Updated 3/15/2014: We’ve redesigned our clinic procedures to not only make it possible to expand the practice, and hire and train new clinicians, but also to streamline the Case Review process. These changes are described below, and become effective on 3/25/14.
The Case Review is the first step for all new patients. The Case Review process is designed to save money and time in the long-term by performing the appropriate diagnostic testing and evaluation before treatment begins. A cornerstone of Chris’s approach is “test, don’t guess.” Identifying the underlying patterns contributing to disease is the key to a successful and lasting outcome.
The Case Review serves several purposes. It enables Chris to more accurately estimate how long your treatment program will last, what it will include and how much it will cost. It gives you the chance to ask Chris any questions you may have about your condition and what you should expect. And it provides an opportunity for us to get to know each other and determine if our clinic is a good fit for you over the long term.
The Case Review includes:
- A thorough review of your medical history and relevant previous lab work (10 page limit).
- A review of your current diet and nutritional supplements.
- A metabolic and neurotransmitter evaluation.
- A one-on-one consultation to review your results (55 minutes; in-person or by phone/Skype).
- A treatment plan including diet, supplements and lifestyle therapies.
- Recommendations for further testing (if necessary).
The Case Review process is broken into two steps, which are described in more detail below.
Step 1: Initial Consultation
During this 25-minute phone/Skype appointment a Patient Navigator (personally trained by Chris) will interview you to determine which lab tests to order for your Case Review based on your chief complaints and your history. This appointment has two purposes: to make sure that Chris has all of the information that he needs to gain a comprehensive understanding of many of the factors affecting your health, and to give you a head start on your treatment before you meet with Chris.
The exact lab testing ordered after the Initial Consultation depends on your individual circumstances, but may include:
- A comprehensive blood chemistry panel. This is the single most efficient, effective and affordable tool for quickly evaluating your health. It screens for a wide range of conditions, including several types of anemia; gut, viral and bacterial infections; insulin resistance and hypoglycemia; liver and kidney issues; and thyroid and adrenal problems. It offers important clues for how to structure and focus your treatment to get the best results. And it provides a baseline of biomarkers that can be used to objectively track the progress of your treatment over time.
- Additional blood tests for specific conditions, such as high cholesterol, hypothyroidism, autoimmune disease, and gluten sensitivity.
- Advanced stool testing to screen for parasites, fungal overgrowth, bacterial infections, intestinal inflammation, dysbiosis and a deficiency of beneficial gut bacteria.
- Urine organic acids testing to screen for small intestinal bacterial overgrowth, fungal overgrowth, problems metabolizing fat or carbohydrate, B-vitamin status, methylation issues, detoxification capacity, oxidative stress, and neurotransmitter metabolism.
- Saliva or serum hormone testing for adrenal and sex hormone status.
The Patient Navigator will also provide you with the Case Review health history paperwork to complete. It is important that you spend time and energy completing these intake forms as they are vital in helping Chris understand your case. This paperwork includes:
- A detailed health and medical history questionnaire
- A survey of your chief complaints and most important health goals
- An assessment of your most troubling and frequently experienced symptoms
- An evaluation of your metabolic and neurological systems
- A thorough analysis of your current diet
Finally, the Patient Navigator will provide you with dietary guidelines to follow after your Initial Consultation. These are extracted from Chris’s New York Times Bestseller Your Personal Paleo Code as well as his online programs, and include:
- Detailed instructions on how to perform a 30-day Paleo elimination diet (i.e. “30 day Reset)
- Cheatsheets and worksheets to help you implement the 30-day Reset
- 3 weeks of delicious Paleo recipes to help you get started
- A diet diary to help you track your progress during the diet program
It is critical that you implement the 30-day Reset diet to the best of your ability. When you talk directly with Chris, your experience with the diet will be as important as any lab findings in guiding next steps in your care plan.
Once we’ve received your lab results and completed Case Review paperwork, you will move on to Step 2: the Case Review Consultation. This typically occurs between 45 and 60 days after the Initial Consultation, because some of the labs we use take up to 4 weeks to deliver the results to us after receiving your sample. While you wait for your labs to come back, you will be implementing the 30-day Reset diet and making forward progress.
Step 2: Case Review CONSULTATION
Prior to the Case Review Consultation, Chris will review the results from the labs we ordered along with your Case Review paperwork, medical history, diet and supplement survey, assessment forms and relevant prior lab work. He will then create a Report of Findings, which is broken into three parts:
- A summary of the underlying patterns that are contributing to your symptoms.
- An outline of the suggested treatment plan, including dietary, supplement and lifestyle recommendations.
- Recommendations for further testing (this will typically be minimal, if necessary at all, because of the completeness of the Case Review process)
During your 55-min (in-person, or phone/Skype) Case Review Consultation, Chris will personally present his Report of Findings as well as your treatment plan. He will also review all of your test results with you, discuss the results of your 30 day Reset, and answer any questions you have about his findings or the treatment plan.
Once the Case Review is complete, you’ll have follow-up appointments on an as-needed basis throughout the remainder of your treatment plan. (Chris will advise you on the frequency of these follow-ups, based on your progress.)
Case Review Fees
The Case Review is the fastest and most efficient way for Chris to determine the underlying causes of your health problems and design an effective treatment plan. While a Case Review may cost more than a typical initial visit to a physician, it is designed to save you money and time over the long-term by performing the appropriate diagnostic testing and evaluation before treatment begins.
Here is a breakdown of the costs involved in the Case Review, with an outline of when fees are billed so you can plan accordingly.
SUMMARY OF FEES
- Consultation fee: single payment of $995, or two payments of $545 (see below for payment schedule). Includes the Initial Consultation, dietary guidelines, Report of Findings, and 55-min in-person or phone/Skype consultation with Chris.
- Labs: typically $300–$1,500 depending on complexity of condition and level of diagnostics required.
- Supplements: typically $150–$300. You will have the opportunity to approve or decline the supplements Chris suggests before you are charged for them (after the Case Review Consultation).
SCHEDULE OF FEES
- Initial Consultation: after the Initial Consultation, you will be charged for the consultation ($995 as a single payment, or first installment of $545 if you’re on the payment plan) as well as the the labs that Chris orders ($300–$1,500). Total due after the Initial Consultation: $845–$1,995.
- 30 days after the Initial Consultation: second payment of $545 is charged if you are on the payment plan.
- Case Review Consultation (60 days after the Initial Consultation): After the Case Review Consultation, you’ll be charged for follow-up labs (if necessary; $0–$300), and supplements (typically $150–$300). Total due after the Case Review Consult: $150–600.
Grand total for Case Review process: roughly $1,500–$3,000
Follow-up appointments are either 25 minutes or 50 minutes (either in-person, or via phone or Skype). You may choose to have your follow-ups with Chris when he is available, or you may choose one of our staff clinicians that has been trained by Chris. (At present, only 25 minute appointments are available. Once Chris hires and trains additional clinicians, 50 minute appointments will also be available.)
Follow-up Appointment Fees
The fee for follow-up appointments is $175 for 25 minutes or $350 for 50 minutes. Ongoing lab and supplement fees vary considerably depending on the patient and treatment plan.
(One-time, non-patient, phone coaching)
A Health Coaching (HC) Session is a one-time, one-on-one, 55-min phone or Skype “coaching conversation” with Chris Kresser. It is designed for people who are currently under the supervision of a primary health care professional, with an existing plan, but would like some additional, non-clinical, input from Chris based on his unique perspective. It is not meant for diagnosis or prescription, but for exploring the nuances of a situation you are already tackling under the supervision of your own, current, medical professional.
A Health Coaching Session might include:
- Conversation about your current health plan, strategies or protocols.
- Ideas about additional strategies that might complement your current plan.
- Questions that help you more thoroughly think through your current approach to finding health solutions.
- Ideas for new topics or questions you might want to bring up with your primary health care professional or new labs that may be appropriate for you. (Does not include procuring labs)
A Health Coaching Sessions does not:
- Replace the advice of your primary health care professional.
- Give you a diagnosis, prescribe any medication, or order any labs for you.
- Make you a patient in my practice.
- Review your medical history or your lab work or provide follow up
after the call.
You may record your Health Coaching Session and/or take notes. No follow up report, notes, email or follow up phone calls of any kind are included.
A Health Coaching Session is fifty-five (55) minutes via phone or Skype billed at $495.00 at the time of appointment.
How to apply:
Use the link below to apply for a Health Coaching Session. Because of high demand, only 60 Sessions will be booked for this enrollment period. Those 60 will then be offered times over the next 6 months in an order chosen by random lottery.
Please Note: If you are accepted for enrollment in a session, you will receive a Client Procedures & Financial Policies Guide document via email within 12 hrs of being notified of your acceptance. You must sign and return this document within 3 days in order to confirm your spot, or it will be given to the next person in line. This strict 3-day policy facilitates fairness to other clients who are ready and waiting, and is critical to keeping appointment booking flowing smoothly since we always have a very long wait list.