The Model

Medicine, the way it was meant to work.

Direct primary care isn't a radical idea. It's a return to a straightforward one: you pay your doctor directly, your doctor takes care of you, and no one else is in the room shaping that relationship.

Why it matters

The system isn't broken because the people inside it are bad.

It's broken because it's structurally incapable of giving them the time and context to get it right.

15
minutes

The average primary care appointment. Long enough to address one problem if nothing goes sideways. Not long enough to understand a patient.

1,800
patients per panel

The average panel size for a traditional primary care physician. At that scale, your doctor can't know your history without pulling up your chart.

2
people in the room

With Fathom, the only people in the room are you and your doctor. No insurance middlemen dictating what's covered. No administrators optimizing your visit for billing codes.

1
ER visit

Under a high-deductible plan, one visit can cost more than a full year of Fathom membership. One avoided visit, for something a well-trained internist can handle directly, returns your annual cost in a single encounter.

The healthcare system is built to obscure cost. Fathom operates on the opposite model: one physician, one fee, complete transparency. No needless urgent care visits, fewer specialist referrals, medicines sourced at cost, and transparent pricing on labs and tests.

Fathom membership isn't an added expense on top of your healthcare. It's the part that makes the rest of it work in your favor.

How it works

A retainer, not a subscription.

You pay a flat monthly membership fee. In return, you get a physician who knows your case inside and out — genuinely available when you need them, whose only professional obligation in your care is to you.

Think of it less like a subscription and more like a retainer: the kind of relationship you'd have with a trusted attorney who stays with your case regardless of the venue. There's no insurance billing, no copays, no surprise charges. Transparent pricing on labs and medications. Direct access by call or text.

The specifics look different from patient to patient, because care should flex to what you actually need. But the principle is constant: you shouldn't lose your doctor just because the setting changed.

What changes

  • Same-day or next-day appointments
  • Extended, unhurried visits
  • Direct call and text access
  • Transparent pricing on labs and medications
  • A physician who knows your full history

What goes away

  • Insurance middlemen in your care decisions
  • Copays and surprise bills
  • Phone trees and 3-week wait times
  • Referrals for things that could be handled in one visit
Full spectrum care

Your doctor stays with you when the setting changes.

A trusted advisor who stays with your case, regardless of the venue.

Most primary care relationships pause the moment you leave the office. At Fathom, the commitment extends across settings, not just across the breadth of disease, but across the stages of illness.

In the Office

hover to explore
In the Office

Visits that take as long as they need to take. A broader procedural skill set than most primary care, including orthopedic injections, dermatologic diagnosis and biopsy, so problems that would normally mean a specialist referral, a wait, and another bill get handled in one room by someone who already knows you.

At Home

hover to explore
At Home

When getting to the office isn't practical, your doctor comes to you. House calls aren't a novelty, they're how medicine worked before the system decided it was more efficient to make sick people drive.

In the Hospital

hover to explore
In the Hospital

When you're admitted, you're suddenly being cared for by a team who's meeting you for the first time. Important details get lost, false assumptions get made. Dr. Bechtold maintains hospital privileges and EMR access, coordinates directly with your hospitalist and specialists, and stays involved throughout your stay and through your transition home.

Membership includes

Everything you'd expect — and the things you've stopped expecting.

Unlimited office visits
Same-day responses to messages and calls during business hours
After-hours availability for urgent needs
Hospital rounding when admitted locally
House calls when clinically appropriate
Labs and medications at cost
Prescription cost optimization via CostPlusDrugs, GoodRx, and direct-to-patient pricing
Comprehensive annual health assessment
Why it works

This level of care isn't possible at scale. It isn't supposed to be.

A traditional primary care physician carries a panel of 1,500 to 2,000 patients. At Fathom, that number is a fraction of that. Small enough that Dr. Bechtold knows your history without pulling up your chart, can return your call the same day, and has the time to actually think about your case — rather than racing to the next one.

Many people are unfamiliar with the membership model of healthcare. But when you weigh it against what most people actually spend navigating the traditional system — the copays, the urgent care visits because you couldn't get in, the referrals that could have been handled in one office visit, the time lost to phone trees — the membership model often works in your favor.

The real cost of the conventional model isn't financial. It's clinical. When your doctor has twelve minutes and eighteen hundred other patients, things get missed. A symptom concern that needed one more question. A medication interaction that no one caught because no one had the full picture.

"The details are the medicine. Everything else is logistics."

Ready to see what membership looks like?

Simple, transparent pricing. No enrollment fee to start.

See Membership Pricing