FAQ's: Dr. Hoffman's Practice

Does insurance cover visits to Dr. Hoffman's Practice?

Sometimes yes, sometimes no. That is to say, many patients obtain substantial or partial reimbursement of the fees they pay to Dr. Hoffman's Practice, depending on their insurance policies. However, we do not accept insurance "assignment", and we do not file Medicare claims.

There are several reasons we no longer participate in medical insurance programs. First of all, they drive up costs for patients who are not insured. Many doctors who play the insurance game knowingly hike their fees, so that steeply discounted reimbursement by insurance companies will still cover their costs. In the backrooms of doctors' offices, expensive ancillary administrative staff then pores over codebooks and negotiates painstakingly over the phone with insurance company personnel to secure often-meager reimbursement for patients. This adds substantial hidden costs to your medical care which don't translate to improvements in the actual quality of your treatment.

Secondly, keying medical practice to insurance payments steers doctors to conventionally recognized, reimbursable procedures, to "mine" for insurance dollars. We believe that patients should be entitled to the highest standards of care, regardless of cost-influenced decisions made by insurance company bureaucrats. Thirdly, while some progress is being made in recognition of complementary modalities, insurance companies and government programs like Medicare lag behind in recognition of such efficacious therapies as nutrition, chelation, and environmental medicine.

We will however endeavor to cooperate fully in giving you appropriately coded medical bills and supportive documentation so that you can submit them to your insurance company. Where required, Dr. Hoffman and his staff will prepare detailed letters explaining and justifying the care we render. In this way, many of our patients obtain reasonable reimbursement. While we do not have a "crystal ball", you can inquire when you make your first appointment as to whether patients with your type of insurance are successful at cost recovery. Sometimes, the costs of supplements or special foods can be applied as health expense tax deductions (consult your professional accountant for the latest tax provisions). Wherever possible, costs can be minimized by coordinating with patients' existing insurance coverage by using participating laboratories.

Does Dr. Hoffman see all patients himself?

It is Dr. Hoffman's goal to keep care at the Practice direct and personalized. To this end, Dr. Hoffman sees all patients, and he directly supervises their care personally. Dr. Hoffman makes use of a small tightly integrated and carefully selected group of health practitioners in a team approach to patient care. Patient's cases are discussed daily with Dr. Hoffman and in scheduled medical rounds and conferences to insure proper individualization of care. Dr. Hoffman is available to review patients, progress at regularly scheduled follow-up appointments.

Do patients at Dr. Hoffman's Practice have to drop their medications to participate?

Most definitely not. The ultimate goal for many patients is decreased reliance on medications with their inevitable side effects. But INTELLIGENT MEDICINE calls for the concerted deployment of rational conventional medical strategies side by side with nutrition, herbs, vitamins, and supplements. In addition, it may take time for alternative strategies to kick in; meanwhile conventional drugs are required to hold the line on such chronic conditions as high blood pressure, high cholesterol, or colitis, for example.

How much does a workup at Dr. Hoffman's Practice cost?

There is no set fee for an initial visit with accompanying tests because workups are individualized at Dr. Hoffman's Practice. Some patients may require only a few specialized blood tests because their conditions are simple and routine, or they have had very extensive and complete workups prior to visiting Dr. Hoffman's Practice (Patients are strongly encouraged to obtain and bring ALL of their prior test results and medical reports). Others may be encouraged to undertake a new series of specialized tests and evaluations to elucidate the underlying causes of their problems. Therefore, expect to pay at least $1000 to $2800 for the first series of tests and visits. Additional ongoing visits and therapy may entail additonal costs.

How often are patients seen after their initial visit?

For most patients, ongoing supervision and follow-up are important elements for successful compliance and prompt resolution of health conditions. After your initial Results Visit with Dr. Hoffman, you will be asked to schedule visits with our nutritionist and possibly to follow-up with allergy treatments and/or regularly scheduled IV's or chelation. A "Tune-up Visit" with Dr. Hoffman will be scheduled for one month later to monitor your progress. Additional visits with Dr. Hoffman or his staff will be scheduled appropriate to the demands of your condition. Once your goals have been achieved, you may be asked to schedule annual or every six-month visits to assure that you stay well.

Can I talk to someone before my visit to see if it's worthwhile to come?

Yes, it's important for us to identify those patients we can help. Since we take a scientific and rational approach to complementary medicine, we recognize that some patients are not ideal candidates for alternative approaches. For example, a patient desirous of avoiding imminent surgery may wish instead to pursue a course of natural care. Upon consulting with us, we may advise them that it would be preferable to undertake the surgery first, then follow-up with Dr. Hoffman's Practice for a program of restorative care to facilitate recovery and prevent disease recurrence.

Additionally, we want to align patients' expectations with our capabilities. Unrealistic expectations are a major cause of patient dissatisfaction. After nearly two decades of experience in complementary care, Dr. Hoffman knows which conditions respond well to alternative therapies, and how long to reasonably expect it will take to see a difference. While often appearing miraculous in its healing scope, we recognize that complementary medicine is not a panacea, and that sometimes patients would be better off pursuing an expeditious course of conventional medicine treatment.

Therefore, take the time to carefully review this website, and check the Medical Conditions section for a outline of the approach we might take to a condition like yours. Secondly, review your degree of personal commitment to the demanding lifestyle-modification measures we might require of you. Then, if you are not sure if you are a candidate for treatment at Dr. Hoffman's Practice, please call us and ask for a patient care specialist to briefly review your condition and preview the care we might offer if you are accepted as a patient.

What conditions does the Practice specialize in treating?

A wide range of medical conditions is treated at Dr. Hoffman's Practice. Additionally many ostensibly "healthy" patients attempt optimization and prevention through our care. We are particularly good at reversing degenerative conditions linked to poor diet and overweight. Dr. Hoffman's Practice is also a resource for many patients with poorly defined health conditions that have not responded well to conventional medical treatments, or have been deemed by default to be "psychosomatic". We regularly offer supportive care for patients with various forms of cancer-with or without conventional chemo or radiation treatment. The benefits of complementary therapies are established in a wide-range of medical specialties including cardiology, pulmonary medicine, infectious disease, psychiatry, orthopedics, oncology, pediatrics, rheumatology, ob-gyn, dermatology, ophthalmology, urology, gastroenterology, neurology, allergy, infectious disease, and otolaryngology. For specifics, consult the Medical Conditions section.

If I'm not interested in following detailed dietary or supplement recommendations, does it pay to come?

If you are unwilling to make any changes, Dr. Hoffman's Practice is likely not the right place for you. We envision ourselves as Health Coaches. Just as a professional athlete requires expert coaching to attain excellence, so too does a highly motivated and intelligent patient require specific techniques and recommendations to recover his or her health. But the "locus of control" for someone's health is essentially their own, barring emergency circumstances like an outbreak of colitis, or a heart attack, or appendicitis. Under those circumstances, medicine is administered or surgery is performed to "put the fire out". But taking personal responsibility for regulating one's lifestyle is a key ingredient in long-term recovery. We at Dr. Hoffman's Practice can provide expert coaching and be on the look out for the need for appropriate emergency care, but we cannot provide your locus of control. Surrender of your personal autonomy, so common in conventional medical care, is a primitive response to the stress of illness. It is ultimately counterproductive to regaining wellness. At Dr. Hoffman?s Practice, we endeavor to return the locus of control back to you, where it rightfully belongs.

How long does it usually take to see results?

Some patients feel better almost from the time they leave Dr. Hoffman's Practice with their first supplements and diet recommendations. In general it takes a while for chronic medical conditions to yield to natural interventions. A good rule is that the duration and severity of a medical condition predicts the rate at which it will respond. A lifelong condition of fatigue may therefore require a period of months or even years to improve gradually. Bear in mind, however, that soon your worst days may seem better than what you previously considered your "best days."

Remember, too, that the mostly natural therapies in which we specialize do not constitute a "magic bullet", unlike drugs. For example, our treatment for allergies may take weeks to reduce a patient's overall allergy burden using diet modification, environmental cleanup, sublingual drops, supplements, and anti-fungal herbs and medications. By comparison, antihistamines may seem like an appealing quick fix, but they have side effects and stop working when they don't get to the bottom of the problem.

What if I don't get better soon?

Not everyone gets better right away, nor are all conditions amenable to our therapies. Be assured that if you're "stuck" we will endeavor to adjust our therapies to jumpstart your recovery. We are also not reluctant to send patients who do not improve for additional medical workups. If you are not improving, it's important for us to find out why. We may exercise the option to send you to other types of medical specialists to perform tests or deliver therapy that we do not specialize in. An example would be to send a patient with dizziness for specialized "Vestibular Rehabilitation". Another would be to send a patient with fatigue to a high-tech Sleep Lab to rule out such conditions as sleep apnea. If we no longer think we can get you better, you will be first to know, and appropriate referrals will be made to facilitate your recovery elsewhere.

Does Dr. Hoffman's Practice treat children?

Yes. We have considerable experience and success in working with children with allergic conditions like asthma, eczema, and ear infections. Dr. Hoffman has been a pioneer in the complementary treatment of autism and ADD/ADHD, and has authored a book entitled "Natural Therapies for Attention Deficit Disorder". Unfortunately, many children now require care for obesity, Type 2 Diabetes, colitis, and autoimmune diseases like rheumatoid arthritis, conditions formerly seen almost exclusively in adults.

Since Dr. Hoffman is trained in Internal Medicine, it will be necessary for you to maintain care for your child via a Board-Certified Pediatrician or Family Practitioner. But Dr. Hoffman's Practice can add the vital perspectives of nutritional support, and allergy advice and treatment to your child's care. We generally prefer to treat children no younger than three years of age. Often, it is our experience that kids respond even more quickly and dramatically to nutritional care than adults, perhaps because they have had less time to acquire stuck degenerative conditions.

What if I live far away?

While the majority of our patients live in the Tri-state area of New York/New Jersey/Connecticut, many of our patients come from other regions, and a few from other countries. It makes sense for some patients to come a long way because the resources we offer may not be available anywhere near where they live. We endeavor to accommodate long-distance patients by coordinating their visits so that everything that requires their physical presence at our center (physical exams, blood and allergy tests, etc.) can be concentrated into as few initial sessions as possible, sometimes comprising two or three consecutive days at the Practice. To this end, we can help patients arrange convenient accommodations at nearby hotels in Manhattan. Some elect to stay with friends or relatives nearby. Then, when results have been compiled and patients are ready for their results visits, follow-up can be arranged by phone or e-mail. Patients may then sometimes be referred to complementary practitioners in their area for on-the-ground follow-up therapy. In this way, long-distance patients can be treated and monitored for up to several years with infrequent need for repeat visits to New York City.

What if my condition has gone undiagnosed for a long time?

Many patients resort to us for treatment of conditions that have been difficult to diagnose. They may suffer distress, but conventional medicine tells them "We can't find anything wrong with you". The temptation sometimes is to fall back on a psychiatric diagnosis. While we recognize that psychiatric problems often contribute to patients' perception of distress, it is our position at Dr. Hoffman's Practice that many patients are amenable to care and relief regardless of whether they have a clear-cut medically defined diagnosis. The question "Is it real or is it all just in my head?" becomes less relevant when we take into account hitherto unrecognized subtle causes of disease like Mercury Toxicity, for example. While we encourage thorough medical workups and evaluations to make sure that we are not missing a critical underlying problem like hidden heart disease, cancer, MS, or an infectious disease, we still believe that diet, environment, or nutritional deficiencies can underlie diffuse and bothersome symptoms.

Medical diagnoses are merely tools to help us classify patients. But their value is limited because many patients do not conform to ideal profiles taught in medical school. By searching for underlying causes of disease and distress, Dr. Hoffman's Practice often provides hope and relief to patients with challenging and enigmatic conditions.

What if my doctor does not support my use of complementary medicine methods?

Conventional doctors vary in their responses to their patients' wishes to utilize complementary approaches. At best, it is encouraging to report that increasing numbers of regular physicians are learning about the legitimate uses of nutrition and alternative medicine in programs in hospitals and medical schools. Dr. Hoffman feels it is an important part of his work to educate doctors and medical students in these methods. Well-meaning conventional doctors, whether or not they believe in alternative approaches, feel they have a fundamental responsibility to support patients' efforts to seek safe and effective means of getting help where conventional medical is not completely successful.

This being said, there are, however, doctors who actively dissuade patients from accessing complementary help. This may result from a sincere but incorrect belief that complementary methods are ineffective or dangerous, or that they distract patients from the goals of what those doctors feel are definitive conventional medical cures. Occasionally, an element of irrational professional jealousy will intrude. Doctors are occasionally openly contemptuous of their patients' pursuit of alternative treatment modalities.

Patients must recognize that this form of intimidation is contrary to a physician's responsibilities to support the therapeutic relationship. Even if a doctor legitimately feels a patient is embarking on the wrong course, they should refrain from sarcasm or anger in pointing our their objection the patient's choice. And ultimately, a fundamental principle of medicine remains the patient's unalienable right to choose his or her course of therapy. Remember that today's medicine is not "rocket science," nor is it etched in stone. Some of the therapies of just 25 years ago now seem barbaric in retrospect. The recent about-face on hormone replacement therapy that took place in the summer of 2002 is a good illustration. Ultimately, the "difficult" patient who challenges his or her doctor's opinions may turn out to be right!

If, as a patient at Dr. Hoffman's Practice, you feel caught in an uncomfortable "paradigm shift", we feel it is important to communicate. Dr. Hoffman and his staff stand ready to explain our findings and proposed treatment plan to your other doctors. We cannot guarantee that they will wholeheartedly embrace OUR perspective on your health problem, but we pledge to share information in an open, respectful, and forthcoming way. If necessary, we will share scientific evidence with your physician to support their understanding of the care we are offering you. After all, you are engaging in a reasonable and plausible exercise of your right to choose complementary medicine.