Before I explain how we've restructure the practice, I'll introduce my new staff members. First is manager Tammy Carter; next is medical technician Jessica Nelson. Forthcoming is also a new front desk assistant.

Tammy Carter. As a professional healthcare facility manager, Tammy has overseen many solo and group physician practices, an Imaging Center, and Patient Accounting Services for a Jupiter, Florida hospital. Her twelve years of experience have given her extraordinary expertise in managing personnel. With Tammy on board, the day-to-day operations of my clinic are in exceptionally efficient hands. When Tammy enters a room, her presence stirs energy and enthusiasm in everyone around her. I know you’ll find her an exceptional delight to communicate with.

Jessica Nelson. Jessica was formerly an emergency medical technician—a paramedic. Because of her experience with technical medical instruments, she’s become skilled at working with the instruments we use to do metabolic evaluations.

Jessica will assist me in several ways. She’ll make sure that patients are properly prepared for their metabolic evaluations, and she’ll test patients with indirect calorimetry and bioelectrical impedance. She’ll also perform part of patients’ physical exams.

In our professional building are some older men and women who don’t exercise, don’t eat a wholesome diet, and don’t take nutritional supplements. In view of their risky lifestyle, they’re reportedly feeling great solace that a paramedic now works in the building.

Front Desk Assistant. As some of you know, I’ve had problems in the past with front desk assistants. Tammy is in the process of resolving those problems. She’s presently screening applicants for the assistant’s position in our clinic. Her skill at selecting and managing personnel assures that we will soon have someone who’ll do extremely well taking care of our patients’ needs at the front desk.

A few years back, I decided to stop providing metabolic rehabilitation for patients. My reason was twofold: First, partly because of the spread of my research and publications, many physicians across the U.S. and in other countries had begun to treat patients with integrated metabolic therapies. Since many doctors were providing these therapies, fewer patients had to come to my clinic. Because of this, I was doing more long-distance consultations and felt I could suspend treating patients.

Second, I had become intensely interested in using the new indirect calorimetry on the market and other high-tech equipment for evaluating a patient’s metabolic status. So, I decided to limit my practice to metabolic diagnostic testing and the long-distance consultations. Because I was no longer spending the enormous amounts of time involved in designing individualized metabolic regimens and guiding patients through rehab, I was able to reduce the metabolic evaluation fees. Many more patients came in for an evaluation because of the lower cost. They were happy and so was I—for a while.

A Prompt for Redirection. After some six months, it became obvious that many patients weren’t getting the treatment I’d expected they would. They called or wrote and complained. Many times, I heard statements such as this: "Okay, I know from your testing that my metabolism is abnormally low, but I can’t get my doctor to treat me the way you describe in your books and articles. I even have a copy of The Metabolic Treatment of Fibromyalgia, but I can’t get my doctor to read it. What am I supposed to do now?" Because of these complaints, I stopped the diagnostics-only practice and went back to providing full metabolic rehab.

After doing this for a while, I became aware of several problems. We were offering metabolic testing only as a part of the larger metabolic rehab process. Many people just want the testing done or can’t afford what we must charge for full metabolic rehab (a labor- and time-consuming endeavor). As a result, many patients were being deprived of the physiological testing they wanted.

In addition, providing metabolic testing only bundled up with metabolic rehab deprived me of something that, as a research scientist, I crave—follow-up test data on patients I’ve evaluated who’ve undergone metabolic treatment. The metabolic rehab protocol I developed works well for most patients who are guided through it properly. But where are the follow-up test results to prove it?

Until now, for patients to get follow-up metabolic testing, they had to pay the full initial fee again. Few of them went for that option. As a result, I have too little data from follow-up testing to statistically analyze and publish. And without that data, it’s hard to convince a many other doctors to provide their patients with metabolic rehab.

Remodeled Practice Procedures. With Tammy’s help, I’ve remodeled our clinical procedures. In doing so, we’ve kept in mind that we want metabolic testing to be available to as many people as possible—even if they don’t want to go through metabolic rehab.

From now on, patients have the option of simply undergoing testing to determine their metabolic status. They won’t be required to undergo the more costly metabolic rehab. Metabolic rehab is now optional. Jessica will do most of the testing. This will free me up to do the interpretation of test results and to spend more time interacting with more patients.

Physiological Tests. When you come to the clinic for a metabolic evaluation, you’ll undergo physiological testing. The tests include a physical exam, measurement of your height, weight, assessment of Achilles reflex speed, an algometer tender point exam, indirect calorimetry (to measure your resting metabolic rate), and bioelectrical impedance (to learn the composition of your body). If you only want to know whether your metabolic rate is normal or abnormal, the physiological testing is all you’ll need.

Lab Tests. Metabolically-related lab tests are important for a particular reason: I can use the results to determine the most likely cause of an abnormally fast or slow metabolic rate. The lab tests are necessary if you want to go through metabolic rehab. If you prefer not to undergo metabolic rehab, you can choose whether or not to include lab tests as part of your metabolic evaluation.

If you want to include lab tests, and you have a doctor who can get the fees for the tests reimbursed by your insurance company, just get a copy of the results to us. If you want me to order your lab tests, however, I’ll be happy to do so. You can go to our Boulder medical lab.

Metabolic Rehabilitation. You can come to our clinic for full metabolic rehab if you wish. With this option, you’ll have the physiological tests, lab tests, and I’ll spend time with you afterward. I’ll then design a program of metabolic rehab that’s individualized to meet your particular needs. As in years past, one important factor in determining the design of your treatment regimen will be whether you are hypothyroid or thyroid hormone resistant.

If you don’t have a local doctor to prescribe for you, you can see my cotreating medical doctor here in Boulder. He’ll prescribe any necessary medications.

Menu of Services. For the full menu of services and fees, please communicate with Tammy Carter. You can reach her by phone at 603-391-6061 or by email at Tammy@drlowe.com.