initiation fee.

If you cancel prior to the 3-month initial term per your contract, you will be responsible for the remainder of the cost of the commitment, or be billed per the consultation rate of $200/hr for in-person and all associated time spent in receiving/revieiwng documents, coordinating care, and communications, whichever is less.

What are your office hours?

Currently, all visits are by appointment only during usual business hours Tuesday - Friday, although these can often be same day or next day for urgent matters. I am available by phone after-hours for urgent needs. Many people find the convenience of a telephone or video visit, or the ability to call or email, to be a big time-saver when an in-person visit is not needed. Home or work visits may be available for a small additional fee, with distance restrictions. For urgent matters, please call (do not email or text for urgent after hour matters, always call).

If there is an emergency, please call 911. You can always call me with an update from the ER.

Is this concierge medicine?

No. The principles are similar, both valuing the patient-physician relationship and high-quality care. They are both responsive to patients’ needs and have more availability than the standard doctor’s office.

Direct Primary Care does not bill insurance, and in principle, aims to provide more affordable care, with discounted prescription medications, labs, and other cost savings. DPC is sometimes referred to as “concierge for the rest of us”, essentially a high level of care and attention at a more affordable price. They both focus on the gift of time. Far more than available at the usual doctor’s office.

How can I enroll?

Click on the "Enroll" button to sign up (Home and Contact tabs).

Click on the CONTACT button to ask questions or make an appointment.

I will send you an email with available appointments for an initial visit, and paperwork that must be signed and returned.

I own a business. Can I provide this service to my employees?

Absolutely. Because we can offer appointments on short notice and even by phone/video, our patients (your employees) can be treated quickly and conveniently.

We are not a worker’s compensation provider, but we can often treat minor problems without additional fees that are not part of a worker's comp claim.

What if I only want a visit for OMT or Lifestyle Medicine?

I am happy to do one-time or occasional visits for these consultative services. Lifestyle Medicine consultations are generally limited to couseling on diet, activity/exercise, mindfulness, sleep, and other health-promoting lifestyle changes, and include review of your labs and other relevant data. This is not primary care, and will not include ongoing treatments or prescriptions, but I will happily provide a summary of our visit including recommendations. These visits can be in-person, by phone, or via video chat. OMT is hands-on and only available in-person. This is not considered primary care, and does not include ongoing treatments except as per visit.