How It Works
A lot of the people who come to me have sat through one too many appointments that end while you're still talking. After enough of them, you stop bringing things up at all, and you start to wonder whether it's just you.
My practice works like this. Instead of running your care through insurance, you pay me directly, one flat monthly fee. That frees me from the insurance company and the rushed schedule that comes with it, so I can give you the time and attention good medicine takes.
One thing to be clear about: Terrain Medical is direct primary care, not health insurance, and it doesn't replace it. I don't bill insurance for covered services, so keep a plan for hospitals, emergencies, surgery, and specialists.
I'm an MD with a PhD and a doctorate in acupuncture and Oriental medicine, and I spent seventeen years in integrative practice before residency. The practice pairs full-scope primary care with functional and integrative medicine: both jobs, one doctor.
Your first 90 days.
- 1
I get to know you.
It starts with paperwork that actually matters: your health, your history, your story. By the time we meet, I already know you.
- 2
The first visit.
We meet by video and I listen deeply. We set your first health goals, cover the primary care essentials like prevention and screenings, and start down the integrative path: diet, exercise, supplements, lifestyle.
- 3
The blood work.
Then you go for your blood work: the Terrain Lab Panel, included, drawn at a lab near you.
- 4
Your plan.
When results are back, we meet again. After every visit you receive a written summary and plan in your messages or email, and it gets updated every time we meet.
- 5
Between visits.
Message me anytime. Small things get handled while they're still small.
My goal is simple: your healthiest, happiest possible life, for as long as possible.
You can actually reach me.
Message me directly. I read messages morning and evening, seven days a week, and you'll hear back within a day, with rare exceptions when life intervenes. When you need to be seen, you get on the schedule, set around clinical need and availability. Visits run as long as they need to, because I carry a fraction of the patients a normal practice does, so I'm never rushing you. All of it is included, so you never think twice before booking a visit. There's no preset cap on medically appropriate visits, and no per-visit fee.
I'm working between your visits, too.
Much of the medicine happens when you don't have an appointment on the calendar. Your labs don't sit in a portal waiting for your next visit. I read them, and you hear from me. A supplement someone talked you into gets checked against everything else you're taking before it causes a problem. And the others on your team, your cardiologist, your acupuncturist, whoever you see, hear from me directly, so your care stays coordinated and your treatments don't quietly work against each other.
Why a video visit beats the trip to the office.
Think about what an ordinary visit costs you. You take time off work, drive across town, park, and sit in a waiting room next to other sick people. Researchers at Harvard put a number on it: the average visit eats about two hours of your day, and only twenty of those minutes are with the doctor.¹ A video visit gives you those hours back. You open your laptop, I'm already there, and I already know your history.
The medicine holds up, too. Going back fifty years, study after study finds that around eighty percent of diagnoses come from what you tell the doctor,² and on video that conversation is the whole point. Much of the exam is watching anyway: how you look, the way you're breathing, what you guard when it hurts. For the few things that truly need hands or a room, a procedure, imaging, your vaccines, I send you to someone local I trust and stay in it with you.
Twice a year, we do your blood work.
Not the rushed version where a few numbers get glanced at and filed. The Terrain Lab Panel checks more than 80 different markers: your blood counts, blood sugar, cholesterol, kidney and liver function, thyroid, inflammation, key vitamins, and more. It’s included in your membership. You’ll skip breakfast that morning, stop by a lab near you, and the results come straight to me. Twice a year shows us what’s working and where to course correct. When a marker needs watching, I designate that recheck as included. The panel is included up to twice a year. I order it when your care calls for it, and kids get testing that fits their age instead of the adult panel.
Want to go deeper? Specialty gut or hormone testing is there when you need it. You pay exactly what it costs us, zero markup. Between visits, I spend real time building your custom plan, so our next appointment starts with answers.
Becoming a member.
You stop bracing yourself to prove that something's really wrong, because the doctor already knows you and takes you seriously. That relief is usually the first thing people notice.
For many members, once they total up the premiums, the copays, and the subscriptions regular care never covered, this comes out close to what they already spend. The full breakdown, including family pricing, is on the pricing page.
The practice is limited to 150 memberships. One membership covers you. Your partner and children join under your membership at family rates, and children under 10 are included at no charge. Only memberships count toward the 150. All 150 founding memberships lock in $500 a month for as long as they stay, in good standing. Once the practice fills, new applicants join a waiting list.
A few plain rules before you join. Medicare limits what a doctor who hasn't opted out can charge Medicare patients, and I can't opt out right now, so I can't accept anyone enrolled in Medicare. I also can't accept Medicaid beneficiaries. You need to be physically in Florida for telehealth care unless we've expressly arranged otherwise and I'm licensed where you are. I don't currently prescribe controlled substances. The Membership Agreement holds the complete terms and controls if this site ever differs.
Start with a 30-Minute Practice Introduction Call, and we'll talk through what's going on and whether this is right for you.
¹Ray et al., American Journal of Managed Care, 2015.
²Hampton et al., British Medical Journal, 1975.