Question 1

Direct Primary Care

Accepted Answer

Is this a concierge medical practice?
Yes... and no. Concierge medicine usually refers to a medical practice in which wealthy patients buy expensive memberships in return for individualized care. Memberships with The Family Doctor are instead affordable, costing less than a typical cell phone plan, yet still provide unlimited outpatient care with a personal physician. The term 'direct primary care' is often used to describe this low-cost approach to concierge medicine.

Where can I learn more about concierge medicine and direct primary care?
These links can tell you more about concierge medicine and direct primary care:

"FAQ on Direct Primary Care," American Academy of Family Physicians
American Academy of Private Physicians
Direct Primary Care Coalition
"Family physicians, patients embrace direct primary care", American Academy of Family Physicians
"Pay flat fees to doctors with direct primary care," The Chicago Tribune

Do you really make house calls?
House calls are available to all members within our service area. There may be occasions when a house call is not appropriate, such as when specialized equipment or testing is necessary. Let us know if you feel that a house call may be necessary; I will make a decision based on the clinical situation if a house call is appropriate.

Can I call you anytime?
I provide my direct cell phone number to all member patients. Please note that I do not respond to phone calls or texts to my cell phone during regular office hours as I am typically with patients. During these times it is best to call the office at (520) 777-1973 to make sure your issue is addressed.

Can I email you?
You can send and receive email messages anytime through your secure patient portal. However, I request that you do not email to discuss new or worsening conditions - call me instead as I may not review emails for up to 3 business days.

Can I check my results online?
Yes. After I have reviewed your results, you will be able access your laboratory and radiology results anytime through your secure patient portal.

Question 2

Clinic Policies

Accepted Answer

Do you see children?
Yes. I provide routine pediatric care, including treatment of ear infections, upper respiratory infections, sports physicals, asthma, and more. I also provide developmental screening, including evaluation for autism and ADHD.  I have a special interest in providing care to children with Down syndrome.

Do you see pregnant women?
I do not provide obstetric care or deliver babies. If you become pregnant, I will help arrange a referral to a qualified obstetrician. I am happy to continue to care for your non-pregnancy related needs.

What procedures do you offer?
I offer most outpatient procedures, including cryotherapy (freezing of warts and other skin lesions), skin biopsy, treatment of abscesses, joint injections, IUD insertion and removal, toenail removal, basic splinting, and more.

What is your view on antibiotics?
I believe that proper use of antibiotics is an essential part of medical treatment. Antibiotics should be prescribed when medically necessary. Because antibiotics can lose effectiveness or even create bacterial resistance, it is important not to prescribe antibiotics when they are not likely to result in any benefit.
 
For example, most cases of the common cold or sinus symptoms do not require antibiotics, and the CDC discourages the use of antibiotics in most cases.

What is your view on vaccination?
Vaccination is an important part of enjoying full health. Participating in a vaccination program benefits both the individual as well as others in the community. I follow the immunization schedule recommended by the American Academy of Family Physicians found here.
 
I respect those that choose not to receive immunizations for themselves or their family members. However, in my practice I provide care for those who are at risk of vaccine-preventable diseases. These include the elderly, young children and infants, and those with a weakened immune system. In order to provide the best care for these patients, I cannot accept patients into my practice who choose not to receive vaccines without a clear medical reason.

Do you provide immunizations in your clinic?
At this time the vaccines I provide in my clinic are limited to travel-related conditions. I also provide vaccines for tetanus and influenza (the flu vaccine). Because I do not participate in insurance plans, most other vaccinations will be more affordable at the health department or at retail pharmacies. Those requiring routine immunizations will be given a prescription.

Are there certain medications you don't prescribe?
I do not prescribe narcotics for treatment of chronic pain, stimulants for adult ADHD, or Suboxone for treatment of opioid dependence. I also do not provide medications that result in termination of pregnancy. For those that require treatment of these conditions, I will help arrange a referral to the appropriate specialist.

Question 3

Health Insurance

Accepted Answer

Is a membership in The Family Doctor considered health insurance?
No. Having a membership in The Family Doctor allows you to have improved access to your own physician, but it is not the same as insurance and does not meet the minimum essential coverage mandated by the Affordable Care Act ('Obamacare').
 
The state of Arizona recognizes the direct primary care model as a service distinct from health insurance. (Click here to read Arizona Senate Bill 1404 for more information.)
 
All members are strongly encouraged to obtain their own health insurance.

Do I even need health insurance?
Absolutely. Health insurance is necessary to pay for expensive, unanticipated medical costs. I have a health insurance policy for myself and my family. A serious illness can bankrupt a household; not having health insurance can be harmful to both your health as well as to your wallet.

What does it mean to be "out of network"?
Because I do not participate in any insurance plans, I am considered an "out of network" provider by most insurance companies. It is important to check to see how your insurance policy will handle this. In most cases, the membership fee I charge will likely not be reimbursed, although additional fees (such as the cost for an injectable medication) may be.

Can I be a patient of The Family Doctor if I have health insurance?
In most cases, yes. For the purposes of insurance, I will be considered an out-of-network provider.

Isn't it more expensive to pay for my healthcare than to have my insurance pay it?
No. In some cases, paying for your health costs directly may be less expensive than having your insurance pay for it. 
 
Insurance is meant to pay for rare but expensive costs. The more things that are included in an insurance policy, the more expensive it becomes. That's why it's best to have insurance for expensive things (like replacement costs for a car or a house), but to pay out of pocket for more routine things (like an oil change or to fix a clogged drain.)
 
Health insurance is often backwards because most companies pay for things that are expensive (like a major surgery) as well as for things that are routine (like treatment for strep throat). Comprehensive plans like these are like paying for car insurance that includes oil changes along with collision insurance.
 
The fact is that most of what a family doctor does is not very expensive. When you see me, you are paying for my time and perhaps for a few inexpensive supplies, like a brace or some bandages. By paying for these services directly, you can then save money by purchasing insurance only for the things you can't afford.

Do you accept Medicare?
Dr. Kartchner is not a Medicare provider but can see patients who are enrolled in Medicare. He can also order labs and imaging studies to be covered under Medicare, although his services are covered directly by the membership fee schedule listed on his website.

Question 4

Travel Medicine

Accepted Answer

What is travel medicine?
Travel medicine is the prevention, diagnosis, and treatment of illnesses related to travel. This includes malaria, traveler's diarrhea, high-altitude sickness, marine illness, and so on.

Am I required to get vaccines before I travel?
Many diseases that are rare in the United States, such as measles, typhoid fever, or tetanus, may be common in developing countries. Some destinations require yellow fever vaccination as a condition of entry to the country, and travelers that have not received this immunization may be turned away.

How far in advance should I plan my consultation?
Because travel medicine often involves immunizations and because immunizations often require multiple doses prior to completing a series, I recommend scheduling the pre-travel consultation as far in advance as reasonably possible. Most immunizations need to be started at least 6-8 weeks prior to departure.

If you do not have this amount of time, you will still be able to schedule an appointment with me, but you may not have as much protection as you could.

Question 5

Miscellaneous

Accepted Answer

How can I join?
Joining is easy. Simply click here if you would like to join. You can then set up an appointment to learn more about your health needs and to make arrangements for payment.

How do I cancel my membership?
It is easy to cancel your membership. Just notify me in writing that you will be canceling your membership. You may be responsible for a partial payment for any portion of the month already used.

What if I have to go to the hospital?
I do not currently provide medical care for patients that need to spend time in the hospital. If you need to be admitted to the hospital, I will coordinate with the hospital to ensure you get the care you need, and be available to assist you when you are ready to leave.

What happens if I need to see a specialist?
The membership fee does not cover the cost of seeing a specialist. If necessary, I will work with you to refer you to a specialist that is in your health insurance plan.

What happens if I have an emergency?
If you experience any of the following conditions, DO NOT schedule an appointment with me. Instead, go to the emergency room or call 911.

Chest pain or pressure
Abdominal pain
Uncontrolled bleeding
Sudden or severe pain
Severe allergic reaction
Coughing or vomiting blood
Difficulty breathing or shortness of breath
Severe or persistent vomiting or diarrhea
Changes in mental status, such as confusion
Heavy bleeding
Large open wounds
Sudden change in vision
Sudden weakness or dizziness
Major burns
Spinal injuries
Severe head injury
Loss of consciousness

What happens if you are out of town?
On occasion, I may be unavailable for appointments due to vacation, illness, or duty with the Air National Guard. In most cases, I will still be available by telephone.

In situations where I will be unavailable for an extended period of time, I will make arrangements another provider to see my patients.

Can I be a patient if I have AHCCCS (Medicaid)?
Unfortunately, we are not able to accept patients enrolled in AHCCCS (Medicaid) at this time.

Direct Primary Care

Clinic Policies

Health Insurance

Travel Medicine

Miscellaneous

Frequently Asked Questions