The language of your care, explained

The fee generally covers access, time and coordination. Laboratory work, imaging, specialists and hospital care continue to bill separately, and the fee does not replace health insurance. What PrimaryMD’s membership includes, and what it costs, is set out in full.

The same model goes by several names, including boutique medicine, private primary care, high-touch primary care, and private doctor. Those labels are mostly marketing. What varies in practice is panel size, what the fee covers, whether families can join on one membership, and whether the practice provides clinical follow-through after a visit. It is worth comparing against direct primary care and traditional primary care before deciding. PrimaryMD practices this model across its New York, San Francisco and Los Angeles locations.

Unlike most concierge medicine practices, direct primary care usually avoids insurance billing altogether, which tends to mean a lower fee and a narrower scope. Patients still need insurance for hospital care, specialists and imaging, and should understand how out-of-pocket care works around the membership.

Whether a concierge membership qualifies depends on how the fee is structured and on current guidance. That is a question for a plan administrator or tax adviser, not a medical practice. Individual services such as blood work are more often eligible than the membership itself.

Sometimes called membership medicine. A clear model states visit length, response times, what happens after testing, and where out-of-pocket care and insurance boundaries fall.

Most concierge practices are out of network for the membership itself while remaining in network for other services, so the plan still matters. Ask what is billed through insurance, what is paid directly, and whether the practice issues a superbill.

In concierge medicine the membership fee is normally out of pocket, while outside labs, imaging, prescriptions and specialists follow their own billing rules. Some of those costs may be recoverable through out-of-network reimbursement or paid from an HSA or FSA.

It separates a practice that produces data from one that produces decisions. Panel size, appointment length and board certification matter mainly because they leave a physician time to interpret. The physicians at PrimaryMD each hold the full picture for their own patients.

It is the discipline underneath every model on this page, whether delivered by a physician trained in internal medicine or family medicine. What separates practices is whether one physician stays responsible for the whole picture. See physician-led care and care continuity.

It lists the service, diagnosis and billing codes so a patient can pursue out-of-network reimbursement themselves. Membership fees are frequently not reimbursable, and no practice can guarantee what a given plan will pay.

Also called insurance-based primary care, it is the model most people already have, and for many patients it works well. The usual reasons for leaving are appointment length, wait times, and the absence of care coordination between visits.

After-hours access is only as good as its boundaries. Ask who answers, how quickly, and what happens overnight, at weekends and on holidays. It does not replace emergency care. PrimaryMD sets out its access commitments as part of membership.

Sometimes called longitudinal care. A physician who has watched your numbers move for five years reads a result differently from one seeing it for the first time. Continuity is what makes preventive care work, because risk is tracked across years instead of judged in one appointment.

It covers choosing the right specialist, getting the records there, and making sure the finding comes back into the plan instead of stopping at the specialist’s office. A referral without that step makes fragmented care worse. Coordination is a standing part of how PrimaryMD works, not something requested case by case.

No membership, phone line or telemedicine service replaces 911, an emergency department, or hospital care. Chest pain, stroke symptoms, difficulty breathing, severe bleeding and sudden severe pain are emergencies. Call 911 first and tell your physician afterwards.

It happens when several clinicians each hold part of the picture and nobody holds all of it. The result is repeated tests, contradictory advice, and findings nobody acts on. Reassembling that picture is much of what a coordinating physician does.

It is one of the most common reasons people look for private care. It works only when paired with triage, so that someone decides what needs to be seen today, what can wait, and what belongs in emergency care. Availability varies by practice and by location.

Virtual visits, portal messages and remote follow-up all sit under it. It works well for medication questions, results conversations, and care while travelling or living between cities. A physical examination, imaging and emergency care cannot happen over video.

A thorough version reviews history, examines current concerns, updates screening and vaccinations, and sets the year’s plan. It is narrower than an executive physical. Its value depends on whether the findings feed an ongoing plan or are filed and forgotten.

Lean mass and fat distribution tell a more useful story than weight alone. Fat stored around the organs carries more metabolic and cardiovascular risk than the same weight carried elsewhere. A DEXA scan is the usual way to measure it.

Colon, breast, prostate, cervical, lung and skin screening each carry their own age, interval and eligibility rules. Mammography and colonoscopy are the two most people meet first. Which apply depends on age, sex, family history and prior results, and every one of them has a false positive rate worth understanding before testing.

Blood pressure is the cheapest and most useful measurement in the category, and sustained high readings, known as hypertension, carry more weight than most advanced markers. Where more detail is warranted, a lipid panel, ApoB, Lp(a) and a coronary calcium score refine the picture.

It makes up most of primary care: reviewing medications, watching trends, adjusting treatment, and keeping the specialists involved pointed in the same direction. It depends less on any single visit than on care continuity and follow-through between them.

Sometimes marketed as executive health. It compresses a long physician assessment, advanced labs, imaging and a structured risk review into a single visit. It earns its cost when the findings produce a plan and someone follows it. See what is included at PrimaryMD.

They are effective, but they are not a standalone plan. Dosing, side effects, nutrition, muscle preservation and what happens on stopping all need managing. Progress is best tracked alongside body composition, since losing lean mass and losing fat are not the same result.

Lifespan alone is a poor goal, because years spent in decline still count toward it. Most of what longevity medicine measures, including metabolic health, strength and aerobic fitness, is aimed at healthspan instead of the total.

Done well, it is preventive care with better measurement and a longer horizon. Done badly, it is test volume sold as foresight. What separates the two is whether a physician decides what to measure and what to do about the answer. That judgment is the part PrimaryMD builds around.

It is the common thread behind prediabetes, raised blood pressure and unfavourable lipids. Insulin resistance, where the body needs progressively more insulin to manage the same blood sugar, usually develops years before an A1C turns abnormal. That is why it is worth watching early.

It is usually identified by an A1C or fasting glucose in the intermediate band. Acting early reliably changes the outcome. It is not a diagnosis of diabetes, and it is often reversible.

It covers screening, vaccination, risk review and lifestyle work, and aims to act before symptoms appear. Done well it is disciplined, not broad: the aim is to connect testing to clinical interpretation and a decision, not to accumulate more data.

It is also how patients get sorted by level of risk, so monitoring, testing and referral can be matched to the person. Good risk assessment decides which tests are worth doing, and which ones will not change a decision.

Because it averages, it is steadier than a single fasting glucose. It is the standard test for identifying prediabetes and for monitoring diabetes over time.

Biomarker panels, hormone testing, inflammatory markers and nutrient levels all sit here. Used selectively, they answer a specific question. Ordered as a bundle, they mostly generate false positives and further testing. Deciding which are worth running is a clinical judgment, not a menu.

It counts particles instead of the cholesterol carried inside them, so it can reveal risk that a normal-looking lipid panel hides. It is most informative when cardiovascular risk is borderline and the treatment decision could go either way.

A routine draw usually covers a complete blood count, a metabolic panel, a lipid panel and A1C, with thyroid and vitamin D added when there is a reason to look. Drawing the blood is the easy part. What matters is which results change a decision.

A score of zero is reassuring for most middle-aged patients, and a high score can justify treating cardiovascular risk more aggressively. It is a quick, low-dose scan, and it is most useful when the decision is otherwise finely balanced.

It reports bone density as a T-score, which is how osteopenia and osteoporosis are identified. The same scan can estimate body composition. Tracking the same measurement over several years is more informative than any single reading.

It uses no radiation, unlike CT, and it will find things. The question is what proportion of them matter. Most abnormalities picked up in someone without symptoms turn out to be incidental findings that lead to more scans instead of treatment. Worth doing with a physician who will help you decide in advance what you would do with each possible result.

LDL is the fraction most treatment decisions are built around. HDL and triglycerides add context, and raised triglycerides often point back to metabolic health as much as to diet. For some patients ApoB or Lp(a) sharpens the picture further.

It is genetically set and stable through life, so it usually only needs measuring once. A raised result will not shift with diet, but it does change how aggressively the other cardiovascular risk factors are worth treating. It is also a good reason to ask about family history.

That last part changes the arithmetic. The rarer the condition in the group being screened, the larger the share of positives that will be false. Age, history and risk decide which tests are worth running at all.

It is among the strongest single predictors of long-term mortality, and unlike most markers it responds directly to training. Formal testing on a treadmill or bike is more accurate than a watch estimate, and is worth doing when the number will shape a training plan.

Resting heart rate, heart rate variability and sleep staging are the measurements people bring to appointments most often. They show trends well and diagnose poorly. A single night’s reading means very little, and none of it substitutes for evaluation when something is wrong.

A test, a referral or a recommendation has little value until someone closes the loop on it. Follow-through is what makes a practice accountable for the plan, not just for the appointment. See how that loop gets closed.

A result can be technically normal and still matter, or flagged abnormal and change nothing. Interpretation is where history, trend, medications and the reason for testing are combined into a decision. It is the step most often missing when patients arrive holding a folder of results nobody has explained. At PrimaryMD it is a scheduled part of care, not an afterthought.

Unlike a screening test, diagnostic testing starts from something concrete: a symptom, a finding, or a decision that needs resolving. The distinction matters, because it changes how the same result should be read.

Its mirror image, a false negative, misses a condition that is present. Both are a normal property of testing, not a mistake. That is why the question to ask before any test is what you would do with each possible answer.

They are common in broad imaging such as a full-body MRI. Some matter a great deal and most do not. The difficulty is that telling them apart often takes further scans, a period of waiting, and occasionally a biopsy.

Ranges are drawn from a reference population, not from what is optimal for you, and they differ between laboratories. A result just outside the range is often unremarkable. One sitting comfortably inside it can still be a meaningful change from your own previous values.

Worth seeking when a diagnosis is serious, the treatment is hard to reverse, or the explanation has not made sense. It works best when the second physician receives the full records and images, not a summary. PrimaryMD physicians review outside findings as part of ongoing care.