Sick today? You'll hear back today.
Text or call before 5pm on a weekday and you'll get a same-day response — with a visit the same day when possible, or the next day if needed, in person or virtual. This isn't urgent care or the ER: it's a good Direct Primary Care relationship that usually means urgent care, and the ER, can be avoided for concerns that aren't true emergencies.
When You Want to Reach Your Doctor, You Get Him
Direct Primary Care includes secure text, phone, and messaging access to your physician. Questions can often be addressed quickly — no call center, no phone tree, no message routed through a nurse line before it reaches anyone who can actually decide anything.
Text or call before 5pm Monday–Friday and you'll get a same-day response — with a visit that same day when possible, or the next day if needed. Virtual visits are available on weekdays as well, for concerns that don't require hands-on exam. This access is not available on weekends, and it's not a substitute for urgent care or the emergency room — for anything that can't wait until the next business day, please use urgent care or the ER as appropriate.
Testing and Treatment Without a Second Trip
A lot of what sends people to urgent care is simply needing a test done. Many of those tests happen right here, the same visit.
EKGs
On-site EKG for chest discomfort, palpitations, or cardiac monitoring — no separate lab or imaging center visit required.
Urinalysis (UA)
On-site urine testing for suspected UTIs and related concerns, with results the same visit.
Strep Testing
Rapid on-site strep testing for sore throat and related symptoms.
Laceration Repair
Minor lacerations requiring suturing, managed on-site rather than routed to urgent care or the ER.
IV Therapy
On-site IV therapy is in development as an additional same- or next-day option for appropriate acute concerns.
On-Site Dispensing
Many common medications can be dispensed directly, often at a fraction of retail pharmacy pricing.
Single-Visit Acute Care — $299
Available to non-members, and especially to visiting family and friends of existing Metronome members who need to be seen while they're in town. We'll always try for a same-day visit, next-day if needed — but for non-members that timing isn't guaranteed the way it is for members. Priority goes to our members first, then to their visiting family and friends. Same as everything else on this page, this is weekday access (Monday–Friday) and not a substitute for urgent care or the ER.
Covers the visit — exam, on-site testing (EKG, UA, strep) if needed, and treatment — for one acute concern. If you decide to become a member afterward, that $299 is credited toward your membership, not lost.
Book a Single Visit →Same- or next-day availability for single-visit, non-member appointments depends on the schedule and is not guaranteed. Priority is given first to Metronome members, then to visiting family and friends of current members.
Many Issues Sent to Urgent Care Belong Here Instead
When your doctor knows you, you can act quickly, together.
What This Actually Looks Like
Three short videos — why insurance was never designed to be the gatekeeper for everyday care, a real story from Metronome's first month, and a same-day letter that would have taken days almost anywhere else.
Insurance and Care — what insurance was actually built for
Acute Care in DPC — a real story from month one
Forms and Consults — a same-day letter, start to finish
A UTI Phone Call Shouldn't Need a Claim
Car insurance protects you after a crash — you don't file a claim for a car wash. Health insurance was designed the same way, for big, unexpected events, not everyday care. The problem is a system where insurance has become the gatekeeper for everything, including a phone call about a UTI.
When that system is overwhelmed — no appointments, call centers triaging patients, distressed front offices — people end up in the ER with a $2,000 bill for something that should have been a 10-minute conversation with their own physician.
An Evening Walk, a Tuning Fork, and a Prescription Under a Dollar
On a day off, a message came in from a recent surgical patient with worsening ear pain and hearing loss, unable to get in with her surgeon or anyone else in her health system for days. That evening, a five-minute walk to the office, an exam, and conductive hearing loss confirmed with a tuning fork — an ear infection.
Antibiotics were dispensed on-site for less than a dollar. No urgent care visit. No emergency room. No copay. No waiting room. Just the judgment and availability that Direct Primary Care actually makes possible.
Ninety Minutes, Not Two to Five Days
A call came in from someone with no established doctor, moving within days, who urgently needed a letter documenting a newly diagnosed condition. They'd called clinic after clinic with no luck before someone passed along Dr. Juan's number.
He invited them in, examined them, reviewed their records, confirmed the diagnosis, and handed over the finished letter. First phone call to letter in hand: about ninety minutes — versus the 2 to 5 days that same request often took in fee-for-service medicine, routed through layers of staff before ever reaching a physician.
Prior Knowledge Changes What's Possible
When acute issues arise, prior knowledge matters. Medical history, current medications, and recent evaluations allow problems to be addressed quickly and safely — without starting from zero with a stranger, the way an urgent care or ER visit usually does.
Same- or next-day care works best when it happens inside a physician relationship that already understands the broader context of your health.
Access Delays Are What Push People Toward the ER
This isn't a claim that anyone wants patients in the emergency room. It's simpler than that: fee-for-service, volume-based medicine and insurance-gated access create real delays, and delays push people toward higher-cost, higher-acuity care by default.
Most ER Visits Don't Need to Be ER Visits
National estimates suggest up to roughly 60% of emergency department visits are non-urgent or could potentially have been managed in a lower-acuity setting — often because that lower-acuity setting wasn't actually reachable in time.
Primary Care Access Measurably Reduces ED Use
Research on Direct Primary Care and telehealth access shows meaningfully fewer ED and urgent care visits per family, with real dollar savings, when a physician is reachable directly instead of through layered scheduling and referral systems.
Volume-Based Reimbursement Rewards the Wrong Moment
Traditional fee-for-service reimbursement pays more for treating a problem once it becomes an emergency than it pays a primary care visit for preventing it from becoming one. That's a structural incentive problem, not a conspiracy — and it's exactly what a same- and next-day-access DPC relationship is built to work around.
None of this replaces emergency care when emergency care is actually needed — see below. It's about everything that doesn't need to be an emergency in the first place.
See: ASPE/HHS ED utilization report · NCQA on ED utilization · PMC — DPC telehealth and avoided ED/urgent care visits
When Urgent Care or Emergency Care Is Needed
Direct Primary Care is not a substitute for urgent care or emergency services. Chest pain, severe shortness of breath, stroke symptoms, major trauma, or other life-threatening conditions require immediate emergency evaluation — call 911 or go to the nearest emergency room.
Same- and next-day access at Metronome is available Monday through Friday only. On weekends, or whenever something can't reasonably wait for the next business day, urgent care or the ER is the right call — not a text to your physician.
Everything on this page describes acute, non-emergency, weekday concerns only — the large share of same- and next-day issues that don't need a siren, but do need to be seen.
Same- and Next-Day Access Is Part of a Bigger Picture
Begin the Conversation
If you're looking for a primary care physician who provides both ongoing care and timely access when something comes up, you're invited to reach out.
Begin the Conversation →Same-day response applies to texts or calls received before 5pm Monday–Friday; the visit itself is same-day when possible, or next-day if needed, depending on clinical judgment and schedule availability. This access is not available on weekends. Direct Primary Care is not a substitute for urgent care or emergency services — for true emergencies, call 911 or go to the nearest emergency room. Sources: ASPE/HHS, NCQA, PMC DPC telehealth study.