For many people the idea of a medical practice that doesn't take insurance is unfamiliar and some think that it's not worth it to pay for office visits on top of paying for  insurance. So I want to explain my thinking and create some context for you. Here's why I think it's a good idea. In order to work with insurance a practice needs to see more people in the same amount of time, which generates more paperwork. The increased number of people and the increased paperwork requires a practice to hire someone for billing and someone for scheduling.  This is very difficult for newly graduated Physicians to do because they already have medical school loans to pay off at the same time they are starting a family. Consequently, most Physicians join practices that are owned by hospitals or other large organizations. Then, all of the other people in those organisations need to get a piece of the pie, so prices increase. Patients don't see these prices because insurance pays for them, but they experience the friction created by being cared for by a practice owned by a very large organization  in the form of long wait times, a very slow response rate to phone calls or emails, rushed office visits, and impersonalized service. After everything is factored in people end up spending more through the costs of wasted time, increased stress, and avoidable visits to urgent care or the ER due to slow office response times.  
    In our practice you will not wait more than 20 minutes without being compensated for your time, you have direct cell access to your provider and will receive a return call, text, or email within 48 hrs, visit times are never rushed, and we will know and actually care about you.  Since we are a small physician owned practice our overhead is low, so we can offer these services at affordable prices. The new patient visit is about the cost of a nice dinner for two people, $100 - $150. Follow-up visits are about the cost it takes to fill up a SUV with a full tank of gas, $50 - $75.   These charges are based upon the amount of time needed for the visit. insurance will still take care of any labs or Imaging we order, and we draw labs in office for your convenience. For your average person who only needs to come and see the doctor two to four times a year (price range for 2-4 vists $150-$375), the cost is quite low for what you get.

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As part of the move to our new space this Novemeber 4th we will begin providing primary care to patients.  This does not mean patients have to do their primary care with us if they want to recieve only Osteopathic manipulation and keep their current primary care provider.  The same is true if you want to come to the clinic for  Primary Care, you are not required to receive Osteopathic Manipulative Medicine.  Our goals in providing Primary Care are to create a healing environment where you feel at home.  One where the provider-patient relationship is taken care of.  In service to this goal we will not be working with insurance because of the constraints that are placed on that relationship if we do.  The main reason that working with insurance constrains the patient-doctor relationship is that it provides no incentive to take care of that relationship. It only incentivizes the physician to go as quickly as possible, to see the most patients in order to bill the most.  Then the physician is left with a mountain of paperwork that they frequently stay after work to complete. If the provider is not happy and ease, he or she will not be fully available to take care of their patients. If they're not fully available, they may miss something.  By taking Insurance out of the picture we can take our time and decrease the typical stresses associated with seeking Medical Care.This does not mean that our prices will be unattainable. in fact, we plan for a simple follow-up (15-30 minutes) visit cost somewhere from $50 - $100 And a new patient visit (about 45 min - 1 hr) to cost between $125 - $175.  We know that the relationship with the patient is a piece that has been undervalued in recent years. This is because it's not reimbursed by Insurance, so it tends to fall by the wayside. The trend has been for Physicians to spend less and less time with their patients, and this rush has decreased their job satisfaction, the quality of the relationship with the patient, and led them to focus too much on what medication can they prescribe. This approach makes it difficult to be holistic.   The top five causes of death in the United States are lifestyle-related, that means they're created by daily choices. Thus, preventative medicine is a crucial component for Physicians to focus on in our society today. The current Insurance system makes it difficult to do that well. We take the time to consider the context in which you live. Inquiring about diet, exercise, relationships, vices, and fulfillment with life in general. All of these aspects of your life influence health and well-being. of course we are also able to take care of all of those other typical Primary Care things such as prescriptions, Laboratories, Imaging, Etc.  In fact, we have a relationship with a laboratory so we will do in office collection for all of our labs, which means you won't have to run over to another place to get it done. Additionally, we have a relationship with a pharmacy that can deliver medicines directly to your home. Our goal is to minimize the stress of Medical Care as completely as possible, and hopefully make an enjoyable experience were you know that you are important and you feel taken care of.  This is our commitment to you.

Most people have some sort of addiction.  No matter the substance that the addiction is associated with the pattern is basically the same.  We have a feeling in our body, me subconsiously conclude that that feeling is bad and we need to change it, we erroneously conclude that the way to fix this bad feeling is to take the substance.  Let's look at sugar to start as an example.  For people who are addicted to sugar they use it as an escape, a way to alter their mood temporarily and avoid confronting a feeling.  Of course there is a way to have a healthy relationship with sugar, but when the relationship is being abused it can be an addiction like anything else.  When it is overused over time we feel worse and worse.  Maybe because sugar causes us to put on more fat and we don't look the way we want to, or because of the physiologic changes from diabetes.  Either way this bad feeling becomes a reason to use more sugar to try and alter our state.  In addition, the bad feeling itself can simply be withdrawl from the substance.  If we eat too much sugar, too regularly over a long period of time we will become tolerant to it (meaning we need more to get the same mood altering effect) and if we take it away we will experience withdrawl.  I know of people who went through headaches, nausea, irritability, difficultly sleeping all from sugar withdrawl.  Now, we can replace sugar with any other addictive substance and the process will be the same.  Bad feeling, subconsious mental conclusion that leads us to use substance, altered mood, experience negative effects of altered mood, experience withdrawl from substance, repeat cycle.  So, addiction is a common human strategy to deal with suffering.  The problem is that it creates more suffering.  It is better to notice the feeling that starts the whole process, look it right in the face, accept, and feel it.  Typically we need counseling to help us be successful in this approach.  
    For someone who is already addicted to something, it can be quite difficult to break the cycle.  Today we see more people dying from Opiod overdoses than any other form of accidental death.  Cigarette smoking has been a leading cause of cancer for years.  There are ways though to untangle even these very strong addictions.  I, Dr. Starsiak, recently completed additional training to be able to prescribe buprenorphine.  This is a medication that helps with stabalizing opiod/opiate addictions.  Most people who try to quit opiods/opiates on their own return to usage within a year, >90% of people in fact.  Buprenorphine is a medication that will stabalize the addiction.  It does not create a high like the opioids that people typically abuse recreationally.   Instead, it will prevent withdrawal symptoms and eliminate cravings for other opioids. This allows a person to get their life in order, to develop a support system, to go through counseling, basically to experience stability, so when they're ready they can be more successful at completely quitting opioids. In fact, buprenorphine itself is an opioid but the way it interacts with the opiate receptors is different than commonly abused opioids and opiates. It does not fully activate the receptors, so it doesn't create the same high. It does however prevent withdrawal and cravings so a person can go on living their life.  Typically a patient needs to be sustained on buprenorphine for at least a year before attempting to  taper it down. Studies show better success rates  with long term abstinence with sustaned mantainence on buprenorphine compared to using buprenorphine to detox quickly from another opiate and then stopping the buprenorphine. Success rates of long-term abstinence go up the longer a patient is on this medication. A patient takes this medication at home and only needs to come into the office once a month to be reassessed, so it is quite convenient and will not interfere with daily life. The phase where we switch over from whatever the abused opiate or opioid are to buprenorphine is called induction. Induction can be done at home or in my office depending on a few medical variables along with the patient's preference. the risk of death from opiate / opioid overdose is quartered when someone is on buprenorphine. So, it really is a matter of life and death for many.  If you are struggling with opioid or opiate addiction please give me a call. I will help.