No visit will be scheduled for less than 30 minutes. Many will be longer, and certain cases (like a procedure or first visit for depression) will even be an hour or longer. Of course, you are the patient and you’ll never be forced to stay for the entire visit length. If we can address your concerns to your satisfaction in less than your visit length, you may always leave earlier. My aim is to make you feel comfortable, relaxed, and never rushed through your visit. Of all complaints I’ve heard from patients about other providers during my career, “he(she) hardly spent any time with me!” is – by light years – the most common. The primary reason we can offer longer visits is that we limit the practice size to around 600 patients per doctor. If there is reasonable demand for membership from much more than 600 patients, we will seek to add another doctor to the staff. Most insurance based medical practices have 2000 patients or more per doctor, which is one reason why appointments are scheduled for 15 minute intervals and often double booked, so that you only spend 8 minutes or less with the doctor, face to face.
NO INCENTIVE FOR UPSELLING
If you’re anything like I, you’ve been monumentally inconvenienced and just plain annoyed but the universal culture of “upselling” that has taken hold of American business in the past 10 years or so. You can hardly buy ANYTHING of your own choosing anymore without some pesky sales person asking you – or pushing you – to buy something extra that you didn’t plan on and really don’t WANT. It might be an accessory for your smartphone, a larger fry or drink order, an extended warranty, the list goes on! Now, of course, once in a VERY blue moon, you might actually get a recommendation that is wise and well priced, so you act on it and are happy with your unplanned purchase. However, for myself, and I’m betting the great majority of you, you simply have to play “ping-pong” with the sales person, repeating the word “no” multiple times before they leave you alone.
Sadly, the field of healthcare is NOT immune to the technique of upselling! We’d all like to believe that it is, because it seems to the average person that a business dedicated to caring for the sick would have only altruistic intentions, right? Wrong. I, and many other physician peers with whom I have spoken, have witnessed first hand the upselling of unnecessary tests, procedures, and extra visits that goes on in healthcare. The key difference though is that unlike many other industries, the overwhelming majority of patients (customers) do not have the knowledge and training needed to reasonably resist these upsold services. Direct Primary Care eliminates the incentive for upselling. The only thing you’ll pay to my clinic, other than your monthly membership fee is a tremendously reduced price for meds (plus shipping/postage if you choose to have them mailed), labs, and tests. All of these are offered to you at my cost plus a 10% mark-up for associated supplies and administrative costs. My profit margin is so thin (almost zero) for these services. I will NEVER insist you receive a test or treatment unless it is absolutely medically necessary. I don’t believe that is ethically right anyway, but even if I did, the financial incentive just isn’t there. The pricing is kept so low on tests and meds intentionally. This removes incentive for DPC docs to order unnecessary tests for profit, and also attracts patients to the practice, knowing that they won’t get upsold unnecessary services. If a service is necessary, they also know they can get it at a huge, deep discount. Furthermore, if a service is medically appropriate (decided at my discretion), but not 100% critical, you may opt to partake of it, if you prefer. Because you are responsible for payment for the service, I don’t have incentive to dissuade you from it. The DPC model virtually eliminates the temptation to over/under treat and over/under test. It is just one more fantastic benefit of this practice model.
NO UNNECESSARY VISITS:
Have you ever questioned whether it was really necessary to go to the doctor (the scenario below is just one example, but there are MANY others):
once for your physical and routine labs
then again for the results of the labs you got drawn at the physical and to start meds to treat those labs
then a third time to see how you were feeling on the meds
and then a fourth time to get repeat labs drawn to see if the meds were fixing the abnormal lab results?
I certainly hope you have. The plain fact of the matter is that most often doctors get paid $0 for telephone conversations, emails, or texts with patients. Furthermore, because of the increased overhead that comes with insurance-based practice, docs have to see more patients per day and document MUCH more per patient than a direct primary care doc does. This increased patient and documentation load severely limits the time physicians have left at the end of the day to spend on 10 minute phone calls or the answering of 10-15 patient emails. It is much easier and lucrative to require patients to come in for visits for virtually every contact they have with their doctor.
With our DPC model, you are paying the monthly fee no matter how you interact with me. If you prefer the in-person visit for everything, you’re welcome to it, and it will cost you $0 extra. If you like the convenience of handling most things over phone/email/text/Skype/FaceTime, you can choose those options and it will cost you $0 extra.
There are certain issues that simply can not be handled without an office visit because they require a hands-on physical exam to diagnose. In these cases, Dr. Wojnicki reserves the right to require an office visit, or, if feasible, arrange a home/work visit to address the relevant issue.
HUGE DISCOUNTS ON TESTS AND MEDS, DISPENSED RIGHT FROM THE OFFICE
Prices for labs and meds are shown here based on pricing for a model DPC clinic based in Wichita Kansas. Prices for our Illinois based clinic will be different but should be close to these prices. This list is to give you an estimate of how much you can potentially save by being a member of our practice. Precise pricing for Illinois will be posted soon, so please watch the site carefully.
WHICH MEDS CAN I GET FROM YOUR OFFICE?
I will be posting a more accurate list within the next 2 weeks. For now, please peruse the atlas md list I have posted here. This list is not exhaustive. Nearly all common generic meds are available to me from wholesale distributors, and I have the freedom to adjust which ones I stock on a month to month basis. If you need something that’s not on the list, PLEASE contact me and I will look into getting it for you. Do not just give up on it!
WHICH MEDS CAN I NOT GET FROM YOUR OFFICE?
All controlled substances will be excluded from the in office medications stock. This is done for several reasons, a few of which are cost, DEA regulations and licensing requirements, creating an incentive for burglary, and an incentive for drug seeking patients to join the practice for ulterior motives. If you have questions about a specific drug and whether it is a controlled substance, you may click this link to check the list from the DEA, or email me firstname.lastname@example.org and ask me directly.
CAN I GET MEDS FROM YOUR OFFICE SUPPLY EVEN IF YOU DIDN’T PRESCRIBE THEM?
Yes…and no. You must be a paying member of my practice in order to get the discounts on the meds I will stock. Otherwise, I’d essentially be running a pharmacy, and an illegal one at that! However, if you have other doctors (specialists, dentists, etc.) who Rx you meds that I stock, you may be able to get them from my office at my usual prices. This should be dealt with on a case by case basis, so please contact me if and when this situation arises.
CAN I GET LABS FROM YOU EVEN IF YOU DIDN’T ORDER THEM?
The same situation is true as for meds.
“24/7” access means that I will be available to contact via phone, text, or email 24 hours per day, 7 days a week, when I am NOT on vacation (see “Doctor’s vacation” link/section for details about how to access care during my vacation days). Direct Primary Care means you get to contact me directly (only exception is during office hours when calls are forwarded to Nancy at the front desk). There is NEVER an answering service and never a pager you to need to call and then wait for a call back. However, it is expected of you, the patient, that this service be used respectfully and judiciously. If you, or your child gets very ill at 2:00 AM, of course, I want you to call me. Wake me up so we can decide the best and safest course of action for you or your child. If you suddenly realize, at 2:00 AM, that you took your last dose of cholesterol medicine today need a refill tomorrow, you can wait until after 8:00 AM to contact me about that. These are extreme examples, but I hope you get the idea. Repeated abuse of the 24/7 access will result in involuntary disenrollment of the offending patient.
Procedures are included at no additional cost over the monthly membership fee.
For all procedures listed, there are rare cases in which the age, cognitive status, cooperation level of the patient, OR the complexity/location of the issue in question may require referral to a specialist or the ER rather than repair in Dr. Wojnicki's office.
Procedures currently offered include:
Simple suturing of simple lacerations
Abscess Incision and Drainage
Ingrown toenail removal
Subungual hematoma (bleeding under finger/toe nail) evacuation
Simple finger splinting
Skin lesion biopsy (a few high risk/highly cosmetic body areas excluded)
Sebaceous/Epidermal Inclusion cyst drainage or removal
Cerumen (ear wax) removal by curette or irrigation
There may be additional procedures that could be offered. If you are desiring a certain procedure that is unlisted, please be sure to email me at email@example.com to request it and I will let you know if I can offer it.
THE OPTION OF HOME, WORK, OR OFF-HOURS OFFICE VISITS
Based on my daily obligations, availability is subject to change, but most days, outside of office hours, these visits will be available from 9AM – 9PM. Home/work visits must be in locations that are NOT within the city limits of Chicago AND are no more than 1 hour driving time from my home at the time of the visit. If you are uncertain whether your home or work place will qualify, please email me the address. I will check the address for you and get back to you within a day. If you are "out of range" but we can organize a time that works for us, I will meet you at my office outside of regular office hours.
Home and work visits are not offered on an “on-demand” basis. The request for a home or work visit can be made by any patient, for any reason, but ultimately the approval of a home/work visit is at Dr. Wojnicki’s discretion. These are nearly always available for newborn babies, but please give me notice when you are in active labor, to be sure I can arrange my schedule around the home visit.
Please see the "Office Hours" section for more details about home visit availability. When I am unavailable for an urgent home/work visit, patients will be directed to urgent care or the ER to obtain care and payment for such will be solely their responsibility.