Membership.

What's included

Every primary-care visit, in person or virtual. Every visit with any clinician on the panel. Direct cell access to your assigned clinician for short questions; voice for longer ones. All in-office procedures: IUD insertions, cryotherapy, ear-irrigation, joint injections, dry-needling, point-of-care ultrasound, suturing for minor lacerations, abscess incision-and-drainage, EKG, spirometry, in-office iron infusions when indicated. Annual well-visits. Sports physicals. Advance-directives visits. Bereavement visits for surviving members. House calls within Duluth city limits during a member's last fortnight at home with hospice.

What's not included

Hospital care, surgical care, oncology, complex specialty care. Prescription medications dispensed at retail pharmacy (we offer many at our acquisition cost from the in-house dispensary; the rest you fill at a pharmacy). Imaging and labs sent out of office (we offer cash prices that are typically 60–80% below retail; we run many in-office labs at acquisition cost). Durable medical equipment beyond what we hand you in the office (a cane, a $39 home BP cuff, a peak-flow meter). Vaccines (cost-plus a small administration fee).

What we recommend you keep

A high-deductible insurance plan, an HSA-eligible catastrophic plan, or — for members above income thresholds — a Christian health-share or other cost-sharing arrangement. The membership replaces your primary-care coverage. It does not replace your hospital, surgical, or specialty coverage. If you do not currently have a plan beyond ours, we will spend a visit with you walking through the Minnesota plan options on MNSure and the open-market HSA options.

How to enroll

Visit begin. The intake is a single page (your name, your household, your plan-of-record, your medical history in your own words), a one-time enrollment fee of $50 (waived for members coming from other DPC practices and for sliding-scale members), and a 90-minute first visit booked at your convenience inside two weeks. The first visit is the moment you actually become a member — not the moment you sign the paperwork.

How to leave

By writing us a sentence on a piece of paper or in an email. Membership is month-to-month; we charge on the first of the month; if you tell us by the 25th of the prior month, you are not charged for the next. There is no penalty, no exit interview, no minimum. If you want your records, we will give you your records, electronically or printed, within ten business days, at no charge. If you would like a referral letter to your next primary-care home, we will write one. We mean it when we say there is no minimum: we want members who want to be members, not members who feel locked in.

The math, worked once

For a couple in their forties with two children under 22, current at our rates: $170 (couple) + $90 (two children at $45) = $260 / month, $3,120 / year. The same household's primary-care copays under most BCBS-MN plans run $25–40 per visit; ten visits across the family is $250–400; their HSA-eligible plan also has the $4,800 family deductible. The membership gets them unlimited visits, all the in-office work above, and the cost savings on labs and generics. For most families with active care needs, the membership comes out cheaper at year-end. For some it is neutral. For families with very few visits, it can be a small premium — and we will tell them so at the first visit.

Cross-references: the about page covers the practice model in more detail; "Why we list our prices" argues for posted-price practice generally; the dispatch page covers operations and how to reach us.