Alyssa Johnston
3 min readDec 16, 2021


The New Healthcare Wave

I was on the phone with a medical supply chain representative earlier to setup a new account. I explained to her I offer in home concierge healthcare, and she went silent for a minute. Then she said, ‘Hm, isn’t it interesting that medicine used to be house calls only, and then they did away with that? Now, you can barely get into the clinic to see your provider!’

Yes, it is interesting! Why did this change occur? Because modernized medicine was pumping out the almighty dollar from each and every one of you. That’s right. Your insurance plans and the doctors (or their affiliated institutions) worked together to say:

See as many patients as possible in an 8–10 hour workday. 30, 50, 100?!

Make them come back every few weeks to months to monitor one or several disease process. More frequently if they have uncontrolled health problems.

Require lab visits every several weeks to months for certain disease processes and then follow-up to go over lab results.

Now, this is the norm all across America. God Bless it.. America, that is.

I have heard patients say, ‘Well, I can’t afford to pay cash for healthcare services. I’m already paying out the nose for my health insurance!’ For the young and/or healthy (yes, there are old people who are healthy!), I would say you do not need health insurance unless you absolutely desire it. Yes, unfortunate situations happen like a car wreck (Requiring hospital attention), a cancer diagnosis, or having a baby (or babies). These tend to be pricey without insurance. For those with health problems that require medications, or frequent hospitalizations, I would say it may be wise to have a good insurance plan.

I am confident and comfortable treating one problem or very complex cases. My belief is even the complex patients can be seen and treated in the home, or via telehealth, and insurance isn’t essential. It’s a personal choice (medical insurance or no medical insurance).

A colleague of mine told me she refuses to pay for health insurance for her, her husband, and her children (3 kiddos under age 18), because she’d rather save that money for vacations, or other desires/needs. I asked her how she pays for medical provider visits, labs, etc. She told me she uses a CareCredit* account, and pays it back as soon as the statement comes in; like a credit card, but for health expenses. If you ask your clinician, they may give you discount pricing if opting for cash. Why? Because we don’t have to hassle with insurance! Genius.

FSA and HSA accounts are also beneficial to contribute to and use for unexpected healthcare expenses. Contributing lowers your taxable income, and you’d also have $$$ when you need it in the event little Billy or Sally needs a root canal, or a cast if they break a leg.

For my business, I take these accounts (CareCredit, or the like; HSA or FSA, Venmo, PayPal, and also debit/credit cards). I work with my patients and offer paid invoices via email so they can submit to their savings account company, or insurance.

I offer as needed or acute visits for a one time (each visit) fee, or a monthly subscription, where the patient pays monthly and receives unlimited care.

If you’re someone who prefers more than 10 minutes with their medical provider, concierge services are for you. I tend to spend 30 minutes to an hour with my patient, or as much time as they need. Some require less and some require more. All I care about is that my patient understands what to do with their medications and treatment plan. And if they have questions, they are encouraged to reach out to me any time. Yes, any time!

I am a Primary Care Provider in Northern California. I subspecialize in Obesity Management, and dabble in aesthetics. If you are interested in concierge healthcare services, but are not in California, please message me and I will refer you to one of my colleagues in your state. If you are in California, and desire one-on-one healthcare, please message me and let’s setup your first visit today!

*I have no affiliation with CareCredit, but I’ve used them and would recommend them!



Alyssa Johnston

I am a Board Certified Family Medicine Nurse Practitioner. I have over 18 years of experience in various modalities in nursing.