As of January 1, 2018, I will be opening up a new practice.
I am, regretfully, leaving Memorial Hospital after 25 years of service. I am opening up a new practice model that is taking the country by storm. It is called, "Direct Primary Care." You may evaluate it at: www.dpc.org.
I want my patients to know WHAT I am doing and WHY I am doing it. Unfortunately, I just found out that the new contracts under the hospital that bought Memorial University Medical Center really are not written in my favor. Most importantly, I was not allowed to speak or write for anyone other that the new hospital. I am passionate about teaching women about menopause, intimacy issues as we get older, and keeping your body healthy and happy. If your know me, you know that I want to help women get through menopause safely, sanely, and well-educated.
I do not have enough time to get a new traditional practice up and going in a short period of time (it takes 3-5 months to get on with insurance companies). However, I think that God closed this door to open another. I have been interested in Direct Primary Care for some time now. In my opinion, this is what health care will look like in the future. Basically, the insurance company is shut out, and the patient and the doctor contract between themselves.
There are no quotas or 10 minute visits with absolutely no physical exam. Direct Primary Care goes back to how medicine was supposed to be practiced. With a relationship that is fostered between the patient and the doctor over years. Again...if you know me and my bedside manner, you know that it takes me 10 minutes just to look at pictures of the kids and grandkids that I have delivered. When I get to discussing your medical care, I don't want you to have to rush through the 2 minute "elevator speech" that you have rehearsed so that you can get all the information to me. You will have the time to talk, and I will have the time to listen.
I also want women without health care insurance (or those who are being charged ridiculous fees) to know that there is a new option for OUTPATIENT CARE only.
There will be no open enrollment - you can sign up anytime. You can also cancel anytime (with 30 days notice).
What is Direct Primary Care provided by Dr. Gaudry?
In this medical practice model, a (female) patient contracts directly with Pamela Gaudry, MD, for her personal out-patient gynecologic, menopausal, and basic health care. No insurance is filed. This keeps costs as low as possible. There are not 20 employees at the central business office arguing with re-imbursement and pre-certifications for office procedures. Remember, a physician’s office is ultimately a small, private business.
There is total transparency with fees. You provide a credit card to be kept on file at the office. We will bill you once per month or once per year (there is a $200 savings to pay yearly). When you come to the office other than the yearly annual examination, you will receive generic medications at wholesale costs and lab work at my costs - all will be transparent on your itemized bill. Your credit card will be charged and you will receive an invoice by e-mail.
All generic medications that are available to me will be prescribed and dispensed at wholesale costs + sales tax + administrative fee (I have to count out the medications, buy the vials, and purchase a special printer for the vials - there will be a small fee for this).
Pap smears and some basic labs are included in your Membership (CBC, CMP, TSH, Vit D, Hgb A1c, Lipid profile) all other lab work, cultures, and pathology fees will be extra fees at Dr. Gaudry's cost.
What is the cost of this membership?
Registration fee: $100. Waived until April 1, 2018
$1000 or $100 per month
Al-A-Carte Services (Labs/Pathology not included)
Annual Exam or Office Visit: $200
Menopause Consult: $300 (1 hour)
Couples Intimacy Counseling: $350 (1 hour)
If you need surgery, you can apply previously paid fees to join "Membership" plan
What if I need Gynecologic Surgery?
If you are a Member of Dr. Gaudry's practice and you need gynecologic surgery, there will be an additional administrative fee for the amount of paperwork that is required for the hospital.
Minor Surgery: $200.00 per surgery
Major Surgery: $500.00 per surgery
This includes all pre-op and post-op visits
What if I want to stop my membership?
You can discontinue at any time provided that you inform Dr. Gaudry in writing. At the receipt of your termination letter, you monthly fees will be stopped and pro-rated. You cannot re-enroll into the practice without paying another registration fee. Dr. Gaudry will provide all emergency care for 30 days after you terminate your contract in order to give you time to become a patient of another physician. Actually, we both have to give each other 30 days written notice to terminate the contract. Dr. Gaudry can terminate the contract with you as well.
Can I submit charges to Medicaid, Medicare, Tricare, or Workman’s compensation?
No. Dr. Gaudry is not participating in any government sponsored health-care service. She has opted-out of participation in Medicare, Medicaid, Tricare, and Workman’s compensation plans. The patient CANNOT submit any charges directly to these health-care providers for services provided by this practice. Dr. Gaudry is opting out of all insurance coverage.
Why is Dr. Gaudry dropping Tricare, Medicare, and Medicaid?
Dr. Gaudry is not dropping these patients – she is dropping her participation in these and all insurance plans. No insurance plans of any kind will be accepted for medical care. Although it has been, and will continue to be, a privilege to take care of our military families, Medicaid recipients, and older patients, the government rules and regulations have become extensive requiring many employees to make sure that all requirements are met, rules are followed, and proper codes are submitted. This has contributed to the exorbitant cost of medical care. These patients are welcome to be a member in Dr. Gaudry’s medical practice. They can use all of their full benefits outside of her office. These benefits just will not be billed for services provided in the office. Many medications can still be obtained in the office at much lower costs than pharmacies offer, and this will contribute to overall savings for the patient.
Why is Dr. Gaudry changing her practice?
Dr. Gaudry has been employed by Memorial University Medical Center since completing her residency July 19, 1993 and has tremendously enjoyed and has been dedicated to working for this hospital. In fact, after receiving exceptional care by a Memorial physician early in her life, it became her dream as a young girl to be a Memorial physician. She never even applied to be an employee of any other hospital system after her residency. As you may know, Memorial was recently bought by another hospital which has a different philosophy than Dr. Gaudry regarding physician re-imbursement and rules for patient care. Currently, her patient visits are conducive to a doctor-patient relationship, and she wants to assure that this continues. She does not want to limit time on patient visits. The extensive coding, billing rules, and government regulations that have to be adhered to on a daily basis and the need for large numbers of employees to assure that these codes, regulations, and rules are adhered to have, in her opinion, are destroying the practice of medicine and the doctor-patient relationship. After several years of research about direct patient care and physician-patient contractual agreements, she had decided that this is the best way to provide totally transparent, quality, and patient-oriented medical care to her patients. She would like to practice medicine the way that she envisioned when she applied to medical school. She wants a personal relationship with her patients in which, together (and not decided by insurance companies or coding rules) they decide the best plan of care.
What does Membership include?
This is an exclusive Medical Membership in her Practice of Medicine for women only which uniquely includes:
Acute and non-acute office visits (up to 6 requested appointments/year with the physician unless surgery is involved). Visits not requiring medical care by the physician are not included in the six visits (BP checks, lab draws, strep throat testing, flu shot, urinalysis, e-mail exchanges, telephone calls)
Blood Pressure Monitoring
All lab draws and urinalysis
Rapid Test for Strep Throat
Removal or biopsy of skin problems, moles, suspicious, or worrisome lesions anywhere
All cervical and vulvar colposcopy and all evaluations for abnormal pap smears
LEEP procedures in the office ($150 fee for supplies needed for procedure)
Simple (meaning, I feel comfortable with doing it in the office) wound repair and suturing
Abscess Incision and Drainage
Basic Annual Labs (Hemoglobin, CMP, Hgb A1c, Lipid Profile, TSH)
Pelvic Ultrasounds performed in the office
Primary Care for Women
Counseling for gynecology, menopause, hormone management, or anything related to primary care of women and gynecology
Medical Sex Therapy (including counseling visits with husband together or separately)
Gynecologic Surgery (with a hospital administration fee*) and all (as many as needed) follow-up visits related to the surgery
The convenience of access to many commonly prescribed generic prescription medications at greatly reduced prices, dispensed on premises (as deemed medically necessary by Dr. Gaudry). This will be wholesale prices plus taxes and administration fees (usually less than your pharmacy co-pay)
Access to Dr. Gaudry during and after business hours by phone
Extended and relaxed visits up to 1 hour long
Comprehensive preventive care exams (1 required per year)
Access to Dr. Gaudry via her patient portal
A patient portal to access lab, pathology, and x-ray results,
Referrals/orders for radiologic exams when deemed medically necessary
NON-MEDICAL, PERSONALIZED SERVICES
The Patient shall have direct telephone access to The Physician with the following non-medical services, which are complementary to The Center’s members.
After-Hours Access. The Patient shall have direct telephone access to The Physician seven days per week. The Patient shall be given a phone number where The Patient may reach The Physician directly for guidance regarding concerns that arise unexpectedly after office hours. Video chat and text messaging may be utilized when The Patient or The Physician feels that it is appropriate.
E-Mail Access. The Patient shall be given The Physician’s e-mail address to which non-urgent communications can be addressed. Such communications shall be dealt with by The Physician or staff member of The Center in a timely manner. The Patient understands and agrees that e-mail and the internet should never be used to access medical care in the event of an emergency, or any situation that The Patient could reasonably expect may develop into an emergency. You agree that is such situations when The Patient cannot speak to The Physician immediately in person or by telephone, that The Patient shall call 911 or go to the nearest emergency medical assistance provider, and follow the directions of emergency medical personnel.
Appointments. Reasonable effort shall be made to assure that The Patient is seen by the Physician as soon as possible after arriving for a scheduled office visit. If The Center or The Physician foresees more than a minimal wait time, The Patient shall be contacted and advised of the projected wait time. Every reasonable effort shall be made to schedule an appointment with The Physician on the same or next normal business day. Visits deemed urgent by The Patient after hours will be accommodated as best as possible.
Specialists Coordination. The Center and The Physician shall coordinate with medical specialists to whom The Patient is referred to assist The Patient in obtaining specialty care. The Patient understands that fees paid under this Agreement do not include and do not cover specialist’s fees or fees due to any medical professional other than The Center’s Physician: Pamela G. Gaudry, MD.
For my patients that cannot change to this type of practice model...I am sorry. Actually, I am heartbroken. Medicine is changing and I cannot continue practicing in the current environment. I a m going to take good care of the patients who join my practice with long, relaxing visits where you can talk and understand your medical care. I can not do 10 minute appointments - it takes me 10 minutes to look at kids and grandkids pictures.
I love you all,
Dr. Pam and Tucker too.