No Insurance and Prices Go Down


Here is a shout out to a Mainer going off the grid.  Dr. Michael Ciampi, from Portland, stopped accepting all forms of health insurance in early 2013.  No more managed care. No more Medicaid. No more Medicare.   Here is what happened when he did this:

  • The decision to do away with insurance allows Ciampi to practice medicine the way he sees fit.
  • Insurance companies no longer dictate how much he charges. He can offer discounts to patients struggling with their medical bills. He can make house calls.
  • “I’m freed up to do what I think is right for the patients,” Ciampi said. “If I’m providing them a service that they value, they can pay me, and we cut the insurance out as the middleman and cut out a lot of the expense.”

That’s Authentic Medicine.

Here are the prices of his care, from his website, when you remove the third parties:

Effective April 1, 2013
Services:Office Visit (brief)                                                                                     $50.00
(one straight forward issue. i.e. cold, sinus infection, bladder infection, etc.)

Office Visit (regular)                                                                                $75.00
(one issue of moderate complexity or 2-3 simple issues.  i.e. diabetes follow up, back pain, abdominal pain)

Office Visit (extended)                                                                             $100.00
(multiple issues and/or a single very complicated issue requiring more time, counseling, and/or coordination of care with other doctors or hospital)

Complete Physical Exam
(comprehensive history and physical exam and review of labwork for preventive health maintenence)

Well Child Exam                                                                                        $150.00
(age appropriate history and physical.  immunizations usually covered by state at no extra cost)

House Call                                                                                                    $200.00
(for patients who are homebound or too sick to come to office.  extra charge could apply if longer travel required)

Nurse Visit                                                                                                    $20.00
(for follow up of established problems such as blood pressure rechecks, etc. Results reviewed by doctor to modify treatment plan)

Telephone Consultation with the Doctor
(for established patients only who cannot come in for appointment who have questions they want to ask the doctor personally.  $20 for a conversation up to 10 minutes.  Additional minutes will be billed $10 for every additional 5 minutes, or fraction thereof.  We will not do telephone consultations on patients who have not been seen by the doctor in the past year)

Minor Surgery (w/o sutures)                                               $100.00-$150.00
(i.e. drainage of abscesses/boils, shave biopsies without sutures.)

Minor Surgery (w/ sutures)                                                  $200.00-$250.00
(i.e. removal of skin lesions which require stitches.  Follow up visit for removal of stitches is included)

Joint Aspiration/Injection 
(cortisone injection of shoulder, drainage of ganglion cysts, etc.)

Ear Cleaning
(flushing of ear to remove wax)

Ear Popper
(use of ear popper device to clear blocked Eustacian Tube)

Cryotherapy                                                                                                 $30.00
(freezing of warts, skin tags, and some pre-malignant skin lesions)

Electrical Muscle Stimulation 
(LaserTouchOne device applied to spasmed muscles to treat pain)

Spirometry Testing 
(simple breathing test to evaluate lung function)

Nebulizer Therapy  
(inhaled treatment for asthma, bronchitis, emphysema)

Pre & Post Nebulizer Spirometry
(breathing test before and after treatment to evaluate effectiveness of treatment and diagnose asthma)

(measurement of electrical impulses of the heart)


Vitamin B 12                                                                                                    $10.00

Toradol                                                                                                             $20.00

Ceftriaxone                                                                                                      $20.00

Lab Tests:

Hemoglobin A1C                                                                                            $20.00

Urine Dipstick Analysis                                                                                $10.00

PT/INR                                                                                                            $10.00

Helicobacter Pylori                                                                                        $10.00
(this fee covers collection of specimen.  lab fees are separate and can be billed to your insurance)

Glucose                                                                                                              $10.00

Urine Pregnancy Test                                                                                     $10.00

Urine Drug Screen                                                                                          $10.00

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  4 comments for “No Insurance and Prices Go Down

  1. MadERdoc
    June 13, 2013 at 2:39 pm

    I think this is great !!! there needs to be more transpernecy in the cryptic billing process of medicne ( $80 for a baby ASA etc ..). I foresee a kayak type website for medicine where a patient can put in a procedure or type of office visit and will get multiple quotes.

  2. Sir Tenthumbs
    June 12, 2013 at 2:34 pm

    I foresee this fee schedule as setting the mark for the Physician Payment Commission. Byoo-ha-ha-ha-ha!

  3. rokosz
    June 12, 2013 at 11:13 am

    There’s a local pediatric dentist who hasn’t taken any insurance in years. They give you (the patient) a bill, you pay it. And then _you_ submit to any carrier available to _you_. Not sure how I feel about it. Don’t know enough to know if dentists are a different breed from PCP/MDs (stop snickering, you that do) and thus _can_ do this. But, the waiting room is always full. I refrain from commenting on the prices.

  4. Pat
    June 11, 2013 at 8:20 am

    This is excellent, and far more honest than any manipulated hospital “transparency” will be. But the article did not address any Medicare/Medicaid specifics: does Ciampi still see government patients, and if so, would he still not be bound by the crushing overhead costs and threat of administrative fines/prosecution? My understanding is that any Medicare patient has to sign off on a multi-page form documenting their understanding that they cannot seek government reimbursement for their visit, and to do so would be fraudulent, etc, etc. We’ll know this trend is really catching on when CMS starts attacking off-grid docs for non-compliance with the whole architecture of gov’t care.

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