I’m quite healthy and don’t go to the doctor often. Will I benefit from membership even if I don’t require frequent medical attention?
Yes – you will benefit. Even if you don't require frequent medical attention, membership is a smart idea.
Unfortunately, health issues are unpredictable, and at some point you will be sick or injured and need acute care. Now more than ever, it is essential to have a doctor who knows you as a person, and who will advocate for you. I will provide first-class care and also do my best to protect you from the perils of the rampant overtreatment and excessive intervention that characterize so much of modern medicine.
Our office is a place when you can feel comfortable being yourself, and be honest about achieving your wellness goals, which may range from weight loss to HIV prevention. The core philosophy is a back-to-basics approach, emphasizing a healthy lifestyle, diet, and exercise. No nonsense. I'll remain a voice of reason in the age of information (and misinformation) overload.
If we can save you just one trip to the ER over the next two or three years – then just a single year of membership will pay for itself.
If I move out of town, can you still be my doctor?
With the new practice model, I can continue to be your doctor whether you relocate to Los Angeles, Lagos, or London – if you'll pass through NYC once in a while. We will remain extraordinarily accessible and available to you, and optimize emerging tech solutions to provide you with the most convenient and efficient care possible. Ultimately, some care must be provided in-person, so we must be realistic about expectations.
What about innovative tech solutions?
The new membership model will optimize emerging tech solutions to deliver the most convenient and efficient care possible.
That being said, our main focus is the essential human element that is at the heart of the doctor-patient relationship. Technology can be liberating, but at the end of the day, a person is not an algorithm.
Along with Sophia and Stephanie, our spectacular office staff, we’ll continue to help you navigate the red tape and administrative absurdities plaguing the rest of the health care system.
Can I skip the membership fee and just pay to come in once a year, or when I need to?
No. The monthly fee structure reflects the value of an ongoing and meaningful relationship, as the nature of our practice is not just simply transactional (like a visit to the dermatologist’s office, for example). Our practice is person-focused, not problem-focused. If you decline to enroll, I will no longer be your physician after December 31, 2017.
What if I decide to cancel my membership? Can I re-enroll later?
We expect to have a straightforward, honest, and respectful relationship with you. There is no minimum commitment beyond two months. We ask that you give us 30 days' notice if you wish to cancel. If you choose to re-enroll down the road, and the practice is full, you will be placed on a waiting list for new patients. The re-enrollment fee will be $399.
Will you accept health insurance for your services?
No. Our office will be out-of-network, and we will not submit claims to your insurance company for our physician services. The Direct Primary Care model liberates us from corporate health care’s nonsensical, opaque, impersonal, and expensive approach to primary care – and allows us to provide you the convenient and phenomenal care that you want and deserve.
Continue to use your insurance to pay for bigger ticket items, such as medications, laboratory studies, blood tests, vaccines, imaging, specialist fees, emergency room visits, surgeries, procedures, and so on.
Will I still need health insurance?
Yes. This membership is not insurance, and you should maintain insurance. We recommend a high-deductible plan, which may be offered through your job, the NY State of Health exchange, or a broker.
Is my membership fee tax deductible?
There is currently a lack of clarity in the tax code about how Direct Primary Care (DPC) agreements should be treated vis-à-vis Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs). The Affordable Care Act clearly recognizes Direct Primary Care as a delivery reform. Your membership fee includes the cost of an annual physical exam, and around the country individuals are using their HSA/FSA dollars to pay for this (as prepaid fees for a qualified medical service). However, keep in mind that any dispute (audit disagreement) would be between you and the IRS, you are bearing the legal risk, and you should consult with a tax professional for up-to-date clarification. HSA/FSA dollars may be used for any copays, medical acupuncture, and other qualified medical expenses. This whole issue should be clarified soon, in light of the Affordable Care Act’s promotion of DPC, and pending bipartisan federal legislation (HR 365: Primary Care Enhancement Act). Direct Primary Care is one thing that both parties agree on, so we’re hopeful.
Why is there a copay for in-office visits?
NY State Law requires that a membership model practice must charge an additional fee for care related to fortuitous events. This does not apply to your Annual Physical.
Is there a limit to the number of in-office visits per year?
After 16 in-office visits per year, we must charge a higher copay for in-office visits. This is in accordance with NY State Department of Insurance regulations. Click Enroll Now and see the Member Contract for more information.
What about medical acupuncture?
In-office visits for acupuncture will be subject to a higher copay. Click Enroll Now and see the Member Contract for more information.
I am uninsured. Can you still be my doctor?
Yes. But we strongly recommend you maintain health insurance.
How are membership fees paid?
The credit card or bank account provided at enrollment will be charged automatically each month.
Can you refer me to specialists?
PPO and EPO plans (carried by the vast majority of our patients) do not usually require that a referral be processed by an in-network doctor. Some HMOs have strict network requirements, and may not accept a referral from our out-of-network practice. You should check with your insurance company for more information.
What is your policy on controlled substances?
Abuse and diversion of controlled substances is a serious problem. We have a general policy of not prescribing controlled substances. These include, but are not limited to: Ambien (zolpidem), Adderall, Vyvanse, Ritalin, Focalin, Concerta, Valium (diazepam), Klonopin (clonazepam), Xanax (alprazolam), Ativan (lorazepam), Lunesta, Halcion, Tramadol, Percocet, Vicodin, Methadone, Oxycodone, Oxycontin, Soma, anabolic steroids, and so on.