What is Direct Cognitive Care?
A New Model for Families Navigating Cognitive Changes
If you or someone you love is experiencing early memory changes, you've likely discovered a frustrating gap in our healthcare system. Traditional neuropsychology offers brief evaluations that result in a report and discharge. Insurance-based neurology provides 15-minute medication checks. Neither offers what families actually need: ongoing partnership, comprehensive assessment, and proactive guidance during the years when planning still matters most.
This is why we created Treasure Coast Cognition as a Direct Cognitive Care practice - applying the proven principles of Direct Primary Care and Direct Specialty Care to neuropsychology and cognitive health services.
Understanding Direct Care
Direct Care is a growing healthcare movement that removes insurance companies from the relationship between patients and providers. Instead of billing insurance for each service, Direct Care practices operate on a membership model - patients pay a periodic fee (monthly, quarterly, or annually) directly to their provider in exchange for comprehensive, personalized care.
The Direct Primary Care (DPC) movement started about a decade ago when family doctors and internists recognized that insurance constraints prevented them from actually caring for their patients. By eliminating insurance billing, these physicians could spend 30-60 minutes per appointment instead of 7-12 minutes, offer same-day or next-day access, and communicate directly with patients via phone, email, or text.
The results were transformative: happier doctors, healthier patients, and lower overall healthcare costs.
More recently, medical specialists have begun adopting this same model, creating what's called Direct Specialty Care (DSC). Rheumatologists, cardiologists, neurologists, psychiatrists, and other specialists are discovering that insurance-free practice allows them to deliver the kind of care they were trained to provide.
Direct Cognitive Care brings this proven model to cognitive health.
Why Cognitive Health Needs Direct Care
Consider what happens when someone starts experiencing cognitive changes in the current system:
The Traditional Path:
Family notices memory problems
Primary care doctor does a brief screening (5-10 minutes)
Referral to neurologist (wait time: 3-6 months)
Neurologist appointment (15-20 minutes, focused on ruling out treatable causes)
Maybe a referral to neuropsychology (wait time: 2-4 months)
One comprehensive evaluation (if insurance approves)
Written report sent to referring doctor
Patient discharged back to primary care
Family left wondering: "Now what?"
What's missing: The ongoing partnership families need during the 7-10 year window between first symptoms and formal diagnosis - the exact time when proactive planning, financial capacity assessment, family education, and care coordination could make the biggest difference.
Insurance doesn't reimburse for these services. Traditional neuropsychology practices can't survive providing them. So families navigate this critical period largely on their own, often making decisions without proper cognitive guidance.
Enter Cognitive Stewardship
Direct Cognitive Care removes insurance barriers and makes true Cognitive Stewardship possible. Here's what Cognitive Stewardship looks like in practice:
Comprehensive Assessment
Instead of rushing through a 90-minute evaluation to satisfy insurance requirements, we spend 4-6 hours across multiple sessions getting to know you and understanding you. We use established neuropsychological measures (not proprietary screens), conduct detailed interviews with family members, and assess real-world functioning including financial capacity - a critical but often overlooked indicator of early decline.
Ongoing Monitoring
Cognition doesn't change once and stay stable. Cognitive Stewardship includes monitoring sessions where we track changes over time, adjust recommendations, and address emerging concerns before they become crises. We catch problems early - when intervention still works.
Direct Access
Questions don't wait for scheduled appointments. With Cognitive Stewardship, you have direct access via phone and email between sessions. Worried about a medication side effect? Confused about what to tell the estate attorney? Concerned about a recent incident? You don't wait three months to ask - you reach out, and we respond.
Care Coordination
Your cognitive health doesn't exist in isolation. We communicate directly with your physicians, coordinate with your estate planning attorney, consult with your financial advisor, and speak with adult children or other family members (with your permission). This coordination rarely happens in traditional practice because insurance doesn't pay for it. In Cognitive Stewardship, it's built in.
Family Education and Support
Understanding what's happening is half the battle. We invest significant time educating families about cognitive changes, what to expect, how to plan, and what interventions might help. We help you make sense of confusing medical information and translate research into practical guidance.
Who Cognitive Stewardship Serves
Cognitive Stewardship is designed for families who:
Are experiencing early cognitive changes but not yet diagnosed
Want comprehensive assessment, not just a diagnosis
Need ongoing guidance as cognition evolves
Are making important financial, legal, or healthcare decisions
Value proactive planning over crisis management
Can invest in preventing cognitive decline complications
Want a genuine partnership, not episodic care
This model works best for families in that critical 7-10 year window between first symptoms and formal dementia diagnosis - when stakes are highest, questions are most pressing, and traditional healthcare offers the least support.
What Cognitive Stewardship Is Not
It's important to understand what we're not:
Not concierge medicine. Concierge practices charge fees for access while still billing insurance for services. We provide all services with transparent pricing and no insurance billing at all.
Not a replacement for medical care. We don't prescribe medications or manage medical conditions. We work alongside your physicians, providing the cognitive assessment and care coordination they don't have time for in their insurance-based practices.
Not one-size-fits-all. Every family's situation is different. Cognitive Stewardship gives us the flexibility to customize services to your actual needs rather than fitting you into insurance's predetermined boxes.
The Broader Movement
Cognitive Stewardship is a new category aligned with the Direct Cognitive Care model. This is part of a larger transformation in American healthcare. Thousands of clinicians across all specialties are rejecting insurance-driven medicine in favor of direct patient relationships. They're proving that when providers can focus on patient needs instead of billing codes, everyone benefits: better outcomes, lower costs, less burnout, stronger relationships.
We're bringing this proven model to cognitive health because families facing cognitive changes deserve the same benefits: comprehensive assessment, ongoing support, care coordination, and genuine partnership throughout the journey.
Is Cognitive Stewardship Right for You?
If you're reading this because someone you love is experiencing cognitive changes, ask yourself:
Do you want more than a one-time evaluation and report?
Would ongoing monitoring and guidance help your family make better decisions?
Do you value having an expert partner throughout this journey?
Can you invest in preventing crises rather than just reacting to them?
If you answered yes, Cognitive Stewardship might be exactly what you need.
Traditional healthcare wasn't designed for the kind of comprehensive, longitudinal cognitive care families facing early decline require. Insurance won't pay for it. Hospital systems can't provide it. But Cognitive Stewardship makes it possible.
That's why we built Treasure Coast Cognition as a Direct Cognitive Care practice, offering a new service, Cognitive Stewardship, to meet the needs of families facing cognitive changes, who deserve better than what the traditional system offers.
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