Jesse Sadikman, MD in Baltimore: Direct-Care Family Medicine Without Insurance Friction

Jesse Sadikman runs a direct-care family practice in Canton, serving adults and children through a membership model that eliminates copays, deductibles, and billing delays. Rather than bill insurance companies for each visit, his office charges a single flat fee per patient per year—typically between $1,200 and $1,800 for adults, depending on age and household size—and handles comprehensive primary care within that structure. It is one of a small but growing set of membership-based practices in Baltimore that appeal to families seeking predictable costs and longer appointment slots.

What direct-care family medicine actually is

Direct-care, sometimes called direct primary care or DPC, is a contractual relationship between patient and doctor outside the insurance claim system. Instead of billing your insurer for office visits, lab work, or preventive care, you pay the practice a flat annual or monthly membership fee, and routine services are included. The model trades the volume-dependent economics of traditional primary care for continuity and time. Sadikman's practice limits its patient roster to maintain appointment availability and phone access; members typically see him within a few days rather than weeks.

The model works best for people who have high-deductible health plans (HDHPs), who are uninsured or underinsured, or who value control over their healthcare spending. It does not eliminate the need for health insurance; members still carry catastrophic or comprehensive coverage for hospitalization, emergency care, and specialist referrals. Sadikman's office helps members navigate those referrals and coordinates care with specialists and hospitals throughout the Baltimore health system.

Membership pricing and what is included

Annual membership runs between $1,200 and $1,800 for adults, depending on your age bracket. Children on the same membership are typically charged a lower flat rate or included at no added cost; confirm current family pricing when you call. This covers unlimited office visits, same-day sick appointments, routine labs (urinalysis, blood cultures, wound cultures, some common metabolic panels), EKGs, vaccines, and preventive screenings within Baltimore-standard guidelines. Prescription management, minor wound care, and suture removal are included. Imaging such as X-rays is billed separately at negotiated cash rates, usually lower than insurance-contracted rates.

The membership does not cover specialist visits, hospital admissions, imaging at outside facilities, or advanced diagnostics. For those, you either use insurance if you have it or negotiate direct rates. Members report that the combination of low annual membership cost plus negotiated cash pricing for imaging often costs less out of pocket than in-network deductibles and coinsurance under a conventional plan.

How direct-care in Baltimore compares to traditional primary care

Most Baltimore family practices operate on the insurance billing model: you pay a copay at the visit, the office files a claim, and you receive a bill later for any remaining deductible or coinsurance. Wait times are often three to six weeks for routine appointments, and phone access to the doctor during or outside office hours is limited.

Practices like Sadikman's reverse that dynamic. Members get same-day or next-day sick appointments, direct phone or email access to the doctor for non-emergencies, and no surprise bills from office visits or routine labs. The annual out-of-pocket cost is fixed and often lower than your annual deductible alone under a high-deductible insurance plan. However, direct-care works only if you combine it with health insurance for major medical events; it is not a replacement for coverage. If you have an HMO with mandatory in-network requirements, a direct-care practice outside that network cannot bill your insurance, so the membership is your primary spending vehicle.

Traditional primary care is still the right choice if you have an employer plan with a low copay and broad network, or if you rely on Medicaid or Medicare, which do not work with direct-care models.

Who this practice suits and who it does not

Sadikman's practice works well for families with high-deductible plans who want to avoid deductible spending on routine care, self-employed people and small-business owners seeking stable healthcare costs, uninsured people who prefer paying a flat annual fee to the uncertainty of cash billing, and patients who value direct access to their doctor and longer appointment slots.

It does not work if you are insured through a traditional HMO with strict in-network requirements, you are on Medicaid or Medicare (though some Medicare Advantage plans are exploring direct-care partnerships; ask your plan), or you cannot afford the annual membership even at the low end of the range. It also requires that you maintain a catastrophic or comprehensive insurance policy for serious illness or emergency.

What the first visit involves

Call the office or visit the practice website to confirm current hours and schedule a new-member appointment. Your first visit typically lasts 45 minutes to an hour. Sadikman will take a full medical and family history, perform a physical exam, order basic screening labs if needed, and discuss your membership terms and what the practice will and will not cover. Bring photo ID, a list of current medications, and your insurance policy details (even if you do not plan to use it for routine care, the practice needs to know what you have for referrals and emergencies). If you are switching from another family doctor, ask your previous practice to send your records.

Hours, location, and logistics

Sadikman's office is in Canton. Office hours typically run Monday through Friday, 8 a.m. to 5 p.m., with same-day sick slots reserved for members. The practice is not open Saturdays. Parking is available at street or nearby lot level; Canton has metered and private lots, so confirm when you book. Telehealth visits are available for follow-ups and non-emergency issues, reducing the need for in-office time.

Direct-care in Baltimore remains uncommon enough that membership practices fill quickly. If you want to join, call early in the year to check availability. Sadikman's practice is a viable choice for Baltimore residents on high-deductible plans or who are self-insured and value cost predictability and access over traditional insurance breadth.