What a First Appointment Involves
People arrive at a first appointment unsure whether they are about to be sold something. Knowing the shape of it in advance removes most of that, and it also lets you judge whether what you get matches what was described.
Before you book
A discovery call comes first. Fifteen to twenty minutes, no charge beyond the stated fee, and the only purpose is to establish whether this is a sensible fit.
It should end in a clear answer, including no. If what you describe needs a cardiologist, a gastroenterologist or urgent conventional investigation, that is what you should be told, and being told so is the service working rather than failing.
The first appointment
The history, which is most of it
Expect sixty to ninety minutes, and expect to do most of the talking. Not just current symptoms but when each one started, what else was happening at the time, what has been tried, what helped and what did not.
Also sleep, food, movement, bowels, cycle, stress, alcohol, work, and what you are carrying outside your own health. These are not small talk. The pattern usually sits in the history rather than in any test, and that is why the appointment is long.
Your existing results
Bring everything you have, however old. Previous results matter enormously, because a value drifting across five years tells you something a single reading cannot.
Testing, if it is warranted
Usually standard panels first: full thyroid rather than TSH alone, ferritin as well as hemoglobin, vitamin D, B12, HbA1c, fasting insulin, lipids, inflammatory markers. More specialized testing only where the history points somewhere specific.
Every test should come with a reason and an answer to "what would we do differently depending on the result?" If that question has no answer, the test is not worth running.
What you leave with
Usually one or two things to start immediately, any testing requests, and a clear sense of when you will next speak. Not a twelve-point protocol. Changing eleven things at once means learning nothing about which one mattered.
Follow-up
Results get reviewed properly rather than emailed with a one-line comment. From there the plan is adjusted, and this continues over months, because that is how long these things take to shift.
Anyone promising transformation in four weeks is describing marketing rather than medicine.
How to get the most from it
- Track symptoms for two weeks beforehand, roughly is fine
- Bring every previous result you can find
- List current medication and supplements, including doses
- Decide what a good outcome would actually look like for you
- Be honest about alcohol, sleep and what you actually eat. Nobody is judging, and inaccurate information produces an inaccurate plan
Signs a first appointment has gone wrong
- A large test panel ordered before the history was taken
- A supplement package presented at the end of the first visit
- A multi-thousand program required before anyone knows what is wrong
- Advice to stop prescribed medication without involving the prescriber
- No mention of your other clinicians
