(816) 330-7575

FAQ's

Frequently Asked Questions

Helpful information about our services, care approach, and what to expect.

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A: Direct Primary Care is a membership-based healthcare model where you pay a simple monthly fee for comprehensive primary care services. There’s no insurance company between you and your doctor—just transparent, affordable healthcare focused entirely on you.

A: DPC is NOT insurance and doesn’t replace the need for coverage for emergencies, hospitalizations, or specialist care. We recommend pairing your DPC membership with a low-cost high-deductible health plan for catastrophic coverage. This combination often costs less than traditional insurance while giving you better primary care access.

A: Your membership includes unlimited office visits, same/next-day appointments, 24/7 direct access to Dr. Tess by text/call/email, annual wellness exams, sick visits, chronic disease management, women’s health services, mental health evaluation and medication management, and wholesale pricing on labs and medications.

A: Yes! DPC memberships are typically HSA/FSA eligible. Check with your specific plan administrator, but most patients can use pre-tax dollars for their monthly membership.

A: We offer same-day or next-day appointments for most concerns. Because we limit our patient panel size, Dr. Tess has time to see patients when they actually need care—not weeks later when problems have gotten worse.

A: Yes! We’re currently accepting new DPC members. Your first visit ($200) includes your initial month’s membership plus a comprehensive 60-90 minute assessment where Dr. Tess gets to know you, reviews your complete medical history, and creates your personalized care plan.

A: No, Garcia Family Medicine does not accept insurance for any services. Insurance companies will not reimburse you for the monthly membership fee, as they typically only pay for specific procedures performed by medical providers. However, you can use your Health Savings Account (HSA) or Flexible Spending Account (FSA) to pay for your membership and services.

A: Dr. Tess will coordinate referrals to trusted specialists when needed and help you navigate the healthcare system. This is where having a high-deductible health plan for catastrophic coverage is important—DPC handles your primary care, while insurance covers major medical events.

A: Yes, you can cancel your membership at any time. Garcia Family Medicine requires 30 days notice to process your cancellation.

A: Garcia Family Medicine focuses on opioid-free pain management using a multi-modal approach. Dr. Tess does not prescribe opioid medications, but offers comprehensive alternatives including prescription non-opioid pain medications, interventional therapies, and holistic strategies.

A: We have partnerships with local labs and imaging centers that allow us to offer wholesale pricing—often significantly cheaper than what you’d pay through insurance. Dr. Tess orders only the tests you actually need, not what insurance companies incentivize.

A: If you’re committed to a long-term program designed to teach you sustainable lifestyle changes so you don’t regain your weight, this is the program for you. During your first consultation, Dr. Tess will perform a comprehensive medical evaluation and order labs to establish your baseline health and identify any existing comorbidities related to being overweight. This thorough assessment ensures the program is tailored to your specific health needs and goals.

A: CoreLift uses FDA-cleared EMSELLA technology that delivers thousands of pelvic floor muscle contractions during each 28-minute session while you sit fully clothed. The typical protocol is 6 sessions over 3 weeks, with 95% of patients reporting significant improvement in bladder control and quality of life.

A: Telemedicine visits are available when you’re unable to keep an in-person appointment. However, Dr. Tess does not conduct telemedicine visits on a regular basis, as she believes face-to-face interaction is essential for developing a strong doctor-patient relationship.

A: We’re conveniently located in Blue Springs, MO at 801 NW Saint Mary’s Drive, Suite 209, easily accessible from I-70 and major routes through the Kansas City metro area.

Q: Do I still need insurance if I have DPC membership?

A: DPC is NOT insurance. We recommend pairing your $99/month DPC membership with a low-cost high-deductible health plan for catastrophic coverage (hospitalization, specialists, surgery). This combination often costs less than traditional insurance while giving you better primary care.

A: Yes! DPC memberships are typically HSA/FSA eligible. Check with your plan administrator, but most patients can use pre-tax dollars.

A: Dr. Tess coordinates all specialist referrals and helps you navigate the healthcare system to ensure you receive the care you need. You will need insurance to cover specialist visits. If you don’t have insurance or are experiencing financial hardship, we will work to connect you with the Truman Medical Center system, which provides care on a sliding fee scale based on your ability to pay.

A: Same-day or next-day appointments for most concerns. Because we limit our patient panel, Dr. Tess has time to see you when you actually need care.

A: Yes! All DPC members have Dr. Tess’s direct number for text, call, or email. She responds personally—no phone trees, no nurse gatekeepers.

A: Some emergencies do not need a trip to the emergency room. Things like lacerations needing to be stitched, or urinary tract infections do not need a trip to the emergency room and will likely take you hours if you do. We recommend calling Dr. Tess when you are having what you perceive to be an emergency to find out if it is something she can handle in the office . . . like stitching up a laceration or treating a urinary tract infection.

A: We have agreements with TestSmartly Labs in Independence for wholesale prices on labs and with Element Medical Imaging for x-rays, CTs, and MRIs at fantastic savings. The caveat is you have to pay either company at the time of service .

A: We do not accept insurance because we are a direct primary care practice. This keeps our costs low and allows Dr. Tess to spend more quality time with you. We don’t participate in insurance processes or file any claims—staying out of insurance matters is central to our model. If you choose to seek reimbursement from your insurance company, that would be handled directly between you and your insurer. We can provide you with receipts for your payments, but any insurance submissions would be your responsibility.

A: Yes, you can cancel your membership at any time. Garcia Family Medicine requires 30 days notice to process your cancellation.

A: No! One of the most attractive benefits of direct primary care is that you won’t experience long waits for appointments. Dr. Tess maintains a smaller patient panel specifically so she can see you when you need her. Contact us today to schedule your appointment.

Q: Do I have to take medication?

A: No. Not every patient needs or wants medication. Dr. Tess creates a personalized plan based on YOUR goals, health status, and preferences. You may not need any medications at all. This program was developed back before the hype about GLP-1A medications. It was designed to work based on nutrition and lifestyle changes alone. That’s how Dr. Tess lost her 80 pounds.

A: Common side effects include nausea, diarrhea, constipation, and decreased appetite (which is actually the desired effect). Most side effects are mild and improve over time. Dr. Tess starts with low doses and monitors you closely to minimize side effects.

A: Weight regain is possible if you return to previous eating habits. That’s why our program focuses on sustainable lifestyle changes. We work on building habits that last beyond medication use.

A: Weight loss typically begins in the first 2-4 weeks. Remember: healthy, sustainable weight loss is 1-2 lbs per week, not rapid drops.

A: Yes. GLP-1A medications were originally developed for diabetes treatment. Their ability to cause weight loss was an unexpected side effect. Unfortunately, the hype over the weight loss has overshadowed their original use. If you already have a primary care physician or endocrinologist managing your diabetes, let Dr. Tess know so she can coordinate with your physician since the weight loss is going to affect your blood sugar, and we don’t want any hypoglycemic episodes.

A: Since you are already paying $99 for your DPC membership, if you choose to join the weight management program, the cost will be only $200.

A: Virtual visits are possible; however, it has been Dr. Tess’s experience that virtual visits for weight management are less effective and she would prefer to keep them to a minimum. Further, your biweekly visits coincide with your biweekly body composition analyses, something that is impossible to do with a virtual visit.

A: You will first meet with Gigi who will be your lifestyle coach. She will then pass you on to Dr. Tess who will perform a complete health and mental health history. She will explain to you how our weight management program works, which will include an explanation of the biophysics behind obesity and weight loss. She will order a panel of lab test which you will need to have done before your appointment with her in 2 weeks. It is unlikely that you will receive any medication at the first visit.

A: For some patients, long-term use is appropriate for weight maintenance, especially if obesity is a chronic medical condition. For others, we transition off medication once healthy habits are established. Dr. Tess creates an individualized plan. 
Prescription of medication requires that a doctor-patient relationship be in place. Therefore, Dr. Tess requires a patient to be enrolled in a membership to receive prescription medicine. Whether it is our regular DPC membership or the weight management program depends on your focus. If you are still trying to lose more weight, you would be in the weight management program.

A: This is the reason Dr. Tess has not pinned the success of this program on GLP-1A’s. She has seen too many patients fail to lose weight on them. Her opinion on these failures is that the patient is depending on the medication to take away their appetite and do the weight loss for them without making the nutritional and dietary changes that are the backbone of this program.

A: Yes! We provide nutrition guidance and eating recommendations tailored to your lifestyle, preferences, and goals. We focus on sustainable changes, not restrictive diets.

A: No, our weight management program is designed so that you won’t feel constantly hungry. If you do experience hunger, it’s most likely because you didn’t eat enough at your previous meal. We’ll work with you to ensure you’re eating adequate, satisfying portions that keep you fueled throughout the day while still supporting your weight loss
goals.

Q: Do I need to be a DPC member to receive mental health care?
For DPC Members:
  • Monthly membership: $99
  • First appointment: $200
  • All follow-up visits with Dr. Tess: included in membership (unlimited)
  • Counseling sessions: $85 per session (in addition to membership

For Non-Members:
  • Each visit with Dr. Tess: $200
  • Counseling sessions: $150 per session

Why Membership Makes Sense:
The value becomes clear in your first month. Dr. Tess always schedules a follow-up visit two weeks after the initial mental health appointment. As a member, this second visit is included at no additional cost. For non-members, that’s another $200.

A: Yes, absolutely. All medical care and mental health care are classified as Protected Health Information (PHI) and are safeguarded under the Health Insurance Portability and Accountability Act (HIPAA). Your medical and mental health information cannot be released to anyone without your written authorization.

A: No, Dr. Tess does not prescribe controlled substances. For ADHD, she uses non-stimulant medications as part of her treatment approach. For anxiety, she offers effective medication options that do not include benzodiazepines. Her treatment plans focus on safe, non-controlled alternatives while providing comprehensive mental health care tailored to your individual needs.

A: DPC members typically get same-day or next-day appointments. New patients can usually be seen within 3-5 days—much faster than typical psychiatry wait times of weeks or months.

A: We offer both! Dr. Tess provides medication management for mental health conditions, and we also have counseling services available. Our approach treats the whole person—Spirit, Body, and Soul—combining medical treatment with therapeutic support to give you comprehensive mental health care. Counseling sessions are available at $85 per session for DPC members and $150 per session for non-members.

A: Dr. Tess will work closely with you to determine if specialized care is needed. If your situation requires the expertise of a psychiatrist or psychologist, she will provide appropriate referrals and coordinate your care to ensure you receive the comprehensive support you need.
Unfortunately, there is currently a shortage of psychiatrists and psychologists, and getting an appointment with one will definitely take time. In recent investigations of mental health providers, Dr. Tess has found that much of the psychiatric work is now being performed by psychiatrically trained nurse practitioners. Ultimately, the choice is yours—whether you prefer to wait months for a psychiatrist, see a psychiatric nurse practitioner sooner, or continue your care with Dr. Tess. As your primary care provider, she remains an integral part of your healthcare team and will continue to support your overall wellness throughout your treatment.

A: Yes, Dr. Tess includes pediatric care in our practice, but there are age-specific guidelines for mental health treatment:

For Depression and Anxiety: Dr. Tess treats children ages 10 and older. Treating depression and anxiety in children younger than 10 with antidepressant medications requires more specialized care.

For ADHD: Dr. Tess can perform ADHD evaluations beginning at age 6. However, since she does not prescribe controlled substances, she cannot prescribe stimulant medications like Ritalin or Adderall. Instead, she uses effective non-stimulant
medications that are not controlled substances to manage ADHD. Dr. Tess will work with you to determine the best treatment approach for your child and provide referrals to specialists when appropriate.

A: Not necessarily. Medication for depression and anxiety is used to reduce symptoms and help you cope more effectively while you work through counseling. This allows you to engage more fully in therapy and develop healthy coping strategies. Dr. Tess typically recommends patients plan to stay on medication for at least a year, but your treatment plan will be individualized based on your progress and needs. Your medication regimen will be regularly reviewed and adjusted as appropriate throughout your care.

A: Most medications require an adjustment period when you first start taking them, and Dr. Tess provides close monitoring during this time. She doesn’t simply prescribe medication and send you on your way—when starting psychoactive medications, she schedules a follow-up appointment within 2 weeks to assess how you’re responding.
In rare cases, some patients may experience increased suicidal thoughts. This is why Dr. Tess makes herself available 24/7 by text. If you experience concerning symptoms, you can reach out immediately, and she will call you back to evaluate your situation over the phone

A: We provide initial support, evaluation, and referrals to appropriate treatment programs for substance use disorders. For active addiction, specialized treatment is typically required, and we will help coordinate your care with the right providers.
It’s important to note that Dr. Tess does not prescribe controlled substances, so she cannot provide medication-assisted tapering for substances such as opioids or benzodiazepines. However, she remains committed to supporting your recovery journey by connecting you with specialized addiction treatment resources and continuing to provide comprehensive primary care as part of your overall wellness plan.

A: No, Dr. Tess does not prescribe benzodiazepines such as Xanax or Valium. However, she successfully treats anxiety using various effective medications that are not controlled substances. Her approach focuses on safe, non-addictive alternatives that provide relief from anxiety symptoms while supporting your long-term mental health and wellness.

A: Standard counseling sessions are 50 to 60 minutes. However, Dr. Tess is known as the “Listening Doctor” and will not interrupt you at the one-hour mark if you’re actively working through an important issue. If the session extends an additional 30 minutes, there is an extra $50 fee. This flexible approach ensures you receive the time and attention you need without feeling rushed.

A: Dr. Tess has found that telehealth appointments can disrupt the natural interaction with patients and hinder the development of a strong doctor-patient relationship, which is essential for effective mental health care. While she will accommodate telehealth appointments in certain circumstances—such as when either she or you are out of town—she strongly prefers that counseling sessions be conducted face-to-face. This in- person approach allows for deeper connection and more effective therapeutic support.

A: Dr. Tess is available 24/7 and can be reached by text for guidance, whether you’re a DPC member or receiving counseling as a non-member.

For life-threatening emergencies: Call 911 or go to the nearest emergency room. However, it’s always best to contact Dr. Tess first if possible—she may be able to meet you at the office to evaluate and treat your situation.

For suicidal thoughts: Call or text 988 (the Suicide & Crisis Lifeline) for immediate support. You can also reach out to Dr. Tess at any time.

Your safety is our highest priority, and Dr. Tess is committed to being there for you when you need help most.

A: No. Both your mental health and physical health information are protected under HIPAA, and nothing from our sessions can be released to anyone without your signed permission. Since we don’t deal with insurance companies, there are no insurance records or claims that could impact your coverage or employment. Your care remains completely confidential and private.

A: Absolutely, if that makes you more comfortable. Family involvement can be helpful for treatment planning and support, especially for ADHD or severe depression.

Q: Does EMSELLA really work, or is it just hype?

A: EMSELLA is FDA-cleared based on clinical studies showing 95% patient satisfaction and significant improvement in quality of life. It’s backed by science, not just marketing. Most patients experience meaningful improvement in pelvic floor strength.

A: No, EMSELLA is not painful. You’ll feel pelvic floor muscle contractions—like a strong workout—but it’s tolerable. Most patients describe it as “strange but not uncomfortable.” You remain in control and can stop if needed.

A: No! You remain fully clothed throughout the entire treatment. Wear comfortable, loose-fitting clothing without metal zippers or buttons in the pelvic area. Clothing that is too thick or too tight will block the magnetic waves so they do not reach your pelvic floor. Denim is particularly obstructive, so don’t wear your skinny jeans.

A: Each EMSELLA session is exactly 28 minutes. No prep time, no recovery time. You can literally schedule it on your lunch break and return to work immediately after.

A: The recommended protocol is 6 sessions over 3 weeks (2 sessions per week). Clinical studies show this provides optimal results. Some patients see improvement sooner, but the full series gives the best outcomes.

A: Many patients notice improvement after 2-3 sessions. Most see significant results after completing all 6 sessions. Results continue improving for 2-4 weeks after the final treatment as muscles continue strengthening.

A: Results typically last 6-12 months or longer. Some patients maintain results even longer. You can return for maintenance sessions (1-2 sessions every few months) to sustain results.

A: Yes! While childbirth is a common cause of pelvic floor weakness, women who’ve never had children can also experience incontinence due to aging, menopause, genetics, weight, or high-impact activities.

A: EMSELLA works regardless of hormonal status. It strengthens muscles through electromagnetic stimulation, which works even when hormones have changed. Many of our successful patients are postmenopausal.

A: Yes! One of the major indications for Emsella treatment in men is erectile dysfunction. By strengthening the pelvic floor muscles, Emsella also effectively treats urinary incontinence in men. Male urinary incontinence can result from various causes including prostate surgery (particularly after prostatectomy), benign prostatic hyperplasia (enlarged prostate), weakened pelvic floor muscles due to aging, neurological conditions, chronic coughing, obesity, and certain medications. Emsella offers a non-invasive solution to address these issues by restoring pelvic floor strength and function.

A: Yes, CoreLift is not recommended if you are pregnant, have metal implants in the pelvic area, have a pacemaker or implanted defibrillator, have active pelvic cancer, or have severe pelvic organ prolapse. Additionally, even if you’re generally cleared to use CoreLift, you should not have a treatment session while you’re menstruating. Dr. Tess will review your medical history during your consultation to ensure CoreLift is safe and appropriate for you.

A: Emsella works well for mild pelvic organ prolapse by increasing pelvic floor strength and improving muscle support. Many patients experience significant symptom relief through this non-invasive treatment. For more advanced prolapse, surgical options may be more appropriate. Dr. Tess will perform a thorough evaluation to assess the severity of your prolapse and recommend the best treatment path.

A: Wear comfortable, loose-fitting clothing without metal zippers or buttons in the pelvic area. Clothing that is too thick or too tight will block the magnetic waves so they do not reach your pelvic floor. Denim is particularly obstructive, so don’t wear your skinny jeans.

A: The intense pelvic floor contractions can create sensations of needing to urinate, but this is normal and temporary. We recommend using the bathroom immediately before your session. You won’t actually lose bladder control during treatment.

A: Yes! There’s no downtime or activity restrictions. You can exercise, work, drive—everything—immediately after your session.

A: EMSELLA is typically not covered by insurance as it’s considered an elective treatment. However, you can use HSA/FSA funds for payment. We also offer CareCredit financing with 0% interest options.

A: Although 95% of patients experience improvement, a small number require 8 treatments rather than 6. If you don’t achieve your desired results, we can talk about additional treatment sessions. Additionally, physical therapists offer pelvic floor therapy, and urologists are trained in pelvic floor surgery. We provide Emsella as a noninvasive alternative to these more invasive procedures for managing incontinence.

A: Absolutely, if that makes you more comfortable. However, the treatment itself is completely private and non-invasive—many patients come alone.

Q: How long does a DOT physical take?

A: Most DOT physicals take 30-45 minutes from start to finish, including paperwork, examination, and receiving your certificate.

A: Yes! If you pass your exam, you receive your Medical Examiner’s Certificate immediately. We provide both the original and a copy for your records.

A: Most drivers receive a 2-year certificate. However, if you have certain medical conditions (high blood pressure, diabetes, sleep apnea), you may receive a shorter certification period (3 months, 6 months, or 1 year).

A: If you don’t pass, Dr. Tess will explain what needs to be addressed. Once your condition is treated or controlled, you can return for re-examination. We want to help you get certified!

A: No. The DOT medical exam includes a urinalysis for medical screening (diabetes, kidney function) but does NOT test for drugs. Drug testing is a separate requirement arranged by your employer.

A: Yes! As long as your blood pressure is controlled (under 140/90), you can be certified. Make sure you take your medication as prescribed before your exam.

A: Diabetic drivers can be certified if blood sugar is well-controlled. Insulin-dependent diabetics typically receive 1-year certifications and may need endocrinologist clearance. Non-insulin diabetics on oral medications or diet control can usually get longer certifications.

A: Yes! Drivers with sleep apnea who are compliant with CPAP treatment can be certified. Bring your CPAP compliance report showing at least 70% usage over the past 90 days.

A: Corrective lenses are allowed! Just bring your glasses or contacts to your exam. You must be able to see 20/40 or better in each eye WITH your corrective lenses.

A: We strongly recommend scheduling an appointment to avoid wait times, but walk-ins are welcome if time permits. Call ahead to check availability.

A: Wear comfortable clothing that allows easy access for examination (loose-fitting shirt and pants). You may need to remove shoes and socks for the exam.

A: Yes, eat a light, healthy meal. Don’t come on an empty stomach, as this can affect blood sugar and blood pressure readings. Avoid excessive caffeine or salty foods right before your exam.

A: If your blood pressure is elevated, Dr. Tess may have you rest and retest. If it remains high, you may receive a shorter certification period or temporary disqualification until BP is controlled. We want to help you pass—sometimes taking a few deep breaths and relaxing helps!

A: Our DOT physical examination is $95, which includes the complete exam and your Medical Examiner’s Certificate if you pass. No hidden fees.

A: Most insurance plans do NOT cover DOT physicals since they’re employer-required exams. However, you can often use HSA or FSA funds. Check with your employer—some companies reimburse drivers for DOT physicals.

A: We offer Saturday appointments by request. Call to schedule. Our regular hours are Tuesday-Friday 9am-5pm.

A: They are separate exams with different requirements, but if you’re a DPC member, we can coordinate both. DOT physicals have specific FMCSA requirements that differ from routine physical exams.

A: We provide your Medical Examiner’s Certificate on the spot. You’re responsible for submitting it to your employer and/or your state’s DMV as required. Keep a copy for your records!

Q: Do I have to attend the IME?

A: Yes, you must attend the physical examination, as it is an essential part of gathering the necessary information to complete the Independent Medical Evaluation (IME) report. The physical exam allows Dr. Tess to conduct a thorough, objective assessment that forms the foundation of the IME documentation.

A: It depends on the circumstances. If the person you’re bringing can help answer questions during the evaluation—such as a spouse or caregiver who has relevant knowledge about your medical history or condition—their presence is welcome. Dr. Tess will determine if having someone accompany you is appropriate based on the nature of the IME and what information is needed.

A: No. Audio or video recording is not permitted during the IME.

A: You may need to undress to your undergarments for a musculoskeletal examination, and a gown will be provided for your comfort. It’s best to wear clothing that is easy to remove. The extent of the physical exam will be determined after Dr. Tess takes your medical history and understands the specific nature of your case. She will explain what the examination will involve before proceeding.

A: No. An IME is an evaluation only, not treatment. Dr. Tess will not prescribe medications, provide treatment, or become your treating physician.

A: Most Independent Medical Evaluations (IMEs) take 90 minutes to 2 hours. This allows Dr. Tess sufficient time to conduct a complete and detailed medical history along with a thorough physical examination to provide an accurate and comprehensive assessment.

A: The report is sent to the requesting party. You may receive a copy through your attorney, claims representative, or employer. Ask the requesting party about obtaining a copy.

A: You have the right to discuss any concerns about the IME findings with your attorney or claims representative. You may be entitled to request your own independent medical evaluation or seek a second opinion. It’s important to remember that the IME serves as evidence in your case but is not the sole determining factor in the final outcome.

A: No. Attorneys do not attend the physical examination. However, your attorney can advise you before the IME and review the report afterward.

A: The turnaround time for an IME report depends on the volume of medical records that must be reviewed both before your physical examination and during the report writing process. Cases with extensive medical documentation naturally require more time for thorough review and analysis. Dr. Tess can provide you with a more specific timeline once she assesses the scope of your case and the amount of records involved.

A: Yes, Dr. Tess is available to provide deposition and trial testimony when needed. Separate hourly fees apply for these services, and advance notice and scheduling are required. Please contact our office to discuss availability and fees for legal testimony.

A: This depends on the stage of your case—for example, whether a ruling has already been made. You should discuss this situation with your attorney or claims representative. If the timing allows for an addendum to the IME to be accepted, Dr. Tess can review the supplemental records and provide an updated report. There will be a separate fee for this additional review and supplemental report.

A: Your physical examination will include a functional assessment as part of the IME. However, formal Functional Capacity Evaluations require specialized physical therapy or occupational therapy protocols that are beyond the scope of an IME. If a formal FCE is needed for your case, your attorney or claims representative can refer you to an appropriate therapist who specializes in these comprehensive evaluations.

A: Our office is located in Blue Springs, Missouri, in Eastern Jackson County. We serve the Kansas City metropolitan area, Jackson County, and surrounding Missouri counties. Out-of-area examinations are possible if the patient is willing to travel to our office for the appointment. IME examinations cannot be conducted via telemedicine and must be
performed in person.

A: No, the IME requires an in-person physical examination. This is actually in your favor—Dr. Tess needs to see you and perform a hands-on physical assessment to gather the most accurate and complete information for your evaluation. A thorough, objective IME cannot be properly conducted remotely.

A: Our cancellation policy depends on the type of appointment:

For regular DPC appointments: There is no cancellation fee for rescheduling. For IME appointments: If you need to reschedule an IME but do not provide at least 48 hours notice prior to your appointment time, there is a 50% cancellation fee.

For canceling the entire IME process: If you decide to cancel the IME entirely rather than reschedule, you will be billed for the hours Dr. Tess has already spent reviewing your medical records prior to the scheduled examination. This reflects the work completed in preparation for your evaluation.

A: Yes. Dr. Tess’s reports are thorough, well-documented, and based on objective medical evidence. She is available for deposition and trial testimony as needed.

Q: Will you prescribe opioids if nothing else works?

A: Our focus is opioid-free pain management. In rare, exceptional cases (such as end-of-life care or acute post-surgical pain), opioids may be appropriate. However, for chronic pain, we believe multi-modal opioid-free approaches are safer and more effective long-term.

A: We can help you safely taper off opioids while building alternative pain management strategies. We’ll work at a pace that’s comfortable for you, managing withdrawal symptoms and supporting you throughout the transition.

A: This varies by individual and condition. Some patients notice improvement within weeks; others take 2-3 months. Multi-modal approaches require time to work, but most patients experience meaningful improvement within 3 months.

A: Absolutely not. Chronic pain is real, and many people were prescribed opioids by well-meaning doctors. There’s no shame in needing help to stop. We’re here to support you, not judge you.

A: Physical therapy can be very helpful, but it’s not mandatory. We’ll recommend it when beneficial, but we understand barriers (cost, time, access). We’ll work with what’s realistic for YOUR life.

A: Chronic pain is rarely “cured,” but it can be managed effectively. Our goal is to reduce pain to a level that allows you to function well and enjoy life, even if some pain remains.

A: Multi-modal pain management uses MANY strategies beyond medication. If one medication doesn’t work, we try others. We also incorporate lifestyle changes, physical strategies, mental health support, and complementary therapies. There are many tools in the toolbox.

A: DPC membership operates outside insurance, making appointments and medication management very affordable ($99/month). Medications are typically covered by insurance or available at low cost. Specialist referrals and PT are covered by your insurance.

A: Yes! We manage post-injury and post-surgical chronic pain using the same multi-modal approach. If surgery is needed, we coordinate with specialists and support you through recovery.

A: We can discuss these options. While we don’t prescribe medical marijuana, we can provide guidance on its potential role in pain management and refer you to appropriate resources if legal in your state. CBD is available over-the-counter and may help some patients.

A: Not always. If you have recent imaging, we’ll review it. If imaging is needed to guide treatment, we’ll order it. But we often start treatment based on clinical examination and adjust based on response.

A: Yes! Fibromyalgia responds particularly well to multi-modal approaches including medication (duloxetine, pregabalin), sleep optimization, exercise, stress management, and mental health support. We have experience treating fibromyalgia patients.

A: Nighttime pain is common and can be addressed through medication timing, sleep positioning, heat/cold therapy, and sleep hygiene. We’ll work on strategies to improve your nighttime pain and sleep quality.

A: Initially, every 2-4 weeks for the first 2-3 months. Once stable, appointments may be monthly or every 2-3 months. DPC members can reach Dr. Tess anytime between appointments via text/call.

A: Absolutely! We work collaboratively with pain specialists. Dr. Tess manages your overall medical care and coordinates with specialists for interventional procedures or complex cases.

Q: What's the difference between wellness coaching and therapy?

A: Wellness coaching focuses on lifestyle, behavior, and practical strategies for health goals. Therapy addresses mental health conditions, trauma, and deeper psychological issues. If you need mental health support, we offer counseling with Dr. Tess. Wellness coaching complements therapy but doesn’t replace it.

A: No! Wellness coaching is available to everyone, whether you’re a DPC member, a medical weight management patient, or someone from the community seeking support. DPC members receive discounted rates.

A: Wellness coaching is an integral part of our weight management program. Participants have two appointments per month with Dr. Tess for counseling specifically designed to address emotional triggers and behavioral patterns related to eating. On alternate weeks, participants meet with Gigi for wellness coaching to support and reinforce the goals of the weight management program. This comprehensive approach addresses both the psychological and practical aspects of sustainable weight management.

A: Absolutely! Wellness coaching addresses nutrition, stress management, sleep, physical activity, chronic disease management, and overall lifestyle improvement—not just weight loss. If you’re managing diabetes, high blood pressure, or just want to feel better, coaching can help.

The frequency of wellness coaching sessions depends on your individual needs and goals. If you’re enrolled in the weight management program, you’ll meet with Gigi twice a month as part of the structured program. Beyond that, the number of additional sessions—whether more or fewer—is tailored to your particular circumstances and what will best support your wellness journey.

A: We review what’s happened since your last session, celebrate successes, troubleshoot challenges, adjust strategies, and set goals for the next period. It’s conversational and collaborative—not a lecture.

A: Yes! Between-session support via text and email is included. Gigi is there when you need encouragement, have questions, or face challenges.

A: Life happens! Just give us 24-hour notice to reschedule without penalty. We understand that things come up.

A: The duration of wellness coaching depends on your specific program and needs.

For Weight Management Program participants: You’ll receive coaching throughout the entire 6-month program with two sessions per month. If you continue on the weight management program beyond 6 months to reach additional weight loss goals, you’ll still receive two coaching sessions monthly for as long as you’re enrolled.

For individual wellness coaching: Sessions continue for as long as you need them. The duration is tailored to your personal concerns and goals, giving you the flexibility to work with Gigi until you feel ready to move forward independently.

A: No, we don’t take a prescriptive approach to lifestyle modification—even in our weight management program. Gigi will offer suggestions and guidance for healthy eating habits, but we don’t provide rigid meal plans or strict dietary rules. Our philosophy is to empower you to make sustainable choices that fit your lifestyle, rather than imposing inflexible restrictions. This approach supports long-term success and helps you develop a healthier relationship with food.

A: If you’re referring to past dieting experiences, it’s important to understand that our weight management program is not based on a diet. Success in our program isn’t measured by whether you follow strict eating rules or avoid certain foods. We don’t view setbacks as “failures”—instead, we focus on understanding your relationship with food, identifying emotional triggers, and building sustainable habits that support your long-term wellness. Our approach is about progress, not perfection, and we’re here to support you through every step of your journey.

A: Most insurance companies do not cover wellness coaching. However, if you have a Health Savings Account (HSA) or Flexible Spending Account (FSA), these funds can likely be used to cover the cost of your coaching sessions. We recommend checking with your HSA/FSA administrator to confirm eligibility.

A: No, coaching sessions are designed to work on a one-on-one basis. This individualized approach allows us to best meet your specific needs and create a safe, focused space for your personal growth and wellness goals.

A: No! Wellness coaching focuses on making healthier choices with regular, accessible foods. No expensive supplements, meal replacement shakes, or specialty products required.

A: Gigi will track your progress with you at every session, helping you recognize changes and achievements along the way. Additionally, if you’re receiving coaching as part of the weight management program, Dr. Tess will monitor your progress through regular body composition analyses and weight measurements every two weeks. This combined approach ensures you have both objective data and personal insights to measure your success and adjust your goals as needed.

A: No, the wellness coaching program is designed to be conducted one-on-one and face-to-face. This in-person interaction is essential to the coaching process and cannot be effectively replicated through virtual sessions. The personal connection and environment created during in-person meetings are key components of successful coaching outcomes.

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