About the Practice

Practice Philosophy

In today's health care system, treatment of the isolated symptoms of disease, often after it is already well-established, seems to be the norm.  This is the basis of what traditional medical education teaches doctors.  And this type of medicine definitely has its place.  The excellent medical training we have received will always remain the foundation of our practice. 

However, we have decided to focus our practice on what we call functional medicine.  Functional medicine is a personalized approach to medical care that deals with primary prevention and underlying causes instead of isolated symptoms.  It is grounded in the principles of biochemical individuality, patient-centered medicine, the dynamic balance of internal and external factors, and the web-like interconnections of all body systems.  Some of the core clinical imbalances we look at include:  hormones, neurotransmitters, oxidation and reduction, detoxification, inflammation, immune system, digestive system imbalances, and structural imbalances.

We will offer you what is most likely a different approach to the symptoms you may be experiencing as well as hopeful prevention of disease and disability in the future.  We cannot promise to stop the ticking of the clock – otherwise known as aging.   However, we can help you age better, with improved health, vitality, and quality of life.  And most likely this will result in healthier, happier years added to your longevity.  That is where the term “Anti-Aging Medicine” comes from.  

The Anti-Aging/Functional Medicine movement is currently taking the world by storm.  By the thousands, unsatisfied doctors and patients are trying new, more natural, and more functional approaches to health maintenance and aging.  We are part of this movement and wish to bring that spirit, innovation and excitement, with all of its possibilities, to our patients.  However, please keep in mind that you will still need to retain your primary-care doctor, as well as any specialists you see.  And you may wish to inform your regular physicians of any treatments we prescribe to you so that they are aware of any potential interactions with treatments they may be prescribing for you. 

Your First Appointment

Things we need from you in order to provide the most comprehensive care for you (if possible):

1. Copies of any medical examinations you have had within the last year
e.g.: pap smear, mammogram, documented breast exam (for women), EKG/ECG, any laboratory  or diagnostic testing (including hormone or nutrition testing), colonoscopy (or stool occult blood, sigmoidoscopy), any xray/MRI/CT scan/ultrasound or other imaging, bone density testing, PSA testing and prostate examination (for men).
Basically we are interested in any information that will help us have a better overall picture of your health and health history.

2. Please download, print out the hormone symptom questionnaire and new patient information sheet from my website (see the Forms page), fill them out, and bring them with you to your first appointment.

3. A detailed supplement and medication list (both over-the-counter and prescription) OR bring them with you in a bag to your appointment.

What You Can Expect From Us

If you have PPO-type insurance plan (not an HMO), we will be happy to submit a bill for the office visit charge on your behalf to your insurance company. However, keep in mind that we are not an “in-network” provider for your insurance company and so there is a chance you have a different “out-of-network” deductible to satisfy before your insurance will kick in.  We do collect payment in full at the time of service.  However, you will be reimbursed if we receive any payment from your insurance company.  Most of the time the insurance company will send payment directly to you since we are an “out-of-network” provider.

Since this is individualized care, costs will vary depending on what you need and decide to have done.  Most patients will start with hormone balancing, so we will use this as an example.  To be tested for and begin a hormone optimization regimen, figure on approximately $600 for two office visits, anywhere from $0 to around $400 for laboratory testing, and $0 to around $5 per day for bio-identical hormones (more if growth hormone or any nutritional supplements are needed).  Insurance coverage is highly variable, but sometimes part or all of laboratory testing and/or treatment is covered. 

Your initial appointment will take you approximately 1 hour to 1 hour and 15 min to complete.  We recommend you arrive early to fill out new patient paperwork.  We will first take your vital signs, while the doctor reviews your records and questionnaires.  Then one of the doctors will take a thorough history from you, perform a targeted physical examination, and determine which testing should be ordered.  This will take approximately 45 minutes to one hour.  Then one of us will discuss the laboratory testing options with you – there are many options depending on what your insurance coverage is and what needs you have.  The cost for this first visit is $350.

Hormone labs take approximately 2 weeks to complete.  Once we have the results one of the doctors will review them and we will call you to schedule your second appointment.  Your second appointment can be at the office or on the telephone and should take approximately 30 to 45 minutes at a cost of $250.  We always prefer to see you in the office, but if you live far away, we can accommodate you by doing the visit over the telephone.

Ongoing Care

If you decide to begin our recommended regimen, we will offer you a brief follow up appointment in 2 to 3 weeks just to check in and make any adjustments to the regimen based on symptoms. 

We will re-test you approximately 4 to 6 weeks after you feel like you are stabilized on your first regimen.  If there are adverse symptoms or adjustments that need to be made right away, based on how you feel, we will attempt to do those adjustments first, and stabilize you for a full 4 to 6 weeks before re-testing. 

One of the doctors will be available by email or telephone for brief questions during your start up time on this new regimen.  We will not charge you extra for the occasional short email here and there.  However, if we really need a bona-fide appointment on the phone or many, many emails, we may need to charge a small fee for the time. 

We will have a follow after the second round of testing is completed.  This process is what we call a quarterly or semi-annual follow up visit – and the cost for these visits is anywhere from $175 to $250 depending on complexity and amount of material to cover.  You should count on a few of these tests followed by office visits to occur before you achieve complete hormonal balance.  It may take up to a year to get you feeling totally right.  This is mainly because we do not have a snapshot of what your levels used to be when you felt great – so we must do a bit of “trial and error” to get you to where you need to be. 

After you are totally in balance, I will need to see you approximately once or twice per year to check on you.  I need to do at least one in-office exam and visit with you per year in order to comply with the law.  If you only come in once a year the visit charge will be $350 simply due to the amount of time necessary to catch up on your history and the length of time required for your visit.

We also ask that you to continue to forward us copies of the medical exams and tests that your other doctors perform as part of your routine care so that your chart and health-maintenance screening stays up to date (pap smears, mammograms, colonoscopy, EKG’s, etc.).

A Word To The Wise

Much of your success as a functional medicine patient depends on your level of communication, your knowledge of your body and it's responses to the new regimen, and how complex your issues are.  To the greatest degree possible, try to be a detective and write down or pay attention to what things make you feel better or worse, and when.  Then share these with us at your next appointment.

If you have any questions ahead of your appointment, feel free to contact the office or email us.  We are very much looking forward to meeting you in-person soon and helping you feel your very best!

At Medical Age Management, our goal is to help you slow or eliminate the unwanted aspects of aging, so that both your inner and outer beauty will shine and you will feel healthy and vibrant once again!  Unfortunately the hands of time can slowly chip away at the beauty of your skin and your inner vitality. Years of sun damage and exposure to environmental toxins, declining hormone and nutrient levels can leave you feeling worn out and unattractive. Hot flashes, restless sleep, fatigue, decreased sexual interest, difficulty losing weight or building muscle – these are just a few of the things that can be eliminated with the proper medical treatment. We will correct deficiencies in skin volume and skin tightness, wrinkles, discoloration, and unwanted marks using state-of-the-art aesthetic dermatologic procedures. To compliment your treatments and help you care for your skin at home, we offer a complete line of medical-grade, nourishing, protective, and rejuvenating skin care products. Your physical wellness will be improved through careful attention to nutrition and physical activity, as well as balancing and optimizing your body’s hormone systems. Bio-identical hormone replacement and nutritional supplementation is used, as needed, to return your body to the most youthful state possible. This type of medical care is not a “one size fits all” program, so you will note a distinct lack of “packages” in our office. Dr. Farnesi completely customizes the care for each individual, based on his or her needs and budget. This allows you to take full advantage of the latest research information and best medical technology, without breaking the bank or paying for services that you don’t need. Plus, more and more health insurance companies are recognizing the value of preventive, pro-active care. So some services may be covered by your medical insurance plan. You will feel immediately at ease with Dr. Farnesi and our warm, inviting office environment. To better serve you, Dr. Farnesi offers some Saturday, evening, and early morning hours. Call or visit us today and discover the life behind Medical Age Management. Your age is just a number. Don’t let it slow you down!