The most common question I get from prospective patients is simple: what am I actually getting for the membership fee? Fair question. Here's the concrete answer in my practice, not a generic concierge-industry brochure.
Direct access to me
Every patient gets my cell phone number. That's not a nurse line, not an answering service, not a covering physician. It's me. Text, call, or email; I answer directly, usually within minutes during the day and within a reasonable window overnight. If you wake up at 2 a.m. with chest discomfort, notice a concerning rash on a Saturday, or want to ask whether a supplement interacts with your blood pressure medication, you reach me.
This access is the cornerstone of the membership. It's also the thing that's hardest to replicate at scale, which is why the practice is capped at 50 patients. If I were carrying 300 or 500, the cell phone would ring differently.
Same-day visits when you need them
In traditional medicine, getting an appointment for a new issue often means waiting two or three weeks. Acute problems either resolve or escalate before you're seen. In my practice, same-day visits are the norm when something is wrong. House calls across Palm Beach County are included; I come to you when that makes more sense than you coming to me.
Visits aren't rushed. Most run 30 to 60 minutes. That's enough time to actually talk through the concern, review medications, discuss sleep, stress, work, and anything else that turns out to matter, and leave with a plan.
A comprehensive annual physical
The annual wellness visit is 60 to 90 minutes. What that covers:
- A full head-to-toe physical examination
- A cardiovascular risk assessment that goes beyond a basic lipid panel: particle-size analysis, ApoB and Lp(a) when indicated, ASCVD calculation, coronary artery calcium scoring for patients whose risk picture warrants it
- Age- and risk-appropriate cancer screening, with coordination of any imaging needed
- Metabolic and hormonal labs matched to your clinical picture
- Cognitive and mental health screening
- A detailed family history update, which usually changes screening recommendations
- A real lifestyle conversation about nutrition, exercise, sleep, and stress
You walk out with a written plan: what we found, what we're watching, what we're acting on, and when the next follow-up is.
Specialist coordination and hospital care
When you need a specialist, I don't hand you a phone number and wish you luck. I connect with the specialist directly, share the relevant medical information, and stay in the loop on what they find. If you're admitted to the hospital, I know about it and I communicate with the admitting team. After discharge, I see you quickly to make sure the handoff didn't drop anything, which is where the majority of post-hospital complications originate.
For snowbirds who split time between Florida and points north, this coordination extends to your home-state physicians. One unified medical picture rather than two disconnected ones.
Real preventive medicine
Prevention is the part of medicine that gets squeezed out first when a physician carries 2,500 patients. With a 50-patient panel, I actually have time to do it: continuous glucose monitoring data review for patients who use it, personalized nutrition discussions, structured exercise planning, sleep troubleshooting, medication optimization. Tracking real metrics over time and adjusting based on what the numbers show.
Generic advice doesn't change behavior. Specific, repeated conversations with a physician who knows your life do.
What's not included in the membership
It's worth being clear about this. The membership covers the things I deliver personally: visits, access, coordination, the physical exam, and the preventive work above. My practice is private-pay; I don't bill insurance. What falls outside the membership is everything that happens outside my office: labs (through Quest or LabCorp), imaging, specialist fees, hospital costs, prescriptions, surgeries. You keep your insurance to cover those, which it does the same way it always has.
What membership actually changes for patients
Patients tell me the biggest change isn't any single service. It's that their medical care stops being something they have to chase. The doctor is reachable. Appointments happen when they need to. Lab results get reviewed with a phone call, not a portal message. Specialist referrals don't get lost. Post-hospital care is handled. The care is continuous instead of episodic.
That's the product, and it happens to solve the access, continuity, and attention problems that define most of what's wrong with traditional primary care.
If you want to understand how membership would work for your specific situation, reach out. I'm happy to walk through the specifics and tell you honestly whether my practice is the right fit.
