FAQs

Direct primary care is a model of care that strips away the intermediaries between the doctor and the patient. Instead of paying for care via insurance premiums, patients pay directly for the care the doctor provides. This eliminates many of the head spinning problems with healthcare by getting rid of the red tape, and focusing on the relationship between the doctor and the patient. Like many direct care practices, we also provide wholesale labs, deeply discounted prescription prices, imaging discounts, and find other ways of saving patients money and time.

Sequoia MD is Sacramento’s first direct care practice. We provide care that is convenient, comprehensive, affordable, and very personal. This means treating you when they need it, and meeting you where they are. It means not rushing through appointments. The doctor-patient relationship is between the doctor and the patient. Period. There is no insurance company, government agency, or other party trying to dictate how the care should be provided.

There are some similarities, and the terms are sometimes confused. There is no standard definition of either concierge medicine (some work with insurance, some don't) or direct care, so comparison is hard. Both direct care and concierge medicine are focused on organizing care around the patient. Our waiting room is nice, and we can offer you a delicious cup of coffee if you’d like, but our focus is on authentic relationships and inclusive care. We are interested in saving our patients money by offering discount labs and medications-- this is not usually the focus of concierge medicine. We think this is a model that can work for pretty much everyone, and so we want to make sure our prices allow most people to join.

We could write a novel to answer this question, and most of it would focus on the insanity of the current system (plus, doing so would get us upset, and who needs that?). In short, direct care allows us to keep our overhead much lower, which in turn allows us to charge less, and pass the savings on. Because the overhead is lower, and the number of patients we see is lower, the amount of time we have per patient is higher. Because we do not have to structure our care to meet the needs of third party billing, we can redesign care to fit the patient's needs. This saves both physician time and patient time; what was an office visit could now be a phone call. By focusing on the elimination of waste (in effort, time and money), our costs (and the patient's costs) drop, and the service level rises.

The practice has been optimized to take care of patients, not to generate billing codes. Red tape? We took a machete to it. Many of the restrictions that doctors in traditional healthcare settings are forced to deal with are simply not there. That leaves time to spend where it's needed: with patients. Our focus and energy is on helping our patients, not filling out paperwork.

No. Blissfully, blessedly, no. This is perhaps the key difference that allows us to spend so much time with patients, focused on patients. The relationship you have between you and your doctor is between you and your doctor. Being paid by our patients means we are focused on serving patients’ needs, not insurance company (or government) dictates.

This also allows us a tremendous amount of flexibility. Have questions about a new medication? Want your doctor to look at a picture of a rash? Insurance companies don’t compensate doctors for that time spent on the phone (helping patients), reviewing blood sugars, or many of the other things you need to stay healthy. Since our goal is meet your needs, we are free to do that however, and wherever, that suits you best.

Cutting out insurance also saves our patients from the capricious, controlling decisions that make sense to a bureaucrat, but not to anyone else. For example, we offer you wholesale prices on laboratory tests, imaging, and medications, which is often not otherwise allowed by insurance contracts.

We recommend our patients have some insurance for unusual or high cost events. The idea behind insurance is to take care of the unusual or the unexpected. Life happens, and if something catastrophic were to happen, its best to have a financial backstop. Realistically, the medical care we offer is much more predictable than that.

Yes. You need only sign a waiver declaring that neither you nor your doctor will directly bill Medicare for our services. Medicare will still cover any laboratory testing, imaging, medications, or hospitalizations we prescribe. The same is true for Medi-Cal. However, if you have Medi-cal or Medicare, you will be responsible for the subscription cost.

This is a complicated question and an unsettled (and evolving) area of tax law. So, as strange as this sounds, we aren’t sure.