Thank you for your interest in Silva Psychiatric Care (SPC). Like the advent and rise of Telemedicine, the Concierge Practice Model is one of the newer innovations in the medical field. The model is also sometimes called "retainer medicine," because concierge practices uniformly require patients to pay an annual fee, simply for the privilege of belonging to the practice. The amount of this fee varies widely, but even the smallest fees are several hundred dollars, usually collected quarterly: the annual cost typically exceeds one thousand dollars, and you must bear in mind that this expense is in addition to the actual cost of treatment!
I am happy to offer concierge-level service to my patients, including direct access to, and responsiveness from, me, personally, at all times, but this practice does not impose an annual membership fee, nor any surcharges of any kind; professional fees are only ever levied for actual services rendered, collected at the time of the appointment, or other service.
CONCIERGE-LEVEL CUSTOMER SERVICE includes:
Direct, and immediate, access to your physician, at all times. The practice phone number directs to my personal cell phone, and if I am available, I will answer. Texts are also encouraged as a convenient, and rapid, way of getting in touch with me and requesting callbacks. If I am unable to answer, voicemails are retrieved and reviewed as soon as possible, and messages returned and/or requests processed as quickly as possible, as well--again, by me, personally. Because I employ no staff, you will never speak to anyone about your care with me, but me: no receptionists to relay messages, no nurse practitioners or physician assistants to substitute, no one but you and I, and any family members or caretakers closely involved in your care, whom you invite to join our sessions. Please see my Treatment Philosophy to learn more about what you can expect from our meetings.
Besides a cell number which you are also welcome to text, e-mails sent to email@example.com, either directly or through this website, are also delivered directly to my cell phone, and therefore also fairly quickly brought to my attention. Again, all requests are always handled by me, personally, and are processed as quickly as possible after I receive them. (Patients are advised not to text or e-mail specific clinical information, as these methods of communication are not entirely secure; for secure, HIPPA-compliant e-mail communications, please use the Patient Portal).
The fees paid at each visit also cover any need to communicate with me between appointments as necessary, whether by phone or e-mail, or through the SPC Patient Portal, including briefly touching base about dosing changes; you will not be expected to return to see me and pay another visit to oversee minor, expected changes to your medications' dosage(s). Similarly, time spent coordinating care with other providers, including therapists, home health nurses and/or primary care physicians, is part of the high standard of care offered at SPC, and covered by the fees paid at each visit, which have not changed in five years.
Same-day, or next-day, access: limited concierge practices are able to offer last-minute appointments within a day or two, and sometimes even the same day. In the absence of a true medical emergency requiring more intensive care, if you have an otherwise urgent need to meet with me, I can offer very short waiting periods for a next appointment. The same is true for new patients, interested in joining the practice: immediate appointments are available, in a field that, in some locations, takes individuals several weeks to get in to be seen for the first time.
Little or no waiting time also applies at each visit. I pride myself on punctuality, and I am rarely more than 5 or 10 minutes behind schedule. Any patient familiar with typical wait times at a busy medical practice will appreciate the difference. When I do run a few minutes behind, it is because I am spending the time necessary to fully and thoroughly address the concerns of the patient that came before; standard follow-up appointments are scheduled for up to fifteen minutes, but appointment times are approximate. Moreover, the concierge experience includes an unhurried atmosphere; rest assured that I will always spend the necessary time to properly and completely evaluate and reevaluate your condition, and to review and explain all of your treatment options. To this end, extended, thirty-minute appointments are always available for those patients who require or prefer more face-to-face time with me. Full counseling sessions are also offered, including standard fifty-minute appointments, at a discounted hourly rate. The advantage of telemedicine--of virtual house calls and essentially eliminating the waiting room--is that, even when I must run behind, you are free to enjoy the comfort and privacy of your own home and to attend to other tasks until I come online, not only drastically improving the waiting experience, but also, in combination with eliminating travel, freeing up hours of valuable time.
Along with these provisions, a concierge telemedicine practice allows me to be extraordinarily flexible with my schedule. In most instances, if technical difficulties or other unforeseen obstacles cause you to run behind for an appointment, I can usually find another slot the same day to allow you to be attended, including early evenings. Early-evening appointments are, in fact, routinely offered, to accommodate school and work schedules. For new patient evaluations, which require a full hour, some weekend appointments are also available.
Prescriptions: all medications, including controlled substances, are filed electronically with the pharmacy of your choice, streamlining the process of having medications filled and refilled by eliminating the initial trip to drop off paper scripts, only to have to either wait, or return at a later time, or even another day, to pick up the actual medication. Using advanced software, I am able to receive and respond to refill-request texts (please text whenever possible) using my own mobile device, even when out of the office. I can also review your medical record, and respond to your needs accordingly at all times, no matter where I happen to be.
Although the majority of patients respond rapidly and well to treatment, and most individuals under my care do not require many interventions between visits, knowing that I am just a phone call, or an e-mail, or a simple text message away--both to patients as well as their authorized family members--is, I hope, nonetheless reassuring.
I strive to make the experience of consulting a psychiatrist as comfortable and convenient and satisfying as possible, and I am always open to, and interested in, your sincere feedback. If you have other concerns about joining the practice, please do not hesitate to contact me directly at (432) 692-4525, and I will be happy to answer any additional questions you might have.
Sincerely, Dr. Silva, M.D.
Comprehensive Psychiatric Evaluations
Psychotropic Medication Management
Brief Counseling Sessions
Pre-Surgical Clearances (elective bariatric and plastic surgery procedures)
+ other fitness-for-duty and focused psychiatric evaluations