The practice
Five programs.Everything else got turned down for a reason we are willing to publish.
We get asked regularly why we do not offer something a competitor does. The answer is almost always one of four things, and it is more useful to write them down once than to answer the question privately one enquiry at a time.
The standard
Four tests.A program gets added when it passes all four.
These are not aspirational. Each of the five programs on this site clears all four, and the things we are asked for most often — usually the ones with the best margins — fail at the first or the second.
Evidence that existsTest one
Trials in humans, published where other people can check them, showing the thing does what it is sold as doing. Not a mechanism that sounds plausible, not animal data, not a study in twelve people funded by whoever sells it. If the evidence is early, we will say it is early rather than call it cutting edge.
A diagnosis in front of itTest two
Something we can identify, describe to you, and treat — rather than a number nudged towards a range someone invented. If a program only works by first convincing you that being normal is a deficiency, it is marketing wearing a white coat.
Monitoring that means somethingTest three
A way to tell whether it is working and a way to catch it going wrong, on a schedule, with a clinician who reads the result. If there is nothing to measure and nothing to adjust, there is nothing to prescribe either.
A clinician who can say noTest four
Someone whose judgement is not overridden by whether you bought something, and who is free to decline. Every program we run turns people away, and a program that cannot is a storefront regardless of who signs the prescription.
The test is not whether something could work. It is whether anyone has shown that it does, and whether we could tell if it were not.
The limits of this
Some things cannot be done down a wire.Here is our half of that.
Telehealth is genuinely good at a defined set of problems and genuinely unsuitable for others. A practice that will not tell you which is which is hoping you do not notice until after you have paid.
Anything acuteCall 911
Chest pain, difficulty breathing, a sudden severe headache, signs of a stroke, a fever with confusion. This is emergency care and it needs to happen now, in person.
Anything that needs hands
A lump to be examined, a joint injected, a lesion biopsied, an internal examination. There is no remote version of a physical examination and we will not pretend otherwise.
Anything infused or injected in a chair
Infusions and in-clinic injectables need a room, a chair and somebody watching you in it. Remote is the wrong setting for them, not a cheaper one.
Mental health beyond the edges
We screen for depression because it explains a great many of the symptoms people bring us, and we treat some of it. Active suicidal thinking, psychosis, bipolar disorder and substance dependence belong with a psychiatric service, and we will help you get there.
Fertility
Trying to conceive is its own specialty with its own testing. We will flag where something we might prescribe would work against it, which matters for testosterone in particular, and then refer.
Cancer, and anything suspicious
Unexplained bleeding, unintentional weight loss, a changing mole, a new lump. These need investigating rather than treating, and our job is to recognise them and route you quickly.
A sleep studyOur most useful referral
We raise sleep apnoea constantly, because it sits underneath fatigue, low testosterone, blood pressure and erectile difficulty. Diagnosing it takes a study we cannot run, and it is frequently the most valuable thing we do for someone.
Being referred out is not being turned away, and it is not a failed consultation. It is the consultation working.
Where this website ends
This website is not your medical record.That distinction matters more than it sounds.
These pages sell programs and explain them. Your intake answers, laboratory results, prescriptions, clinician notes and messages live in the practice’s medical record system, which is a different system with different obligations. Nothing you tell a clinician is held in the marketing stack.
One sells you a program. The other holds your chart. They are not the same database and they do not share one.
Analytics on public pages stay separate from routes that carry protected health information, including the patient area and authenticated intake. Questionnaire answers are not sent to advertising pixels.How to get a copy of your chart, and who to ask
Once you are in active care you have a legal right to your record. Requests to access, amend, or restrict how your health information is used go through the practice and its medical record system rather than through this website, and they are handled on the timelines the law sets rather than at our convenience.
The practical route is the patient area, which is where messages to your clinician and requests of this kind are handled together in one place. The patient area
Our full privacy and consent documents are published rather than buried. Privacy · Telehealth consent · Safety information
That is the whole standard
If a program on this site cannot tell you what it is treating, how it will be measured, and what would make us stop,it should not be on this site.
About three minutes. Nothing is prescribed at this step and nothing is charged.