What is Direct Care?

“Direct care” means that you, as a patient, agree to a professional relationship (or contract) directly with your doctor, instead of through a third party (the insurance company). In other words, your doctor provides skin care services and you pay for those services directly, just as you would pay for the services of a lawyer, electrician, or accountant.

The direct care model is medicine the way it used to be practiced, with the focus on the doctor-patient relationship, and no third parties in between. Our first and only responsibility at Clara Dermatology is to our patients - to deliver high-quality, affordable and personalized care. Because we do not contract with insurers, we do not have to follow their rules about who we can treat or how we can treat them.

Traditional medical practices have high operating costs due to excessive insurance company requirements - paperwork, regulations, billing issues, and mandated reporting. These costs are indirectly passed on to you as a patient - offices typically set their prices several times higher than what the insurance company will pay, and overschedule patients to cover these costs. In addition, patients often face a limited selection of providers dictated by their insurance, long-wait times for appointments, high insurance premiums, overly complex medical bills, and less time face-to-face with their medical provider.

Health insurance, like car or home insurance, is best suited to covering large, unexpected expenses that would otherwise be financially devastating - major surgery, a heart attack, or a hospitalization - not routine care like annual skin checks, acne management, or physical exams. This is similar to how car insurance covers an accident, but not an oil change, or home insurance covers fire damage, but not the maintenance of the fire alarms. Health insurance today attempts to cover both the large, occasional expenses AND routine care - the “maintenance” of your health - and in doing so, has allowed costs to spiral out of control.

Direct care practices separate routine “maintenance” care from rare, expensive health emergencies, which continue to be covered by health insurance, leading to lower costs and higher quality care across the healthcare system.

Direct care allows you more control over your routine care - who you want to see and when you want to see them - and gives you a clear, affordable price for the service before your visit even begins. We are not a concierge practice and therefore do not have a membership fee.

The idea of direct care may be old-fashioned, but we carry it out in a modern way. At Clara Dermatology, we use the latest technology to treat skin, and offer modern visitation options including the ability to see our patients in the office or virtually. We offer a curated collection of skincare products in our office and online store, and even dispense some prescription medications for a low cost directly from our office. We believe you’ll find that our approach to skincare is modern, intelligent, convenient, and relationship-driven.

Benefits of Direct Care

More time with your dermatologist

We respect and value our patients’ time. Because our appointment slots are longer and we don’t book multiple patients at the same time, we almost never run behind schedule! We also believe that we need time to get to know you and to choose the best treatment for your skin. You can choose between several appointment lengths to ensure that we have plenty of time to meet your needs and personalize your care. You won’t feel rushed during your appointment at Clara Dermatology, and we’ll address as many of your concerns as possible during the time allotted.

Flexible care options

We offer several care options for our patients, including in-person appointments in our comfortable office and virtual telemedicine appointments where we bring skin expertise to you. We also travel to corporate campuses to offer dermatologic care to your company’s employees; please contact our office for more details.


No need to wait months to see your dermatologist! Same day to same week appointments are available. We reserve appointment slots each week to accommodate new patients, referrals from other doctors, or emergent skin care needs quickly. If you need to be seen urgently and cannot find an appropriate appointment slot through our online scheduling service, please call our office for assistance.

Higher-quality care

At Clara Dermatology, your board-certified dermatologist can spend her time caring for you rather than focusing on the ever-changing insurance imposed regulations, rules, and checklists. Your doctor can tailor an individualized treatment plan based on the best medical evidence and your particular needs, not simply what your insurer allows.

Price Transparency

Clara Dermatology does not contract with any private or government insurance plans. Instead, we contract with our patients directly. Our prices are clear and available prior to your appointment. You don’t have to worry about hidden fees or surprise bills after your visit.

Cost savings

We do not carry the overhead costs of a traditional insurance-based practice, meaning we can pass these cost-savings along to our patients. Visits are reasonably priced and based on time spent with your doctor. Additionally, we can provide many commonly prescribed medications at your visit for close to cost (and typically for much less than commercial pharmacies) saving you time and money. See below for specific examples of the cost of a typical visit with an insurance model versus a direct care model.

Example of Direct Care Benefit

The following is an example of how your costs and experience could differ between our direct care practice and an insurance-based dermatology clinic. We use conservative numbers in our example; however, some practices charge much higher rates depending on their contracts with insurance companies. As always, please check with your own insurance company for the most accurate estimate of your costs under your plan.

A 35-year-old woman, who is generally healthy, schedules an appointment for a new concerning spot on her forehead, some sun damage, and to discuss hormonal acne.

Traditional Insurance

New patient 10 minute office visit: $175
Biopsy of concerning spot: $165
Freezing of 1 precancerous sun damage spot: $125

Total Cost: $465
Time Cost: 2-6 hours wasted waiting, doing paperwork, driving to pharmacy, scheduling additional appointments

Though you waited an additional 30 minutes for your visit to start, it’s over before you know it. Your doctor is in a hurry and barely sits down to speak with you. The acne discussion is rushed at the end of the visit; it’s recommended that you schedule an additional visit to discuss acne. In the meantime, a prescription is provided for tretinoin cream (Retin-A, $180), which is initially denied by insurance, but is finally approved after several weeks of waiting for an appeal.

How much you pay through insurance:

Gold plan (high monthly premium $450; low annual deductible, $3000): $40 co-pay to see specialist, $35-80 prescription cost = $75-$120

Bronze plan (low monthly premium, $280; high annual deductible, $8150): you pay all office charges until deductible is met + full price of prescription ($180) = $645

Direct Care Dermatology Office

30 minute office visit: $175
Shave biopsy of concerning spot: INCLUDED
Freezing of 1 precancerous sun damage spot: INCLUDED

Total Cost: $175
Time Cost: None! Time is precious, and we won’t waste yours


We have plenty of time to discuss your acne concerns and all of the potential lifestyle factors that may be contributing, such as diet, stress level, and hormonal factors. Your dermatologist took time to listen and understand your particular needs. Your prescription for tretinoin can be purchased from the front desk on your way out, for much less than a commercial pharmacy (~$60).

You can choose to pay your bill with your HSA or FSA account, or we can provide a coded receipt for you to submit for reimbursement from your insurance company. Additionally, you had a luxurious 30 minutes to spend with your dermatologist, did not have to wait months to get an appointment, were called back to your visit on time, and picked up your prescription from the front desk without an additional stop at the pharmacy.

We think you will find that Clara Dermatology is the best value for your money and your time!