Frequently Asked Questions
I blend evidence-based medicine ("science") with listening to you as a person ("the art of medicine") to practice Patient-centered medicine.
I am a doctor who believes her patients. I am open to patients and parents' lived experiences even when they may be different from what is described in the literature -- every patient is an individual. I listen to what helps you or your children and work with you accordingly. I am primarily a traditional medical doctor, but we may explore Eastern and other integrative modalities. I do not lean heavily on extensive lab workups, nor prescribe too many pills or supplements, but I am open to exploring diagnosis and treatment with you and your child in the ways you feel you need.
The short answer is that I generally follow the PPN and ASPIRE guidelines and recommend you check those out (see links).
If we decide on prescribing medication (e.g. antibiotics, steroids, ibuprofen, prozac, or other western medications for example), I can send those to your local pharmacy. IVIG is possible as well.
Supplements and herbals have some evidence to support their use, and I can point you in that direction. I collaborate with a Chinese medicine doctor who can see you by zoom as well.
If you need labs drawn, a letter with diagnosis, or treatment recommendations to bring to your primary care doctor or other for example, I will provide that.
I can prescribe all medications (including psychiatric, IV, etc) except those which are controlled substances (eg benzodiazepines, adderall/ritalin) due to change laws in telemedicine. If one of those is needed, we can sometime use other non-controlled medications in place of them.
You do not need to have labs drawn. PANS is a clinical diagnosis and can be made without labs. However in some cases, they will be recommended to assist in understanding the details of the diagnoses, and if you would like to have something checked, we can certainly order it.
I usually try to see patients within 1-2 weeks because it's often an acute issue. If you do not see a time in the next few weeks and need to be seen, please write me directly and let me know and I will do my best to see you quickly.
Most kids hate going to the doctor and hate talking online to adults, so I tell parents that I like to spend a moment or two (or longer if they wish) meeting the patient, and then they can go on their way leaving the parents to meet with me.
Teens of course are welcome to engage in their appointments as much as they are willing. This helps them build the 'muscle' of self-advocacy. No pressure though.
I do see adults. PANS/PANDAS has been traditionally considered a pediatric diagnosis, but that clearly does not reflect the reality of the disorder.
Payment is per consult or per month depending on your plan. You can choose a single consultation (as often as you like), you can choose a 1 year membership. The membership is designed to make regular touch points more affordable, and is recommended for those desiring ongoing care.
Unfortunately, I am not set up to accept insurance at this time since that complicates practices greatly (making things more expensive) and I strive to keep my practice as straightforward for patients as possible.
Patients who had an initial consult may continue on to the lower cost monthly membership, if desired.
If you were seen once and after a number of months passed, you would like a second consultation, this will be charged the single consultation fee.
Membership is for 1 year (billed monthly) and allows ongoing management: Emails and questions, advice on issues that may arise during the year, school letters, prevention and treatment of flares, continued prescriptions, any appointments needed by phone or video.
Extra fees: 1. Any meetings requested with outside professionals (eg with schools, psychologists, pediatricians, other) are billed at $200 for 1hr meeting (or incrementally for partial hours). 2. Starting IVIG incurs a cost of $250 (one time fee) as this requires extra time on forms, prior authorizations, monitoring, etc.
Prescriptions are generally covered by your insurance. Labs as well. The only thing that insurance sometimes gives issues about is IVIG and other specialty care. We will work together to apply to your insurance to cover that as well but it is a process.
Please write me directly for alternate payment plans. I believe cost should never stop someone from getting the proper care.
If you scheduled an appointment and need to cancel before the appointment, please let me know. You will not be charged/you will be refunded. Yearly subscriptions can be cancelled early with 3mo penalty.
The practice is telemedicine only (we meet on zoom). I live overseas and do not maintain a physical office.
Step 1 - Scheduling: Self-scheduling is available. If you need an alternative time, please reach out with alternate morning hours that you can be available (Welcome@DrRothMD.com). All consultations are virtual (by zoom). We will meet directly for around 45-50 minutes. For many parents and patients this is the first time they have had a chance to be fully heard, and please feel free to bring all your questions. Note: For young patients, I prefer to meet the patient even for a few minutes. Sometimes this is not possible or desired and parents are simply looking for information and to speak with the doctor which is fine for a first discussion.
Step 2 - Enrollment: Open your child's chart and lines of communication. When registering a pediatric patient for membership, first the parent should enter their own info, set the toggle that they will not be part of the membership, then enter their child's info on the subsequent form.
Step 3 - Medical History: Fill out the intake form before your appointment so that we can jump right into the conversation with me already up to speed.