Subject: A note regarding concierge fee increase

News from the desk of Dr. Biemer


To all of our patients,  

We so appreciate all of you and your faith in the “old school” model of care we provide. We know it is an extra investment in your health care at a time when the cost of everything is going up. With that in mind, we hope you will understand that our costs have risen significantly in all areas, and with only one price increase in the past 14 years, we have fallen behind. It is necessary for us to increase our monthly/annual fees. The alternative, to significantly increase the size of our practice, would change our ability to deliver the same kind of care. That is unacceptable to us and we believe it would be to you as well. 

Summary of changes 

We will transition to the following fee schedule as of November 1, 2022: 

Individual over age 45     $90/month         

Individual age 30-45  $60/month  

Individual under age 30 $30/month 


We have moved away from family and couple discounts, in favor of the more commonly used age-based scale. We would also appreciate most of you moving to monthly payments if possible, either via direct bank withdrawal or credit card payment. Exceptions of course can still be made. 

What you can expect:

Within the next few weeks, we will send out an updated version of our concierge contract by email via a secure cloud-based document management service. For those of you unable to use email-based platforms, we will mail documents.

We will request your e-signature, but will not collect credit card or bank information on this form. Following your agreement to the updated contract, we will either use your existing payment information on file for monthly fees, or a staff member will contact you and enter your information directly into our secure Quickbooks Online platform.

Here are a few of the ways we are innovating and intend to make these increases worthwhile to you:  


Scheduling with specialists and for advanced testing has become very difficult, as many of you well know. We will be adding another medical assistant position this fall, giving us increased capacity to aid in communications with specialist clinics and appointment scheduling.  


We intend to obtain a limited pharmacy license. This will enable us to dispense common medications like antibiotics through the office. In addition, we will be able to give the full range of immunizations, including those on “Part D” for Medicare that have required you to go to the pharmacy in the past. The timing of this addition will depend on the Oregon Board of Pharmacy and its procedures.

We will be increasing our dermatology services. We recognize that visits to the dermatologist are costly and time consuming. We will be purchasing equipment for closer monitoring of skin lesions, and liquid nitrogen spray canisters for treatment of pre-malignant and benign lesions. 

When feasible and when you would like, we will continue to manage medical care via phone calls or remote virtual visits, saving you time and money on office visits.


As the practice continues to evolve, our primary objective remains to provide high-quality, individualized care. Over the next year, we would like to have a thoughtful conversation with each of you about your healthcare goals and preferences. Some of you may be interested in minimizing costs, in which case we are happy to discuss ways to reduce unnecessary services. This may include a thorough medication review to make sure you are paying the best available price for your prescriptions. Alternatively, there are many of you interested in more robust preventive and exploratory testing with the possibility of enhancing your health and the early detection of disease. We are here to help you access the education and services that you seek. Whatever your healthcare goals, we want to understand them and become your partner in achieving them. 


Once again, we thank each of you for your trust in us and look forward to a continued partnership in the years to come.  



James Biemer, Julia Jones, Kazumi, Tinh An and Amy  

Please don't hesitate to reach out to our office at any time and look for our next update by mid fall.

Thank you for allowing us to serve you.