A doctor’s office that charges a monthly fee and doesn’t take insurance wants to stop the 'revolving door' of appointments for sick kids

parsley health

Parsley Health is a medical practice that charges a monthly fee and doesn't take insurance.
For $150 a month, the membership provides access to doctors and health coaches, with the goal of treating conditions in a more comprehensive way than traditional primary care.
Now, the practice is expanding into pediatrics in its New York office, aiming to provide better care for children and teens with chronic conditions.
The cost for kids is $129 a month.

Parsley Health, a new kinds of doctors office that charges a monthly fee and doesn't take insurance, is expanding its practice into pediatrics.

Parsley Health got its start in 2016 and now has centers in Los Angeles, San Francisco, and New York. The practice, founded by Dr. Robin Berzin, is focused on functional medicine, a type of practice that tries to take a more comprehensive approach at treating the underlying cause of a particular disease, looking at it more holistically than on a case-by-case basis.

For a monthly fee of $150 you get primary care visits, nutrition plans, supplement regimens, as well as as more in-depth genetics and microbiome testing.

Until now, Parsley only treated people ages 18 and up. That's changing so that its doctors can apply the Parsley model to teens and children who might benefit from the approach.

The pediatric practice is led by Dr. Gaby Safdieh, a pediatric rheumatologist, who joined Parsley a little more than a year ago. Safdieh had been practicing pediatrics and rheumatology as part of a fellowship at the Hospital for Special Surgery in New York.

Along the way, she grew frustrated by the way she saw children diagnosed and treated for chronic conditions, like asthma, frequent infections, eczema, and allergies. Initially when she started at Parsley, she saw young adults between 18-30, with the plan to one day create a pediatric practice within the organization.

"We want to treat children at what is the root cause of a medical problem they’re having and set them up for a clear path for health," Safdieh said.

Safdieh started seeing patients between the ages of 0 and 18 as part of a small pilot in August. The program's now open to the children of existing Parsley Health members. Membership for kids and adolescents is $129 a month or $1,400 a year.

How it works

A pediatric membership includes five visits with a physician and five health coaching sessions. Through those meetings and potentially genetic and microbiome testing, the hope is to get a comprehensive look at kids and teens' medical histories, diet and exercise habits, and other factors that could play a role in the chronic condition he or she is experiencing. Not included in that monthly fee are things like prescriptions, supplements, or lab work.

While Parsley Health doesn't take insurance, it may be considered as out-of-network care, which might be reimbursed. (Ultimately, Parsley's goal is to collect information on how its approach to primary care and pediatrics is working to keep patients' healthier and one day bring that to insurers who might want to pay for Parsley's services for their members.)

Parsley Health's new center in NYC's Flatiron neighborhood For instance, Safdieh has been seeing as part of the pilot a teenager who for years had been treated for sinus infections, going on antibiotics as many as five times in a year. While antibiotics can be helpful in clearing out bacterial infections, anytime they're used, it can expose patients to side effects and risks building antibiotic resistance.

Ideally, Safdieh wanted to help decrease that antibiotic usage. So she looked into the patient's history with those antibiotics, as well as stressors, diet and did some testing to get a better sense of the bugs that live in her gut. Safdieh's now been working with the teenager for six months, making adjustments so the teenager is getting more sleep and physical exercise, exploring the use of some supplements and acupuncture as well.

"Our goal with pediatric is similar to adults in many ways," Safdieh said. "We want to stop the revolving door of frequent doctor visits and being thrown around to specialists."

So far, the American Academy of Family Physicians, which represents 129,000 family medicine doctors, hasn't found sufficient evidence for doctors to use functional medicine in family practice, though the organization in March 2018 said it will allow for certain courses to educate doctors about how to talk to patients about it. The American Academy of Pediatrics, which represents 67,000 pediatricians does recognize pediatric integrative medicine, which encompasses evidence-based treatments that might fall outside the scope of Western medicine, used in conjunction with traditional care.

New models for pediatrics

Parsley isn't alone in using a subscription model for pediatrics.

Others who practice direct primary care have set up pediatric practices or see kids alongside their parents. Still, the cost of direct primary care can be tough to justify for most kids, who tend to need relatively little ongoing medical care.

One Medical is a startup medical group that aims to make it easier for patients to see their doctors, is getting into pediatrics as well. It charges $199 a year for same-day visits with a doctor or other care provider and takes insurance, different from Parsley's model. To date, it's opened up five pediatrics practices based in the Bay Area and NYC, a number it anticipates will increase over the next year.

The sites serve as places where both adults and kids can get care, and they'll be centered in areas where people live rather than near the office — for example one of the New York locations is in Park Slope, a residential neighborhood in Brooklyn.

"They're all 100% full immediately," One Medical CEO Amir Rubin told Business Insider. "It's kind of a no-brainer."

Zachary Tracer contributed reporting.

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