Frequently asked questions

Both, honestly. Private MD is a single-physician micropractice: you get the direct, unhurried access people associate with direct primary care, and the depth, coordination, and advanced screening people associate with concierge internal medicine. I use the word concierge because it is the closer fit, but the label matters less than the structure — one board-certified internist, formerly on faculty at Mayo Clinic and the University of Minnesota, and a panel deliberately small enough that I know every member by name.

Likely a good fit if you want unhurried visits with one doctor who holds the whole picture, like being an active partner in your own health, have chronic conditions that benefit from attentive management, or want serious screening for the diseases that actually matter — heart, cancer, brain, metabolic.

Probably not a fit if you need pediatric or prenatal care (I see adults 18+), want 24/7 on-demand availability, need ongoing controlled-substance prescribing, or prefer a large insurance-based health system.

Signature is $349/month, or $299/month when paid in two installments of $1,794 a year — founding rates, locked for twelve months from the day you enroll. Executive is by invitation, with pricing arranged individually. There is also a $149/month corporate rate available only through an employer, not to individuals.

Founding rates are offered to the founding panel only. Published rates rise for members who join later; yours does not.

Yes — a one-time $250 enrollment and processing fee, charged in addition to your first month of membership. It is non-refundable and covers setting up your chart and getting you onboarded. There is nothing else up front.

The fee covers access to me and the time to use it: visits, chronic disease management, preventive care, messaging, care coordination, and follow-up after a hospital stay.

Labs, imaging, and medications are passed through at the vendor’s cost with no markup, ever — you pay the lab or pharmacy directly, and invoices always show tests at cost and my fee on separate lines. Optional extras — additional home visits, home lab draws, advanced longevity programs, and certain specialty-test interpretations — are available for a fee and are never a condition of membership. I give you the cost in writing before anything is ordered.

You don’t have to work it out on your own. We talk first — an unhurried conversation, no cost and no obligation — and I recommend a level based on how much ongoing attention and coordination your care realistically asks for, not on how sick anyone thinks you are.

It is a recommendation, not a gate: every level is the same physician and the same standard of care, and you may choose differently. You can also change levels later, in either direction.

Membership itself is not billed to insurance — it is a flat monthly fee paid directly to the practice, which is what makes the small panel and the unhurried visits possible. Keep your health plan for hospitals, specialists, surgery, imaging, prescriptions, and emergencies.

Yes. I participate in Medicare and have not opted out. Covered services are billed to Medicare as they would be at any practice, and membership covers access and services Medicare does not cover. Medicare patients are welcome.

Yes. Membership covers your relationship with your physician; it is not health insurance and does not replace it. Keep a health plan for hospital stays, emergencies, specialist visits, surgery, and prescriptions. Many members pair membership with a high-deductible or catastrophic plan.

Directly — call, text, or secure message through the patient portal. My number, not a call center, not a triage line, not a nurse who takes a message and calls you back tomorrow. Office hours are Monday through Friday, 9 AM to 5 PM Pacific.

Replies are prompt because the panel is small — that is the whole point of keeping it that way. Signature and Executive members have priority response.

For urgent needs outside business hours, use urgent care, telehealth urgent care, or an emergency department. This practice does not provide emergency or urgent care services.

In an emergency, call 911. For a mental health crisis, call or text 988. Tell me afterwards, whatever happened — I pick up the follow-up and make sure nothing falls through the gap.

I still work as a hospitalist, and that is deliberate — it keeps me sharp on acute and complex illness and makes me far more useful to you if you are ever admitted. I give members reasonable advance notice of those blocks.

During hospital shifts and planned time away, urgent matters route to arranged coverage and non-urgent replies may be slower than usual. You will never find your care handed to a stranger without knowing about it first.

Telehealth visits are available anywhere in California. In-person and home visits are offered in the Folsom, Granite Bay, and El Dorado Hills area, with the office in Folsom; locations beyond that by arrangement.

Home visits are part of Executive membership, which includes access to up to three a year as clinically appropriate, including after a hospital stay. Additional visits are arranged individually. Signature members can arrange a home visit individually, at a separate cost. Home lab draws are available to any member through an outside phlebotomy service, billed at its own cost with no markup.

I refer you and stay involved. Because this practice is independent and not owned by a hospital system, I choose the specialist on merit — the right one for your problem, not the one inside a particular network. I send the clinical context ahead, review what comes back with you, and keep the overall plan coherent. The specialist’s own care is billed to your insurance, not to membership.

Tell me. I see patients in the hospital myself, so I know how it works and can talk to the team looking after you. I can see your chart directly at Sutter and Mercy, with UC Davis coming soon. I help you understand what is happening and what your real choices are, and I pick things up when you come home — which is where most of the avoidable trouble after a hospital stay happens. At the Signature level and above, I also check in with you by text or phone every day you are in. Specialist accompaniment and family liaison are part of the Executive level.

No. I do not provide ongoing controlled-substance prescribing — including stimulants for ADHD, chronic opioid therapy, and benzodiazepines. If that is central to your care, this is not the right practice for you, and it is far better to know now than after you have joined. I am glad to help you find a physician or specialist who is the right fit.

These are core internal medicine, not an afterthought — mood, anxiety, sleep, and stress shape how you feel day to day and matter for long-term brain health. I manage them directly, as the physician who knows you and your whole history. For deeper specialty needs — severe psychiatric illness, addiction, or intensive therapy — I refer to the right specialist and stay involved.

Yes. Each person enrolls in their own membership at their own level, since the fee reflects one physician’s time and attention for one patient. Couples often land on different levels, and there is real value in one doctor knowing both of you — household health rarely stays in one lane.

Yes, in either direction. Most people find the right level after a few months of actually using it, and your founding rate protects you for the first year.

Yes. There is no long-term contract. You may cancel at any time with 30 days’ written notice, and there are no cancellation fees. If you pay in installments, unused months are refunded pro rata. The enrollment fee is non-refundable.