Monthly subscription fee to see the doctor? It’s an option

SAN ANTONIO – His patients call Roger Moczygemba, MD “Doctor Roger.”

The longtime family physician diagnoses illness, treats injuries and writes prescriptions as you’d expect. What he does not do is take insurance. He says there’s just no need for it in primary care.

“It’s like everybody has insurance for their car, but we don’t use it to change the oil. Right?” Moczygemba said.

His practice is called Direct Med Clinic, located along Loop 410 at Blanco Road. This week, he opened a second location on Barlite on the South Side.

Just like people pay monthly subscription fees for Netflix or their internet service, direct primary care clinics also charge a membership fee. Here, adults pay a flat $89 a month. It’s $39 a month for children.

What they get is unlimited access to visit, text, video chat with the clinicians. But, there’s no co-pay at the end of the visit. Common, basic services like strep tests or antibiotic shots are covered. Some services like x-rays or some labs are extra, but at a lower, negotiated price that’s posted in black and white. Moczygemba believes in transparency and no surprises.

“How’s that?” he said. “I mean, how is that for contrast in the traditional medical system?”

Moczygemba said he offers his patients and small businesses struggling to afford health insurance another option he calls affordable access.

Danielle Haywood figures she’s saving about $500 a month now that she’s not paying her previous $700 per month insurance premium.

“So, yeah, it’s huge for me, especially being a single mom of two kids,” she said.

Haywood now also has a low-cost, high-deductible insurance just in case of a catastrophe, which Moczygemba does recommend. Direct primary care is not insurance, nor is it a substitution.

“From a doctor’s perspective, it is so fun and refreshing to practice this way,” he said.

In this business model, Moczygemba has fewer patients and spends more quality time with them without insurance dictating how he treats them.

Critics of direct primary care warn it can exacerbate the shortage of primary physicians, thereby inhibiting access. They contend it could leave people who can’t afford the monthly subscription without access to quality care. And, they say people without adequate insurance could get socked with big expenses because direct primary care does not cover expenses like specialists or hospital stays.

“It might not be a good fit for everybody,” Moczegemba said. “Some people might have great insurance from their company or their spouse’s company. But, there’s so many people that need what we have.”

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