Primary Care Built Around You, As an Individual
Built to be different, built for better care
I designed Nexus Primary Care to center the needs of patients, not insurance companies. With Direct Primary Care, visits are covered by your monthly membership fee. This means that we can keep the practice small, so I can spend more time with patients, focus on your specific needs, be available to you directly via phone or text, and personalize care to be most impactful to your health.
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How Do Pharmacies Work?
There’s so much confusion about pharmacies, and how they work, and just the daily practical aspects of working with them. I thought I’d write up a post to try and clear up some confusion.
Primary Care That Is More Flexible for Our Patients
Getting Primary Care Can Be Easy and Convenient
With DPC, your visits are covered by your monthly membership fee, so we are not bound by insurance requirements to see you in the office every single time. We can take care of many of your common needs easily and conveniently through telehealth visits, patient portal messaging, and texting the office — whatever is most convenient for you.
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Inclusive Primary Care for All Identities
We care for you, and we care about you, as a whole person
We are all individuals, and we all want to be treated kindly, respectfully, and with understanding. This is especially important when dealing with something as sensitive as your healthcare. We want you to feel safe, supported, and seen.
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Another Real-World Example of Saving Money with DPC
Last week I had a new patient who came to me from a traditional insurance-based practice. She was tired of not being able to get through to her physician, and having to wait months for an appointment — the typical reasons people check out Direct Primary Care (DPC) practices like Nexus Primary Care.
Spending $150 per month on a doctor was a tough choice for her. By the end of the visit, she was only spending $50 net per month. And it wasn’t because she talked me into giving her a big discount. How did we accomplish this?
Personalized Primary Care for Everyone
Including Patients with Complex Needs
15 minutes isn’t much time. But that’s how long you get with a typical primary care appointment. So what happens when you need to really talk through next steps? What happens when you have a question? What are your options if you have complex conditions and have to keep a team of physicians up-to-date on your conditions?
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Thoughts from DPC Summit 2026
We just returned from the DPC Summit. This event was in New Orleans. More than 500 doctors gathered to network and learn. Our goal was to support one another as we build and grow our little practices.
I had three big takeaways from the Summit this year.
Facts and Info About GLP-1 Medications
GLP-1 drugs are a class of drug that helps people lose weight. These were originally diabetes drugs, but since introduction we have learned that they help people lose weight. Here we discuss a bit about the different groupings of medications, safety in sourcing, cost, and more.
If you’re a patient at Nexus, we’ll figure out what the right option is for you. Different drugs are better or worse for different people, depending on your goals and your unique situation. I’m glad to help you sort through all of this and make some wise choices — this stuff is complicated!
Do You Know Your Numbers?
Dr. Jay presented to fellow members at The Quad Chamber of Commerce how several very simple health screenings can go a long way towards managing health and improving longevity. If there are some of these numbers that are missing, and you’re wondering why you haven’t been tested, these are good conversation-starters with your doctor.
Open Enrollment Season, and Paying for Primary Care with HSA
It’s October. This is the month that most employers start Open Enrollment (OE), the time when employees choose their benefits for the coming year. It’s also the time when Medicare enrollees can change their health plans. This year, Congress passed rules making it clear that Health Savings Accounts (HSAs) can be used to pay for Direct Primary Care practices like Nexus.
Special Rates for Students at Wash U, Webster U, SLU Students, etc.
Kids away at college need medical care. Whether it’s for illness, injuries, physician support for mental health medications, or just overall peace of mind, I would love to provide that care. If you have a child attending Washington University, Webster University, St. Louis University, or any other college or university in the St. Louis area, we are available to provide them care — at a special rate.
ADHD Diagnosis and Management
One of the more frequent reasons people come see me is to help them manage a confirmed or suspected diagnosis of ADHD. I get patients of all ages looking for ADHD support. I find treating ADHD really satisfying. People do so well once they are on medication. It can be life-changing! Very often, other symptoms of depression and anxiety clear up as everything becomes easier and more satisfying.
Causes of Exhaustion: Fatigue, Insomnia, Sleep Problems, etc.
Chronic fatigue is a really tough thing for anyone to manage. Not feeling well-rested or being unable to sleep not only saps your energy, it can make aches and pains worse, contribute to depression and anxiety, and even cause other chronic illnesses to flare up.
There are a lot of possibilities for things that can cause chronic fatigue. I have lots of time to figure things out, and if it takes more than one visit to sort things, that’s okay.
Thinking Ahead to Cold, Flu and COVID Season
There are many questions swirling right now regarding vaccinations and availability of COVID and flu shots in the fall. The actions of the current administration with regard to the CDC and FDA have us all concerned about how the winter respiratory season might shape up. Here are the ways I anticipate this might impact you, and what I recommend.
Mindful Meditation
A few years ago, I discovered the concept of meditation, and it’s changed my life. I think it’s essential for almost everyone to learn this skill, and I try to work it into almost every treatment plan I help a patient create.
The reason meditation is so important is that it helps us understand what’s going on in our brains. If you don’t know what’s happening in your brain, you’ll have a hard time managing all kinds of problems.
Nexus and Insurance Providers
One of the most common questions I get is how insurance works with a DPC practice like mine. Many people don’t realize that they can have insurance coverage from any insurance provider (Anthem, Blue Cross Blue Shield, UnitedHealthcare, Aetna, Cigna, Medicare, Medicaid, etc.), and still see me as their physician.
The short answer: It’s fine for you to have insurance, and in fact most of my patients do.
Cardiovascular Health in Women
We’ve all had it drilled into our heads that heart disease is a number one cause of death. And while we talk often about the symptoms in men, the message in the media around cardiovascular symptoms in women typically boils down to: “Well, the symptoms are different in women and so it is hard to get them appropriately diagnosed or treated because ERs work off of the symptoms that men exhibit. Good luck…”
We don't hear is people talking about all the diagnostic tests we can use to help identify cardiovascular issues and risk factors in women before they have a chance to turn into a heart attack/coronary event.
Healthcare in Uncertain Times
Even in times of financial or political uncertainty, it’s important to have a plan to maintain your health. In fact, I would argue that these are the times when watching your health is most important.
One advantage to having a practice like ours is that if you change jobs, your healthcare is not affected. This continuity of care is a tremendous benefit of direct primary care practices like ours.
Thoughts about Ozempic and Other Weight Loss Injection Treatments
I have lots and lots of thoughts about weight, weight loss, and weight loss meds. Here are a few…
Primary Care for Kids Away at College
As a dad, I’ve dealt with trying to find care for my kids because they didn’t have access to their regular doctor, either because of an acute need, or distance, or both. It can be frustrating and worrisome.
I think we can do better by offering care for adolescents and young adults. When a household has 1 or more adult enrolled as a patient with me, they can also add dependent kids for $25 per child. We see dependent kids, starting at age 13 all the way up to age 25, for this fee.