What to expect at your visit with me

• Intake/New Patient Visit:
  Your first visit with me is a deep dive into your health story during a 1.5 hour appointment. Mast cell disease can impact nearly every system in the body, and symptoms often mimic or overlap with other conditions. To provide you with the highest level of care, I take the time to understand your full medical picture, not just one or two aspects of your health.

  Before we meet, I will thoroughly review your medical history, so it’s vital to ensure Clinical Paradigms receives your records at least 1–2 weeks prior to our appointment. This includes:

  • Most recent visit notes from your primary care provider and specialists (e.g., hematology, gastroenterology, cardiology, rheumatology, neurology, dermatology).

  • Lab results and diagnostic tests from the past 2–5 years.

  If you already have a diagnosis of SM, CM, HaT, or MCAS, I will carefully review your previous workups to ensure we can build on your current care plan.

  Our 1.5-hour private Zoom appointment is a space where you can share your experiences and feel truly heard. I will:

  • Listen to your story in depth to understand how mast cell disease may be affecting you.

  • Explore your symptoms across multiple systems, considering how they connect to your overall health.

  • Collaboratively set health care goals and create an initial plan to improve your quality of life.

  This is more than just a medical appointment - it’s a partnership where we uncover the patterns in your health and work toward meaningful solutions.

  Fee: $700 (includes comprehensive chart review and 1.5-hour appointment).
  

• Follow-up Visit:
  Follow-up visits are an opportunity for us to connect, review your progress, and ensure your care is on the right track. During our 1 hour appointments, I’ll dedicate my full attention to understanding how you’ve been doing and addressing any new developments in your health.

  Together, we will:

  • Discuss your progress and evaluate how treatments are working for you.

  • Review new symptoms, lab results, or other changes since your last visit.

  • Adjust your care plan to continue moving toward improved stability and quality of life.

  • Most patients see me every 3–4 months as we fine-tune their care. Once your symptoms are well-controlled, visits can be spaced to every 6 months or even annually, depending on your individual needs.

  Beyond treatment adjustments, I strive to empower you with education about the interconnectedness of your mast cell disease and other health issues. Together, we’ll explore how your treatment approaches—including pharmacologic and non-pharmacologic options—can support your overall health. My goal is to give you the knowledge and tools you need to manage your condition with greater confidence and independence over time.
  This empowerment can help you move toward a more joyful and relaxed life, freeing you from the constant fear of "what ifs" or setbacks from unpredictable reactions.

  Fee: $350 per hour.

• Setting Expectations for Your Care:
  I am deeply committed to providing thoughtful, personalized care during our visits. My availability is focused on providing excellent care during scheduled appointments.

  • At Clinical Paradigms, we are proud of our collaborative team approach, and while the team works together to support patients and providers, there is often only a single office staff member assisting with scheduling, managing communications, faxing forms, and other administrative tasks for the entire practice. I work from a home office and do not have personal staff assisting me directly.

  • For questions or concerns between visits, you are always welcome to reach out through the patient portal. While simple questions can often be addressed promptly, more complex concerns may require a real-time conversation to ensure I fully understand your needs. In these cases, I may recommend scheduling a brief 20–30 minute follow-up visit or addressing the matter during your next scheduled appointment.

This approach allows me to balance my commitments as a provider, educator, and advocate for mast cell disease care, while sustaining my ability to offer thoughtful, high-quality care to all my patients over the long term.

I hope this approach aligns with your expectations and empowers us to work together in a meaningful, effective way. Please note that I provide fee-for-service care, which covers the time and expertise during our scheduled appointments, but does not include ongoing concierge-style availability between visits.

By setting these boundaries, I can continue to provide the highest level of care while contributing to the education and advocacy necessary to improve care for all mast cell disease patients. Thank you for your understanding and trust!

• Next Steps if Mast Cell Disease is Unlikely:

  • If you come to me seeking a workup for a mast cell disorder and, after thorough evaluation, we determine that your symptoms are unlikely related to mast cell disease or another allergy/immunology diagnosis, I will work with you to help identify the appropriate next steps. In some cases, I or your primary care provider may refer you to another medical specialist or field that can provide more targeted care for your condition. My goal is always to guide you to the right treatment, ensuring you receive the care you need.

• Why I Don’t Accept Insurance:

  The level of care I provide requires significant time, thought, and preparation—something insurance-based models don’t support. By working outside of insurance, I can dedicate the time necessary to holistically evaluate and care for you, without the constraints of rushed appointments or limited scope.

  This model allows me to deliver truly personalized, high-quality care and focus on what matters most: helping you achieve a better quality of life.

Local Healthcare Support & Provider Collaboration
for Your Best Health Care

Since I am seeing patients via telehealth only, it's important to have local healthcare providers who can assist with necessary in-person care. This typically includes support from a local allergy/immunology office for skin testing, allergy shots (immunotherapy), or certain biologic medications. Additionally, if your evaluation requires an in-person physical exam, such as for moderate to severe asthma exacerbations or possible pneumonia, you will need to coordinate with a local provider for that care. Collaborating with trusted local providers to ensure comprehensive care has always been my approach for patients receiving telehealth services.