Friday, January 20, 2017

Inauguration Day 2017

Why Can’t We Just Stand Shoulder to Shoulder?
Today, my daughter isn’t allowed to watch the Inauguration at School

For 18 months I have watched, listened and observed angry people share their views on the election, candidates and now ultimately the 45th President of the United States.  I have kept my mouth shut, my pen off of the paper and my hands off of the keyboard purposely.  Not because I am a wimp about what I believe and stand for, but because quite honestly I didn’t have the desire to start a pissing match with people I love, admire and respect for various reasons.  I didn’t delete “friends” from Facebook, Twitter or any social media outlet.  I never once commented on anyone’s opinion.  And clearly opinions are like ass holes right?  We all have one. It’s not that your opinion doesn’t matter, anyone who knows me, knows I love diversity (I talk about diversity all day long and how important it is for our health).  I have had lots of diversity in my life.  From dating women (I would NOT recommend doing that while you are married, no matter how unhappily married you are)! That’s a story for another day though.   To several other controversial things in my life that I am grateful to have had the right to do in this country. 

My heart hurts today for the thousands of children across the country (and Middle TN) that are NOT allowed to watch the 45th President of the United States take the oath of office today. The schools will not allow the inauguration to be viewed.  I had no idea that Ella couldn’t watch it today at Centennial High School in Williamson Co. !!  We were watching Fox News on my computer (we don’t have a TV or cable) this morning and I was discussing the inauguration with her.  She informed me that none of the teachers are allowed to view the inauguration today with their students!  That if students are caught watching on their phones, computers or other devises they would be sent to ISS!!  WHAT THE HECK?  Apparently parents didn’t want their students watching!  THEN KEEP THEM AT HOME AND GIVE THEM A KITTEN, HOT CHOCOLATE, COLORING BOOK OR WHATEVER MAKES THEM DISCONNECT FROM REALITY!  Ella didn’t vote for President Elect Trump, she voted for Jill Stein.  But she understands that HE IS OUR President now. Any inauguration is an historic day.  Only 45 men have ever had the honor of standing up there and taking that oath in front of God and the world.  It is my hope that someday a woman stands there as well.  But for today, she doesn’t. 

I am honored to be an American and living in the greatest country in the world. I  will watch the inauguration today of a man who is an outsider, a rebel, a deal maker and imperfect.  Just like all of us.  I am not throwing the first stone, and I dare anyone else to. There was only one perfect man who walked this earth, and it isn’t any of us.  If you don’t want to watch, that’s your right.  If you want to protest, that too is your right.  It’s your right because we live in a country that you are afforded the privilege to protest, picket and even burn the flag if you so choose without being sentenced to death or imprisoned. And, you are free to move to another country at any moment, if you don’t believe this is the greatest country on earth.  Syria, Aleppo, Haiti, Iraq,  Baghdad would all be great places for you to go and live for a while (or forever) if you are so disgruntled with America. 

If you don’t believe this is the greatest country on earth, then move.  Move to Haiti where I spent 3 weeks after the earthquake in a huge army tent with no running water other than a water hose. Where I witnessed young children die in front of me from lack of medical care, where I delivered babies whose moms walked for hours to the clinic with their own pail to use as a toilet.  Who labored and recovered in a room with others and no sterile instruments, food or running water.  Then walked home or rode a donkey with their babe on their back.  Move to Honduras where I was part of a medical brigade that the people would walk all night to stand in line for hours and hours to get aspirin, lice and parasite medication, vitamins.  Then walk hours and hours home while they had stood in line all day with very little food or water. 

I am honored today to watch the 45th President of the United States be sworn into office.  Yes, I voted for Trump.  Had I voted for anyone else I would still be honored to watch this historic day.  Not because it is Trump.  But because we live in a country that allows us to vote freely, watch freely and protest freely.  If you are boycotting the Inauguration and are in elected office, then in my opinion, you are boycotting America and your constituents.  Shame on you.  But, I acknowledge it is your RIGHT to boycott. 

My candidate did not win 8 years ago and I was shocked he won 4 years ago. I did not protest, march, cause a ruckus or cry like a baby because the man I voted for was elected.  I didn’t need a coloring book, hot chocolate, a kitten or puppy to decrease my anxiety over what just happened. I didn’t see anyone asking Vanderbilt to cancel classes at that time or any university for that matter. I thought college was about learning about diversity, tackling challenges, integrating with other’s opinions and ideals? When President Obama won I embraced him, supported him and went about my life.   
I love my liberal friends, patients and family.  I have four best friends in my life.  The roots, the people that keep me grounded.  3 out of 4 voted for Trump.  I love and admire the 1 that voted for Clinton (and it’s not because she owns a house on the beach).  

I love diversity and my friends and family are more important to me than any election!  Our future depends on us!  You and Me…if you want change then get up and go out and change something.  But, like it or not, Donald J Trump is YOUR next President of the United States.  I feel certain he couldn’t give a rats ass if you like him or not.  He is president, and we are not.  He was voted fairly and squarely (even if he didn’t win the popular vote).  Keep fighting for what you think is right, vote him out in 4 years, move to Aleppo or whatever helps you deal with this very sad day in America according to many on my Facebook feed.  If you have a home and a car..guess what?  You are in the top 1% of wealth in the world!  THE WORLD!  I for one am honored to live here, in this country. 

I am saddened for my SR in High School today, along with the thousands of other children that are not watching the inauguration of our 45th President of the United States.  Shame on us for being so shallow we shelter our children (the future of our world) from what?  From the freedom to watch a man be sworn into office that was elected by us?  Not everyone wins the race, not everyone gets a price, not everyone is a winner, life is hard, life if beautiful, life is not fair sometimes, life is not to be taken for granted.  Buck up buttercup….stop dumbing down this next generation!

God Bless America.  Democrat, Republican, Green Party, Independent or whatever party you choose….CHOOSE being the key word.  We live in a country where we can CHOOSE.  But, my child didn’t get that option today.  I could of kept her home from school, I chose to send her.  Thank God for the ability to watch online when she gets home. 

Congratulations Mr. President, my President, the countries President.  Make us proud, prove those of us wrong that didn’t vote for you.  Keep us safe.  Keep your promises.  

Monday, August 10, 2015

I Walked on Water Last Year

One year ago today….I stepped out in faith!
And walked on water!
It was exactly one year ago today that I left my former job and stepped out in faith to open my own practice.  I have been filled with emotion and tears the past few weeks as I knew the month of August would be emotional for me.  My first born is leaving to start his sophomore year at ETSU as a premed student, my youngest started her junior year at Renaissance high last week (a second chance to find her way and thrive in school), I miscarried twins at 12 weeks 16 years ago that would have been due this month (yes, if you do the math…I would have had 4 children 4 and under), I have my first ever speaking gig at a conference in Denver this week….all during the same month I am celebrating my 1 year anniversary of opening Integrative Family Medicine!  No wonder my adrenals are screaming at me!!

The past year has reminded me of the sermon my pastor Pete Wilson preached earlier this year on “Water Walkers”.  Matthew 14:25-32 is the story of the 12 disciples in the boat who were afraid when they witnessed Jesus walking on the water toward them. There were 12 in the boat, but only Peter had the courage to GET OUT OF THE BOAT.  He walked on water toward Jesus, but began sinking as he took his eyes off of Jesus…once again he was rescued and safely got back in the boat.  For the first time in my life I sat quietly for nearly a year without making a move.  I prayed, I sat, I waited on God to give me a sign if I was to leave the security of my job and open my own practice.  And in July 2014 I heard it as clear as day while at the beach alone; “It’s time, go now”.  I have spent my entire life in warp speed and never taking the time to listen or obey.  This time I did both and even though it has been a wild ride and not without bumps in the road, adversity and fear on my part, I have stayed the course and kept my eyes on HIM the past year….

Needless to say my last year has been a whirlwind of chaos (not organized most of the time), blessings beyond belief, uncertainty as I pray every day that patients will actually show up and pay to see me, gratitude that THEY DO and that I can pay my bills and student loans every month!  Here’s a little refresher of the last year in the life of me and Integrative Family Medicine……
August 11, 2014 I gave my notice at work…August 11, 2014 UHOHHHHH…no notice needed! I was free to leave that day. That afternoon after I left my job of the past 4 ½ years for the last time I posted on Inside Out that I would no longer be working at my old position and would be opening my own practice …and low and behold….the phones started ringing and the voicemail filled up in a matter of less than an hour.  Jackson was at the gym working out (and had the new cell phones with him) and called me asking what to tell people. I was speechless, I had no idea if anyone would really call, if anyone would really want to come see me in private practice.  I was loaded with insecurity, determination and scrappiness! That night as the phones rang, and it was just me and Jackson at the house I remember telling him “this is a night we will never forget son.  This is the beginning of something amazing. Let’s don’t mess it up”! 

August 12, 2014 command central was set up at my house with some of the most incredible friends ever who dug in and did whatever was needed to get my practice set up.  Jackson took charge of the phones and worked 18 hours a day as the scheduler! He had patients texting him at all hours of the night to set up appointments and I couldn’t have set up practice in 3 WEEKS had it not been for that kid!  Ella jumped in and helped haul supplies, office furniture and any work that needed to be done!  It truly is a FAMILY practice that got the foundation laid with the best family of all…my kiddos!
The next 3 weeks were a blur of building out the new office, finding mix and match furniture, Jackson hanging shelves, pictures, putting together desks, painting, ordering supplies, setting up my supplement vendors, finding a lab company to work with, being wined and dined by various reps,   getting computers bought (we had no internet for the first 6 weeks and borrowed from the neighbor), the electronic medical records crashing one night and us losing ALL appointments that Jackson had worked so hard on making, me breaking down and crying more than once that day and afterwards, food brought to the house and office from friends and patients cheering us on!  The list of tasks needed to do was done in 3 weeks times was overwhelming…but it never occurred to me that we couldn’t get it done!  All the while you all were cheering us on through the Inside Out Healing From Within Facebook updates! Showing up willing to work, clean, paint, make appointments or whatever needed to be done. 

We got that office up and running by the first week of September and dang if a few weeks into it, Tammy called me late one night in tears telling me that Blue Cross was going to make me use a different supervising physician. I scrambled to find a new one and then they said “nope, you now have to credential all over again the time limit has past and you can’t bill for one patient you have seen.  They cost me 40,000 in claims since I had not billed anyone with BC/BS. I was calmer than Tammy and quietly decided that there was no way I was fighting that.  I would take the loss (I hadn’t even been open 2 months yet) and move on.  And pray my patients stayed with me. 
Thank YOU to every one of you that has been a part of something short of a miracle the past year.  I can’t name names because there are too many to mention, but you know who you are.  You have supported me, loved on me, lifted me up when I was doubting, fed me and the kids, drank wine with me and simply stopped in the office just to say hello! I love you all more than you will ever know and am eternally grateful and humbled daily that you show up!! I promise to keep showing up…if you will! I’m by no means the smartest NP out there, but I love my patients like family and will walk this journey with you as long as you want me to!

My kids have seen me divorce 13 years ago, receive Food Stamps and be on a Medical Card for 5 years while going back to school in KY and then starting Vandy for 3 years, seen me cry as I left Vandy with 200,000 in student loans and no way to pay the minimum payments, seen me scratch my head the first 2 years in practice wondering what in the heck I was doing…and have now been an integral  part of their mom deciding at 48 to take one more chance and GET OUT OF THE BOAT….I hope they remember this past year as the year we were WATER WALKERS together all the while giving God the glory for anointing me to do what I do and giving me the courage to STEP OUT IN FAITH and walk on water!

Hoping for 20 more years in practice…actually, I am hoping Jackson changes his mind and decides his true calling is endocrinology and NOT orthopedic surgery!!  J

Wednesday, August 5, 2015

Marching to the beat of a different daughter's story

Marching to the beat of a different daughter's story

March 26, 2009 at 9:10am
Many of you know that as a parent I have struggled with my daughter and her learning style, personality and her short term memory difficulty. Since she was in kindergarten I have fought to find out just exactly what might be going on with her. She has always "marched to the beat of a different drummer" as her father says. But as a mother, I was certain something was "amiss"  with Ella Kate.

Long story short.....after discovering last year that she has a 70% hearing loss in her right ear she was given an IEP at school to have work modified etc. Still, something was not right. I took her to the TRIAD center at Vanderbilt, which is the premier Autistic Spectrum Disorder diagnosing center in this part of the country. We spent 6 hours in testing; the doctor said to me " I can tell you what she doesn't have, but I am not sure what she does have going on inside her". Again, another vague answer. It appeared she is not autistic, but had several Asperger autistic traits.

Fast forward to Dr. Lanpher a geneticist at Vanderbilt; Dr. Lanpher did extensive DNA testing on Ella Kate in August. We have now discovered that she has a micro-deletion on the short arm of her 16th chromosome. This kind of discovery has only been possible for the last three years. As he told me this week, our technology is ahead of our actual research. Therefore, what we don't know about this sort of DNA mishap is far more than what we do know. We know that this area of the 16th chromosome that is missing is related to learning difficulties and autism spectrum disorders!! Unbelievable!! Like he said, this is not a definitive diagnosis, but it is a start and will help her with getting services at school. Is it connected to the hearing loss? No one knows. Both Greg and I will be checked to see if we too have this sort of deletion. Highly unlikely, but not impossible. So, once again I have another gray area!! But, also one that is wide open for research. Given the fact that this research is so new, she is on the cutting edge of research and hopefully her DNA analysis can be used to further research into this amazing field of genetics.

Moral of the story, I have been persistent for years in attempting to find a way to make learning easier for EK. Nothing has worked, and because I didn't have a medical diagnosis, many services are not available to her. I am a true believer that as parents we know if something is askew in our children. I have now come to believe that the reason I was accepted into the MSN program at Vanderbilt might very well be because God knew that this is a place that we could finally get to the bottom of EK's learning difficulties. Had I not been here, we would not have been able to take it to the next level and actually analyze her DNA. And to think I though I came down here for a man that ended up breaking my heart!!! He doesn't get that much credit anymore!! God knew all along why we were on this difficult journey in Nashville....and to think I thought it was all about me!!!

It looks like we have found Ella Kate's drummer that she has been marching to for so many years.....will it make a difference in her life? In many ways no it won't. But, in many more it will give me the knowledge to continue the fight to get my daughter the very best help she can get. Do I know what her potential is? Do I care if she wants to work at PetSmart (like she told me last week) the rest of her life? I don't know what her potential is, but if it is working at PetSmart as a stock person, retail sales or a a vet then it is my job as a mother to make sure she reaches whatever her potential is.....a journey that I now have a different outlook on than I did 3 days ago! How many of us are walking around this world with a slight deletion or addition to one of our chromosomes? Dr. Lanpher says millions most likely...and they are just "quirky individuals"...

God is good indeed...and I thank God for putting me in a place that can help us give EK the best care and support to rebuild her confidence and self esteem. Whatever her potential is in this world, I am grateful that she is my child...and I was chosen to be her difficult and oftentimes overwhelming as it is for both us!


UPDATE:  6 1/2 years later...

What a wild ride the past 6 1/2 years have been for us!  Not long after starting work at my former job for CSFM, I had EK tested for an MTHFR mutation.  And low and behold she has a compound heterozygous MTHFR mutation.  Meaning she has a decreased ability to detox and she is unable to make the methylated form of folic acid and b12.  She was also tested for pylouria and elevated copper, and histamine levels..all three were abnormal.  That added another kink into our already complicated medical history!  Add that to the hormones of a teenager, the resistance to take any supplements at all and a peri-menopausal mom whose hormones are insane, while trying to learn a new career and then transitioning to her own practice...and you have the perfect cocktail for stress and explosive moments!   Her first 2 years of high school were not a pleasant experience for both us.  As we were at our wits end this spring with school and tutoring and the mentioning of quitting school and getting a GED, I learned of Renaissance High School.  A public school that takes kiddos like mine and basically nurtures them back to the self confident young adults they were meant to be.   

Tonight I cried as I sat in the back to school night for Renaissance High School in Franklin TN.  The high school that EK was accepted into after 10 years of struggling with her academics! I sat in silence tonight as I listened to the principle, Dr. Brian Bass explain how every child that is in that school (and there are only 42ish in each grade) was chosen and CHOSE to be there.  This is a school dedicated to educating the kids who "March to the beat of a different drummer" as he stated. Their mission is to  nurture them to not only survive but to THRIVE and find their passion in life.  As stated above, we have had nothing but failure in the school system dealing with EKs processing and learning style.  Tutor after tutor, IEP meeting after IEP meeting, parent/teacher meetings and the list goes on and on.  It wasn't until this Spring that my friend Stuart Tutler told me about Renaissance.  I sat tonight looking at the quirky, clearly uniquely dressed, artistic teenagers wondering how many of them had similar experiences as EK through the years.  I wondered how many of the parents there had cried, not understood, yelled, said harsh words to their kids during terribly high times of stress. I wondered how many kids wanted to just disappear and not be noticed in class and in life, how many shut down daily in classes they didn't understand.  I wondered how many broken families were sitting there tonight with me praying that this school and their dedication to teaching out of the box, nurturing our kids self esteem back to health is the answered prayer we had all been praying for?  EK and I have a second chance to heal and find the passion in learning that she has never had. What a gift from God that out of only 4-5 openings in the Junior class and 100's that applied...that sweet kid of mine was accepted!  

For the first time in 11 years of school, I am looking forward to seeing what this year brings for not only EK but for me as a mom...a single mother who has fought nonstop for this kid year after year in the school system.  I know her classes will be difficult, but her confidence will be preserved and self esteem nurtured back to health in an environment that is dedicated to making sure EVERY CHILD succeeds.  I drove home tonight listening to a kid talk nonstop about the kids in her new school.  The school is small, but the demand is HUGE!  Evident by the hundreds of kids that did not get in, that are on the wait list.  I cried tonight as I thought about the parents that were desperate to find a better way for their babes, a safe harbor in a broken educational system that is not equipped to educated the ones that are "marching to the beat of a different drummer".  I am humbled that my babe is given a second chance to spread her wings and find her passion, a love of learning and chance to thrive in an environment where everyone is a little quirky!  The English teacher told us that all the teacher there are a little quirky and relate to our kids quirkiness!  

She still has an MTHFR mutation, microdeletion of the short arm of the 16th chromosome, hearing loss (that she refuses to wear her hearing aid for :)), pylouria etc...won't take her supplements (even though I screamed out last week that "people travel from all over to come see me for help EK..why won't you listen to me and take your supplements"?....And I am closer to menopause than I was yesterday (meaning my fuse is short, and my sheets get changed several times a week due to catching on fire at night) and hormones are insane!!  BUT MY BABY HAS A SECOND CHANCE...AND THAT MAKES ME SMILE!  

Sunday, October 26, 2014

My first stab at Lord, I hope it gets easier!

WARNING: This blog could be detrimental to your opinion of me, but this event that happened is too funny not to share! So read it at your own risk, or if you want a good laugh…..

I did something last week I swore I would never do (although I did sign up briefly 1 year ago, and quickly stopped my subscription).  I signed up on, at the advice of a patient of mine who met, married and moved away with the love of her life after meeting him on Match.  She told me how Internet dating is for people like me who are busy and don’t have time to get out to meet and mingle with other single men.  She pumped me up on all the reasons I should give it one more shot and this time open my horizons to a “nationwide” search versus a “regional” search.  
After taking the time to write a glowing, yet honest bio of myself and what I am looking for in a relationship; I promptly filled out all of the “qualities” I was looking for in a Match.  I love bald headed men; check, I DO NOT want small children in the mix: check, I would prefer he be a widower or at least 5 years divorced; check, preferably makes more money than me; check, Christian, check, no smoking; check, sense of humor, check……added my recent big red 80’s hair photos to the mix and I hit submit…….
I promptly get a notice that says not ONE match is out there for me with those qualities!!  “No matches are found, maybe you should broaden your qualities”…..I read that to say LOWER YOUR STANDARDS… I added they could have hair (I didn’t change that I preferred the ex-wife be deceased (don’t’ judge me….have you ever dealt with an angry/jealous ex of a boyfriend? or they make less money than me)…salt and pepper, gray etc…the basic hair colors…BINGO….thousands of matches nationwide with hair!   Now, I am set and apparently ready to go LIVE with my search for love, friendship, marriage, etc….
Within an hour, the “winks, likes and emails” start coming in.   I am still a doubter on this and amused at the responses I am getting…some are not at all what I put on my profile…….
Fast forward to yesterday….I decided to meet this guy for coffee and so I did.  He shows up looks fine, is half bald (but not in a bad way), tall and slim.  Is an excellent conversationalist (if you know me, that’s important), raised Baptist (as was I), good job, a 12 year old son he shares custody of with his ex.  Who is alive and they get along well he says……she is a hairdresser in Cool Springs off of Mallory Lane……that immediately caught my attention…so after a game of 20 questions…..and we narrowed down the salon’s name….then I asked HER NAME….
HOLY CRAP…his ex-wife is MY hairdresser and Ella’s as well!!  I nearly snorted out my Chai Latte and ran out of the building!  Of the thousands of men (I should of stood my ground and stayed with bald men) I matched up with the qualities I had listed….first out of the gate I go out with is MY HAIRDRESSERS EX HUSBAND!!!  No stinking way is this ever going to work out!  His exact words were “will that be a problem”?
YOU DARN RIGHT that’s a problem…if I have to choose between a Match date and my hairdresser (the one who controls my color, cut and style of my hair)….I choose my hairdresser…case closed! 

We had a great time, he asked me to go canoeing soon and we left it at that!  I immediately called my hairdresser and told her what had happened!  We laughed and she encouraged me to move forward….not sure about that! 
I am sure my patient is correct, I won’t meet a date in my work; where I treat mainly women with hormone, thyroid and adrenal problems. I love my church, but it’s full of younger people. There are no men where I work out at Releve’ One and I am too tired to get back out when I get home and fix dinner, do laundry, check on the kids etc everyday……good thing I am not looking to get married anytime soon (or maybe never).  Because this whole internet dating thing is difficult!  I think to be successful at it, one has to commit to spending time (time I am not sure I want to give up) on the hunt.
It’s entertaining and I do love a good laugh……and certainly got one yesterday afternoon at a table for 2 in a coffee shop in Nolensville.  I have no idea if we will ever see each other again (he did text afterwards) or take off canoeing one day…..but I do know it was the hair that he noticed first on my profile (and commented on as well), and it may be the hair that detours the prospect of a relationship as well!  I love a risk (have taken a few lately)…….but not sure I am up to this!  It took me 8 years of driving back and forth to Paducah for Lisa Holt to do my hair every month, before I was brave enough to find a stylist here….
I may lower my standards and add men with hair to my qualities I am looking for…but, the hairdresser is not negotiable!! I can’t wait to hear what she has to say about all of this next month when I get settled in to spend 3 hours in the chair as she does her magic…magic I am not willing to give up currently for some man.
I happened to have had a good hair day yesterday, and as he was leaving…he shouted out “great hair Dani, who does it”?  HA!  Sense of humor; check!

Wednesday, October 8, 2014


October 8, 2014

Dear IFM family,

The past 2 months have been a whirlwind of blessings and new challenges for me and my family.  Since leaving my last job on August 11 I began an exhaustive 600 page credentialing process with Blue Cross that was to take only 2 months.  Tammy has worked like a champion in that process putting countless hours and late nights (as we all have) to provide me the “privilege” of taking BCBS.  Since I was not credentialed at my last job, this was a necessity.  Three weeks from the time BCBS stated everything was progressing smoothly with credentialing and my supervising MD, I set reasonable fees for non-BCBS patients and opened my doors with their assurance of the process. And the added assurance that any patient I saw with BCBS, I would be able to submit claims to BCBS for payment after credentialing was completed.

              Almost 1 month into practice (7 weeks after beginning the credentialing process) while Tammy was continuing follow-up with their progress, they informed her that (even though this is MY practice) the MD who supervises and collaborates in difficult cases must also be in network with BCBS.  Despite continual phone calls and status updates, this information was not delivered to us until 2 days before a deadline (Monday night) leaving us inadequate time to find a replacement MD.  To top it off, this change went into effect after we began credentialing so there was no way of knowing ahead of time. 

              Despite thinking through every possible scenario and willing MD’s to supervise me, we are unable to secure an MD and get the paperwork processed through the BCBS system in time.  It is devastating to me and my staff to have put so much effort, time, and financial resources into this hoop jumping endeavor all to be treated this unethically and put in a very uncomfortable position both financially and emotionally.  My decision to start my own practice would not have changed one bit, but I certainly would have put my efforts into more productive patient related matters (not the hoop jumping we have all done the past few months). 

              So what does this mean for my beloved patients?  If you do not have BCBS this has no bearing whatsoever.  If you do have BCBS do not worry.  You will not receive a bill from us for our services rendered for past appointments. If you have an appointment tomorrow (Friday October 9, 2014), I will still honor it for whatever your copay is.  It is unethical to tell you it will be covered and come back on you if it is not.  However, from here out I have to proceed without accepting BCBS and utilizing the fee schedule as I do for my non-BCBS patients already.  I am heartbroken to deliver this news to those with BCBS who put their faith in me from the beginning.  Your lab coverage will not change and you may file your own insurance if you wish as this is for MY services only.  Tammy will help you with that process. 

              God has blessed me beyond words with an amazing staff, incredible patients, and a peace of mind that has stayed with me through this entire transition.  It is time to focus on patients and not jumping through unrealistic and unethical insurance hoops.  I completely understand if finances prohibit you from being able to stick with our original treatment plan/frequency.  We will do whatever we can to find a way to work with you as we do our current non-BCBS patients.  If that means only seeing you 2x a year or less, we will work hard to find a middle ground for all of us.

              For those of you seeing Dr. Myers, he will continue to take BCBS since he was credentialed before the transition.  Please share this information with anyone you know who has an appointment and BCBS.  It makes me sick to think this will causes a disruption in the care of someone who needs it, but please know that we have done everything possible based on what BCBS told our certified biller with 13+ years of experience.  Please contact us if you have any questions.  As much chaos as it has been, I am excited and energized to move forward and continue walking with you on your healthcare journey.  Thank you for your patience and understanding with this sensitive matter. 

Fees are as listed:
New Patient: 275.00 for 90 minutes
Follow Up: 150.00 for 30 minutes
Phone Consults: 150.00 30 minutes



Dani Williamson  

Tuesday, August 26, 2014

What a difference 2 weeks turning dreams into reality!!!

Wow! What a difference 2 weeks makes! This time 2 weeks ago, I had given my 3 week notice to my former employer and 8 hours later went from being employed to self-employed in the simple act of turning in my key.  The same key that I had used for almost 4 ½ years to unlock the back door every morning. The same key that started my journey on the quest to learn as much as I could on the practice of balancing traditional and Integrative Medicine by one of the greatest mentors I have ever had.  I will be forever grateful for that opportunity.
This time 2 weeks ago, Jackson’s phone was ringing like crazy and I was in shock for multiple reasons.   I had no idea that people would actually call for an appointment, and I had promised Jackson 5.00 for every appointment he actually scheduled!!  As Jeannetta Hitt said “one for the record books”. That night two weeks ago yesterday, was a game changer for me.  The past two weeks have been humbling, frustrating, lightning speed and so very fulfilling as I have watched a practice go from dream to reality in record time! Patients bringing food, donating office supplies and showing up to help do anything they could do to help me and the kids.  We went from an empty office building to a space that feels like “home”, and very peaceful.  I hope you feel so as well.
Jackson has listened to over 400 women and some men tell him things I am sure he never dreamed of.  He now knows that I have actually been going to work at 5:45 most days of the week for the past 4+ years and building relationships with people, and a foundation that is solid.  He has a clearer sense of what I do for a living now.  He knows that my patients are like family to me, and I to many of them.  He knows now, why I do what I do. He is invested in this practice now, and that makes me proud.  More than anyone will ever know.  Ella started school, but has helped so much by typing in emails as well.  She has not listened to patients, but she knows how important this transition is for us as a family.
I scheduled a “soft opening” this week to work out the kinks that would need to be worked out.  Thank goodness I did that. I have seen 9 patients the past 2 days and feel like I am a brand new NP!  It is amazing how much you don’t know you need when you start a practice like this!  This week will be spent working on the flow and making it smooth for September 2 when we open full force! I saw my first patient yesterday. It was as nerve wrecking as it was 4 years ago!  We have no internet, no fax, no landline, very few supplements, the scale is weighing 8 lbs light (good news for all of us), paper charting until our EMR is transitioned, no sign out front yet and yet we have survived!!  I left at 7 pm tonight and felt a sense of peace, even in the chaos.  Amazing isn
t it? 
No insurance, no retirement, no paycheck guaranteed, still owe 193,000 in student loans to Vanderbilt, longer hours and more stress than I had 2 weeks ago….but I have a smile on my face and a determination that is solid! An amazing group of family, friends, and patients that are rooting for Integrative Family Medicine to succeed.  I am at peace. 
Thank you for your patience during this transition. I promise you that I will do my best to walk with you on your healthcare journey. I am looking forward to spending more time with you in appointments and really digging deep to find the root of what is going on.  I am honored to be called your healthcare provider, and have learned so much from all of you the past 4+ years!  I suspect September will be full of surprises and kinks, so just be patient!  I promise it will be worth the hassle!

Onward and Upward,

You must take personal responsibility. You cannot change the circumstances, the seasons, or the wind, but you can change yourself. That is something you have charge of.

Jim Rohn

Monday, August 11, 2014

Effective Immediately I am no longer associated with Cools Springs Family Medicine

I am excited to announce that as of September 2, 2014 I will be in private practice of my own.  I will be venturing out on my own, after 4+ amazing years with an office that laid the groundwork for me to be able to take the chance on opening a practice of my own.  After many months of praying for guidance and planning I have decided to step out into the unknown and take a chance that I will be able to make a living while supporting my children and balancing my work and personal life. I apologize to anyone I was scheduled to see the next 3 weeks. I gave my notice today, and was not expecting to be told a notice wasn’t necessary.  On the flipside of that, my sudden departure allows me to spend the next 3 weeks getting my office set up, specialty labs ordered in, the supplement store set up and scheduling finessed.

Integrative Family Medicine, LLC will officially be open to see patients on September 2, 2014. The primary focus will be on gut health, thyroid conditions (with an interest in Hashimoto’s Thyroiditis), hormonal balancing, adrenal health and autoimmune issues.  The endocrine system is my passion and I intend focus on that alone with the gut for this practice. 

I fully support the transition that Cool Springs Family Medicine is making into a direct pay practice.  As the years have progressed, providers are being forced to see more patients, spend less time with them and are being reimbursed less and less.  I have a fellow NP friend who was paid 8.00 recently (from insurance) on a visit that also involved an injection. This kind of treatment from insurance companies, is forcing us to work longer hours seeing more patients while receiving record lows in reimbursements.  IFM will be a hybrid clinic for at least the first year.  Meaning that we will only take Blue Cross and Blue Shield. No Medicare, Medicaid, or any other insurance. Those patients without BC/BS will be direct pay patients. And will be given a Super Bill to file your own insurance with at the end of the visit.  The rates are fair and listed below.  My goal is to transition to a full direct pay practice in 12-18 months.

This model of care allows me to spend from 1- 1/2 hours with you during the initial visit and 30-45 minutes during the follow up.  This allows us to take an extremely detailed history, discuss lifestyle changes and focus on the “root cause” of your illness.  All the while having time to EDUCATE, EMPOWER AND ENCOURAGE you to take the steps needed to begin to heal your body from the INSIDE OUT. By spending more time up front on the initial visit, we can get as much accomplished as approximately 5-6 follow up visits.  Imagine, being able to dive right in to finding the “root” cause of your illness?
My goal is to see no more than 12 patients a day, limiting my new patients to 3.   And again, you will be given a statement that you can file with your insurance company for reimbursement.

I am looking forward to this new chapter in my life.  Words can’t tell you how scared I am, uncertain of the future and excited for all God has in store for me and my children! I am asking that you pray for me and those involved in helping me succeed (and there are many). Pray for favor as well in building a practice whose main focus is on QUALITY and not QUANITY in terms of patients seen.  I am stepping out in faith that God has my back and will provide for me during this uncertain time. If I don’t take this opportunity NOW I feel like I am failing myself, my patients, and my God.  Therefore, at the age of 48, once again I am shaking up my life and starting fresh. This time with no safety net, no health insurance, no retirement and no guarantee of a paycheck! I can’t tell you how vulnerable I feel right now! 

If you are interested in scheduling an appointment, please call
615- 944-3529 for the 2 weeks while my office manager recovers from a thyroidectomy (how ironic is that). Jackson is my son, and will take good care of you! He is excited about this next season in our life.  And will be helping out in the office when he finishes class most days.

Thank you for all the emails, texts and calls today while I was working. For those of you that continue care with me at IFM, I am honored. For those of you that are not able to, it has been a pleasure and an honor to have been a part of your healthcare journey the past 4 + years. 



Integrative Family Medicine
330 Mallory Station Road
Suite B3
Franklin, TN 37067
Tammy Breece ,Office Manager

Jackson Hobgood, Scheduling until August 24
615 944-3529

7:00 AM- 5:00 PM
6:00 AM-4:00 PM
6:00 AM-12:00 PM




I will not be drawing labs in the office.  If you have labs already scheduled at CSFM, I can give you a lab order 2 weeks prior to your visit and you can take them to QUEST OR LABCORP~or anywhere you want to have them drawn.  Or call CSFM and see if you can have them drawn there. Just make sure you have a copy of them in your hands when you come for your appointment! 

Please be patient with us!  I was not expecting such overwhelming support and Jackson has 40 voicemails right now to return and the VM is 100% full. 

You can email him at with your name, phone number and any questions you have.  He will email you back ASAP! 

Integrative Family Medicine