1100 Queensborough Blvd Unit 102, Mt Pleasant, SC 29464
fast-food

Testosterone Chain Franchises
vs The Men's Center

QUESTIONS TO ASK YOURSELF AND YOUR MEN’S HEALTH PROVIDER…

Folks, the corporate-run, nationally-franchised, fast-food of “men’s health” clinics are spreading like wildfire, surely to be coming to The Lowcountry soon.
 
No need to mention the name – I am sure you will see lots of advertising. The corporate offices have established scripts. Their target audience is men who want testosterone. In truth, if that is all you are looking for, they may serve your purpose. Their operations are streamlined – not Chick-fil-A good, but they know how to run a profitable business. 
 
But what do you really get?
As you know, I am a big believer in the value of testosterone in the right patient if managed well. As a urologist who has a particular interest in hormonal health and wellness, I have prescribed testosterone to hundreds of men.
There are a lot of entities looking to capitalize on what has become a testosterone craze. Coming from a doc who has lived in the men’s health world for my entire career – if you choose to go to a chain clinic I encourage you to think about questions such as these:
 
1) I believe in total transparency. Patients should have access to quality and price info so they can be informed consumers. You should be able to easily obtain any information regarding the background about the people treating you that you need in order to be comfortable. There should be no secrets. All of my background and experience is easy to find on my website, as is that of my RN. It is featured prominently in fact. Many of my patients arrive to their first appointment with detailed knowledge of my background and training. Additionally, many have read my reviews on Healthgrades or the like. It is hard to do that when you don’t know who your doctor or other provider will be.
At a chain clinic, you will almost certainly be seen by a PA or nurse practitioner, AKA a midlevel provider, rather than an actual doctor. Midlevels do not do residency training, so there is a mixed bag of actual men’s health experience in that crowd. A midlevel’s men’s health knowledge must be gained on-the-job under a doctor who teaches them. Some have great experience (they may have worked for a urologist previously), others have very little. A midlevel can be very good. But if their only experience is, for example, at a pain clinic, gynecologist or pediatrician, their men’s health training is minimal. Ultimately a midlevel’s training may be limited to how the franchise’s corporate office indoctrinates them with their protocols and sales pitches.
 
You should feel comfortable asking your midlevel what their training in testosterone therapy and ED consists of. At the chain clinics, there will also be a “medical director” whose job is to rubber stamp the work of the midlevel provider. This job exists because the law requires it. The MD is unlikely to be on the premises. They may be required by the company to step foot in the office once a week for compliance purposes. Ask what type of doctor the medical director is, and what his training is. Is he formally trained in the subject matter? Is he a urologist, an ER doctor, anesthesiologist, or what? Are the doctor’s qualifications easy to access? They should be prominent on their website but often are not. Why is that?
 
2) If your desire is to feel better and be healthier, you may want to ask them what other labs they check at your appointments. Do they evaluate your cardiovascular and metabolic health – which are intertwined with low T and ED- with any labs? Do they evaluate for any other causes of your symptoms? Do they follow-up on other labs that may be affected by testosterone treatments, such as blood counts and pituitary hormones? Do they discuss the risk of infertility? What do they do if your PSA goes up while on treatment (probably send you to a urologist)? As a urologist I get plenty of business from other men’s health clinics who don’t know what to do in this setting. Bottom line, your health is a lot more than your testosterone level. You shouldn’t look at testosterone in a vacuum. In fact, low testosterone can be a sign of other health issues.
 
3)) I have also treated erectile dysfunction for 20 years. I regularly attend high-level urology conferences. I know that there are some great outside the box options as well as plenty of snake oil. Again, I believe in transparency and honesty.
 
You will notice that many of these clinics offer you shockwave therapy for ED. Ask them what type of technology they use. This is really important. I just returned from the Harvard testosterone therapy and sexual health conference, and the issue of non-transparency regarding shockwave devices was highlighted. Does the chain clinic use focused linear shockwave (very good scientific data to support use) or radial acoustic wave therapy (practically no data to support use)? Most clinics offer the latter because the machine is a fraction of the price and does not require a medical professional to purchase or operate it.
 
They may also push other treatments for ED. PRP or “The P-shot” is one example. They may make claims about the efficacy of therapies that are still considered investigational by the scientific community. This is not always bad, as long as they are honest and can inform you about the existing data and scientific basis. But how well they understand the services they are providing?
 
For any treatment they offer, they should be able to tell you if there are any prospective, double-blinded, randomized placebo-controlled studies and should be able to summarize the results, at least ballpark. They should also be able to explain how the treatment might work (what is the proposed “mechanism of action”?). If they cannot give you the information required to make a truly informed decision about how to spend your money, I would be skeptical of both the treatment and the qualifications of the person endorsing it. In many cases the list of services is delineated by the corporate office, and some are “high ticket” procedures with little to no evidence to support claims that are made.
 
4) At the end of the appointment, listen to your gut. Ask yourself “is this person’s goal to make me healthy and productive or is it to sell me something?” Spoiler – much like at a used car lot, their bonuses are often tied to number of sales. The chain testosterone clinics keep track of “conversion rates”, meaning what percentage of their patients purchase one of their programs. They have target goals. They report back to the corporate office. Does this seem like more like sales and less like healthcare? Testosterone is not for everyone, so emphasizing conversion rates doesn’t feel right to me. A healthcare visit should never feel like a sales pitch.
 
Do you feel like their prices transparent and easy to access? Are they on the clinic’s website (ours are very clear) or do you find out after the sales pitch? Are they “starting at…” prices? There is no good reason for prices to be confusing or opaque.
 
I recently saw an ad from one national company looking for franchisees, stating NO MEDICAL EXPERIENCE OR QUALIFICATIONS REQUIRED. Mull that over…