General Medicine Consultation

and

Convenient Care

 

Nonmember

Fear of commitment?

We've got you covered.

We think primary care is best when patients have direct access to their physician.  We understand that the direct primary care model is not right for everyone.  

We offer a convenient care visit option  for nonmembers, subject to availability.  It is our belief that everyone should have a primary care physician, and as such, we will not provide screening or chronic medical care at these visits.  

You will have access to our discounted pricing for acute medication only.  We cannot offer chronic medication since we cannot guarantee follow-up.  We will not draw labs, but we will offer access to point-of-care testing for conditions such as urinary tract infection or influenza.  If you like our service and want to become a member of our direct primary care practice, we will apply your first office visit's costs toward your enrollment fee.

Fee for service is not a good option for those with chronic illnesses.  In order to avoid gaps in your care, we suggest the direct primary care membership, so you can have access to our physician, discounted medications/labs and proper follow-up.

Telemedicine Nonmember

COVID Testing

We want to do our part to keep Maine healthy as we transition into fall and winter.  We are offering telemedicine consults and testing for COVID in addition to our convenient care options.  COVID testing is available for free through the state at various locations.

Telemedicine

  • Telehealth consult with focused physical and test administration

    • Cost = $100​

      • Please email hello@fulcrumfamilyhealth.com for availability

      • When you verify availability, please use the link below for "Telemedicine Nonmember."  This will create a chart with your basic information.  It will ask for a credit card for payment.  This will not be charged until you are seen.  We offer full transparency of cost.

Tests available (Costs in addition to consult)

  • Rapid (15 minute) COVID antigen testing 

    • Appropriate for symptomatic patients in the early stage of illness when the viral load is most likely high.  May need to be followed by molecular testing (1-3 days for results) for high risk individuals.

    • Not appropriate for asymptomatic patients (except certain settings)

    • See below for more information on our antigen test.

    • Nasal swab.  

    • Cost = $0 to $50 (depending on test availability)

  • Molecular PCR COVID testing​

    • Appropriate for all patients symptomatic or asymptomatic ​patients (1-3 days for results)

    • Nasal swab

    • Cost = $0 to $100 (Depending on lab and insurance)

  • Rapid (10 minute) influenza​ antigen testing

    • Appropriate for symptomatic patients in the early stage of illness when the viral load is most likely high. 

    • Nasal swab

    • Cost = $20

  • Rapid (15 minute) Strep antigen testing​

    • Appropriate for symptomatic patients in the early stage of illness when the viral load is most likely high. 

    • Throat swab

    • Cost = $10

 

BD Veritor

Rapid COVID Antigen test

Questions

  • Are Antigen tests FDA approved?

  • Is this comparable to molecular tests?  I heard these are the best.

    • This is true.  Molecular tests can detect smaller amounts of virus in our system.  The problem is that take more time to run. These tests must go through a process of heating and cooling to help find those viral particles.  This is the gold standard test.  Antigen tests are promising for their speed and ability to put action into place early.  They are most helpful for symptomatic patients when their viral load is likely the highest (1-5 days of symptoms).​  We look at sensitivity to rule out diagnoses and specificity to rule it in.  Therefore, if it is positive, it is positive.  If the antigen test is negative and the patient is high risk, we may want to consider a follow up molecular test.

  • Is it comparable to other antigen tests?

    • There is always a concern about how good these tests are.  New studies that show BD is on par with Sofia Quidel.  There used to be discrepancy between 86% and 93% sensitivity but this was challenged in a recent article and favored BD as the more "accurate" test when compared to known positive cases.  These and other new studies were submitted to the FDA showing sensitivity of 93% and specificity of 99%.  ​

  • What does the CDC say about antigen tests?

    • The CDC says that antigen tests can be used by physicians patients must be considered on a case by case basis.​

    • "In most cases, negative antigen diagnostic test results are considered presumptive. CDC recommends confirming negative antigen test results with an RT-PCR test when the pretest probability is relatively high, especially if the patient is symptomatic or has a known exposure to a person confirmed to have COVID-19." 

    • "Confirmatory nucleic acid testing following a negative antigen test used for screening testing may not be necessary if the pretest probability is low, the person is asymptomatic, or has no known exposures, or is part of a cohort that will receive rapid antigen tests on a recurring basis. Nucleic acid testing is also considered presumptive when screening asymptomatic persons, the potential benefits of confirmatory testing should be carefully considered in the context of person’s clinical presentation."

  • What does the Maine CDC say about use of antigen tests?

    • Antigen tests can be used for out of state travelers into Maine.​

    • Antigen tests will be available at the state-testing locations in Maine from our local Abbott Laboratories.  It will be integrated into their algorithm for appropriate patients.