Frequently Asked Questions

No.  Non-member patients receive care either through their insurance plans or by paying directly as detailed under Fees. Membership has a number of significant benefits not covered by insurance and not available in most medical practices.  Examples include 24 hour access to Dr. Costley's cell phone, reserved Member appointment slots for same or next day appointment access, reduced visit and lab fees, and others detailed under How It Works on this site.  We welcome the opportunity to discuss whether being a Member of the practice would make sense for you.

No.  The many benefits of being a Member such as direct access to your doctor's cell phone number, phone consultations, etc. are not covered by health insurance.  However, Membership fees are typically eligible for Health Savings Account expenses.  Dr. Costley encourages you to check with your insurance agent or company for specifics on your situation.

Yes.  Every plan has its particulars, but most HSAs have no problem with people using their HSA dollars for health producing benefits such as those offered by Ponce Primary Care.

Dr. Costley doesn’t like the label “concierge medicine” because it sounds elitist and doesn’t describe in any real way what the practice is about.  However, most “concierge” or “boutique” practices are similar to Ponce Primary Care in that they limit their practice sizes to reasonable levels so that the practice can provide personalized, quality care to every patient.  

Ponce Primary Care offers you the choice of receiving care through a traditional, per-visit approach either through insurance or by paying directly for your care.  Whether or not they have insurance, many patients choose to become Members of the practice and receive numerous benefits not covered by insurance plans.  See How It Works for details on these benefits.

I entered medical school and worked through the very long hours of medical residency in order to have the privilege of providing great care to my patients.  That may sound like a medical school application cliché, but it happens to be true.  When I chose to pursue my passion for preventive, comprehensive care by becoming a primary care physician, I entered an area of medicine that traditionally sits at the heart of any quality healthcare system.  However, the primary care work environment in this country has deteriorated dramatically in the 12 years since I graduated from medical school, causing an alarming number of quality doctors to burn-out and retire early and very few quality medical students to pursue primary care careers. In typical practices, physicians are challenged to care for increasingly complex medical problems in visit times that now average just eight minutes.  The population is aging, people are living longer with more complex diseases, technology is advancing, and primary care doctors are being squeezed by a system that fundamentally undervalues their work.

It is clearly unrealistic to pretend that within a few minutes a doctor could obtain a thorough history from a patient with congestive heart failure, perform a physical exam, adjust a complex medication regimen, discuss diet changes, prescribe an exercise regimen, and order lab tests.  Unfortunately, such a charade is being acted out in countless primary care practices across the country every day.  Doctors are increasingly paid to be more “productive”, specifically meaning that they see more patients every day rather than focus on taking the best possible care of those they do see.   Sadly, this is not an academic concern or a problem just for doctors.  As the Institute of Medicine has dramatically detailed, people are dying because of this nonsense.

The Ponce Primary Care model reestablishes the central role of the doctor-patient relationship therefore and allows us to practice medicine the way it should be practiced: time to listen to patients, time to read the medical literature, time to use technology to expand care beyond face-to-face visits when appropriate, time to think, time to breathe.  Practicing like this just makes sense.  It’s the way I want my parents' doctor to take care of them.  It’s what we all deserve.  Unfortunately, it’s not what most Americans get.

First, the fact that we know you so well is invaluable when phone, electronic communication or video conferencing are the only possible ways to communicate.  If dealt with early, problems that arise can often be addressed without you coming to our office.  This remote access is a significant benefit of being a Member of our practice.

Second, as a Member of Ponce Primary Care, you receive access to a national network of like-minded medical practices throughout the country.  Through our participation with the Society for Innovative Medical Practice Design, you will be able to see a primary care physician the same or next day if you get sick.  No more relying on unfamiliar urgent cares or emergency rooms for your primary care.  Just get in touch with us and we’ll arrange for one of our colleagues to provide you with great care and communicate the results of your visit with us.  We provide the same service for our partner practices’ patients when they travel to Atlanta.

Yes – to both questions.  Ponce Primary Care will help you be proactive about your health.  Visits will be comprehensive and follow-up communication will be timely and complete.  When questions and problems get addressed in this way the need for urgent communication goes way down.  This is obviously good for our patients and allows us to provide our direct phone numbers with the confidence that our phones will not ring constantly in the middle of the night.  The quality of the doctor-patient relationship we create allows us to trust that our patients will not call us outside of normal practice hours unless they truly need us, and if they truly need us, we want to be the ones providing or coordinating the care.  As a Ponce Primary Care Member, you will not be referred to a nurse triage service after hours so someone who doesn’t know you or your health history can do their best to give you care.  You’ll talk to us and get the personalized care you deserve regardless of the time or day of the week.  Importantly, Ponce Primary Care’s electronic medical record allows us to access your health records regardless of whether or not we are in the clinic.  No more explaining on the phone the details of a complex history that sits in a paper chart, locked in a dark room at night.

First, it’s important to note that most of these practices charge significantly more than our prices for memberships, so patients have in effect paid more for theses physicals or diagnostic tests up front.

Second, and most importantly, Ponce Primary Care diligently practices Evidence-Based Medicine. The standard is that you should receive care that is justified by what solid research tells us works.  While annual physicals have been proven to benefit many patients, there is no evidence that a “full physical” is necessary for every patient.  You should not pay for one if there’s no evidence that in your particular case it will be of benefit.  Similarly, there is zero evidence that putting healthy people without symptoms in a CT scanner to look for disease improves health outcomes.  In fact, if this approach was widely used, the radiation from the testing would kill more patients every year than would be saved by the rare detection of a disease.

A similar truth drives our commitment to not ordering unnecessary blood tests in order to screen for diseases that are unlikely to be present.  This is a common, and ill-advised habit in primary care that results from poor communication between physicians and patients about the risks and benefits of tests.  Before you have a test ordered in our practice, we will communicate with you the purpose of that test and how the results will be used to benefit your health. If you are used to receiving a lot of blood work, x-rays, etc. in order to “make sure nothing is wrong”, we will take the time to explain why that approach is more likely to cause something to become wrong than to detect a hidden problem.

Emphatically yes. While we encourage you to obtain high-deductible health insurance coverage if at all possible, we also know that exceptional primary care can dramatically reduce your risk of serious illness.  Our Level 1 Membership fees are only $2 per day – less than a cup of Starbucks coffee, less than cell phone service, less than a pack of cigarettes.  For this modest fee you’ll obtain access to a primary care physician who knows you well and can help you avoid delays in care and expensive trips to emergency rooms.

If you choose to pay us directly for visits and tests as a Non-member patient, our fees for services are very competitive compared to what you would pay at most doctor's offices.

Yes.  Dr. Costley and David Orozco, registered dietician, offer a reduced fee clinic on the first and third Thursday mornings of each month.  Patients must bring documentation from a reputable not-for-profit organization stating that they have true financial hardship.  For qualified patients, appointments for this program with Dr. Costley are $40 and consultations with Mr. Orozco are $20.  Labs and tests are charged separately but at significantly reduced rates.  All payments are due at the time of service.