A Note From Miguel: Breast Cancer Awareness Month, and why I added primary care

October is Breast Cancer Awareness Month. It's a good time to explain why screening is part of every hormone conversation here.

When my practice opened, it was focused on hormone therapy. But I have a hard time ignoring everything else.​

Sometimes, I'd evaluate someone's hormones and find that a prescription wasn't the right answer. It could have been a low vitamin level, metabolic markers heading the wrong way, or low iron stores, an early sign of iron deficiency.

Not everyone needed hormones.

I also kept hearing, "I don't have a primary care provider."

That matters, especially before starting hormone therapy.

Screenings like mammograms need to be current. I ask where patients stand, then I request documentation to confirm it. Without a PCP, there was often no one to follow up. Finding one and getting an appointment in a reasonable time was a real barrier, and referring out didn't make sense. So I stepped into that role.

Some online services prescribe hormones or weight loss medication based only on an intake questionnaire, then leave routine care, like labs and screenings, for the patient to arrange elsewhere. When that follow-up doesn't happen, care gets fragmented.

I wanted it to be easier. Here, I do the risk assessment and the evaluation. If you're due for a mammogram, I just put in the order. When you need a specialist, I refer you, and I follow up to confirm it happened. It's coordinated in one place, and it isn't left up to you. When I prescribe, I'm responsible for the whole picture, and I take that seriously.

Adding primary care also meant changing how the practice runs. Earlier this year, I realized the way I'd been running things wasn't sustainable. I was never good at asking people for money, and there were days I questioned whether I could keep going. Moving to insurance means most visits now cost patients a copay or count toward their deductible, which has meant less out-of-pocket for most people. And I can keep doing this work.

If you're overdue for a mammogram, thinking about hormone therapy, or looking for a primary care provider, I'd be glad to help.

Schedule an appointment here: https://www.bluezonehw.com/schedule-appointment or visit bluezonehw.com for more information

Remembering those we've lost, celebrating survivors, and sending strength and support to everyone living with breast cancer today.