TWR Posted March 15, 2015 Share Posted March 15, 2015 Has anyone worked at one of these in TX? Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted March 15, 2015 Moderator Share Posted March 15, 2015 I know a guy who graduated from my program but in a different class year who runs a testosterone clinic- not sure if it's the "Low T" brand clinics I've seen. He seems to like it from both a financial and personal satisfaction standpoint- and those two things do seem to be somewhat mutually exclusive from listening to him talk about it. I admittedly know extremely little about this phenomenon, but the way it's exploded here there has to be some shady practice going on Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted March 15, 2015 Moderator Share Posted March 15, 2015 I know a guy who graduated from my program but in a different class year who runs a testosterone clinic- not sure if it's the "Low T" brand clinics I've seen. He seems to like it from both a financial and personal satisfaction standpoint- and those two things do seem to be somewhat mutually exclusive from listening to him talk about it. I admittedly know extremely little about this phenomenon, but the way it's exploded here there has to be some shady practice going on I'm guessing everyone tests low and needs expensive supplementation only they can provide... Link to comment Share on other sites More sharing options...
gbrothers98 Posted March 15, 2015 Share Posted March 15, 2015 Of course everyone tests low or low in the range. This is a money grab just like Phen/Fen in the 90s. Testosterone is expensive. Insurance companies wont cover the cost dependent on legitimate diagnosis. This can be an all cash business which is why it is popular. It is also low maintenance. No one at a low T clinic is going to mess around with the usual comorbidities, that takes time and thought. Go to your PCP for that. Come in weekly, get your shot, answer questions about side effects and other concerns, swipe your credit card, see you next week. What a scam. G Brothers PA-C Link to comment Share on other sites More sharing options...
SocialMedicine Posted March 16, 2015 Share Posted March 16, 2015 take home points ... direct to consumer advertising of pharmaceuticals is powerful and will impact the practice of medicine... make sure the clinic is following evidence based medicine and standard of care in the absence of robust evidence i would be uncomfortable working in a clinic that started T on those with normal values i do not feel medicine understands at what age T should just be allowed to decline and when it is not ideal to replace if all you do is work in a low T clinic your broader skills will suffer and make you less marketable if your career interests change that being said I am sure some of these places pay big dollars especially if you create the salesmanship they need Link to comment Share on other sites More sharing options...
browndog Posted March 16, 2015 Share Posted March 16, 2015 What about the increased risk of CVD associated with HRT? Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted March 16, 2015 Administrator Share Posted March 16, 2015 What about the increased risk of CVD associated with HRT? What about it? That's what informed consent and insurance are for. Ethical provides who really care about patient wellness are simply not attracted to one-trick quick-fix get-rich schemes. Link to comment Share on other sites More sharing options...
cc56 Posted March 19, 2015 Share Posted March 19, 2015 As someone who takes testosterone in his early 30's, I don't think it is necessarily a gimmick. I tested at 219, with VA standards that is the lowest number that is "normal". I think everything can be a gimmick, but they probably are providing benefit for guys. It made a difference in my life. I think of it like pain clinics. Some treat true chronic pain patients who benefit from meds, others are a cash only pill mill for addicts. Link to comment Share on other sites More sharing options...
sk732 Posted March 19, 2015 Share Posted March 19, 2015 I can honestly say I've encountered three people that truly had testosterone deficiency issues - one with panhypopituitarism, one with Kleinfelter's and the other I found due to depression that wasn't responding to a variety of antidepressants. I used to get a lot of folks in primary care coming in looking for that magic hormonal cure all for all their ills, because they didn't want to hear that largely they're not well because they're not looking after themselves, aren't eating and sleeping properly, are overweight and/or maybe the problem is between their ears. They'd get upset when the test results showed that, indeed, most of their ills may have been self induced. Frankly, in Canada, public advertising for prescription drugs is technically illegal...though we do get quite a bit from American TV. I do believe it should be banned - would make our lives an awful lot easier than having to explain why someone doesn't need what they've come demanding, thinking we're nothing more than McDonald's. It's better and easier, for me anyway, to chat with the person, hear what's ailing them, examine and order APPROPRIATE labs/tests, and treat based on what the findings of everything are. Less time wasted, and the time that is, is time well wasted. Makes the relationship better for both parties, since the person airs their concerns, gets a proper looking over, then gets what they really need vice what they really want. I'm not against pharmaceutical companies per se, just how they go about business sometimes. $0.02. MM Link to comment Share on other sites More sharing options...
jmj11 Posted March 19, 2015 Share Posted March 19, 2015 I've been to High Tea in Vicotria, BC a few times. Does that count for anything? Link to comment Share on other sites More sharing options...
sk732 Posted March 19, 2015 Share Posted March 19, 2015 "High Tea" sometimes has other connotations in BC ;-). sk Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted March 19, 2015 Moderator Share Posted March 19, 2015 I've been to High Tea in Vicotria, BC a few times. Does that count for anything? probably at the Empress, yes? High-T at the empress is not a bad thing... Link to comment Share on other sites More sharing options...
sk732 Posted March 19, 2015 Share Posted March 19, 2015 No it is not. Been a long time since I've been there. SK Link to comment Share on other sites More sharing options...
jmj11 Posted March 20, 2015 Share Posted March 20, 2015 probably at the Empress, yes? High-T at the empress is not a bad thing... Yes, with the pinky extended and the whole ball of wax. So to digress these posts. Link to comment Share on other sites More sharing options...
SocialMedicine Posted March 23, 2015 Share Posted March 23, 2015 it is not a gimmick if you have low testosterone and have had a proper work up as to why and treated with hormone if appropriate. it is a gimmick when you feel tired or not as sexual with a testosterone of 500 and pay $200 every 2 weeks for an injection which may have negative health consequences and a placebo effect. Link to comment Share on other sites More sharing options...
BruceBanner Posted March 23, 2015 Share Posted March 23, 2015 Of course everyone tests low or low in the range. ... This can be an all cash business which is why it is popular. ... What a scam. G Brothers PA-C ^He's right. About 6 months back I was on the cusp of taking a job with a Low-T clinic (different brand, same thing). They "specialized" in men's sexual health; which amounts to testosterone, oral PDE-5 drugs, and injectable erection drugs. I started a thread on it I believe. These businesses have the potential to be a HUGE cash cow. The owner/proprietor told me the only reason he got into it was his brother was the accountant for this family of clinics on the east coast, and basically told him 'you gotta see these books...these guys are making a killing'. So how it works is they attract cash payers--typically wealthy middle-aged men--and charge them a low initial consult fee, get them tested, tell them they fall in the "low" range, and then get them on an expensive all-inclusive treatment plan. The clinic buys the drugs wholesale somehow and keeps them onsite for dispensing, or has a deal with the distributor and does it via mail order. So they rake in a few grand per patient on an annual treatment package, then make a killing on the drug markup. Sex sells, ED/low T are chronic problems, and they have these guys on the hook. These clinics also attract the recreational and professional bodybuilding crowd who have steroid-induced low-T, or are in the low-normal range and just want to get legit hormones for personal use. Saying no to that job was probably the best career decision I could have made. It sounded like a fun gig on paper, but it would have gotten me nowhere as a PA. And it would've gotten old pretty fast. There is minimal brainpower involved. Link to comment Share on other sites More sharing options...
SocialMedicine Posted March 23, 2015 Share Posted March 23, 2015 I have no problem with cash cows in medicine at least how I understand the word. if you have a business model that people enjoy and provides quality healthcare why not get paid well for it. However, when you prescribe medicine outside of evidence or sound theory then it becomes concerning to me. Medicine lacks innovation and change ... I actually welcome more of a business model in medicine especially when it comes to delivering patient services. Link to comment Share on other sites More sharing options...
BruceBanner Posted March 23, 2015 Share Posted March 23, 2015 I think low-T clinics are bordering on irresponsible practice. The data on TRT is looking better in terms of CV risk, but we still don't have solid guideline on when to initiate androgen therapy. Making money is great, but the problem is making money on a fee-for-service basis can influence care. E.g.---raising the androgen therapy threshold. Link to comment Share on other sites More sharing options...
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