February 18, 2025

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Dear Patient, 

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I am writing to you to notify you about a change in my practice meant to allow me to continue to provide the kind of high-quality care you have come to expect hands on, personalized, always accessible. If I cannot implement this change, I may, unfortunately, be forced to retire. Let me explain.

 

I think you will agree that the healthcare system has become broken. Outside of my office, patients in Albany have experienced many frustrations. For example, it is not uncommon to wait weeks for an  appointment, only to be seen NOT by a Physician, but by a Physician's Assistant, or Nurse Practitioner; it is not uncommon to make multiple calls to a specialist without getting a call back, to wait hours to  be seen at the Emergency Room, and to have increasing difficulty to get the cost of certain medications  covered. With this ongoing breakdown in medical care more responsibility must be accepted by the Primary Care Physician to get the patient what they need to ensure the highest quality of care- be it ordering special tests in anticipation of a specialists work up, be it the authorization of a needed medication or simply to advocate specialists for a timelier visit. Simply put, more time is required.  

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Patients in my practice have unprecedented access. You call my office and a person answers or responds quickly to messages. You leave a message and you get a call back. You have an urgent concern and you have your Physician's cell phone number for text or in emergencies you can call that cell phone and your physician answers 24/7/365 days a year (as you no doubt have personally experienced, even when I am seeing patients). Unfortunately, continuing to offer this kind of care is  becoming increasingly difficult.  

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As a result, I find it necessary to change the financial structure of my practice from insurance based to a “concierge” model. A concierge practice bills the patient directly rather than billing insurance. Current patients will be asked to pay an annual basic subscription fee (see below); I will not be billing insurance, Medicare or Medicaid. In this model you will have unlimited access, including my phone number and unlimited in office or video visits with NO co-pay. Your insurance will still cover labs, imaging, specialists, urgent visit centers, hospital ER visits, and hospitalizations. 

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How This Transition Benefits You: 

To help clarify what this transition means for you, here is a comparison of the typical primary care experience versus what you can expect as part of my new concierge practice:

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Feature:                   Primary Care Industry:               Concierge Care:

Access to Physician:   Limited to office hours;                     24/7/365 access via call,

                                      often redirected to NPs or PAs         text, or email with your PHYSICIAN.

 

Appointment                Often requires weeks of waiting      Priority scheduling with same/next day Scheduling:                  for non-urgent concerns                  appointments                 

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Visit Duration:              Visits often limited to 10-15             Extended, unhurried appointments

                                      minutes                                               tailored to your needs

 

Primary Care               Covered by insurance; subject         Included in concierge membership.

Visit Costs:                   to copays                                            No co-pays or insurance billing

 

Virtual                          Limited or not offered                       Unlimited virtual visits included

Appointments: 

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Proactive Care:            Reactive; focuses on                         Proactive and preventative care, 

                                      immediate issues                              addressing long-term health goals

 

Specialist                     Limited support for referrals           Streamlined specialist coordination
Coordination:               and follow-up

 

Insurance                     Covers physician, labs,                     Covers labs, imaging, specialists and 

Coverage:                     imaging, specialists, and                  hospital stays

                                      hospital stays

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Patient Load:               High; limited time per                       Limited patient base for truly personalized 

                                      patient                                                care

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Informational Sessions: 

 

I understand that transitioning to a concierge model is a significant change, and I want to ensure you have all the information needed to make the best decision for your health. To explain the benefits and details of this transition, I will be hosting informational Zoom sessions where I will share a presentation deck outlining the changes, answer your questions, and discuss how this model enhances your care. Click one of the dates below to join.

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Next Steps to Secure Your Spot: 

 

The program will begin August 11, 2025, and will run through August 11, 2026. I understand that a concierge practice will reduce the size of my current practice, but it will also ensure those who subscribe will have the highest level of personalized medical care that can be delivered and that is my passion and my goal. 

 

Current Patients: 
As an incentive, if you sign up before April 11, 2025, you will be guaranteed a spot at the discounted initial bi-annual subscription fee of $750.00 ($1500.00/year),

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If space is available and you sign up between April 12, 2025, and May 12, 2025, the initial bi-annual subscription fee will be $1,000.00 ($2000.00/year).

 

After May 12, 2025, the practice will be open to NEW and current patients at an initial annual subscription fee of $2500/year. 

Family discounts and discounts for referrals are available.

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For each subscription level provides unlimited access to our weekly Prevent It Now! Lifestyle Medicine Zoom classes (led by Dietitian Laurie Burton-Grego and myself), which uses diet, exercise, and lifestyle changes to reduce the reliance on medications (including GLP-1 receptor agonists like Wegovy), as well as the weekly Prevent It Now! book club with in-depth reviews of the works of Michael Greger, MD; Peter Attila, MD; David Sinclair, PhD; and others on nutritional practices, supplements and exercises for maintaining health and hopefully slowing the aging process. ​

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How to Join: 

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To make this transition as convenient as possible, there are several ways to sign up:

1. Online: Visit our secure portal on our web site at www.centerforpreventivemedicine.com to complete your enrollment.  (** PLEASE NOTE - We are currently in the process of setting up the portal and will be posting a link once it is in place)

2. Email: Contact the office by email at lemanskireception@gmail.com.

3. Phone: Call our office at 518-722-0099 and leave a message in the concierge mailbox (option #4).

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If This Model Isn’t Right for You:

 

The concierge model is based on the concept that YOU GET WHAT YOU PAY FOR. Delivering hands on, personalized care, 24/7/365 is NOT sustainable in the current insurance reimbursement system. With that said, I understand that the concierge model may not be the right fit for everyone. If you decide not to participate, I understand and completely respect your decision. I will work with you to help identify other primary care offices in the area that may be accepting new patients, helping to ensure a smooth transition for your ongoing healthcare needs. I will continue to refill prescriptions until your care is transitioned or October 11, 2025, whichever comes first.  

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Thank you for the privilege of being your physician! 

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Paul E. Lemanski, MD, FACP