Direct Primary & Behavioral Healthcare

Update 03/10/24:  

• I had hoped that I would be able to run the practice from home, but the City of Lakeway would not allow it.  I have been looking for a physical location, and I have found one, but it will likely still be a few months before I can get moved in there.  I will try to keep this site better updated from now on, but it has been hectic.  

• Former BCFP patients: We are now more than 9 months out from the closing of the old office, and I am getting busy enough with this new practice that I will no longer be able to handle old patient issues.  If you need something now, I would ask that you enroll, or if you are still trying to find someone else to serve as your PCP, you can do the single issue visit fee - see "Services" tab above.

Update 08/01/23:  

• Charts from Bee Caves Family Practice: Patients who wish to get their charts from the former practice can do so by clicking here.  When it asks, just click to accept the redirect link.  You can also find the form on beecavesfamilypractice.com.  You can download and print the form, fill it out, and either scan or take a picture of it to send it to request@completemm.com.  You can also fax it or mail it to them, but I think this is the quickest method.  I think they have been dealing with a large number of patients, so it may take some time for you to get the copies in hand.  If you have access to the portal there, some patients have been able to download copies of their recent chart notes, which have your medical problems, medications, and other important history elements in them.

Update 07/27/23:  

• Prescriptions: Electronic prescribing was experiencing technical difficulties once I got it enabled, and those have now been resolved.  For me to be able to send controlled substances, the law says it has to be done electronically, so you will need to enroll as a patient.  YOU WILL NOT BE BILLED FOR THIS, UNLESS YOU ACTUALLY WISH TO SIGN UP WITH ME AS A CONTINUING PATIENT.  

If you send me an email or a text asking for medication, I must have the following before the "send" button is clickable:

• • • Full prescribing information: Name of the drug, dose, how many times per day it is taken along with any other instructions, the number and form (tablets vs capsules etc.), the diagnosis it is treating, any known drug allergies, and the pharmacy to which you need it to be sent.

    • Keep in mind that I do not have access to your chart from Bee Caves Family Practice anymore, so I cannot see previous visit notes and the diagnosis list etc.  Treat it as though I have never seen you before.

    • Your current height and weight

  • Any patient that has been seen in the last year can get a refill of their medication to tide them over to when they can be seen by another provider, regardless of whether or not they intend to continue as my patient.  If it has been more than a year, I can do 30 days, but any more than that I think goes against regulations.

• Appointments: For the time being, all appointments will have to be virtual.  The city of Lakeway needs me to have a permit to operate the practice out of my home, and that process could take a few months.  If there is something that you need in-person, such as labs etc., I can send the order in to LabCorp etc.  If it requires a physical exam, you may need to wait or be seen in urgent care.  I will not require in-person visits to fill controlled substances during this transition.

• Payments:  For those of you who wish to continue with me as your primary care physician, there are options for this.  You can mail me a check or drop one by, or pay in cash.  I will have to figure out what to do about the automatic billing, because the program appears to only have options for age-based tiers.  For the time being, it may be best to avoid this option.

Update 07/25/23:  

• Prescriptions: Electronic prescribing has been enabled in the EMR, finally.  For me to be able to send controlled substances, the law says it has to be done electronically, so you will need to enroll as a patient.  YOU WILL NOT BE BILLED FOR THIS, UNLESS YOU ACTUALLY WISH TO SIGN UP WITH ME AS A CONTINUING PATIENT.  If you simply want a refill of a non-controlled medication, you can text or email, and I can call it in as long as the pharmacy already has a record of it.  If you send me an email or a text asking for medication, I must have the following before the "send" button is clickable:

  • • Full prescribing information: Name of the drug, dose, how many times per day it is taken along with any other instructions, the number and form (tablets vs capsules etc.), the diagnosis it is treating, any known drug allergies, and the pharmacy to which you need it to be sent.

    • Keep in mind that I do not have access to your chart from Bee Caves Family Practice anymore, so I cannot see previous visit notes and the diagnosis list etc.  Treat it as though I have never seen you before.

    • Your current height and weight

  • Any patient that has been seen in the last year can get a refill of their medication to tide them over to when they can be seen by another provider, regardless of whether or not they intend to continue as my patient.  If it has been more than a year, I can do 30 days, but any more than that I think goes against regulations.  

Update 07/24/23:  

• Prescriptions: Electronic prescribing has been validated through the third party, but it has not been made available in the EMR yet.  I  had to wait on a code to be sent in the mail to prove my identity, and this has just come through today, so I will put that into the system.  It is now up to the people at AtalsMD to turn the feature on, so it should only be a short while longer before I am able to prescribe controlled substances electronically.  Thank you all for your patience.

• New location:  I have been hesitant to add my home address to the website, and have instead been giving this out to those who make appointments only.  This has made things too difficult for myself and patients alike, so I have added it above.

Update 07/17/23:  

• Prescriptions: The electronic prescriptions should take another 2-3 weeks before I will be able to send in controlled substances.  In the meantime the Freelands have continued to send them in from the old electronic medical record.  The custodians of the records, Complete Medical Management, have allowed them to continue using remote access for the time being, but I am not sure for how long they will be able to continue doing this.  If you ask the pharmacy or use their app to have an electronic refill request, it should go directly to the old EMR. For anything Class II (opiates, stimulants like Adderall etc.), this is the only way to get a refill until my registration goes through.  The Freelands terminated me on the last day the clinic was open, and have decided not to allow me access to the charts.  For lesser classes of controlled substances (which should be noted on the bottle from the pharmacy), I can call or fax them in for now.  

• Medical Records:  Since I will not have direct access to the old charts, you will need to get a copy of them from Complete Medical Management.  The form for this is on the Bee Caves Family Practice website: beecavesfamilypractice.com.  An electronic copy would be easiest.  I can enter your basic info during an appointment, even if you do not have a copy of your full record, which we can add to your chart later.  

• Pricing:  I am rethinking the monthly subscription fee in light of the fact that I am now opening the office in my home, and will not have the added concern of rent as a portion of my overhead costs.  I based the original fees off of another local physician who has been running the same type of practice for the last 5 years or so.  Dr. Freeland has decided to open his own DPC and is charging fees based on age, which a number of other practices have done in this model in other locales.  I want to do what is best and fair for everyone, so I am open to suggestions.  You can text or email these to the contacts for the new practice, which I have added above.  If you have already paid for a subscription, and the fee changes, I will either credit it for a longer period or refund the difference to you.

• Enrollments are set up so they can be done online, but for now I am entering appointments manually through text or email.  

Dear Patients,

The end of BCFP came sooner than I anticipated, and I was not able to find a suitable office space in time.  This is Family Medicine after all, so at least for now, I have set up my office in a room in my home.  Direct Primary & Behavioral Healthcare was born prematurely on the 4th of July, thanks to a few of you that have offered your help in getting things set up, for which I am extremely grateful. 

I looked into the prospect of continuing to bill insurance, but with the notice being less than two weeks, I will not be able to arrange for that.  I will move ahead with the practice as a direct primary care.  I will update this site in the near future with more pages to cover the different aspects of the new practice, but for now I will only briefly explain: I am going to charge only what is necessary to pay the minimalist overhead for supplies etc., and pay myself fairly.  I will get a cell phone dedicated to the practice and all of my patients will be able to call/text/email me directly to make appointments etc., as well as request medication refills and ask questions whenever needed.  I will have EKG and lab draws in-house, and I will see what other services and procedures will make sense once I know what the needs are of the patients in my panel.  I will also continue to use electronic prescribing, which will include Suboxone and all the other medications I have been filling for you in the past.  The policies for controlled substances will be pretty similar, but if there are any changes, they will be less cumbersome.  The price for these services is a monthly subscription of $150 per adult, $250 for a couple, and children can be added for $50 each.  These rates are intended to build in some breathing room as I am getting started, but they are subject to change.  If it turns out that the expenses are less than anticipated, I will credit the amount to the next year or refund it.  A few of you have already signed on and paid for the year in advance.  Some practices using this model make that a requirement, but I do not want to make things any more difficult for my patients than I absolutely must.  Anyone who wants to sign up can do so for any number of months they wish, and this will help me to get things off the ground, so I greatly appreciate those of you who decide to do so.  For now, if you have Zelle, you can send the fee to the email address that was sent out before BCFP closed, or you can bring a check to the first visit.  

I will be collecting insurance information for the purposes of laboratory testing only.  The lab will be the same one, Medscan, and the phlebotomist has decided to come with me, so you will be able to get the same level of in-depth testing without having to worry about getting a bill.  I will work with the local imaging centers as well, and if there are bills that come with that, I will work to arrange imaging at a reduced cost for cash pay.

-E Garrett Pratt MD