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Primary Care

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Letter to My Patients: The Problem with American Healthcare (and Why I’m Doing It Differently)

 

 

America has some of the best healthcare in the world — but one of the biggest problems we face is access.

 

I recently bought an insurance plan for myself. I pay over $600 a month and spent hours comparing every option to find the best one. When I finally tried to use it, I just wanted to see a gynecologist. I found one that supposedly took my insurance — and it was awful.

 

I want to be clear: the doctor and the staff did nothing wrong. They were just playing by the rules of insurance. But that game made me feel like a number. I was pushed into a room, had a painful procedure done without anesthesia, and pushed right back out the door with my questions unanswered.

 

And the craziest part? As a nurse practitioner, I knew my questions were valid. I wasn’t being difficult — I was being a patient who deserved answers.

 

So I tried again. I decided to find a family doctor. I miss what family practice used to be — someone who actually knewyou, not just whoever’s on shift at the clinic. I looked up the provider my insurance assigned me… and guess what? They don’t even take my insurance.

 

Seriously. What’s the point of paying for healthcare if we can’t actually access it?

 

Here’s the truth — as a provider, this system breaks my heart. Most of us in healthcare care deeply. We don’t want to rush you in and out. We don’t want to give you five minutes of our time. But the system is built around reimbursement — and to make ends meet, providers have to run patients through like cattle.

 

So what if we did it differently?

 

I’ve loved helping hundreds of Boerne patients lose weight at Crafted — truly, it’s been one of the most rewarding experiences of my career. But the growing need for real, personal primary care has pushed me to expand what I offer.

 

 

 

What Primary Care Really Means

 

 

When people hear “primary care,” they often think it just means going to the doctor when they’re sick — but it’s so much more than that.

 

Primary care is your first point of contact in the healthcare system — the person who knows you, your history, your medications, and your story. It’s the foundation for keeping you healthy, not just fixing you when something breaks.

 

Here’s what a primary care provider actually does:

 

  • Preventative care: Annual checkups, screenings, labs, and catching problems early.

  • Chronic condition management: Managing things like high blood pressure, thyroid issues, anxiety, depression, diabetes, or hormone imbalance — in a way that actually fits your life.

  • Acute care: Treating things like sinus infections, UTIs, rashes, or stomach bugs — without the revolving door of urgent care.

  • Medication management: Making sure your medications work safely together and adjusting them when needed.

  • Whole-person care: Looking at your sleep, mood, nutrition, stress, and lifestyle.

  • Care coordination: Referring you to specialists when needed and staying in the loop so nothing gets lost.

 

 

In short, primary care is your health home base. It’s where you go for prevention, for connection, and for care that actually makes sense for you.

 

 

Even if you have insurance, it often works out to be cheaper to carry that insurance for emergencies while using a concierge-style primary care provider for your everyday needs. The insurance is there for the “what ifs,” but your daily care should feel more personal, more upscale, and centered around you.

 

If you’ve already been part of my semaglutide program, adding primary care will be just $79 per month. For new patients, it’s $98 per month. I’ll also see the children of members for a one-time visit fee of $50.

 

And here’s something people don’t realize — when you pay your deductible with insurance, most of that money goes toward inflated rates. Providers charge as much as insurance allows. Independent providers like me, without layers of corporate overhead, can offer the same (or better) care at a fraction of the cost.

 

I believe we can bring access back to healthcare — real access. Care that’s preventative, thoughtful, and built around your actual life.

 

That’s what I’m doing. I’m done playing the insurance game. Let’s go back to what medicine was supposed to be: real people helping each other get healthy and stay that way.

 

Robyn Cogburn, FNP-C

Crafted Sustainable Wellness

© 2023 by Crafted Sustainable Wellness

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