Our Philosophy – More Time with Your Doctor, Better Care, Better Access


The philosophy at Gateway Internal Medicine and Pediatrics is to give you more time with your doctor when you need it.  In a fee for service world with insurance, in order for physician practices to operate they must see more patients and take more visits.  More and more reporting regulations by third-party payers (insurance companies and the government) require paying more staff to justify billing.  Patients everywhere feel the pressure as visits become shorter and  doctors become less engaged. Complex problems that cross specialties get lost because specialists want to deal with their organ system only and the primary care doctor cannot begin to address complex issues in short visits. 


There is a solution and Gateway Internal Medicine and Pediatric believes it works.  A new movement has started called direct primary care.  It is a membership model that supports a strong patient-doctor relationship and encourages access to your physician both in and out of the physician office.  By opening the communication channels and fostering a more personalized delivery of healthcare, patients can see their doctor when they need to, ask questions if they are not sure what to do, and their doctor can offer individualized management of complicated medical problems.


The end result:  Individuals and families have a doctor who takes the time to address all their medical issues and can deal with complex problems. They also have direct access to their doctor both in and out of the office.

Bio-Identical Hormone Replacement

Traditional and Functional Medicine in One Practice

Functional medicine approaches symptoms and the expression of disease in a different way.  Instead of focusing on the disease itself which is the end result, it uses systems biology to identify the problem upstream.  Almost all chronic disease is caused by chronic inflammation, including autoimmune disease, GI issues and coronary artery disease.  The current model in modern medicine assumes the disease is incurable, and that pharmaceuticals can limit further risk or subside symptoms.  The pharmaceutical regimen is based on the disease, not the individual.  Many of these medications have long-term side effects, some more serious than others depending on one’s individual genetics.  More importantly, the source of the disease is left unchanged.  Trained as an internist, I understand the importance of treating disease because there are times when it is necessary.  However, getting to the source is even more important.  Such investigation can occur concurrently and the necessity of the medications should be an individualized discussion based on the patient’s risk which includes family history and markers in the blood, stool and saliva.  The body wants balance.  Disease indicates a problem with homeostasis and a genetic propensity.  The best approach is investigation that is individualized, using food as medicine, supporting the body with supplements and using medication if necessary.  For patients with chronic disease or for patients with ongoing symptoms despite normal testing or treatment, this approach is completely individualized to identify the upstream cause and get the body back into balance.

Hormones affect metabolism, muscle mass, bone density, energy and much more.  Many women today are experiencing hormonal imbalances before menopause.  Many women in menopause suffer from hot flashes, night sweats, decreased libido and mood changes.  In both cases, hormone levels in the blood and saliva can indicate the misbalance.  Bio-identical hormones are compounded hormones that most mimic the natural hormones in the body.  Instead of chemical compounds engineered in the lab, natural sources of hormones are used to support natural hormonal function giving men and women a better sense of well-being and health.  This approach is also a safer way to replace hormones.  At the initial visit, risk factors are discussed in depth.  Hormones are tested and an individualized plan is developed.