As a naturopathic physician, I practice differently than medical physicians--because I am not a medical doctor. So some of the practices you may have become accustomed to with your MD may be very different in my office, and I ask for your understanding.
Also having been in practice for going on 23 years, I have found certain ways of doing things that make it easier for me to practice what I call "good medicine", which is my goal as a physician. Some of these things may not make sense to some of you and may also be different from how other naturopaths practice, but I assure you there is a method to my madness. Below I address some of these.
I require new clients to bring all their medications and supplements with them in their original packaging.
Today, there are so many supplements out there that it is impossible to be knowledgeable about all of them. Some of their names are so vague that it is impossible to know what they are for, let alone what is in them. Also, a supplement may proclaim itself to be a herb, but on the ingredients label, not only is the herb listed, but also vitamins and minerals as well. How much of each ingredient is also important and these are listed on the label, so being able to check the label is very important.
Supplements may interact with medications, and/or each other. Some supplements, if taken in too high of doses, or if not needed, can result in toxicity symptoms that can have serious consequences.
For example, a new client, who thankfully brought in their supplements, had a bottle of vitamin D. The client was taking 1 daily which was 50mcg (20000 IU). I consider this to be a low to moderate dose for most people, and depending on their symptoms or conditions, I may increase it to 100-125mcg (4000-5000IU) daily. But as I was looking at their other supplements, it turned out that unbeknownst to the client, they were actually taking 250mcg (10,000IU) daily which is a very high dose for most people and one that can cause vitamin D toxicity. Had I not found out from looking at those other supplements, how much was actually being taken, I may have inadvertently raised their total vitamin D intake to 300-325mcg (12000-13000IU) daily, which would have put them in danger. As it was, I was able to revise the dosage and decrease the number of pills the client had to take daily.
Therefore I find it medically necessary to know exactly what my clients are taking, and how much, before I prescribe any medicines or supplements.
Bringing in a list of your supplements or taking pictures of the front of the bottle are NOT sufficient.
Dual or Secondary Insurance:
We are happy to bill both your insurances for you. If you have 2 insurances, please be sure to inform us of both of them, so that we can get the information we need to bill both insurances. Failing to notify us that you have 2 insurances could be construed as insurance fraud.
When we schedule a new client appointment for you, we are setting aside an hour to get to know you, understand your symptoms, and put together a treatment plan. We ask for a 2 business day's notice if you need to cancel, in order to give other clients a chance to schedule in your spot, as we typically have a waiting list. If you cancel without the 2 business day's notice, we will charge you $50 to reschedule.
As above, we ask for 2 business day's notice if you have to cancel or reschedule. We understand that life happens, and you might forget an appointment. So everyone gets one exception. For subsequently missed appointments, we charge a $65 rescheduling fee, payable in advance of your next appointment.
When you are due for lab testing, you will schedule an appointment so we can reassess what and why we are retesting, and then I will either draw your blood, or send you to a draw site of your choice.
I do NOT send out lab orders in advance of appointments, except in a very few RARE instances. When I do make an exception, we will have discussed this ahead of time, most likely at your appointment, and I will make a note in your chart that we have done so. Otherwise, no lab orders will be sent out prior to appointments.
I know this is very different from how many other physicians practice, but I have found this is the best way for me to practice good medicine.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient's consent or knowledge. Due to HIPAA, my staff and I cannot disclose if someone is a patient here, let alone schedule an appointment for them or give out any information about them--even if you are married to them--unless they are a dependent under the age of 18. We do have a place on the intake forms for you to write down the name(s) of anyone you want to allow us to share your medical information with. If you want to talk to us about another client, and they have not written in your name, we absolutely cannot give out any information.
Also, if you have very kindly referred a client to me, I cannot tell you whether or not they have been to see me. This makes me sad because I really appreciate referrals, but I am bound by HIPAA to not divulge anything about any of my clients without their express written consent.
Prescriptions and Refills
I do not prescribe medications without an appointment. Appointments can be either face-to-face or virtual.
Prescription medications are by prescription for a reason and it is not good medicine to prescribe one without knowing whether or not it is indicated, or continues to be indicated.
For acute situations like urinary tract infections, we can typically see clients the same day on an emergency basis Monday-Friday during our normal business hours.
When I prescribe medication(s) for you, I will let you know when you will need to make an appointment for us to monitor your medication. We will also send you a reminder postcard one month before you are due for an appointment. Sometimes this will also be indicated on your prescription medication bottle/container. If you notice you have no refills left, it's time to schedule an appointment. If you do not schedule an appointment within 1 month of when you were due, I will not be able to authorize any refills until you are seen.
When we go over the results of the lab tests that we are using to monitor your prescription medications, and you will be staying on the same dose, I will ask you to contact your pharmacy for refills. Because mine is a small practice, (and I don't have a nurse like MD's) it saves a considerable amount of time to not to call in refills. I really appreciate your doing this!