Without a doubt, the most difficult part of the whole testosterone therapy process is finding the right doctor. This is the part where I see guys get bogged down and discouraged as they struggle to find someone experienced who’s within driving distance and takes their insurance and actually knows what he’s doing.
All I can tell you, guys, is that you have to kiss a lot of frogs before you find your prince. You may have to switch doctors at least a couple of times before you find someone good.
My own husband went through 6 or 7 doctors before he found someone who knew what he was doing. If I recall correctly, 1 GP, several urologists and endocrinologists, 1 holistic doctor, and 1 guy who specialized in hormone therapy, but wasn’t experienced enough. We wasted a lot of time and money along the way.
There’s a really broad spectrum out there between the drive-thru testosterone therapy clinics, where you barely have to slow down to get your testosterone injection as you walk in the door and the holistic doctors who don’t want to prescribe testosterone therapy, but instead recommend snake oil and yoga chants. 30,000 om om om‘s later, your testosterone levels are still in the toilet.
So, how do you find someone good?
The first thing you have to understand is that most doctors get zero training regarding hormones while they’re in medical school. That’s right. Zilch. Zippo. Nada. Bupkas. In his book, “I’m Still Sexy So What’s Up with Him?”, Dr. Sloan Teeple mentions how surprised he was when he was diagnosed with low testosterone .
“Most surprising of all, perhaps, I had no clue about any of this — and if anyone should have had a clue, it was me. After all, I had studied hard for many long years to become a urologist, a glorified plumber. If any medical doctor should know about testosterone problems, it’s a urology resident. But like nearly all of my colleagues, I had received almost no training in diagnosing or treating low testosterone and the life-altering problems that such a condition can provoke.” pg. 3
If a urologist, who is trained to study the male reproductive organs, gets so little training in testosterone therapy, how much training do you suppose the average GP receives? You’d think you’d have better luck with an endocrinologist. After all, endocrinology is the study of the endocrine glands, the glands that secrete hormones. However, my experience is that many endocrinologists focus primarily on thyroid and diabetes. In my own personal experience, as well as that of my clients, I haven’t seen many endocrinologists with the deep understanding of hormone therapy necessary to safely administer it.
Who does this leave you with, then?
Your best chance of finding a doctor who really knows the ins and outs of testosterone therapy is to find someone certified through the A4M (American Academy of Anti-Aging Medicine). You can google ‘anti aging doctor’ plus <your zip code> to find a doctor in your area. Then it’s a matter of looking at their website to see what they offer.
Many hormone replacement specialists don’t accept private insurance. You pay out of pocket and file the bill with your insurance company on your own. They do it this way because typically they spend a lot of time with you, usually between 45 minutes to an hour, and don’t want to be constrained to a shorter amount of time by insurance company dictates. You might be concerned that it will be insanely expensive, but that’s not necessarily the case. Depending on your area of the country, an initial visit may run between $200-300, with follow-up visits typically being slightly less. While that’s not cheap, you won’t have to sell your first-born.
As long as your insurance company will cover your lab work, and most of them do, then testosterone therapy can be surprisingly affordable.
Many of the full service clinics are moving to a concierge system, where you pay a flat fee which covers a year’s worth of care, including lab work and follow-up visits. That’s a good model for some people, and allows you to budget for your T therapy at the beginning of the year, knowing what the overall cost is going to be.
What really determines whether your doctor is first-rate is whether he looks for known risk factors and contra-indicators for testosterone therapy as I discussed in this post. Testosterone therapy is not a one-size-fits-all situation and there’s a whole battery of tests he needs to run to determine risk factors for your specific situation. I’ll talk about that in the next post.