Frequently Asked Questions

 "Primary care practitioners in several states ... decided to restructure their practices in a way that enables them to see a much smaller number of patients and to spend more time with the ones they do see. Patients enrolled in these practices, referred to as "luxury primary care," pay an annual fee to the practice. In return for this annual fee, they can expect certain amenities that are not ... part of primary care, such as access to their physicians 24 hours a day, 7 days a week, using cell phones or prompt paging devices. The primary care provider is no longer under pressure to see as many patients as possible each day, because the up-front fee paid by the patient changes the financial structure of the practice. Many physicians are enthusiastic about this new approach because it allows them to take more time in providing care for individual patients. Many patients who dislike the rapid pace and tight schedules that have become characteristic of primary care in the United States are also attracted to this model."

New England Journal of Medicine, April 11, 2002


After practicing internal medicine at the Eisenhower Medical Center since 1990, Dr. St. Louis introduced the first-of-its-kind "Luxury Primary Care" medical practice in the Coachella Valley in 2003.

Since then, patients have experience  the "ideal" doctor’s office: the assurance of unprecedented physician access, including immediate contact 24/7 via cellular telephone or direct pager; the security of cutting-edge medical care with added emphasis on disease prevention and health promotion; and the comfort and convenience of unparalleled personal attention. Amenities include same day appointments, frequent and extensive physicals, unhurried visits with no waiting, even housecalls when necessary. The headaches, hassles and delays often encountered in our local medical systems are eliminated because we are each patient’s personal advocate with subspecialty consultants, radiology and laboratory services, and other ancillary medical care providers. The size of the practice is carefully restricted (no more than 200 total patients) to ensure that at all times, "each patient is the only patient."  This arrangement offers a renewed opportunity for an "old-fashioned" patient-doctor relationship, working year-round towards optimizing each individual’s good health. The worries and discomforts of medical problems are not compounded by delays in communication or scheduling or by frustrations in arranging subspecialty testing or consultation. Urgent conditions are managed by us, not by an overburdened emergency room doctor. Office evaluation, explanation and treatment, health screening and preventive education are never pressured by time constraints. Year-round continuity of care is encouraged through direct communication with out-of-town physicians.  Our physicians continue to pursue traditional standards of medical excellence - patience, empathy, attention to detail, scholarship, conscientious follow-up, and respect for the personal needs of each patient.



  • Q:        Does the single annual fee cover all primary care services?
  • A:        Yes, there will be no other charges from the office beyond the comprehensive annual fee.  Refer to the "Scope of Services" (About Us) outline for more details


  • Q:        Does this luxury primary care arrangement take the place of my health insurance?
  • A:        No, one of the assumptions of luxury primary care is that patients will retain their health insurance coverage. Your health insurance plan will continue to reimburse you as ever for the cost of medical services that we cannot provide, such as lab and x-ray studies, hospital costs, subspecialty consultation and care, etc.


  • Q:        Will the annual fee be covered by Medicare?
  • A:        Medicare forbids physicians from collecting fees which exceed its mandatory charge limits. Medicare cannot be billed and you will not be reimbursed by Medicare for this annual fee.


  • Q:        Will enrollment in this luxury primary care practice jeopardize my Medicare benefits?
  • A:        No, your Medicare benefits will not be affected by your participation. Medically-necessary services that cannot be provided in the office (such as lab, x-ray, hospital costs, other doctors care, etc. ) will continue to be covered by Medicare and any secondary policy that you might carry.


  • Q:        Is this fee tax-deductible?
  • A:        Consult with your tax adviser to determine if this fee qualifies as a deductible medical expense in your case


  • Q:        Do you offer a discount for "snowbirds?"
  • A:        The annual fee is the same for all patients, as is our year-round duty and commitment. Many patients live in their desert homes for only part of the year, and these patients are likely to benefit most from our care while in residence in the desert. However, having a personal primary care physician who is always available has year-round advantages. We will continue to be actively involved in each patient's medical care from any distance, and will regularly communicate with patients and collaborate with any hometown physicians to assure optimum quality and continuity of care.


  • Q:        I am healthy and only need to go to the doctor once a year for my physical. Is this a necessary luxury for me?
  • A:        The "annual physical," although beneficial, may not be sufficient to provide for a patient's unpredictable medical care needs. If you should become ill, the availability of personal physicians in our community is limited. Rather than just a once-a-year snapshot of your health status, this practice offers immediate access to superior, year-round care whenever you need it.  Because of the restricted number of patients in the practice, we can offer a level of personal attention unavailable in a conventional primary care practice. Patients joining the practice will receive something of value in return: confidence in their physician; peace of mind that they will receive an immediate response if they have medical trouble or questions; assurance that the hassles, headaches and delays that they now encounter while negotiating the medical system will be taken care of for them.


  • Q:       What is your refund policy?
  • A:        Because the majority of practice expenses are incurred on an annual basis, $3,000 of each patients annual fee is nonrefundable. The remainder of the fee will be refunded on a prorated basis (by month) in the event of a patient's withdrawal from the practice. If a patient is asked to leave the practice, or should it become necessary to close the practice, a prorated refund of the entire annual fee will be provided. Because medical care is typically most intensive near the end of life, no refund will be provided in the event of a patient's death


  • Q:        How will you provide access 24/7/365?
  • A:        We will be available to our patients 365 days a year, an unprecedented professional commitment made possible only by the restricted number of patients under our care. Outside of office hours, your calls will always come directly to the doctor, either via pager or cellular telephone, and the response will be immediate. For minor or routine problems, triage or treatment can be performed over the phone. If you need to be seen, we will see you at any time.  Only when out of town and not physically able to attend you, will we arrange for another excellent internist provide for your hands-on care needs. 


  • Q:        What is the difference between an MD (Doctor of Medicine) and a DO (Doctor of Osteopathic Medicine)?
  • A:       In most ways, MDs (allopathic emphasis) and DOs (osteopathic emphasis) practice medicine in identical ways. Like MDs, osteopathic physicians provide all medical services: diagnosis and treatment of medical problems, medication prescription, surgery, and advanced sub-specialty practice in all medical fields. Both physicians study the same medical science curricula and complete four years of medical school. Both complete residency programs in their chosen field of practice, often training in the same programs.  However, osteopathic physicians are trained in some special areas beyond those included in the education of allopathic physicians. In particular, students at osteopathic medical colleges receive training in Osteopathic Manipulative Treatment, which involves learning specific hands-on diagnostic and treatment skills to address  illness or injury.