Direct-Pay Internal Medicine· Online Visits for Wisconsin Residents
Your health deserves more than ten minutes
Board-certified in Internal Medicine and Obesity Medicine. Sixty-minute first visits. No insurance company dictating what happens in the room. Just a physician with the time — and the training — to look at your whole health, connect the dots, and build a plan that adapts as your life does.
The problem
You already know what the ten-minute visit feels like. The hand on the doorknob. The lab result flagged "normal" with no conversation about what it means for the next twenty years. The sense that no one is actually looking at the whole picture — just the one box insurance is paying them to check today.
That's not a knock on the physicians caught inside it. It's the system. And it's why this practice is built differently.
Meet your physician
I'm Dr. Safa Shiari. I trained in internal medicine at Henry Ford St. John Hospital in Detroit, served as Chief Resident, and spent two years as faculty teaching the residents and medical students who are now practicing on their own. I'm board-certified by the American Board of Internal Medicine and the American Board of Obesity Medicine — a combination that's genuinely uncommon — and a Fellow of the American College of Physicians. My graduate training is in public health, epidemiology and biostatistics, which is a long way of saying I think in evidence and trajectories, not trends.
For three years I practiced at Mayo Clinic Health System, managing a complex panel of patients in their 60s, 70s, 80s, and 90s. That's where I learned the thing this practice is built around: the most expensive thing in medicine isn't a hospitalization. It's losing the ability to live independently. Almost everything I do in prevention traces back to that.
I treat my patients the way I like being treated.
How I practice
Three principles shape every plan I build, whether you're 38 and focused on prevention or 78 and managing several conditions at once.
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Longitudinal analysis. I look at where your numbers are heading, not just where they sit today. A single lab is a snapshot. Your risk lives in the trend.
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Medication stewardship. I start medication when the evidence says it meaningfully improves your life — and I'm just as willing to take you off something that no longer earns its place. Avoiding unnecessary treatment is as much a part of good medicine as starting the right one.
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Functional longevity. Decisions get made for how you actually live — your strength, your cognition, your mobility, your independence over decades — not just for how a lab value looks on paper.
What the comprehensive consultation includes
The initial visit is sixty minutes, and it's a genuine deep dive: a full medical history, a focused review of whatever's on your mind, a physical exam when telehealth allows it, and an individualized risk assessment that looks further out than the standard ten-year window. You leave with a clear plan and an actual understanding of why each part of it is there.
These are unrushed conversations. That's not a marketing line — it's the entire design of the practice.
Who this is for
This practice fits two kinds of patients especially well.
If you're largely healthy and want to stay that way — focused on cardiovascular and metabolic risk, longevity, frailty prevention, evidence-based weight management, and a real physician relationship that doesn't feel like a conveyor belt — this is built for you.
If you're managing complex or multiple conditions — heart disease, diabetes, hypertension, thyroid disease, fatty liver, kidney disease, osteoporosis, polypharmacy, menopause-related care — and you need real continuity and physician-level oversight, this is built for you too.
It's not the right fit for emergencies, crisis-level care, or one-off urgent needs. If something is an emergency, please contact your local emergency services.
Transparent pricing
You'll know exactly what every visit costs before you book — no surprise bills, no insurance games.
Initial comprehensive consultation: $350 (60 minutes). Follow-up strategy sessions: $200 (30 minutes), for established patients. For patients who need ongoing oversight, a Comprehensive Care Membership is available at $425/month — intentionally limited to a small panel so each member gets meaningful physician time.
HSA and FSA accepted. Superbills available if you'd like to seek out-of-network reimbursement. This practice doesn't bill insurance directly — but you can still use your insurance for other aspects of your care like labs, imaging, referrals and medications.
Don't wait for your labs to turn red.
If you want a physician who thinks about your health this way — across decades, not appointments — that's exactly what this practice is built for. Start with a free discovery call, or book your comprehensive consultation directly.
This page is educational and isn't a substitute for personalized medical care. Telemedicine services are available to Wisconsin residents. For medical emergencies, contact your local emergency services.