Sexual Health and Direct Care: Tailoring a Membership Plan

Explore the importance of addressing sexual health in primary care, the types of services involved, and an example of a membership plan.

The DPC model offers benefits across various fields, including Sexual Health. You can incorporate this into your primary care membership plan or create a dedicated sexual health membership plan.

By focusing on sexual health, you play a crucial role in fostering a comprehensive approach, ensuring your patients receive the care and attention they need.

The Importance of Addressing Sexual Health in Primary Care

Dr. RaeLeigh Crawford Payanes is a Family Medicine physician, and co-founder at All in Health. As a Direct Care physician, she has a desire to connect with their patients in a more meaningful way and to empower individuals to become the best version of themselves.

“There are many reasons patients and doctors might not feel comfortable talking about sex. Doctors may feel that it may take too much time, they worry about saying the wrong thing, or they don't believe their patients are having sex at all. We want our patients to feel comfortable talking to us about anything, even sex, and we are so happy to offer this model of care that allows us to spend more time with our patients to discuss these important issues that impact their lives.”Dr. RaeLeigh Crawford PayanesFamily Medicine Physician and Co-founder at All in Health

Here are four key benefits of addressing sexual health in your Direct Primary Care or Direct Specialty Care practice. 

1. Holistic Patient Care

Sexual health impacts various aspects of a person’s life, including physical, mental, and emotional well-being. Addressing sexual health ensures a holistic approach to patient care, recognizing the interconnectedness of overall health and sexual well-being.

2. Prevention and Early Intervention

Regular discussions about sexual health can lead to early detection and prevention of sexually transmitted infections (STIs), unintended pregnancies, and sexual dysfunctions. This proactive approach can significantly improve patient outcomes and quality of life.

3. Reducing Stigma

By normalizing conversations about sexual health, Direct Care doctors can help reduce the stigma and embarrassment often associated with these topics. Creating a safe and open environment encourages patients to share concerns and seek help.

4. Promoting Healthy Relationships

Sexual health education and counseling can promote healthy relationships and safe sexual practices. This includes understanding consent, communication, and mutual respect in sexual relationships.

Types of Services Included in Sexual Health Care

When addressing sexual health in primary care, the services provided can be broadly categorized into the following areas:

Preventive Care

Preventive medical care focuses on proactive measures to maintain sexual health and prevent potential issues. The key services include:

STI Screening and Counseling

Regular STI screenings are crucial in early detection and treatment, preventing the spread of infections. Counseling provides patients with the knowledge to engage in safe sexual practices and understand the importance of regular testing.

Vaccinations (e.g., HPV vaccine)

Vaccinations such as the HPV vaccine play a significant role in preventing sexually transmitted infections that can lead to serious conditions like cervical cancer. Educating patients about the benefits and availability of these vaccines is essential.

Contraceptive Counseling and Services

Providing comprehensive contraceptive counseling helps patients make informed decisions about their reproductive health. This includes discussing various contraceptive methods, their effectiveness, potential side effects, and how they fit into the patient's lifestyle and health needs.

Education on Safe Sex Practices

Educating patients on safe sex practices, including the correct use of condoms and other protective measures, is fundamental in preventing STIs and unintended pregnancies. This education should be ongoing and tailored to the patient's age, relationship status, and sexual orientation.

Counseling and Education

Counseling and education are vital in providing patients with the support and knowledge they need to navigate their sexual health. Key services include:

Relationship and Sexual Counseling

Counseling can help patients address relationship issues, sexual dysfunctions, and communication problems. This involves creating a safe and non-judgmental space for patients to discuss their concerns and receive professional guidance.

Education on Sexual Orientation and Gender Identity

Providing education on sexual orientation and gender identity helps patients understand and accept themselves. This includes supporting patients in exploring their sexual orientation and providing affirming care for LGBTQ+ individuals.

Support for Survivors of Sexual Trauma

Survivors of sexual trauma require sensitive and comprehensive support. This includes providing trauma-informed care, connecting patients with mental health services, and offering resources for ongoing support and healing.

Diagnostic Services

Diagnostic services involve identifying and addressing sexual health issues through thorough assessments and evaluations. Key components include:

Diagnosis and Treatment of STIs

Early and accurate diagnosis of STIs is vital for effective treatment and preventing complications. This involves not only testing but also providing appropriate treatment options and follow-up care.

Evaluation of Sexual Dysfunctions

Evaluating sexual dysfunctions such as erectile dysfunction, premature ejaculation, and female sexual arousal disorders requires a comprehensive approach. This includes taking a detailed medical and sexual history, conducting physical exams, and utilizing appropriate diagnostic tests.

Assessments for Conditions like Erectile Dysfunction, Vaginismus, and Libido Issues

These conditions often require a multidisciplinary approach involving medical, psychological, and sometimes surgical interventions. Detailed assessments help in formulating effective treatment plans tailored to individual patient needs.

Therapeutic Services

Therapeutic services aim to manage and treat sexual health issues through various medical and supportive interventions. These include:

Treatment for Sexual Dysfunctions

Treating sexual dysfunctions can involve medications, such as phosphodiesterase inhibitors for erectile dysfunction, as well as psychological therapies like cognitive-behavioral therapy (CBT) to address underlying mental health issues.

Management of Chronic Conditions Affecting Sexual Health

Chronic conditions like diabetes and cardiovascular diseases can significantly impact sexual health. Effective management of these conditions through medications, lifestyle modifications, and regular monitoring can help improve sexual function and overall well-being.

Hormone Therapy and Management for Menopausal Symptoms

Hormone therapy can be beneficial for managing menopausal symptoms that affect sexual health, such as vaginal dryness and decreased libido. Personalized treatment plans and regular follow-ups are crucial for effective management.

Example of Membership Plan Focused on Sexual Health

In All In Health, a practice based in Modesto, California, co-founders Dr. RaeLeigh Crawford Payanes and Dr. Karen Ann Rayos decided to build three different membership plans: sexual health, mental health, and healthy living.

“Sex is an important part of everyone's health. At All in Health, we have personal relationships with our patients that allow us more time to develop trust and discuss these types of topics. We offer a comprehensive sexual wellness membership that includes an in-depth consultation and ongoing management of their sexual health and wellness as a whole.” Dr. RaeLeigh Crawford Payanes

Here’s an overview of what’s included in the sex health membership plan:

Comprehensive Sexual Wellness Membership:

Cost: $125/month with a $70 startup fee.

Services: In-depth consultations, ongoing management of sexual health, contraceptive counseling, STI screening and treatment (including PrEP), treatment for urological and gynecological issues, managing low sexual desire and sexual dysfunctions, addressing abnormal menstrual cycles and menopausal symptoms, providing gender-affirming care, unlimited virtual or home visits, and continuous physician communication.

Focused Contraceptive Care Membership:

Cost: $50/month with a $70 startup fee.

Services: Comprehensive contraceptive management, STI screening and treatment, unlimited virtual or home visits, and continuous physician communication.

One-time Consultation Options:

  • Virtual Visit: $150 for 30 minutes.
  • In-home Visit: $225 for 30 minutes.

By integrating sexual health services into primary care, you can provide comprehensive, patient-centered care that addresses the diverse needs of your patients. 

Open, respectful, and informed discussions about sexual health can significantly enhance your patients’ overall health and quality of life.

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