All Annual Physical Exams include:

• Physical Exam:  Complete physical exam, with vital signs

  • At this time the exam does not include PAP or other gynecological testing, nor breast or rectal exams, due to legal concerns with working alone in a home office.

• EKG:  For all patients 35 years or older, or those who have underlying conditions or symptoms that necessitate it

• Urinalysis:  Checking for evidence of blood, protein, infection etc. in the urinary tract.

• Blood tests:  For all adult patients (and younger patients at the request of the parent or guardian). This is done through a custom lab, MedScan, using insurance with no out-of-pocket cost to the patient.  Those who wish to have lesser testing, or those without insurance can elect to pay cash for an abbreviated panel of their choosing. Full panel includes:

  • CBC (Complete Blood Count): Checks for issues with immunity, infection, leukemia, anemia, etc.

  • CMP (Complete Metabolic Panel): Checks for fluid and electrolyte balance, glucose levels, kidney and liver function.

  • Lipid Panel, with Advanced Lipids:  Checks for cholesterol and triglyceride levels, and includes additional testing for certain risk factors to help guide treatment goals

  • Hgb A1C with eAG (Hemoglobin A1C and estimated Average Glucose): Diabetes screening

  • Thyroid Function Tests:  TSH (Thyroid Stimulating Hormone), Free T3 and Free T4 (circulating thyroid hormones), Thyroid Globulin Antibody, and TPO Antibody (checking for underlying causes of thyroid dysfunction due to autoimmune disorders). 

  • Hormone Panel: Testosterone and estrogen levels, along with related binding proteins, as well as Cortisol, and numerous growth factors

  • Vitamin/Nutrient Levels:  Vit. D3, Vit. B12/Folate, Magnesium, and Phosphorus

  • Iron Panel: Circulating iron, Ferritin (storage form of iron), and other related levels

  • Other specific lab testing as requested by the patient, if available

• Referrals:  Any referrals needed for routine purposes (for abnormal EKG etc.)

• Paperwork as needed:  Forms for employee incentive programs, travel etc.

• Specific Problems/Refills:  In an insurance-based practice, there are rules against a physician refilling prescriptions or handling regularly scheduled appointments on the same day as a routine preventative care appointment.  As a direct primary care, DPBH does not have to schedule additional appointments to separate these types of services.

• Diabetes

• High Cholesterol

• Thyroid Disorders

• Hormones:  See Below

• Mental Health:  See Below

• Suboxone:  Whether you are taking it for chronic pain or maintenance of opioid dependency, you will treated with compassion and without judgement.  Frequency for these appointments will depend upon whether or not you are just starting out, or have been on the medication previously.  Established patients with a record of good compliance with urine drug screens etc. will be seen every 3 months, with drug screens done on a randomized basis.

• Testosterone:  A single low level of testosterone in blood testing does not establish the diagnosis of a deficiency.  These levels can fluctuate from time to time, so another test has to be done with results showing a low level of this hormone before we can consider treatment options. Frequency for these appointments will depend upon whether or not you are just starting out, or have been on the medication previously.  Patients who have a history of low testosterone and have been on replacement previously can be seen every 6 months to have relevant blood tests done.  Those who are just starting with it need to be seen at 3 month intervals until the treatment regimen is established.  Many places require that the patient come to the clinic to have the shots, if that is their method of replacement.  I am happy to let those who wish to treat themselves at home do so with supplies from the pharmacy.

• Female Hormones:  Postmenopausal women 

• No Transgender Hormones:  This is out of the scope of my practice.  Regardless of my beliefs on the matter, I am not qualified to offer this service.

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