T Nation

Necessary to Test Prescription for Legitimacy? Online vs. In-Person Clinics?

2 Questions:

  1. Has anyone had or heard of someone who received illegitimate/fake testosterone for TRT purposes from a HRT clinic via online? To be clear, this is referring to someone who went through the proper channels to obtain Test through legal channels (e.g., lab work, doctor visit). I’m not talking about illegal purchases from a UGL. I’m curious if something such as labmax for testing purposes would be appropriate or if it is a standard practice for all to “test” their Test (little play on words there lol). I know…I’m probably just paranoid. I just don’t want to be scammed.

  2. How many of you guys go through a HRT clinic via online (i.e., telemedicine)? Perhaps there is already a poll, but the search function is not working for me (maybe its my browser). Do you prefer online or in-person HRT clinics?

I am using an online clinic, but I would prefer an in person visit. Defy Medical is probably the most reputable and we have many members who use them. If you find a walkin clinic with a bunch of hot babes, get out while you can.

I just confirmed search function works for me just fine.

Telemedicine. Make phone call, get T in mail, inject, feel good and get jacked.

A TRT clinic’s sole purpose is to sell T. If what they are selling isn’t T then they aren’t going to be doing too well especially since there’s 8 million out there. If you need a telemedicine clinic that sells real T feel free to email me (in bio). Mine runs $150/month.

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Yes, I have heard from a few who claimed that happened. They did have lab test to back that up. I suppose some of the online stuff is suspect, but when it comes to legitimate prescriptions, I think most are fine as they use reputable and FDA accredited pharmacies.

Clinic. It’s always best to have a doctor that actually knows you that you can go see from time to time. A doctor treating you without the benefit of an appropriate examination (which means he or she actually did it), and who has never personally met you is not best practice. I think telemedicine is fine, if the clinic follows state statutes and the patient has nothing unusual. That means an initial face to face consultation is required before going the telemedicine route. This is why reputable doctors require the patient to travel to their clinic for the initial visit. Most states require the doctor to be licensed in the state in which the patient resides. You get around that by traveling to see the doctor in their state. There are other state to state variations. Florida, for example, requires a face to face visit with the doctor prior to telemedicine if prescribing CIII drugs, like testosterone.

My doctor is out of Florida but I reside in another state. I only had to visit a doctor in my state and send the paperwork from that visit to the doc in Florida. I also had to get labs done and sent directly to the doc in Florida. Anything out of the norm here?

That’s what I had to do too, however, I’ve read they technically are really supposed to do an in person first meeting to “establish” the relationship before telemedicine is OK. I don’t know if there’s more to it than this, and people clearly do it regardless, but that’s what I’ve read.

Well at least I’m not the only one lol. I’m naturally a skeptical person, especially when it comes to online…

How much does Defy Medical cost? I’ve also heard about titan medical and Live like a Viking. I currently go through a local clinic and signed up for a year. I have a few months left. Going to try to get a script through a urologist but if I can’t I want to check out some cheaper options. Clinic I use charges almost $2300 a year. I figure I could get the test, syringes and 3-4 blood tests per year for under 1K even without insurance if I can get a script. I am paying more than double that.

$250 for initial consult. $90-160 per consult after that (doctor vs PA). Actual cost for labs. Meds just depends what you’re on but it’s through Empower.

They will supply the paperwork for $15 to seek insurance reimbursement if you wanted to try to get some of it back.

Once things are stable you can go 6 months between consults/labs if everything is going good.

Due to your response to me I believe they don’t require you to travel to Florida for a consultation or initial consultation?

How often are consults/follow-up lab work required while on TRT through their program? Thank you for the info good sir.

Correct. It’s all been over the phone. They required a local physician give me a physical first, for whatever that is worth

I don’t recall exactly at this point but I think I started at every other month then went to every 6 once things were stable. Obviously I can have more as needed. If they don’t hear from me then they assume all is well

Here is the statute:

Ch. 2019-137 LAWS OF FLORIDA Ch. 2019-137
393.17; part III of chapter 401; chapter 457; chapter 458; chapter 459; chapter 460; chapter 461; chapter 463; chapter 464; chapter 465; chapter 466; chapter 467; part I, part III, part IV, part V, part X, part XIII, or part XIV of chapter 468; chapter 478; chapter 480; part II or part III of chapter 483; chapter 484; chapter 486; chapter 490; or chapter 491; who is licensed under a multi-state health care licensure compact of which Florida is a member state; or who is registered under and complies with subsection (4).
(2) PRACTICE STANDARDS.—
© A telehealth provider may not use telehealth to prescribe a controlled substance unless the controlled substance is prescribed for the following:

  1. The treatment of a psychiatric disorder;
  2. Inpatient treatment at a hospital licensed under chapter 395;
  3. The treatment of a patient receiving hospice services as defined in s. 400.601;
    or 4. The treatment of a resident of a nursing home facility as defined in s. 400.021.

Yes, according to the statute that was illegal if testosterone was prescribed.

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There are laws that provide an exempt. This is getting old Highpull and you’re just coming off as stubborn. Please read it, process it, read it again until it sinks in. You made the same claim about Defy Medical and got schooled by someone who personally knows DR. Saya and how he wouldn’t risk his life/career/reputation over something so stupid as breaking a telemedicine law.

Anyone who wants to join up, favorite the post are choosing the same path, ignorance. It’s no different than me chastising doctors on this forum I don’t even know who I routinely rail against which I will try to refrain from doing.

President Trump just signed into law the Special Registration for Telemedicine Act of 2018, requiring the Drug Enforcement Administration (DEA) to activate a special registration allowing physicians and nurse practitioners to prescribe controlled substances via telemedicine without an in-person exam.

https://www.foley.com/en/insights/publications/2018/10/president-signs-new-law-allowing-telemedicine-pres

Geez systemlord, I purposely avoided mentioning your precious clinic and your beloved doctor in hopes of not inflaming you. I see I failed. Anyway, I guess I can always count on you for a good laugh, and lately that applies to about every thread in which you post.

Perhaps you should read your own advice. Did you even read the material in your own post? Did you miss this:

" If I Meet an Exception, Can I Prescribe Controlled Substances Without Any In-Person Exam?

No, not necessarily. Whether the exam is conducted in-person or via the practice of telemedicine, a prescription for a controlled substance must always be issued for a legitimate medical purpose by a practitioner acting in the usual course of his or her professional practice. Moreover, practitioners must comply with both federal and state laws, as DEA considers a physician who engages in the unauthorized practice of medicine under state law to be someone who is not acting in the usual course of his or her professional practice."

How about calling some other TRT clinics in Florida and asking about their policy and procedures? I called three and they all require the patient present for the first visit. But, it’s only three, probably not good enough for you. It satisfied my curiosity, but call dozens if you’d like.

What about all of these other TRT doctors nationwide? You were raving about Dr. Rob Kominiarek (acting like you know him well, which is suspect) on another thread a while back, even pointing out that he requires the face to face initial visit like it is a good thing.

For the sake of argument, let’s say it is legal. They were still doing this well before this was signed. What about then?

Also, if I am a doctor, no way in hell am I basing treatment, and putting my license on the line, on exam findings from another doctor, especially one I do not even know. I find that very odd, would not do it, even if it were legal. It does not look like many do either.

No, I think I was absent that day.

Please, don’t change a thing. Just be the real you.

Also, after running a simple search for online HRT clinics, why do most (or all) seem to be in Florida?

BTW - thank you both, systemlord and Highpull for the info!

If you can do a one time introductory visit it opens up a world of doctors who can treat you.

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