[I’m] curious [about] why you wait until the case review to get [a] detailed comprehensive history and background. I would think that those details might help to determine which tests to order.

We get enough of the history in the initial control to determine which tests [to] order. That’s really, in many ways, the primary purpose of the initial consult, at least from our perspective as a clinician, is to determine what tests to order and then order those so that we have them all done when the patient comes in for the case review appointment. I’ve been doing this for 10 years, and still to this day, I consistently get feedback from patients saying that the case review is the most valuable health appointment they’ve ever had because they sit down with you and you’ve done all the testing already, and you’ve spent time going through it, analyzing the results, and creating a report for them. They finally feel like they have an answer to why they’re feeling the way that they feel rather than they come in to see you and you say, “Okay, I’m going to order some testing,” and then they come back for a follow-up, but the follow-up is only 15 or 30 minutes, so you don’t really have time to go over all the test results nor to make a cohesive report and explain everything to them, and so it always just kind of ends up feeling piecemeal after that. So yes, [for] the initial consult, we do 30 minutes. Tracey, my nurse practitioner, does them, and that’s enough for her, but a couple of other clinicians at CCFM [California Center for Functional Medicine] do 45-minute initial consults because they prefer to have [a] longer time to do a more thorough history. So, again, there’s no right or wrong way to do it. You can decide what works best for you. Of course, the case review model with the initial consult and the case review is only one way to do it. It’s a way that has worked well for me. But there are many other models out there, as well, and we’ll talk about some of them in [the] practice management side of the course.