Frequently Asked Questions

Q. I’m not sure that my symptoms are hormonally related or that I am appropriate for your practice. What do you suggest? 

A. FIRST, take the Hormone Self-Questionnaire for women or men, or the PCOS Self-Questionnaire and the Fibromyalgia Self-Questionnaire contained in the new patient packet available on our website. Based on your scores, these tests will give you an idea whether your symptoms are hormonally related and whether our services will benefit you. 

NEXT, read Dr. Vliet’s books to give you background on other patients’ stories, the research supporting her clinical approaches, and her philosophy and treatment options. If you find that you identify with the patient stories in the books, and you “reasonate” with Dr. Vliet’s approaches, then we encourage you to schedule an in-depth evaluation or a Second Opinion Consult.

Dr. Vliet is the author of these popular books on hormone issues for women from puberty to menopause and beyond:

1. Screaming To Be Heard: Hormonal Connections Women Suspect ...and Doctors Ignore (First edition, M. Evans, 1994)

2. Screaming To Be Heard: Hormonal Connections Women Suspect ...and Doctors Still Ignore (Revised and expanded edition, M. Evans, 2001).

3. Women, Weight and Hormones: Are Your Hormones Making You Fat? (hardback, M. Evans, 2003)

4. It’s My Ovaries, Stupid! (Scribner, 2003)

5. It’s My Ovaries, Stupid! (Revised and expanded edition, paperback, 2005)

6. The Savvy Woman’s Guide to Testosterone (paperback, 2005

7. The Savvy Woman’s Guide to PCOS. Paperback, 2006

Q. May I see the physician without doing the suggested labwork or additional tests? 

A. We feel the laboratory information added to an in-depth history and physical examination is critical to making a correct diagnosis. Symptom lists are non-specific and may lead to incorrect diagnoses if you just base the diagnosis on “symptoms” without proper laboratory evaluation to clarify the underlying causes.

 

Q. Do you offer physical exams and PAP Smears? 

A. Yes - to meet Arizona regulations, all of our new patients have a physical exam by Dr. Vliet as part of our complete evaluation. We do not feel it is ethical or necessary to charge you again for a PAP and pelvic, since this service is done by your OB-GYN or primary care professional. For this reason, we ask that our new patients bring a copy of a current Pap and mammogram or send these reports to us prior to initial appointment. Dr. Vliet also recommends that you continue to have a regular annual check-up (including PAP and Well Woman exam) with your primary care physician or OB/GYN physician to maintain that relationship and continue to include them in your care as much as possible. 

 

Q. What other services do you provide? 

A. We offer or can refer you for the following services:

• Individual Nutritional Consultation Dietary Evaluation
• Exercise Evaluation and Recommendations
• Diet and Exercise Coaching
• Radiology Services for Bone density
• Mammograms
• Thyroid/Abdominal

other specialty imaging or consult referrals.

As part of your overall evaluation, we discuss positive changes in your eating habits to achieve your health goals, whether you need a specific diet, are trying to lose weight or desire to stabilize your blood sugar for optimal energy or develop balanced meal plans to deal with allergies.

Nutritional Analysis: Are you really eating as much protein as you should be? Do you know how many carbohydrates and fats you are getting? Are your calories adequate for you to be able to lose weight? Is your diet helping you meet your health goal and give you enough energy to get through the day? 

Not sure? Have your food intake analyzed. Bring a food diary or fill out a simple food intake questionnaire and our nutritionist will give you a detailed report analyzing the percentage of protein, fat and carbohydrates you are consuming, as well as tell you if you are getting enough essential vitamins and minerals. Your intake will be compared to Dr. Vliet’s nutritional recommendations for women and we will recommend changes to help you with your specific goals. 

 

Q. Do you evaluate men's hormones also?

A. Yes. Hormone Health Strategies in Tucson and Dallas provide a comprehensive package to assess men’s health concerns regarding sexual function, hormone issues, cardiovascular risk factors, weight management, sleep disruptions, fatigue, memory loss, depression and/or anxiety.

Q. What can I expect to pay for Dr. Vliet’s New Patient package? 

A. All patients are seen in person in our clinical office for an in-depth, several hour consultation-evaluation that includes detailed and comprehensive laboratory studies that check hormone levels and many other crucial measures. Our New Patient packages consist of five different packages of hormone and metabolic testing designed to address your individual patient concerns. We do not participate in any insurance plans, and have opted out of Medicare. We give you a detailed "walk-out" statement that provides the summary of services, codes and fees for you to submit to your insurance plan. Each insurance plan varies in terms of coverage of services and reimbursement is possible. All of our patients are responsible for filing their own insurance claims for reimbursement by their insurance plans according to the terms of your insurance plan.

Q. Are all services covered by insurance and will your office file for me? 

A. Coverage of specific services varies by insurance company and health care plan. Because each plan and insurance company has a different policy, we suggest that you call and verify which services they will cover and how to submit your claim. 

We will provide you with a “walk out” statement itemizing services received and payments made. You then file your own claim for possible reimbursement according to the terms of your insurance plan. We do not provide claim filing services. We feel strongly that, as your health professionals, our focus and loyalty should be with you and not directed by your insurance company’s dictates based on their profits. 

Since we do not file electronic insurance claims, your medical privacy is also better protected. Your medical records are never sent to any insurance company or any other third party – medical records are sent ONLY to you to review and decide what information you want released to others.

Because Dr. Vliet has not signed a contract with any insurance plans, she is able to practice medicine in the way that is in your best interests, without inappropriate restrictions and more time-intensive appointments devoted to you. Dr. Vliet’s practice is not “assembly line” medicine or 5-minute office visits. We will provide one “medical necessity” letter at no charge for you to submit to your insurance or prescription plan. There will be a charge for subsequent medical letters if required by insurance plans. 

Q. Do you recommend that I have a bone density test? 

A. Osteoporosis is the most common health problem after menopause, and is also the third leading cause of death in women after age 60. The average woman has lost about one-third of her hip bone mass by menopause, but this “silent thief” is not just an older woman’s disease. We see an epidemic of bone loss among younger women, particularly smokers, those with anorexia-bulimia, those who over-exercise, drink too much alcohol, coffee, or soda, or have low vitamin D or too little calcium intake. 

You cannot tell by looking at the outside of your body what your bone condition is inside! The best test to determine whether you have bone loss is the Dual Energy X-ray Absorptiometry (DEXA) of both hip and spine. Heel and forearm measures are not reliable measures in women under age 65.

We advise women to have a baseline DEXA of the hip and spine done at least by age 35, just as you do with your mammogram. This test helps detect early bone loss and allows us to plan NOW to prevent bone thinning that leads to increased fractures, disability, chronic pain and early death. 

Many insurance companies cover this test. We provide a prescription for you to have this done at a site of your choice or if you prefer, we can arrange an appointment with a radiologist near our office. In our comprehensive package we include the NTx test, a marker of bone breakdown. The NTx test is useful in conjunction with your DEXA bone mineral density test to assess osteoporosis risk and monitor response to any therapy. 

Q. I still have questions. How can I find out more about the services at Hormone Health Strategies medical practices? 

A. See additional information on our website.

B. Read Dr. Vliet’s books: 

1. Screaming To Be Heard: Hormonal Connections Women Suspect ...and Doctors Ignore (First edition, M. Evans, 1994)

2. Screaming To Be Heard: Hormonal Connections Women Suspect ...and Doctors Still Ignore (Revised and expanded edition, M. Evans, 2001).

3. Women, Weight and Hormones: Are Your Hormones Making You Fat? (Hardback, M. Evans, 2003)

4. It’s My Ovaries, Stupid! (Scribner, 2003)

5. It’s My Ovaries, Stupid! (Revised and expanded edition, Paperback, 2005)

6. The Savvy Woman’s Guide to Testosterone (Paperback, 2005)

7. The Savvy Woman’s Guide to PCOS. (Paperback, 2006)