My approach

How the consultation works

What happens in an appointment with me, the ways we can work together, why all care here is private, and where to check the reimbursement rules of your health plan.

Something I hear a lot in a first appointment is that the person has already told that story any number of times, always in short visits, always to someone different, and left nearly all of them without having managed to say the main thing. I built my practice against that, around having enough time for the whole story, including the part that was never in the referral letter.

Before you book anything, you have a right to know how things work here, what I ask, who can come into the room with you, how long we have, what happens between one appointment and the next, and where to look up the reimbursement rules if you have a health plan.

Why all care here is private

Every appointment I offer is paid directly rather than through a health plan network, and that is a clinical decision before it is anything else. A team led by Greg Irving, at the University of Cambridge, reviewed 179 studies in 2017 covering more than 28 million consultations across 67 countries, and found an unsettling range in how much time a primary care physician spends with each person, from 48 seconds in Bangladesh to 22.5 minutes in Sweden. Eighteen countries, home together to roughly half the world's population, offer five minutes or less. The authors linked consultation length to concrete outcomes, among them hospital admissions for conditions that could have been resolved earlier, and to the satisfaction and burnout of the physician.

There is no way to do in five minutes what I describe here, because you cannot listen to a whole family, understand what has already been tried, review medications that came from three different prescribers, and still agree on a plan the person is actually able to follow. Working privately is what lets me keep short lists, few people per session, and appointments long enough for connection, autonomy, respect and clarity to stop being pleasant words and become practice.

In mental health care, time is not a comfort, it is a condition for the work to function at all.

Ways of working together

There are three ways to work with me, and which one fits depends on what you need right now. You do not have to work that out on your own, we can talk it through before anything is booked.

I prefer to discuss fees and payment terms directly, because they depend on the format, on how often we meet, and on how many people in the family will be involved in the care. Send a message to the practice WhatsApp and we will sort it out.

Where it happens

I see people in person in Uberlândia, Brazil, at the Artem Curant practice, at two addresses, Rua das Rosas 338, in Cidade Jardim, and Center Shopping, Avenida João Naves de Ávila 1331, in Tibery. I also work by video, for people who live in another city, another state or outside Brazil, following Resolution 2,314 of 2022 from the Federal Council of Medicine, the body that regulates medical practice in the country.

A video appointment is not a reduced version of an in-person one. It is the same consultation, with the same length and the same attention, and in many cases it solves a problem the consulting room cannot solve, which is bringing family members who live in different cities onto the same screen.

How to prepare

Nothing is required, and no one needs to arrive with the whole history straight in their head. Even so, a few things help a great deal. If there are recent test results, current prescriptions, reports from other professionals or school assessments, bring them, even the ones that look old or beside the point. If you take medication, a list with names and doses is worth more than an approximate memory.

Think as well about who else lives inside this story. Often the person who describes best what is going on is not the one who came to the appointment, and bringing that person along, in the room or on the screen, changes the quality of what we can build. And if there is a question you are afraid to ask, write it down beforehand. It tends to be the most important one.

Reimbursement from your health plan

Care here is private. Some Brazilian health plan contracts provide for reimbursement of appointments held outside the plan's own network, and the conditions, percentages and deadlines vary according to the contract and the operator.

At the end of the appointment you receive a receipt or invoice identifying the service provided. The reimbursement request, where applicable, is made by you directly to your operator.

To find out whether your contract provides for reimbursement and under what conditions, check with your operator and with the official information published by the National Agency for Supplementary Health, the Brazilian federal regulator of private health plans:

• ANS · What your health plan must cover, reimbursement (in Portuguese)
• ANS · Reimbursement guide (PDF) (in Portuguese)
• ANS · Consumer support channels (in Portuguese)

The links above are given only so that you can consult the official source, and their content may be changed by the ANS at any time. This page does not provide guidance on reimbursement, does not interpret health plan contracts, and does not state that any care described here will be reimbursed. The rules, deadlines and percentages depend exclusively on the contract signed between you and your operator. We do not intermediate, request, follow up or guarantee reimbursement of any kind, and we take no responsibility for decisions, deadlines, denials or amounts applied by your operator. If you have a question or receive a refusal, contact your operator directly and, if necessary, the official ANS channels.

One last thing

If you got this far looking for care for someone in your family rather than for yourself, there is something I want to say before finishing. Whoever organizes the appointments, the medication and the routines of another person holds up a large share of what makes care work, and almost never gets asked how they are doing. Here that question gets asked too. Looking after you is part of the same job, and it is usually what gives the rest its breath back.

Dr. Marcelo Gobbo Jr.
Family and Community Physician (CRM-MG 74.511 · RQE 69038), with a master's degree in Psychology from the Federal University of Uberlândia and training at the Program for Recovery and Community Health at Yale. He cares for neurodiverse families and people living with severe mental illness, in person and remotely.