PAYMENT:

Do you accept Medicare?

No, Dr. Fox is not a Medicare provider.

Do you accept insurance? No, Dr. Fox does not accept insurance as a form of payment due to quality-of-care issues when insurance companies dictate care. This gives Dr. Fox time to work collaboratively with patients on lifestyle choices, nutrition, and therapy. This approach allows Dr. Fox to use medication as needed, rather than as the only option.

Can I still submit a receipt to my insurance company? Yes, you can submit a receipt to your insurance company. A superbill receipt is provided the day of your office visit by email, and you may elect to send the receipt to your insurance company for reimbursement directly to you. Some people only save the receipts for taxes, and in that case, you may request that I leave off the diagnostic codes if you wish. Be aware that insurance companies save diagnostic codes indefinitely, and they also share them. Be sure to contact your insurer about your coverage for “out of network” physicians if you have questions about your reimbursement, as each insurance is different.

How much are your services?

In the interest of fairness to all patients, Dr. Fox does not offer a sliding scale, but there is a $50 discount available for office visits if payment is made in cash at the start of the session. Discounted times for office visits are available at 11 AM, Noon, 1 PM, 2 PM, and 3 PM (PST), and are $400 per 45-minute session. (With both discounts applied, the total cost would be $350 for a 45-minute session). The initial 60-minute office visit for adults is $800. The initial 90-minute visit for children is $900. Please note that a regular visit with Dr. Fox lasts 45 minutes, rather than 15, 20 or 30 minutes as is common with many psychiatrists. So you shouldn’t need to feel rushed. Dr. Fox charges for appointments that run significantly overtime, no-shows, and some services done on your behalf outside of scheduled appointment times.

Services done during an appointment are free. Collaboration with primary care physicians, specialists, teachers and therapists on your or your child’s behalf are typically free.

Do you prescribe stimulants for ADHD or benzodiazepines for anxiety?

Yes, when these treatments are indicated.

What is the benefit of a solo private practice?

Aside from the reasons above, it is important to have your medical care physician-directed. In other words, non-physicians won’t be directing your medical care.

This is a private practice. I am my own boss. I have no reliance upon private equity funding or insurance company funding. I’m not in a group private practice that can overrule me and sell out, either. So I make my medical decisions in collaboration with you, for your best interest. I feel this gives the people who are most interested in your health, you and your physician, the freedom to work on your health in the areas creating distress, without anyone looking over our shoulders, or saying that they don’t “authorize” the treatment you need.

I don’t accept more patients than I can care for carefully at one time. This was not true in many medical practices I worked in before my private practice. Accepting a huge amount of patients is a big moneymaker. As patient, you might not think about it. But if your doctor is taking on at least 2 new patients a day for 5 days a week, after one year your doctor could have close to 500 patients. After two years, close to 1000. So when will they have time to see you or your child? What if you have side effects and need to be seen sooner? What if your child suddenly outgrows their ADHD medication dose and is struggling at school? What if the ACT is coming up and your busy doctor has no room to help your child until well after the test date?

The fact that many clinic administrators insist physicians keep taking on more and more patients every day to the point of not having time for them all is profit-motivated, not patient-motivated. It’s also a pretty good example of “administrator math,” which pretty much doesn’t parallel reality in a medical practice.

Because this is my solo private practice, I’m not beholden to a private equity (PE) organization. (PE organizations are buying up hospitals and clinics for investment purposes). Recent research (Zhu et all) on physician perspectives regarding PE investments in healthcare is telling. A key point was how PE firms are skirting laws that are in place to prevent undue influence of non-physicians over the practice of medicine. PE firms skirt this law by hiring a physician as a figurehead. But in practice, a non-physician administrator makes all the big decisions.

So essentially, a non-physician is deciding what you are allowed to get for medical care! This greatly influences patient care, as I’m sure you guessed. It also stresses out and burns out the physicians that work for these places. Most physicians I know despise being forced to shortchange their patients! As a result, these types of practices can have trouble holding on to physicians. Doctors quit. Understandably. But how does this quitting impact you as a patient? Does it help your care if you keep getting switched from doctor to doctor, because your doctors keep quitting and leaving the clinic?

Even the academic environment, which I was part of until recently, is now using non-physicians in leadership positions. In my experience, this can be concerning for the quality of patient care, and at times, even dangerous. It depends on the benevolence of the administrator. Do they listen to their physicians? Some do. But there are others. Some non-physician administrators demand practices that physicians disagree with, but are forced to go along with or risk losing their jobs, or even their entire careers.

Unfortunately, many patients don’t realize they’re being short-changed. The old saying that “you don’t know what you don’t know” applies. In my experience, non-physicians directing medical care is a pretty good sign that leadership is prioritizing profits over patients. Even if you don’t choose my practice, you might consider asking the physician you decide to work with if their supervisor is an MD?

In my private practice, patients are the priority.