FAQs

Concierge or subscription medicine, as practiced at Private Medicine Lafayette (PML), is a personalized healthcare model where a limited number of patients (always fewer than 300) pay an annual fee to receive comprehensive primary care services from a dedicated physician. At Dr. James Hood’s practice, we specialize in serving men between 30 and 80 years old. Our approach focuses on two key aspects: helping patients live longer through comprehensive primary and preventive care and enhancing their quality of life by improving fitness and athletic performance. This model allows for more personalized attention and a proactive approach to health management.

• Annual membership fee: $2,250 (refundable unconditionally on a prorated basis at any time)
• Office visits, telemedicine consultations, and other medical services are charged separately from the annual subscription fee and are “direct payments” charged on the day of service.
• First-time comprehensive examination (90 minutes): $500
• Acute care and subsequent annual exams: $300
• Telemedicine visits: $100
• Wellness fitness testing visits: $100
• Minor office surgery: Cost varies based on procedure complexity (Medicare accepted)

• Same-day telemedicine or next-day office visits Monday through Saturday.
• HIPAA-compliant communication through our Patient Portal
• Comprehensive head-to-toe exams by an MD in a private, luxurious setting in Lafayette.
• A proprietary electronic medical record with an after-visit summary for each visit.
• Wellness visits using Microfit testing lab with protocols from the American College of Sports Medicine (ACSM).
• An experienced private physician focused on helping you live longer and better through proven science.
• Referrals to the best specialists when needed. We refer to UCSF, Stanford, Sutter, and John Muir depending on your situation

• Direct pay is required at the time of service
• We will file claims for your reimbursement with commercial insurance as an “out of network provider”
• You will receive an Explanation of Benefits (EOB) from your insurance company
• Being out-of-network may result in higher out-of-pocket costs

• Medicare-covered services will be billed directly to Medicare
• You are responsible for copays, coinsurance, and deductibles as determined by Medicare
• We will submit claims to Medicare for all office services
• Medigap or supplemental insurance may help cover some costs not fully paid by Medicare

• Yes, as your laboratory studies, imaging, and hospitalizations require insurance or Medicare coverage
• Private Medicine Lafayette will submit charges to Commercial insurance as an “out of network” provider and to Medicare for office services
• For more detailed information about Medicare coverage and concierge care, please visit
  https://www.medicare.gov/coverage/concierge-care
• To learn how to read your Explanation of Benefits, visit…
  https://www.verywellhealth.com/understanding-your-eob-1738641

• Preferred method for secure messaging is our Patient Portal.
• Email: Encrypted communication to our email (checked twice daily).
• Telephone: Call 925-283-6448 during office hours:
  • Monday: 7:30 AM – 4:30 PM
  • Tuesday to Friday: 7:30 AM – 11:30 AM
  • Saturday: 7:30 AM – 12:30 PM
• Text Messaging: not HIPAA compliant; avoid sending personal health information.

• Dr. Hood will be out of town four weeks per year.
• During these periods, the office remains open for messages and prescription services except the six major U.S. holidays.
• Limited telemedicine options will be available during these four weeks when Dr. Hood is away from the office.

• Call 911 immediately.
• After hours call Dr. Hood’s mobile phone to inform him of your situation. (mobile number provided on onboarding forms and leave a message on Dr. Hood’s mobile phone if he’s unavailable)
• Please note: James Hood MD Private Medicine Lafayette is not a 24/7 service and does not serve as an urgent care or emergency room facility. We are open Monday: 7:30 AM – 4:30 PM, Tuesday to Friday: 7:30 AM – 11:30 AM and Saturday: 7:30 AM – 12:30 PM

• Access medication refills, annual exam reminders, and lab/imaging requisitions and results through our Patient Portal
• Bookmark our Patient Portal on your computer and smartphone browsers for easy access.
• Please note: James Hood MD Private Medicine Lafayette is not a 24/7 service and does not serve as an urgent care or emergency room facility. We are open Monday: 7:30 AM – 4:30 PM, Tuesday to Friday: 7:30 AM – 11:30 AM and Saturday: 7:30 AM – 12:30 PM

Cardiovascular disease and cancer are the primary factors that shorten men’s lives. To combat these threats, we employ a data-driven, scientific approach that centers on preventing and aggressively treating key risk factors such as hypertension, hypercholesterolemia, diabetes, and increased body mass.

This strategy, combined with promoting a healthy diet and regular exercise regimen, forms the cornerstone of our efforts to help men live longer. Moreover, these preventive measures, along with simple but effective cancer screenings, not only reduce the risk of cardiovascular disease and cancer but also play a crucial role in preventing Alzheimer’s dementia.

• If your current physician meets your healthcare needs, it’s advisable to maintain that relationship rather than switching to Private Medicine Lafayette.
• At Private Medicine Lafayette, we offer telemedicine consultations on the same day during office hours and in-office appointments within 24 hours.
• The average wait time for a doctor’s appointment in the United States typically exceeds two weeks.

• Our mission at Private Medicine Lafayette (PML) is to provide care based on proven medical science and community standards.
• PML’s medical practice standards are founded on credible scientific evidence published in peer-reviewed medical literature and generally recognized by the relevant medical community.
• We adhere to FDA guidelines regarding approved drugs and dietary supplements. For more information, you can refer to:
  • FDA’s guide on approved drugs…
  • Or the FDA’s overview on dietary supplements…
• We consider alternative medicine treatments when they have data-driven outcomes that demonstrate improved health conditions. For example, chiropractic care and acupuncture have shown efficacy in treating lower back pain in some studies.
• Our approach is to present all viable treatment options supported by scientific evidence, whether they are conventional or alternative, to ensure you receive the most effective care possible.
• We encourage open discussions about any supplements or alternative treatments you’re considering, so we can provide informed guidance based on the latest scientific research and your individual health needs.

Below is an evidence-based analysis of supplements

1. Harmful Medication-Supplement Interactions
   Common high-risk interactions include:
   • St. John’s Wort: Reduces effectiveness of antidepressants, birth control pills, and blood thinners like warfarin.
   • Calcium/Magnesium: Impairs absorption of antibiotics (e.g., tetracyclines, quinolones).
   • Ginkgo Biloba: Increases bleeding risk when combined with aspirin, warfarin, or NSAIDs.
   • Vitamin E: Amplifies anticoagulant effects when paired with blood thinners.
   • Green Tea Extract: Associated with liver injury and interacts with blood pressure/heart medications.
     Symptoms of interactions include irregular heartbeats, jaundice, or sudden medication ineffectiveness.
2. Rising Liver Toxicity from Supplements
   • Prevalence: Herbal/dietary supplements account for 20% of drug-induced liver injuries in the U.S., with 15 million adults using hepatotoxic botanicals like turmeric, ashwagandha, and green tea extract.
   • High-Risk Supplements:
     • Bodybuilding supplements (anabolic steroids) cause prolonged cholestasis.
     • Multi-ingredient products (e.g., Hydroxycut, OxyELITE) linked to acute hepatitis and bile duct damage.
     • Red yeast rice (contains lovastatin analogs) and Garcinia cambogia.
3. Supplements Sourced from China and FDA Regulation
   Manufacturing and Regulation
   • China’s Role: Many raw supplement ingredients are sourced from China, where regulatory oversight (CFDA) is less stringent than U.S. standards. Products labeled as “health foods” in China often bypass rigorous safety testing.
   • FDA Oversight:
     • Supplements are not pre-approved by the FDA; manufacturers self-report safety.
     • Potency/Purity Issues: Contaminants like heavy metals, pesticides, and unlabeled pharmaceuticals are found in 12–20% of tested supplements.
     • Labeling Gaps: Studies show discrepancies of 10–1,000% in labeled vs. actual ingredient amounts.
       
       While not all supplements are made in China, the global supply chain heavily relies on Chinese-sourced ingredients, raising contamination risks.
4. Lack of Proven Longevity Benefits for Healthy Adults
   For a healthy male with no deficiencies or prior gut surgery:
   • Multivitamins: No mortality benefit in large trials (e.g., Physicians’ Health Study II).
   • Antioxidants/Herbs: No evidence of lifespan extension; some (e.g., beta-carotene) may increase cancer risk.
   • Exceptions: Vitamin D or omega-3s may benefit specific populations, but not universally.
5. Creatine is generally safe for healthy adults and consistently shown to improve muscle mass and exercise performance, especially in athletes or those engaging in high-intensity training. Side effects are typically mild, such as water retention or GI upset, and it should be avoided in people with kidney disease. While general longevity or cardiovascular benefits are not established, new research suggests creatine may offer modest neurocognitive benefits, particularly in older adults, including improvements in working memory, processing speed, and possibly reduced risk of mild cognitive impairment. Product quality remains a priority—opt for third-party tested supplements.

Plant-Based Diets are superior to supplements: Whole-food diets (e.g., Mediterranean, MIND) are strongly linked to healthy aging, unlike supplements.

Key Recommendations

1. Avoid unnecessary supplements if dietary needs are met.
2. Verify third-party certifications (NSF, USP) for purity.
3. Monitor liver enzymes if using hepatotoxic supplements.
4. Prioritize dietary patterns over isolated nutrients for longevity.

This analysis aligns with current clinical and James Hood MD Private Medicine Lafayette guidelines as well as peer-reviewed evidence.

• Our primary focus is on men aged 30-80, as this demographic often faces significant health challenges and has the most to gain from our preventive and primary care approach.
• Men in this age range are at higher risk for cardiovascular disease, certain cancers, and metabolic disorders, which we aim to prevent or manage effectively.
• While we target this age range, we do have a limited number of patients outside these parameters, including some younger adults and those over 80.
• We are committed to continuity of care. If you’re an existing patient who reaches 80, we will continue to provide care tailored to your evolving needs.
• Currently, PML does not specialize in pediatrics, adolescent health, geriatrics, or women’s health. However, we can provide referrals to trusted colleagues in these areas if needed.
• We offer wellness and Fitness testing visits for all ages and genders, which include comprehensive evaluations of lipid profile, blood pressure, Blood glucose, HgA1c, Body mass index (BMI), strength, flexibility, and VO2.

• Early Prevention is Key: Even if you feel healthy, early detection and management of risk factors can significantly impact your long-term health:
  • Hypertension (high blood pressure) often develops silently in your 40s
  • Lipid levels can start to rise, increasing cardiovascular risk
  • Early signs of insulin resistance or pre-diabetes may emerge
  • Gradual weight gain is common in this age group
• Personalized Health Optimization: We go beyond just preventing illness:
  • Comprehensive health assessments to identify your unique risk profile
  • Tailored strategies to maintain and improve your current health status
  • Proactive approach to address potential health issues before they become problematic
• Performance Enhancement: For active individuals, we offer:
  • Advanced wellness and fitness testing
  • Personalized training recommendations based on your physiology
  • Strategies to improve endurance, strength, and recovery
  • Nutritional guidance to support your athletic goals
• Achieve Your Athletic Ambitions: Whether you’re aiming to:
  • Complete your first marathon or triathlon
  • Improve your cycling or swimming performance
  • Enhance your tennis or golf game
  • Tackle challenging hikes or mountain climbs
    We provide the medical support and expertise to help you reach these goals safely and effectively.
• Time-Efficient Healthcare: As a busy professional, our concierge model offers:
  • Same-day telemedicine or next-day appointments
  • Extended, unhurried consultations
  • Direct access to your physician for quick questions or concerns

By investing in your health now with a concierge doctor, you’re setting the foundation for optimal health and performance in the decades to come.