Should I switch Doctors?

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Style

New Member
I have a extremely good wellness / Primary care doctor here in Las Vegas/Henderson, NV. I've been seeing him every 3 months for TRT for several years. I'm doing well. i think my TRT regimen is dialed in fine and I don't need to change anything.

He's a great doctor, but right now he's spending like an additional 30+ hours a week after office hours just doing charting for patient records and its burning him out. I know that the only way to make money with the low reimbursement rates that insurance companies pay is to see lots of patients and make it up in volume - So I don't have a problem with him having a life and not working from 5AM - 10PM 5 days a week and half a day at home on Saturday (that's what he personally told me his current work schedule looks like).

He's changing his practice over to a concierge service where he will have only about 400 patients and will be able spend much more time with them (and less time dealing with insurance red tape). In order to do this, he will be charging $1800/year (payable in quarterly installments) as a membership fee and then still charges for visits for whatever my insurance will pay. In his new practice I would get an "Executive Physical" exam once a year that takes 2-3 hours to complete. I can also get same day appointments and talk to him whenever I want because he's only seeing a few patients a day, so he has open slots.

I'm turning 50 years old next year, I am in good health otherwise, I workout 3x a week, no chronic conditions or other reasons to see him other than TRT and the occasional illness/cold/flu.

I don't know if I should find a new doctor (since $1800 is not an insignificant amount of money - almost $5/day), but I do spend around $5 at Starbucks almost everyday - so it's not a break the bank amount.

The way I see it, my choices are:
A) Stick with my current Doctor, pay $1800 more a year, probably get slightly better health since I get a better physical and he'll spend more time getting me in peak physical condition.

B) Find a new doctor, hope they know what they are doing, see them instead. This also covers me for any other issue like if I get the flu, a weird mole, ear infection, annual physical, etc. I assume my old Doctor will recommend someone with TRT experience for those that don't stay with him in the membership fee practice. The specialty pharmacy where I get my TRT supplies at can also probably recommend other local doctors too that they work with regularly so I'll get someone who regularly does TRT prescriptions.

C) Go with a local Men's health "ED" clinic where I probably have to pay a membership fee or whatever (many advertised on billboards here in town). I see that Primebody.com (recommended on this site) has a location here in Las Vegas, but its cash-based protocol (so I'm paying out of pocket even with insurance). For all I know that may cost me $1800/year and I could stick with my Doc for the same price.

D) Go with a telemedicine doctor like Defy Medical (assuming since they are based in Tampa, FL that its done over the phone, skype, or facetime) - no idea on cost. I assume that this is all they do so they do it well. Downside is that I don't have someone to see locally if I get sick. Also its a 3 hour time zone difference from the West Coast, so unsure if a Doctor is available after 2PM Eastern Time to talk to about my health.

Anyone have a recommendation on what's worked best for them or anything I should ask?
 
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Systemlord

Member
A $5 coffee everyday adds up, that's $150 per month, the cost for Defy Medical yearly labs, medicine and consults. Priorities are not where they should be, priorities should be about your health.
 

Style

New Member
A $5 coffee everyday adds up, that's $150 per month, the cost for Defy Medical yearly labs, medicine and consults. Priorities are not where they should be, priorities should be about your health.
My health is great. and I should probably cut back on the $5 vanilla lattes but I only drink them when I am with friends so there is a social benefit as well....I'm not opposed to spending the money, I'm just opposed to spending it unnecessarily. A lot of health comes down to social and economic factors, diet, exercise, avoiding vices (Smoking, excess drinking, etc.) and managing stress - all of which I am doing. 20% of health is clinical care and 5% is genetic and biology. I think this site does a good job of talking about the clinical and biology (such as dropping testosterone levels with age).

My question is would my health be even better for $1800 more per year? Because that's the same cost as a nice trip to Hawaii. If it's going to cost me that same amount ($150/month or $1800 year) more for Defy Medical labs, results, and consults, then I would prefer to stay with my current local doctor.

I see a lot of these wellness websites talking about Bio-Identical hormone replacement therapy (BHRT). Is that more than just a TRT protocol for men? In other words, do they provide more benefits than my current doctor?
 

stevep

Member
If I'm not mistaken Defy just changed their hours of operation; M-F until 9PM EST and Saturday 9AM to 2PM. Defy is no where near $1,800 annually. Best thing to do is call them and they will explain their cost.

I use my local PCP (insurance) for all required lab work and have my PCP fax the lab work to Defy which saves me out of pocket $$ as well.
 

Blackhawk

Member
My first year with Defy has been close to that, but it very much depends on who you consult with and how often (The MD consults are more than the PA/NPs), and how many meds you get from them vs other channels. It seems if you are pretty much dialed in anyway, it would likely be around 1/2 that amount.

Likewise SteveP! I recently have been able to have my PCP order labs through insurance, but I get the results and send them to Defy and my hematologist/oncologist.
 

Will Brink

Member
Anyone have a recommendation on what's worked best for them or anything I should ask?

A doc that does not suck at HRT that you're happy with is one you stick with if you can afford it. That one is a no brainer. If $ is the issue, then that's another issue.
 

mooseman109

Active Member
As you are saying you are all dialed in, you could go to Defy and see if they will prescribe the same protocol. They listen to you and most likely will follow the same or make suggesions to try to tweak you. I would say you will not spend $1800 with them the first year, but probably $1000. Plus a physical and and maybe one other office visit at another NEW, primary care, and you are getting close to $1800.
I agree with Will, a good dr who has this figured out is like gold. As you said you are 50,as a guy who is 55,I can say I go to dr more frequently than ever did before. So you might do so as well. I would vote staying with him. Move your blood work, to dicscountedlabs if not already there, which would help offst costs maybe. Having to find a new PCP can be a pain in of itself, even if Defy serves yo well
 

Style

New Member
Thanks everyone for your replies. My Doctor has been unable to find good hormone doctors to turn his TRT patients over to, so he's keeping me. I will have to pay $960/year (better than $1800 for the MD concierge service he's switched over to - which he completely filled and has a waiting list) but I'll stay where I am and he can order my bloodwork and I only pay the $40 insurance co-pay at the lab. One of the other doctors in his office will handle me if I need to visit for illnesses or physical exams.
 
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