Direct Primary Care & Addiction Treatment


Frequently Asked Questions

What’s Direct Primary Care (DPC)?

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.

What is Sequoia MD?

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.

Is this the same as concierge medicine?

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.

How can you offer so much at such a low price?

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.

What is different about Sequoia MD?

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.

Does Sequoia MD accept health insurance?

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.

Will I still need health insurance?

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.

What if I Have Medicaid or Medicare?

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.

Is my membership to Sequoia MD tax deductible?

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

What happens if I need the hospital or a specialist?

This probably (hopefully) will not happen much. Because of the easy access you have to your doctor, it is possible to handle problems in the office rather than the hospital. Our goal is to keep you out of the hospital. However, sometimes a specialist, or a hospital admission, is required. In those cases, we expect to work closely with your hospital team or specialist. The goal is to take good care of you, whatever your circumstances, and wherever you get your care.

Can children join Sequoia MD?

Yes! We are happy to accept patients of any age. Children need to have one parent enrolled in our practice. At this time, we do not offer routine childhood immunizations (though we do recommend them), but will work with you to obtain them for your child.

If we are seeing your child for the management of type 1 diabetes, the fee is $85/month, and we do not require a parent to be enrolled.

Can I contact my doctor after hours? And how?

Of course! Life doesn’t stop at 5 o’clock, and neither do your health needs. The idea behind Sequoia MD is that you can reach your doctor when you need help. Sometimes, that is not during normal business hours. As to how, there is telephone, email, text message…

What if I travel or am away from home?

For people who are often on the road, we are able to offer a level of care that is nearly impossible to match. The fact that we know you, and many illnesses can be managed over the phone or via video, means we can help things stay on track even if you can’t come in to the office. If needed, we can even send some medications to the pharmacy for you. Or, if your symptoms sound like they really need to be managed more urgently, direct you to a local hospital.

Do you share my medical records?

Only if you ask us to. Otherwise, what you say in private remains private.

How do I know if I will like the doctor?

Give us a call! The doctor is happy to chat with you, so you can get a sense of what we can offer.

Why does addiction treatment cost more?

Treating opiate dependency requires a higher level of ongoing care and time. Because of this, our long-term costs are to provide this level of care are higher. However, you will likely find the cost of treatment with Sequoia MD to be less than the cost of most other providers in the Sacramento area - plus, we can take care of your other primary care needs at the same time for the same price.

Will I still be able to see my regular doctor?

Of course! If you already have a primary care doctor, you are welcome to see us only for opiate dependency treatment - whatever works for you.

Can I see you just for Type 1 Diabetes?

Sure thing. If you already have a primary care doctor, you are welcome to come in only for diabetes - whatever works for you. Conversely, you can keep your specialist, and see us just for primary care. The choice is yours.

What about privacy?

Because we do not contract with insurance companies, your information stays with us. We will never share it (unless you ask us to) with any third party. In fact, some patients turn to Direct Care because the level of privacy is so great.

Get a Free Consultation

Book a free consultation right now and sign up for our services.

Admissions FAQ

What are the steps of the admissions process?

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.

Is Sequoia MD accredited?

There is not an accreditation. We practice medicine. We’re all licensed. I’m board certified in addictions and family medicine.

How is Sequoia MD different from other programs?

  • Subscription based
  • Significantly more time with clinicians/more comprehensive
  • Not a mill
  • White glove approach
  • Accessible
  • Focused on and invested in patient’s long term care
  • More services than most outpatient substance abuse treatment clinics

What if my loved one is not ready for treatment but needs it?

We often have appointments with family members if they are not ready to stop using

Goal is harm reduction/meeting people where they are

Sometimes people are willing to stop one drug but not others (ex. Stop heroin but want to keep using meth). We can work with this.

What happens if I have a pending legal issue?

Many of our patients do. We work with you around this.

What happens if I need transportation assistance getting to treatment?

That is not generally something we arrange. However, after the first appointment, there is flexibility with video and/or phone visits.

Clinical FAQ

What therapies do you provide?

Medications (buprenorphine– injection and SL, naltrexone pills and injection, acamprosate, disulfiram. Associated physical and mental health treatment and evaluation. Groups (starting soon). Coordination with other local providers. 

How often do clients attend therapy?

Every 2 weeks to every ~3 months, depending on where someone is in their recovery

How long can I expect to be in treatment?

Up to you. We don’t like to advertise this number much, but we tend to stress its the patient’s choice. However, we view addiction as a chronic disease which means on some level, treatment is life long. However, that does not mean people need to see us for the rest of their life.

Is my treatment confidential?

Highly confidential. Some people come to us because they do not want insurance knowing they are in treatment. 

How many times a week will I receive individual therapy?

We are not therapists. We tailor a treatment program to the individual. Some people, for example, go to meetings in the community daily. Others can't stand meetings. We start with what works for the patient, what they are willing to do, and build on that.

How will my treatment plan be decided?

It's a conversation between the clinician and the patient. Ultimately, the patient decides what is best.

How will my family participate in treatment?

That is at the patient’s discretion.

Is there a Psychiatrist on staff?

No, though we have relationships with psychiatrists in the community.

Primary Care FAQs

What conditions do you specialize in treating?

Normal primary care: acute illness, chronic disease management, and preventative care.

How do I make an appointment?

Call, text, email.

What don’t you treat that people might assume that you do?

We do not prescribe a lot of controlled substances for mental health or chronic pain. Sometimes, people assume that because they are paying us, we will write prescriptions for whatever they ask. This is very much not the case. 

Subscription FAQs

How many times can I have appointments per month with the subscription models?

As many as needed

Am I locked into a contract?

We ask for 3 months for primary care patients. Otherwise, cancel with 30d notice

Can I access other services that Sequoia MD offers?

Everyone gets everything…however, if primary care patients become patients on the addiction side, then the subscription fee gets adjusted.

We Make It Easy

How It Works

Sign Up for Care

On this free call one of our doctors will answer any questions you have about our practice and approach.

Personalized Healthcare

We’ll work together to identify the best care to fit your unique health concerns and craft a treatment plan that works for you.

A Happier, Healthier Life.

Our accessible approach to healthcare means you can stop worrying about your healthcare and start enjoying your life.