A Personalized and Functional Approach
What to Expect…
It is very important to stress that this integrative model of patient care is “process-care” and not “episode care” as is typical of modern Western medicine. There is no “quick fix.” There is no “magic pill.” There are no “one size fits all protocols” that are appropriate for the conditions that we evaluate and treat. Results take time to achieve and achieving the best result requires the dedication and commitment from you, the patient, and your support group or family if applicable.
Sex hormone imbalances often get your attention that something is just not right with your body by displaying obvious symptoms that negatively impact your quality of life.
Reestablishing your sex hormone balance is best achieved through the use of bio-identical hormones. These are hormones whose molecular structure matches that of the hormones that your body has made in adequate amounts until now. They can be administered as creams or oils on the skin, tablets under the tongue, pellets inserted under the skin, injectables, suppositories, and occasionally pills (only for progesterone).
Optimal hormonal balance can be achieved to relieve those bothersome symptoms, to slow down aging, and to reduce the risks of major diseases in the second half of life. This requires periodic testing , which is reliable if done appropriately and interpreted by a trained clinician. Nothing can take the place of testing to provide assurance that you are in the best physiologic balance with the hormones you are taking. Newer types of testing can even indicate how your body is processing the hormones, allowing us an opportunity to further reduce risks of imbalance.
But these are not the only factors that we must address to achieve optimal health. Several other systems of your body are directly implicated in creating hormonal balance. These include your thyroid gland – often under producing, a cause of low energy, poor sleep, PMS and other issues. The system that underlies all your other hormones is your adrenal glands – controlling your sleep, energy, ability to deal effectively with stress, and regulation of carbohydrate (glucose) metabolism and insulin. These also have to be addressed and given support.
Also affecting your vitality and wellbeing is your diet with the types of food you eat, your exercise habits, sleep patterns, stress management, and other lifestyle practices. Other systems and health issues that we may need to address in your health plan can include: gut health, healthy weight management, detox, methylation pathway defects, inflammation, allergies, neurotransmitters, and others.
The basic philosophy of medicine that I have come to embrace is Functional Medicine, where we assess, diagnose, and treat what is out of physiologic balance, restoring the natural balance of your body and mind/spirit with the most effective treatments giving the least side effects, while trusting your body’s natural ability to heal and bring itself into balance.
For us, to best understand your health condition and the factors that are contributing to your health disorder it is important for us to have as complete an awareness as possible of all the many factors that contribute. To facilitate this, we ask that you complete, as thoroughly as possible, a very detailed general health survey that includes your environmental exposures, your family tendencies, your individual sensitivities, and your current symptoms.
It is also important for us to have a complete list of your current medications and supplements, both prescription and nonprescription, in addition to any recent medical evaluations and tests including labs that you have had in the past. Please let us know about any other treatments that are on-going.
The clinician will review your medical history with you taking additional information as individually required and will then perform a physical examination and review appropriate reports. Based on your unique, individual circumstances we will order any additional studies that are deemed to be necessary to diagnose and appropriately monitor your condition upon obtaining your consent. These studies are not included in the office clinician fee. Some labs are billed through the office and other labs are billed by the laboratory directly. This will be discussed when the labs are ordered or obtained with your consent.
The interpretation of laboratory reports is a very important part of your care and should be done during a visit with the clinician. We will notify you of any urgent lab results that we feel need your immediate attention. Your treatment regimen will then be modified as appropriate.
If the complexity of your condition does not allow complete coverage of all information in the time period scheduled, an additional appointment on a different day may be necessary. We try to schedule enough time to cover the majority of the patients we treat. As recovery proceeds, return visits are scheduled further apart.
If you require refills between appointments, we ask that you have your pharmacy fax or send by electronic Rx system the refill request to us with two business days advance for us to authorize your refill.
We are happy to respond to procedural questions between visits as a part of our service to you. Questions that require a clinical opinion need to be handled with a clinician appointment (either by phone or in person). We will attempt to schedule “impromptu” appointments as the schedule permits. You may be contacted between visits by one of our Patient Advocates between service appointments. The role of the Advocate is to assist you with issues related to your care with us and to assure that we are providing you with the service that you expect from us. Your condition and our recommendations for treatment will then be discussed with your provider.
Since our approach to care is “integrative” and includes both standard and “alternative” approaches to treatment, many insurance companies classify our treatment as “unproven” or “experimental” and therefore exclude it from reimbursement. This is very unfortunate but does require that we not participate in any form of medical insurance including Medicare and Medicaid. The Federal government requires that Medicare patients must complete and sign a Medicare “opt out” contract which we will provide. No claim for reimbursement can be made to Medicare or your Medicare Secondary although approved ancillary services (example labs) may be covered. Your private insurance may provide partial coverage for our services if “out of network providers” are covered. We also request that you review and sign a consent form indicating your understanding of the alternative nature of some of our recommended treatments and acknowledge your consent.
Payment for our services is expected at the time of service. We accept cash, personal check and major bank cards. Patients are expected to keep their account paid in full in order to receive continuing care. Costs for testing, prescriptions and supplements are charged separately. They may be covered by insurance but this varies greatly between carriers and we urge you to discuss this with your insurance company if this is important to you. We are considered an “out of network provider.” We will provide you a medical receipt which can be submitted for possible reimbursement. This can also be used as documentation for use of health savings accounts. We do not maintain insurance processing staff. We are not able to arrange “prior authorization” for the tests and treatments that we recommend. If additional reports are required by your insurance company there may be an additional charge for the time involved to prepare these reports. We will obtain your approval before these additional services are provided informing you of any additional charges.
As a reminder, we do not act as primary care providers but provide consultation medical and wellness services. It is important for you to also maintain the services of a primary care provider. We are not available after hours and do not provide “on call” coverage. We do not maintain hospital admitting privileges. In case of emergency, we ask that you call 911.
Not near our Santa Rosa office?
No problem, our Forum Health Santa Rosa team is available to you no matter where you are.