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Drs. Bagheri and Talieh have both served as the lead physicians in several different clinical settings ranging from directing intensive care units to geriatric programs for major medical group, hospice re-organizations as well as running home care programs in major metropolitan areas. This means than when other physicians in the group encountered complex cases, patients with puzzling and unusual health problems and failure to respond to standard therapies they would refer their cases to us for a second opinion.
Physicians who call us are at times younger, less experienced physicians who are encountering their first major complication or puzzle they can not quite fit together. At times the physicians have the same if not more training and experience than we do. However, as we have discovered through our own experience in supervising other physicians the unique ability to navigate the complex maze of symptoms, findings, lab and radiographic tests and the differing opinions from different sources has little to do with education, training or experience level. It requires a unique mix of talent, ability, interest and open-mindedness. Of course, as with any professional exercise, specially medicine, caring about the outcome and the determination to find the answers and help another individual is the primary characteristic that allows us to provide the service we are offering here effectively.
All cases referred to us for second opinions are reviewed by both physicians in great detail. Additionally, they are further reviewed in weekly meetings with Dr. Conway in order to obtain a different perspective (naturopathic approach) on diagnosis and treatment of these complex cases. Subsequently, all opinions are transcribed and sent to you with appropriate recommendations for further testing or treatment. Although we can not provide treatment without actually seeing the patient and becoming the treating physicians we can provide valuable opinions that can be subsequently shared with your physicians. We can however proceed with facilitating appropriate testing or recommending supplements that may be highly effective in reaching a final diagnosis or treating a suspected condition.
Opinions are almost always sent to you within one week of receiving your records. Responses will be elaborated in simple, easy to understand terms so you can completely comprehend our opinions regarding your condition. In addition, a concise summary of our conclusions will be included so that you can share our impressions of your condition with your health care providers.
We sometimes recommend further laboratory or radiographic testing that you may again recommend to your healthcare providers. frequently, we can also order these tests for you. We also provide the option for you to submit your blood, urine, saliva or hair samples for analysis in our CLIA certified state of the art laboratory facilities at your discretion.
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Virtually anyone can benefit from our services. Even the healthiest of individuals who just went to his/her annual physical and had a borderline abnormal cholesterol level can benefit from having a second set of eyes evaluating the borderline abnormal lab test. Question would be if there is any further intervention or testing that can improve long term outcomes and/or was th eoriginal test interpreted and treated appropriately or not. Another individual who is basically healthy but takes one or two medications for mild, chronic disorders can benefit from having a second look at his/her medical issues to see if she can do without the medications or have further work up to discover and treat the underlying disease rather than being subject to taking medications long term to treat the symptoms of the disease. Of course, the most complex and challenging individuals usually suffer from many ailments, likely related to oe another, and take multiple medications and treatment every week. These individuals could benefit most from getting a second opinion since their illness has taken the highest toll on their lives and can make the most impact.
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Many individuals with complex medical problems end up spending an inordinate amount of time going from one physician’s office to another, from one lab to another, from one imaging center to another only to end up frustrated. At the end of the day either the diagnosis has been incorrect all the while, the treatment suboptimal or the necessary tests never ordered to reach the correct diagnosis. In the process the life of the individual has been altered and a once normal life has been transformed to that of a “patient”.
The downside of going to multiple specialists would be that if they are a hammer they will treat you as a nail. If you suffer from fatigue and you go see a Lyme specialist, then you are likely to walk out with the diagnosis of Lyme. If you suffer from fatigue and see a mitochondrial specialist then with all the same symptoms and lab results you will get a diagnosis of mitochondrial damage. If you see a neurologist with special interest in MS then you get a diagnosis of MS and if you see one with special interest in myopathy you get needles placed in various parts of your body and have an electromyogram and get a diagnosis of myopathy. All the while all treatments for these conditions are long term, toxic and often unrewarding except in making you a long term patient. In the process transforming the life of a previously healthy individual into a long term/full time “patients”.
We hope that our services will provide some continuity by integrating all aspects of care and providing a concise view of our clients’ condition once all the aspects of care and testing have been summarized. It is difficult for even the best of physicians to provide an objective diagnosis when they have been seeing a patient for years. They often get locked into the impression they had on day one that may have been confirmed by consultants and specialists. Many incorrect diagnoses are the result of one opinion generated on one occasion subsequently perpetuated blindly by everyone who followed. In today’s busy medical environment where physicians have to see 20-30 patients a day it is often easiest to go with the flow and not rock the boat.
We do not misrepresent ourselves. We offer opinions and not actual treatments. We would be happy to provide direct care for patients who come to our clinic but we can only render recommendation through our Internet service. Your physicians would have to comply with our recommendations before you can get the tests or medications we recommend. An exception to this rule would be if testing were done in our lab or in facilities in and around San Luis Obispo California where we practice and have privileges as providers.
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Simple laboratory test review and evaluation: This is the most basic service we provide and involves evaluation of one set of laboratory test results and commenting on the appropriate management based on these lab tests alone without considering any other variables. This type of limited evaluation is best suited for simple medical problems such as isolated elevated cholesterol, anemia, borderline elevations of liver enzymes and other simple laboratory abnormalities. This is best suited for those who are basically healthy but have an abnormal blood test. Cost for consultation $100.
Complex laboratory test review and evaluation: This is the next level in laboratory test evaluation with review of several sets of laboratory tests to be evaluated over time. This would also include a one paragraph summary provided by the patient describing ongoing symptoms and signs that he/she is experiencing. Cost for consultation $250
Complex review of history as well as laboratory and radiographic testing: complete medical records to be provided by patient will be reviewed in detail. All labs, X-rays, EKG’s and other information provided by patient will be reviewed by physicians individually and then discussed in a group meeting. Feedback will be provided by one of the physicians in writing within a week of receiving medical records. $500
Complex review of history as well as laboratory and radiographic testing as well as obtaining medical history and information from up to two sources: All above services but in addition we will take responsibility for obtaining medical records from two different sources. This will require a written consent from you authorizing us to obtain these records from hospitals, labs, imaging centers, physician offices, … $750 plus any fees required by these facilities to release records.
Complex review of history as well as laboratory and radiographic testing as well as obtaining medical history and information from up to two sources and compiling all information on CD for future reference: $1000 plus any fees required by these facilities to release records Obtaining medical history and information from up to two sources and compiling all information on CD only: $250
Case Management: $500 a month
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