Question 1

The FAQ is TLDR, can I just get a vibe check?

Accepted Answer

Yes! Dr. Holt practices holistic, evidence-based medicine. Holistic doesn't necessarily mean alternative, though. As a doctor of osteopathy, she practiced "functional medicine" before it was cool. However, she is NOT certified in the current concept of functional medicine. The founding principle of Osteopathic medicine is that, given the right conditions, the body can heal itself. Dr. Holt works holistically to to treat the whole person--mind, body and spirit, but as a graduate of Columbia University Family Medicine residency (an MD program), and as a graduate of Tulane's Master in Public Health program with concentrations in Epidemiology and Maternal and Child Health, she is pretty good at reading scientific literature and thus she tends to be more cautious with herbs and supplements when there isn't robust evidence to support their use, and especially when they could harm the patient. Patients at Poppy are offered access to a discounted website (Fullscript) where they can purchase the handful of supplements that Dr. Holt tends to recommend when she does recommend supplements, and this is passive income for the practice, some of which we put back into the pot to allow sliding scale memberships for those who can't afford regular prices at Poppy. But convincing patients to purchase hundreds of dollars in supplements is not our gig here. We're more about just practicing good medicine, and we definitely spend a lot of time trying to find you savings on your health care.

Dr. Holt is open-minded and willing to learn. But if you're transitioning to Poppy from an Integrative Medicine doc or a Functional Medicine doc, or if you're already on at least 3 supplements on your own, we recommend you do a meet and greet with Dr. Holt before committing to membership. Ask a lot of questions about her comfort level with alternative therapies you might be hoping for. Yes, she sometimes prescribes compounded medicine when it could be beneficial. If there's an FDA-approved alternative, she will likely recommend that first. She is a firm believer in the science of vaccines. She does not prescribe medical marijuana. She does not prescribe daily benzodiazepines or opiates, so if you are already on these prescriptions, you will need another doctor to prescribe them for you while you're a member of Poppy. Dr. Holt is a great listener and is firmly committed to patients' autonomy. She will listen, look at the "big picture" of your health and concerns, and give you an expert's opinion for preventative care, diagnoses and treatment options. We keep our practice small, comfortable and personable. You might run into Dr. Holt's 3 kids or husband at the clinic one day, or catch Dr. Holt mopping the floors in the evening. The level of attention you will feel as a patient is concierge-like, but Direct Primary Care is not concierge medicine, which tends to cost a lot more. If concierge medicine is like making groceries at Dorignac's or Robert Fresh Market, Direct Primary Care is like going to Costco-- it's nice, and you leave with a lot more, and more money in your wallet.

Question 2

What can a Family Doctor do?

Accepted Answer

Family doctors are primary care experts and have the training to manage 85% of all health conditions. Many patients don’t realize the full potential of a primary care doc because in the United States, our profit-driven healthcare system is heavily biased toward specialty services, so primary care is not easily accessible or prioritized by your health insurance company.

Dr. Holt is trained to provide medical care across the age spectrum. She has focused her current practice on adults ages 18-65 and provides preventative, chronic and acute health care. Examples include well checks, STI screening, pap smears, breast exams, high blood pressure, diabetes, hypothyroidism, migraines, Irritable Bowel Syndrome and PCOS (to name a few). Mental health conditions like anxiety, depression, eating disorders, ADHD and insomnia are well within her scope of practice. She can also manage minor traumas and urgent issues like sprained ankles, UTIs, respiratory infections and rashes!

Question 3

What is an Osteopathic Doctor?

Accepted Answer

Doctors of Osteopathic Medicine, or DOs, are physicians just like MDs, but they must complete additional training in hands-on medicine called Osteopathic Manipulative Medicine. Both DOs and MDs must complete a college degree, take specific “premed” classes, score well on the MCAT (a standardized test to get into medical school), go to a four year medical school, and complete a residency (3+ additional years of training) in a specialty of medicine or surgery, and pass standardized medical exams along the way in order to ultimately be “board certified physicians.”

The American Osteopathic Association explains, “DOs receive special training in the musculoskeletal system, your body’s interconnected system of nerves, muscles and bones. By combining this knowledge with the latest advances in medical technology, they offer patients the most comprehensive care available today….DOs bring a unique, patient-centered approach to every specialty across the full spectrum of medicine. They are trained to listen and partner with their patients to help them get healthy and stay well. DOs practice in all medical specialties, including primary care, pediatrics, OBGYN, emergency medicine, psychiatry and surgery. Moreover, DOs hold some of the most prominent positions in medicine today, including overseeing care for the President of the United States, the NASA medical team, Olympic athletes and many who serve in the uniformed services.

From their first days of medical school, DOs are trained to look beyond your symptoms to understand how lifestyle and environmental factors impact your well-being. They practice medicine according to the latest science and technology, but also consider options to complement pharmaceuticals and surgery.”

Dr. Holt went to an osteopathic medical school so she benefited from learning this extra musculoskeletal training. Her residency program at Columbia University was more MD-focused, so she did not refine her skills in manipulative medicine (using her hands to manipulate the musculoskeletal system). She does, however, highly appreciate this approach, and can connect patients to practitioners who use it as a complement to other medical services.

Question 4

Is Poppy Direct Care good for students?

Accepted Answer

Direct Care is great for college or graduate students. Often, students get sick much more frequently than they are used to when they join a campus and are suddenly exposed to germs they haven't encountered before.  Students also often need help with things like sexually transmitted infection testing, contraception, or mental health medications like for anxiety or depression. Members can have unlimited visits with Dr. Holt for sick visits, get rapid testing for things like mono, strep, pregnancy and an initial test for urinary tract infection for free with membership, rapid flu tests for $11, rapid COVID for $12, and rapid HIV for $14. If they need a typical primary or urgent care medication, Dr. Holt can dispense it on site without using their insurance (for example, Dr. Holt sells amoxicillin for $0.20 per tablet, so a prescription for a typical course of amoxicillin for strep throat, for example, would cost the patient $4.00 plus tax, and it would be dispensed on site at the time of your appointment so no waiting around at pharmacies). Busy students can text or call Dr. Holt, and enjoy same day or next day visit options instead of waiting around for a campus health appointment or going to Urgent Care.

Question 5

Is there a long-term commitment for DPC?

Accepted Answer

No, membership is month-to-month. You can cancel at any time with 30 days notice (to ensure a safe transfer of care). There is no cancellation fee. However, if you want to re-enroll within 9 months of cancelling your membership, there is a re-enrollment fee of $300.

Question 6

Do you offer discounts for families and groups?

Accepted Answer

Yes! We trust our members to define their families and significant relationships for themselves, so the only requirement for a group discount with the Sustainable Membership Tier is that there is a single payer. Discounts are automatically applied at the time of enrollment: 10% off for groups of 2-3 members, and 15% off for groups of four or more. This can be particularly helpful for roommates or housemates.

Question 7

What about the specialists I need to see?

Accepted Answer

Most insurance companies will allow us to refer you to your specialists in the same way your previous doctor might have. Some exceptions are HMOs (eg. Kaiser) and TSHIP, which require you to see one of their providers to get any referral approved by their insurance coverage. In these instances, we can make suggestions to your insurance-based doctor about what to do, but we cannot complete the referral ourselves. For TSHIP (Tulane's student health insurance program), you can use your insurance for things Dr. Holt orders as long as you have a referral from Tulane Campus Health to see Dr. Holt.

A frequent example of why Tulane students pay for membership fees to Poppy even though they have TSHIP is that college students tend to get sick often, and being a member of Poppy virtually ensures same day or next day care from Dr. Holt herself. Often, college students also need help with things like sexually transmitted infection testing, contraception, or mental health medications like for anxiety or depression. Tulane students don't need a referral from Campus Health in order to benefit from Poppy's on-site labs or prescription dispensing for wholesale prices. Members can have unlimited visits with Dr. Holt for sick visits, get rapid testing for things like mono, strep, pregnancy and an initial test for urinary tract infection for free with membership, and rapid flu tests for $11, rapid COVID for $12, and rapid HIV for $14. If they need a typical primary or urgent care medication, Dr. Holt can dispense it on site without using their insurance (for example, Dr. Holt sells amoxicillin for $0.20 per tablet, so a prescription for a typical course of amoxicillin for strep throat, for example, would cost the patient $4.00 plus tax, and it would be dispensed on site at the time of your appointment so no waiting around at pharmacies).

Question 8

What’s the difference between DPC and concierge medicine?

Accepted Answer

The level of attention you will feel as a patient at Poppy is concierge-like, but Direct Primary Care is not concierge medicine. Concierge practices typically charge a (much higher) monthly or annual membership fee to protect access, and they also bill your insurance for each visit. We do not charge your insurance for our services, but instead get paid by you directly. This means we are working for you instead of the insurance company. This allows us to keep our hearts and resources where we think they should be: invested in you and our local community. If concierge medicine is like making groceries at Dorignac's or Robert Fresh Market, Direct Primary Care is like going to Costco-- it's nice, and you leave with a lot more, and more money in your wallet.

Question 9

Is Dr. Holt available 24/7?

Accepted Answer

Sort of… Poppy DPC has normal business hours, is closed on weekends and holidays, and Dr. Holt and staff do take vacations (with plenty of notice to patients)...caring for ourselves in this way helps us avoid “burn out” that has become so pervasive in primary care, and keeps us rested and energized to care for others. Often, patients have a random question that they don’t want to forget, or are studying at 2am and have a question…when that happens, feel free to text! We won’t see it until the morning or after the weekend, when we will promptly respond. Don’t worry, Dr. Holt doesn’t wake up to text dings. If you want to make an appointment for the morning, you can do it straight from our website, and if there isn’t a time that works, text and we’ll find a better time. If you have a concern that can’t wait until the morning or after the weekend, or if you’re not sure if you need to go to the ER, just call, and Dr. Holt will try to answer and talk through whether it's something that can wait or not.

Question 10

Will I get kicked out of the practice after age 65?

Accepted Answer

No. As long as you enroll at or before age 65 years, we will not cancel your membership when you turn 66. However, we cannot under any circumstances see patients in direct primary care if they have Medicare for health insurance. If you get on a Medicare plan at age 65, we will help you safely transition to a different practice that can see patients with Medicare.

Question 11

Does Poppy provide gender affirming care?

Accepted Answer

Yes. Gender affirming care is primary care, and we offer primary care.

Question 12

Do I have to be a US citizen to get care?

Accepted Answer

No, of course not. Dr. Holt is a physician. She does not discriminate her care for humans based on immigration status.

Question 13

What are the highlights to know about the Membership Agreement?

Accepted Answer

If you're nervous about signing up for membership, we encourage you to schedule a free 15-minute meet and greet to ask all your questions about membership before signing up. You can also request our Membership Agreement via email before scheduling, by emailing info@poppydirectcare.com. (info@poppydirectcare.com.)Some important things to know about  Membership include: 
1. There is a non-refundable $100 booking fee for your first visit as a member. 
2. Your membership will start the night before your scheduled first visit, and you will be billed for the first month the night before your visit, so that you arrive at Poppy already a member! This means that you will pay $200 total before your first visit-- $100 booking fee for your first visit, and $100 for the first month of membership. 
3. There is a three month minimum commitment to membership. 
4. There is no fee to cancel membership, but we ask for 30 days notice to safely transfer your care to another Primary Care Doctor.
5. If you decide to cancel membership and ask to re-enroll within 9 months of cancelling, there is a $300 re-enrollment fee. 
6. Dr. Holt does not prescribe long-term daily opiates or benzodiazepines. If you're on one or both of these daily, Dr. Holt will offer to help you taper off, but she will not prescribe them daily for long periods of time. 
7. This is a Primary Care Membership, and signing up for it implies that you expect Dr. Holt to be your Primary Care Doctor. Sometimes folks bounce around cities/states/countries throughout the year, which is great, but if you sign up for membership at Poppy, Dr. Holt expects to be your go-to doc for all your primary care needs in New Orleans, not just to refill one particular prescription, for example. If you already have another doctor taking care of your Primary Care needs, such as a functional medicine doctor, it's not recommended to also sign up at Poppy Direct Care. 
8. If you are a patient who has an active eating disorder that requires at least monthly medical monitoring, or if you suffer from either one complex medical condition requiring at least monthly visits, or from 2 or more medical conditions requiring at least monthly visits, Dr. Holt might offer you the following add-ons to membership: Eating Concerns Add-On, or Advanced Coordinated Medical Care Add-On. 
These Add-On programs each come with an additional monthly fee of $200 to the Primary Care Membership (total $300/month). The prices for these Add-Ons is intentionally higher to protect the time needed to accomplish this level of care. Patients who enroll in Add-On programs will also be given personalized treatment plans. If at any time, a patient's healthcare needs exceed the care that can be safely provided under the traditional Primary Care Program, Dr. Holt might offer the patient an Add-On program. If the patient declines the Add-On program, Dr. Holt reserves the right to terminate membership in the Primary Care Program and will provide 30 days of coverage to bridge the patient to their next Primary Care Doctor.

Question 14

Why are Add-Ons like the Eating Concerns and Advanced Coordinated Care more expensive?

Accepted Answer

Our philosophy is to be a model for sustainability in the medical care we provide and the business model we've created. We charge what we believe is a fair price for the services we provide so we can give each and every patient the amount of time with the doctor that they need. Rather than charge patients per visit, which can discourage people from seeking care when they need it, our membership model is designed to charge a fair amount for primary care services while also reserving time and space for patients to see the doctor when unexpected health issues arise.

We keep our membership roster quite small by design, we protect time for all our members with same day and next day urgent care availability, we give all our members Dr. Holt's cell number to text if needed, we operate only 5 days a week so we don't overdo it, we take holidays off,  and we give back to the community with free or discounted patient services. All of these things figure into the price of a membership with us.  When a patient has one or more medical conditions that require a necessarily more intensive time commitment from the clinic, we charge a fair correlating fee to protect that time for the patient and remain fair to everyone else. Remember, your membership fee is all that Poppy Direct Care receives from you for our services. We do not bill your insurance company for visits.

Patients who receive add-ons for eating concerns and advanced coordinated care are receiving lagniappe-- something different and extra-- than patients who are in the regular Primary Care Membership. This necessarily costs more so that our small business remains sustainable.

Question 15

Do I have to have insurance to be seen?

Accepted Answer

No. We do recommend that you have insurance, though. Your membership with us will not cover you in the hospital, operating room, or for specialist visits or a new diagnosis like cancer. We encourage all members to have, at minimum, a catastrophic coverage option. 
We cannot see patients who have Medicare or TRICARE insurance.

Question 16

Why don’t you take insurance?

Accepted Answer

We appreciate insurance for big life-events. And we encourage all members to have at least some sort of catastrophic coverage, though many patients maintain full coverage health insurance and find that even with adding Poppy's membership fee, they still pay less for healthcare than if they just relied on their health insurance for it. But our healthcare system just isn’t working for patients in a way that is convenient, accessible, or affordable. The current trends in healthcare aren’t how we want to deliver care, and people are affected by all health conditions, not just the ones covered by insurance. We want time to get to know our patients by their first names, and better understand their personal health goals. Since we aren’t dependent on reimbursement for services by health insurance, we don’t have to rush to see many more patients a day required by accepting insurance. We also don’t have to make medical decisions based on what the insurance company wants to pay for. The monthly membership model provides both consistent care and dependable access for you. Because we work for you, not the insurance company, we get to use the latest evidence to decide together what is best.

Question 17

Can I use my health insurance to cover visits?

Accepted Answer

No, because we don’t accept insurance as it severely limits the quality of care we are able to provide to patients in the primary care setting. Similar to how car insurance doesn’t pay for oil changes, wipers or gas, your health insurance doesn’t work well when trying to use it for health maintenance or little health events like sickness. Our predictable monthly membership fee will cover your health maintenance needs like visits to talk about psychiatric medications or blood pressure treatment, and will also cover problem visits that arise like getting sick. You get the satisfaction of having someone you trust at your fingertips when health stuff comes up.

We highly recommend you also keep insurance coverage to cover the big stuff like hospitalizations and surgeries. Some members choose to use insurance for labs or prescription medications, but most find it is actually cheaper to pay for these directly through our discount program.

We can see patients who have Medicaid insurance, but we don't bill Medicaid (or any insurance for that matter) for your membership fee. We cannot see patients at all if they have Medicare or TRICARE insurance due to government restrictions.

Question 18

What makes this different from insurance-based practices?

Accepted Answer

Bottom line: you get more time with your doctor, more doctor availability, more personalized healthcare delivery, and more convenience (text my doc? Yes please) because we don’t let insurance push us around in what we offer and what we do (we do still use your insurance if you have it for things like specialists and radiology, etc….the big expensive stuff).

We see about ¼ the typical number of patients of an insurance-based primary care physician. Membership is limited to protect our availability for you. Our visits are 30-60 minutes long, but if you just have a quick question that can be answered via text or email, you can do that too with no extra charge. That’s total, unlimited access.

Price transparency is a priority for us. We’re sometimes patients, too, and we’re sick of an insurance-based healthcare system where we have no idea how much something as simple as a strep test at an urgent care will cost us after insurance decides what they will pay (spoiler alert, Dr. Holt found out the hard way when using her commercial insurance policy that she was charged $200 for a rapid strep test at an Urgent Care after her insurance paid. That means she owed $200 for a test that she can buy for $2 as a physician and provides her patients for free as a part of their membership). At Poppy Direct Care, we’ve negotiated wholesale pricing for prescription medications, labs and point of care testing like strep tests and flu tests, and we’ve passed that savings on to you with full price transparency. You’ll see that paying cash for these things is often cheaper than using your insurance.

Question 19

Is the membership fee an insurance policy?

Accepted Answer

The short is answer is, “it’s complicated.” The membership fee will get you quick, direct access to our physician for your health needs that are chronic or new. Often, those in the young adult age range that we see (ages 18-45) have many, unpredictable illnesses (think mono, strep, respiratory illnesses, gastrointestinal bugs). Having a membership to a primary care doctor makes it easy to get those things addressed quickly and conveniently. We can also help with young adult needs that require more comprehensive and unhurried care, like mental health and unexplained chronic symptoms (eg. chronic fatigue or diarrhea). As these things come up, your membership fee covers your physician care for them and gives you access to wholesale prices on prescription medications and labs. It’s kind of like the maintenance plan you might buy on your home air conditioner or other appliances.

Question 20

What if I have TSHIP (Tulane's Student Health Insurance Program)?

Accepted Answer

TSHIP prefers you to see one of their providers at the Campus Health center, but you can also see physicians in the community for your primary care as long as you have a referral from the Campus Health Center to that physician for your care.

A frequent example of why people pay for membership fees to Poppy even though they already have TSHIP is that college students tend to get sick often, and being a member of Poppy virtually ensures same day or next day care from Dr. Holt herself. Often, college students also need help with things like sexually transmitted infection testing, contraception, or mental health medications like for anxiety or depression. Members can have unlimited visits with Dr. Holt for sick visits, get rapid testing for things like mono, strep, pregnancy and an initial test for urinary tract infection for free with membership, rapid flu tests for $11, rapid COVID for $12, and rapid HIV for $14. If they need a typical primary or urgent care medication, Dr. Holt can dispense it on site without using their insurance (for example, Dr. Holt sells amoxicillin for $0.20 per tablet, so a prescription for a typical course of amoxicillin for strep throat, for example, would cost the patient $4.00 plus tax, and it would be dispensed on site at the time of your appointment so no waiting around at pharmacies).

FAQ

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Dr. Emily Holt, DO, MPH

info@poppydirectcare.com

504-788-2904

812 Hillary Street

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FAQ