The Initial comprehensive consultation is for new patients to our clinic (does not apply to any existing patients). We will thoroughly review your history and story in a detailed fashion using an in depth questionnaire and any other data you can provide including prior labs, imaging studies, and any other doctor’s reports . The length and thoroughness of the questions will attest to the fact that I hold in high value what the renowned Doctor Osler said about patients, ” It is much more important to know what sort of patient has a disease, than what sort of disease a patient has.” This is a much more exhaustive historical analysis than is used by most primary care physicians.
Areas to be reviewed will include :
- Current and past medical history including a timeline of key events
- Review of symptoms
- Nutrition and fitness history
- Goals and readiness assessment
- Lifestyle assessment
- Detailed questionnaires covering areas of nutrient deficiencies, toxins, hormones, and metabolism
- Examination with vital signs
- Detailed measurement of body composition to include muscle mass, body fat, and resting metabolic rate using a state of the art bioelectrical impedance scale
- Specific laboratory recommendations which may include traditional labs and more detailed or functional labs (for example-digestive, metabolic, and hormone testing)
The visit is primarily an information gathering and sharing session. I may make some simple recommendations at this time, but most customized advice will be deferred until after lab results are in and there has been time to thoughtfully consider your case. The session will last approximately 60 minutes.
A follow up consultation is recommended and can be done in person or via a secure telemedicine video-conference or by phone. A detailed action plan will be created with specific and personalized goals and treatments outlined. I have found this is best done speaking either with a face to face encounter or through telemedicine/phone. This may last anywhere from 15-30 minutes.
Physical Examination
Physical exams will cover the areas as above but since this is reserved for existing patients that I am familiar with and will have less outside data to review, it is priced accordingly. The session will last approximately 60 minutes.
Laboratory review consult
BASIC
Arguably, the most essential tool in assessing how healthy one is and how best to achieve optimal function is to obtain comprehensive laboratory studies or blood work. One needs to look deeper than the eye can see. Even if one feels well, it is imperative to act and measure biomarkers that often predate the onset of an illness. I often like to draw my patients’ attention to this point by quoting President Reagan in dealing with the Russians, “we need to trust but verify.” Most people don’t realize that there are comprehensive labs available thru such companies as Quest and Lab Corp which can measure important markers such as inflammation, glucose control, advanced lipid/cholesterol profiles, hormones, immune function, and nutrient depletions. These, however, are not usually ordered by most primary care doctors or specialists.
This consult can be done in person or with secure telemedicine/video-conference or by phone. This review is ideal for patients who have a primary care doctor and/or specialists but want to get a more detailed picture of their state of health and review labs that may have not been offered to them.
It is important to note that the patient is responsible to check with the insurance plan to find out which lab company is preferred and if any labs will not be covered. Our preference is to use Quest, which we believe has the most complete and inclusive tests available although Lab Corp also may be used.
How does it work?
- Brief questionnaire that includes your medical history, list of medications and supplements, and any recent labs.
- Ordering of personalized labs- once we have the above info we will create a requisition that is tailored to your needs and avoids any duplicate tests that you may have recently so as to save undue costs and excessive tests.
- If done through Quest labs we will transmit your requisition through the Care 360 portal which can be accessed at any Quest location in the area.
- If done through Lab Corp we will provide you with a lab requisition for you to take to one of their locations.
- We will contact you when the labs are back and schedule a consult either in person, via telemedicine, or by phone and will usually last approximately 20-30 minutes
You will receive:
- In depth lab interpretation and copy of all labs.
- Action items to for you to use which may include lifestyle changes, nutraceutical or supplement support, and next steps such as further testing to review with your physician.
ADVANCED
The advanced lab review consult is as above but also includes the evaluation of more comprehensive studies or specialty functional labs. Such examples would include in depth analysis of digestive function, salivary or urinary hormone assessments, and detoxification and metabolic profiles to name but a few. These reports are more detailed and lengthy and require further time and effort to review and may have a longer turnaround time. The approximate time will be about 30-45 minutes. These kits generally can be dropped shipped to you or picked at the office.
