More cash-only and cash-friendly doctor’s offices, Part III

Two weeks ago I began what is intended to be a multi-part series about cash-only and cash-friendly doctor’s offices. Here is Part III of the series, introducing two more medical practices on the East Coast that cater to self-pay patients.

Dr. Kordonowy, Fort Myers, Florida

Dr. Raymond Kordonowy’s practice in southwest Florida, Internal Medicine, Lipids & Wellness of Fort Myer, offers patients both a fee-for-service option where he is paid for each individual treatment or visit as well as an annual plan that includes a number of benefits. Here’s a bit of his bio from his web site:

Board certified by the American Board of Internal Medicine and the American Board of Clinical Lipidology, Dr. Kordonowy has been practicing medicine as a partner of Internal Medicine of Southwest Florida* in Fort Myers since 1993.  Recognized as an outstanding physician by the American College of Physicians, Dr. Kordonowy earned his degree from the University of Kansas School of Medicine in Kansas City, and completed his residency as Chief Resident at the Orlando Regional Hospital System.

…Dr. Kordonowy understands how best to treat his patients, ensuring that they get the highest quality care for competitive, market based prices.  His practice, Internal Medicine of Southwest Florida, provides a full-fledged “medical home” model, with comprehensive labs, diagnostic equipment, and primary care all within one conveniently located office in Fort Myers, Florida.  A firm believer in preventative care and a holistic approach to delivering healthcare, Dr. Kordonowy promotes a healthy lifestyle of longevity for each of his valued patients.

In keeping with his holistic approach to healthcare, Dr. Kordonowy has a certified dietitian available for consults, coaching, and strategies for helping his patients lose weight, gain cardiovascular health, and have more energy.

In addition to his Internal Medicine expertise, Dr. Kordonowy is a specialist in complex cholesterol disorders

As you’d expect from a doctor that caters to self-pay patients, the pricing at Dr. Kordonowy’s office is pretty straightforward, with one oversight (more on that in a second). Here are his prices for a visit by a new patient:

Level one…$68.37

Level two…$117.34

Level three…$171.45

Level four…$263.74

Level five…$327.61

And here are the existing patient prices:

Level one…$31.36

Level two…$68.92

Level three…$115.02

Level four…$165.05

Level five…$226.42

 The only drawback to these prices is that there’s not much of an explanation of what a ‘Level one’ visit is and how that might differ from a ‘Level 2’ or any other level of visit.  Fortunately I found a handy table on the web site, that can help explain the difference for those who aren’t familiar with the different levels of visits to doctors. I’ve excerpted some of the information from that table here:

Level 1: 10 minute visit. Single simple problem – rash, bladder infection, scrape or minor cut requiring no treatment.

Level 2: 15 – 20 minute visit. Routine problem: respiratory infection or a simple problem requiring extra testing – a minor injury requiring an x-ray, for example.

Level 3: 25 – 30 minute visit. Several routine problems or a single problem requiring multiple testing, such as abdominal pain with blood tests and x-rays needed.

Level 4: 40 – 45 minute visit. Complicated or poorly controlled problem requiring extensive examination, history-taking, and testing or several problems each requiring extensive evaluation. A diabetic patient with intermittent chest pain, for example.

Level 5: 60 minute visit. A new patient with a complicated problem or problems which requires also detailed review of history, past records, etc. (Unclear distinction between a Level 4 and Level 5 visit for an established patient)

I’m assuming that Dr. Kordonowy uses a similar classification system for visits to his office. The above is apparently based on the Medicare classifications for office visits, and while Dr. Kordonowy doesn’t accept any insurance, he does accept Medicare. For most self-pay patients seeking relatively routine care at Dr. Kordonowy’s office, the prices for Levels one, two, and three are probably going to be the most relevant.

There’s also an annual healthcare package offered by Dr. Kordonowy that may be of interest to some. For $825.99, patients can get an annual physical that takes about one hour, two additional visits to the doctor, an EKG plus interpretation, and a comprehensive package of lab tests.  For people in generally good health this package may not be necessary, but for someone with a chronic condition that needs monitoring I can see where it could be a great value.

One thing worth keeping in mind is that a visit at Dr. Kordonowy’s office is probably unlike those at conventional practices, where typically some or even most of the time is spent with a nurse or technician. At most cash-only practices, the full visit is with the doctor.

If you’re in the Fort Myers area in Florida and are looking for a cash-only internist or someone to be your primary care physician, Dr. Kordonowy’s practice is worth checking out! He’s at 6311 South Pointe Boulevard in Fort Myers, and can be reached at (239) 275-0040 as well.

*Dr. Kordonowy’s practice name has since changed to Internal Medicine, Lipids & Wellness of Fort Myer. Post updated 8/26/2016

Dr. Jack Forbush, Hampden, Maine

Another cash-only practice on the East Coast (OK, technically Fort Meyers is on the Gulf Coast) is the Osteopathic Center for Family Medicine (OCFM)  in Hampden, Maine, just a few miles southwest of Bangor. Operated by Dr. Jack Forbush, OCFM is a direct care practice that also sees patients on a fee-for-service basis.

Dr. Forbush explained to his existing patients in a letter why he made the switch from a conventional insurance-based practice to direct care, and he posted the letter on his site as well. I’ve excerpted part of it below:

Do you remember a day when you could see your doctor and your doctor could take care of you?  No red tape.  No government bureaucracy or insurance company “middle man” telling you which doctor you could see, where you could receive your care, which medications were “authorized” and how often you could receive treatment?  Well, that day has returned!

Welcome to the Osteopathic Center for Family Medicine Direct Care Plan.  A plan specifically designed for your health and well-being.  A plan created to reinstate the patient-physician relationship we all need and deserve.  A plan developed to put you back in charge of your health care…

Increasingly, decisions about your healthcare are being made by special interest groups and faceless government and corporate bureaucrats.

The rules and regulations imposed by the Affordable Care Act (aka Obamacare), other government programs, for-profit insurance companies, and large hospital systems are coming between physicians and patients. They are making it increasingly difficult for independent private physicians like me to practice medicine…

He also described what patients who sign up for his direct primary care practice will get in terms of benefits and services:

The OFCM Direct Care Plan is built around your well-being, with my undivided and ongoing attention as your personal physician, at every visit.

At the heart of the plan is Wellness Care, which includes: comprehensive annual examinations, lifestyle evaluation, review of applicable preventive healthcare and treatment options, and a written plan for each member of your family.

Other features of the plan include:

  • Access to low-cost medication
  • Access to low-cost lab work and medical testing
  • Online appointment scheduling through our office website
  • Same or following day appointments for acute illnesses or injuries
  • Access to your own medical records through a personal “patient portal”
  • Access to a library of information to help you better care for yourself and your family
  • Chronic disease management

A quick look at the services offered shows a wide range, including prenatal and obstetrical care, newborn, pediatric, and adolescent care, as well as general health issues faced by adults. The fees charged to enroll in the direct care plan are towards the high end of what I’ve seen for a single person ($1,250 for the year, which works out to about $104 a month).

For couples or families with children the cost per person drops significantly though, with an annual fee of $1,750. That would work out to less than $50 per person in a family of three, which is close to the cost of most direct primary care practices around the country.

OFCM also offers simple prices for self-pay patients that aren’t members of their direct care practice. The full price sheet shows that a brief visit (think ‘Level 1’ above) is $65, while what would probably be a Level 2 or Level 3 visit is $65. More complex visits cost $150.

Dr. Forbush and OFCM is located at 603 Main North Road in Hampden, and can be reached at (207) 945-5400.

To be continued…

Lots more in the queue, will be writing up several more cash-only and cash-friendly medical practices in the coming weeks!


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10 Responses to More cash-only and cash-friendly doctor’s offices, Part III

  1. Pingback: More cash-only and cash-friendly doctor’s offices, Part III | Free Market Medical Association

  2. marilyn mitchell says:

    Why don’t you talk about telemedicine. CADR+ is an excellent delivery of care for
    70% of what persons go to the emergency room for anyway; especially if they’re
    self-pay. CADR+/mmitchell will give you much more information (NOT multi-level).
    Thank you.

    Marilyn Mitchell

    • says:

      Actually I have written about telemedicine, including CADR+. But thanks for reminding me I need to cover it again soon!


  3. Liz Ernst says:

    You misspelled Fort Myers.

  4. Please add me to your list! I have Direct Primary Care practice in Central Louisiana, Thank you for your blog!

  5. TR says:

    I am the Office Manager for a new cash only pain management clinic located in Wisconsin. We’ve only been open less than a month but don’t have very many patients as of yet. What type of person uses cash only clinics? How do we find those people.

    • says:

      Basically your market is the uninsured and those with high-deductible plans, I would guess. Might start by introducing your practice to other doctors in the area that might be able to direct patients to you, as well as health clinics.

      • Tawana says:

        Thank you so much for your response! Madison, WI is a unique market. We have 3 hospitals here and each owns the various clinics as well as have their own insurance companies. I have heard many a healthcare executive/administrator who has come from a different area (even a different area of the state) who say the same thing–they have never seen anything like it! Including the doctor whom I work for–he came from out of state. I have lived and worked in healthcare in this market since 1993 and while unusual, it works. But it is not the place to be if you want to be in private practice. There are 2 clinics that are independent and a OB/GYN clinic that came in a few years ago that is also independent–that’s it! That is part of the challenge. My plan is to go out to the outlying, rural areas and introduce our clinic and services. In your opinion, do billboards, or any other type marketing of that time work? Is it effective?

  6. Dr. Kordonowy’s new practice is called Internal Medicine, Lipid and Wellness Practice. The link will takes you to the right website, but the group name is incorrect. I have new memberships and prices posted on my website.

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