Frequently Asked Questions
Our model is different from traditional concierge medicine because we do not provide "on-demand" access to your doctor, but rather your doctor will work to create a personalized medical plan for you based on your diagnoses, labs, health history, etc.
One way to understand the difference between what we do and concierge models, is that concierge practices are giving a higher level of physician access, while in functional medicine, you will receive a higher level of physician investment. A lot of this time is spent with you during your initial intake and follow-up, but then there are additional hours spent outside of your visit interpreting labs, researching cutting edge therapies specific to your needs, and developing your individualized plan of care to address your health needs and/or diagnosis.
We do provide health coaching, however, to help you make changes in your lifestyle if needed and recommended by your provider.
Functional medicine is a partnership between patient and physician where the care plan is 100% personalized but developed by the physician based on extensive training, patient labs, how the patient responds to given treatment/therapies, etc. You can read more about becoming a patient here: https://richmondfunctionalmedicine.com/patient-membership/
In functional medicine, we do a variety of laboratory tests, including blood, urine, and stool analysis. These are complex testing procedures that can be costly at times. We work hard to collaborate with laboratory partners that are accepted by commercial insurance providers. It's not a guarantee that your labs will be paid for, but we do make a concerted effort to leverage your insurance as much as possible.
Commercial insurances cover the vast majority of our tests, and your standard deductibles apply in that scenario. If you have high-deductible insurance through your employer or buy it separately, you'll be responsible for the deductible. Some plans will reimburse you at the negotiated lab fee on the front end, while others won't until you've met your deductible.
We accept over 80 different insurances, so we cannot know how your individual policy works. Many of the functional labs are not covered by most insurance carriers. In this scenario, based on your insurance, we'll try to utilize the lab that is both most cost-effective and appropriate for your condition. Organic acid testing, advanced stool testing, salivary, hormone, and adrenal testing fall into this category. We use vendors ranging from Genova and Doctors Data to Great Plains Labs and Mycometrics.
We strongly recommend that you reach out to your insurance provider and inquire what their policy is concerning functional/integrative medicine coverage.
Straight, non-supplemented Medicare offers the most comprehensive coverage by far for our practice, as it covers the majority of functional and routine labs. Supplemental insurance with Medicare, on the other hand, may sometimes "take over" the expense and not cover functional labs.
The answer to this question depends on a number of variables. It depends on how sick you are, and it depends on how you're responding to treatment. You can always talk with your doctor or provider about any questions or concerns you have.
RIFM practices personalized, customized health care in which we strive to listen to our patients. If you have a concern about excessive lab testing, we'll weigh your concerns and do our best to follow your instructions. Our objective is to give the finest care as well as access to the most up-to-date testing that leverages all of our experience for your health benefit.
RIFM offers access to integrative and functional medicine services through two in-person membership programs, featuring personalized 1:1 doctor-patient visits that focus on a functional medicine approach.
To explore full details and pricing, visit: https://richmondfunctionalmedicine.com/becoming-a-patient/.
We see a lot of young, healthy women who want to make sure they're in top physical condition for pregnancy; they come to me specifically for that goal. One of the best ways to detoxify your body is actually to get pregnant and breastfeed. Breastfeeding is the best way to feed your baby. And though pregnancy is a wonderful process, it actually is one of the ways your body detoxifies.
Our objective would be to detoxify your body before getting pregnant and breastfeeding. One of the things I tell a lot of expectant mothers is they're making baby brains in their bowels. They're actually taking fatty acids and making a baby's brain and taking minerals and making baby's bones. They're taking nutrients from their own body to grow their baby and their body will actually steal from itself to have a healthy baby.
But what if a female has low levels of vitamin D for example when she is pregnant? That child is more likely to have autoimmune diseases, asthma, atopy, and eczema. So something as simple as getting your vitamin D level optimized before pregnancy will impact your child positively. How about fatty acids? As seen in many kids with ADHD and with other neurological issues, many will have low cholesterol levels, which is quite bizarre, because you want children to have elevated cholesterol because they're building brains and they're making connections. Despite the fact that a kid's brain mass is established by the age of two, neurological connections in their brain do not cease until their mid-twenties. If you want to maximize fatty acids for making baby brains and you want to maximize vitamin D levels? Get your gut in order so that your baby will have the right bacteria when it's born. Many things can be done to help expectant moms prepare for pregnancy and beyond, and we routinely do these in functional medicine.
The short answer is that yes, functional medicine is appropriate for any woman considering pregnancy or who is already pregnant.
We are specialist practitioners of integrative, functional, and holistic medicine, but we are not trained in integrative cancer therapy. We have assisted patients who have already undergone cancer treatment for prevention of recurrence or those who are dealing with a conventional or integrative cancer physician on many occasions. This is where we shine.
If you are looking for a doctor to treat your cancer, Dr. Hartman recommends Dr. Mark Rosenberg. He trains doctors across the country in integrative cancer therapies, and his office is in Florida. His practice is called "Advanced Medical Therapeutics," and you can find more information about him on this website: https://www.amtcare.com/
The short answer to this question is yes; we do hormone replacement therapy. It does, however, need a little explanation. There is a concept known as the hormone hierarchy. Your adrenals, thyroid, and sugar or insulin levels are at the top of the list. If these are malfunctioning, it has an impact on all hormones in your body. Thyroid, sugar (insulin), and adrenal problems are fairly widespread.
Next, we need to work on the gut. The female sex hormones are mostly detoxified in the GI tract. Estrogen dominance can occur if the gut is not properly treated, resulting in hormone imbalances. Then we'll move on to hormones like progesterone, estrogen, testosterone, adrenals, pregnenolone, and other related hormones. There's a method to it that we follow based on data research and how your whole body functions.
We don't just go in and drop hormones on everyone immediately. If the thyroid, sugar levels, insulin, pancreas, adrenals, cortisol, or gut are not addressed properly, you can create a feed-forward cycle in which people feel great for one to two years before declining catastrophically. We are guided by our doctor's oath: "first and foremost, do no harm" and tend to avoid doing therapies that will cause damage. Beginning hormone treatment before addressing the rest of the issues can actually hurt patients in the long run.
To sum it up: we do hormone replacement therapy, but not in the way most people think about it. We have a specific method and process that we follow to ensure that our patients get the best possible care and results. If you have any questions or concerns, please don't hesitate to reach out to us.
From time to time, we will get questions posed to us through our contact page, social media, email, et cetera.
We are unable to respond to medical queries via email or social media due to HIPAA and a variety of medical criteria for licensing. We can, however, provide a wealth of instructional materials in a variety of ways.
We've compiled a list of recommended reading, which includes several books that are excellent for learning more about functional medicine and diving into particular subjects.
For some great basic information, we have a large variety of educational blog posts on our website.
We also send out a weekly newsletter to assist educate patients about gut health, inflammation, mold, and a number of other issues.
Dr. Hartman and his team of experts provide a holistic perspective on health, including Q&A, group coaching, and access to guest experts in fields such as nutrition, aromatherapy, and exercise/movement. With this comprehensive approach, members of the online community can learn to discern their own health stories and heal with the support of the community.
Those who wish to go even deeper may come in for an appointment with one of our physicians.
We hope you find this information helpful, but due to our legal environment and the manner in which things are at present, we are unable to answer medical questions outside of the approved channels.
We've compiled a great deal of information about supplements, how we choose them, how to take them, etc, on this page: https://richmondfunctionalmedicine.com/nutrition/supplements/
Additionally, the video below explains more:
We do offer telehealth as an option for your healthcare but only AFTER an in-person intake and evaluation when you are established as a patient at RIFM. After that initial visit, follow-up visits can be done, as needed, via telehealth.
Patients are welcome to continue seeing their current PCP since the focus of the RIFM membership is on functional medicine—discovering underlying causes and implementing lifestyle modifications, among other things. Of course, our hope is that acute needs also become fewer as one works through their underlying health issues.
The short answer is yes, that is something we are open to. The key is to make sure that it benefits your care and that the physicians involved are supportive of the lifestyle changes you will be implementing. There are many ways to do this, so feel free to ask us how best to integrate into your care team. We are here to support you.
No, we do not require patients to be vaccinated in order to be seen in-office.