A Physician With Over 35 Years of Experience
James DeStephens, MD
Internal and Anti-Aging Medicine
The Ohio State University 1973, BA Biology
Medical College of Ohio at Toledo
Internal Medicine, Board Certified 1980
Medical College of Ohio at Toledo
US Army MEDDAC, Ft Wainwright Alaska 1980–1983
Chief of Medicine and Cardiology
Gainesville Florida 1984 – Present:
Internal and Anti-Aging Medicine, Noninvasive Cardiology
BS Integrated Biology and Chemistry
University of Florida 2008
Hi, I’m Dr. DeStephens, and welcome to our practice. I want to share with you a bit about my background and experience as well as those areas of medicine as individual subsets of Internal Medicine on which I have chosen to focus and why that could be important to you. My background begins with board certification in Internal Medicine following a year of reflection training as an OB-GYN before deciding that I wanted the broader and deeper medical experience that I could get with an Internal Medicine background.
Regardless, that year of training in OB-GYN provided me with insights about female issues that uniquely serve my patients today, especially in the realm of hormone replacement therapy options in the menopause which I also specialize in since the aging process for both men and women accelerates rapidly after they begin to lose their sex hormones.
My personality is such that I want to be able to shepherd my patients through the entire diagnostic and treatment process even as at times it is necessary to call in consultants. Regardless, if my patients request it of me, and most do, any extraordinary testing or invasive procedures not anticipated initially by me can be required by the consultant to be cleared with me prior to submitting my patient for them.
And this remains a critical distinction for you if I am helping to navigate the at times difficult and certainly confusing waters of attempting to first diagnose your problem and then recommend proper treatment. Just as I would for a family member or close friend, I listen carefully to recommendations from any consultants and ask pointed questions based on my over 35 years of experience in both hospital and office-based medicine.
By keeping the patient at the center of the conversation, we can then chart out the best course of action both in terms of diagnosis and treatment. I have developed a very sensitive sniffer for what is both right and wrong in medicine and if the recommendations conflict significantly with my broad experience, I will not hesitate to question any recommendations to make sure that my patient’s evaluation and treatment are consistent with the best standards of care.
Overutilization in hospitals for services and procedures runs rampant all across the country and I understand how most of that happens. Even though I would allow the hospital-based physician to be primarily responsible for your care since I otherwise focus primarily on caring for folks in an office setting, I can still ride herd on your evaluation and treatment process if you insist that I be contacted whenever a critical decision is being offered to you.
I have over the years helped countless patients avoid otherwise recommended but unnecessary and dangerous back surgeries, heart catheterizations, heart stents, bypass surgery, and even the removal of a kidney in an 88-year-old. This particular fellow was told that based on a routine scan of his kidneys done in anticipation of the removal of a kidney stone, he also had a high likelihood of kidney cancer.
This seemed very unlikely to me based on my experience and the particulars of this case so the scan was sent to a different radiologist and then repeated just to be sure. No cancer, no surgery, and the patient is still fine now four years later even though the urologist argued strongly for the surgery nevertheless. You just don’t submit an 88-year-old to such major surgery without a much stronger indication than that.
I would never permit it in my family and will argue strongly against it for any of my patients if the situation required it. And yet, in spite of such experiences, the Gainesville area is blessed with tremendous talent in the various medical specialties, and my long service in Gainesville has allowed me to get to know many of these folks. I carefully study their recommendations and usually find that their suggestions are sound.
And in the process, because I carefully study their logic as to how they wish to both evaluate and treat someone, I get to closely understand how they think. Over the years, I have learned tremendously from many of these folks as we both learn from each other. So if you’ll allow me to be at the helm of your ship, I can help guide you through these frequently confusing waters of diagnosis and treatment.
And yet, as I was told by the urologist who wanted to remove the kidney from my 88-year-old patient, “Nobody else does that!”, referring to my questioning his recommendations for surgery. But yet I responded that every internist in the country is trained to do exactly that. If they don’t properly engage the consultant on their diagnostic and treatment recommendations then they are doing a disservice to both their patient and to their profession as well.
So the bottom line becomes, that I will do that for you if you ask me just as I would for anyone in my own family or among close friends.
So that’s my approach to how I take care of my patients from an Internal Medicine perspective. But there’s much more all based upon where my sometimes diverse interests in medicine have taken me.
You will see sections on this site for “Anti-Aging Medicine” which includes a broad and well researched holistic approach to medicine about the fundamentals and evolving science of how we can literally turn back our functional biologic clock 10–20 years if we are just willing to consistently do the right things. As a member of the American Academy of Anti-Aging Medicine, I am in touch with the best experts in this very broad field and am constantly learning what the state of the art best practices are for those who are not willing to slow down, if they don’t have to, compared to the average individual their age.
The section on Anti-Aging Medicine will also include esthetic expertise for skincare including a state-of-the-art leader in the field of skin tightening for the face using ultrasound called Ulthera. This will also be presented as a subset in the section of Anti-Aging Medicine along with other procedures for skincare that are available for esthetic purposes. Check them out and see if they might be right for you.
You will also see a section on historically my primary area of subspecialty within Internal Medicine and that is Noninvasive Cardiology. The vast majority of cardiologists, probably about 95%, spend their day in a hospital setting taking care of critical care heart patients and performing various heart procedures such as heart catheterizations, heart artery stents, and pacemakers to name just a few of these potentially life-saving procedures when indicated.
These folks are critically necessary for an emergency and have saved countless lives through their ability to intervene in emergency situations. Unfortunately, sometimes these folks can be a little too quick to pull the trigger on doing an invasive procedure including the placement of such heart stents and referral for bypass surgery. And that’s where sometimes we might disagree. The criteria for when these things should be done are well known and I know how those decisions are properly made.
Every heart catheterization that is done on my patients, I review personally to make sure that what is reported is actually what I can see myself in the original films. Usually, they match up well, but on occasion, they don’t at all. When there is a mismatch, it’s usually that the report suggests that the severity of the blockage is worse than it really is. A study that was done in 2007 that looked at the nearly 1 million coronary stents that were placed in the U.S. in the preceding two years showed that nearly 40% of those stents were unnecessary.
If placing a coronary stent was absolutely risk-free then one could justify placing many more such stents. Unfortunately, the placement of stents is not risk-free. Complications from their placement can lead to a heart attack or at least the major threat of a heart attack based upon a sudden worsening of symptoms in 10–30% of those stents placed depending on their complexity. So we only want to place such stents in those folks whose risk of complications is actually less with the placement of the stent than if the individual is treated medically.
In the “Heart Care” section you can read about and see a video on what many have labeled “Secret Cardiology”. You can learn how with a little help, the heart can actually significantly heal itself by stimulating the growth of new blood vessels in the heart known as collateral circulation. This procedure is called “External CounterPulsation” or ECP and is sometimes known as EECP or “Enhanced External CounterPulsation” though the terms are essentially referring to the same thing. You will see explanations from world-class cardiologists explaining how this works and here from a number of patients who discuss how it has helped them.
Many of you are already aware of my innovative approach to rapid and permanent weight loss. Check out the section on “Rapid and Permanent Weight Loss” and learn what every program should be doing but doesn’t and why 90% of folks who have about 50# to lose are never able to lose the weight on any of the programs that you see commonly advertised. And consequently, what you must do if you want to be part of the 10% or less who are able to beat the odds and not only get the weight off but keep it off.
Many of you have been regular listeners of a Saturday radio show I used to do on WSKY here in Gainesville called “The Dynamic Fitness Hour”. In the near future, you will see me duplicating these discussions in the form of 15–20 minute video blogs on anything and everything that I wish I had time to tell my patients but couldn’t in the office setting.
Progressively on these video blogs, you will see a whole host of information on physical, mental, and emotional fitness placed in separate folders depending on the topic with occasionally written documents to accompany them if it would be useful. It will take a while to populate these blogs but I’m committed to doing 1 or more each week. With your email address, we can send you notices when new content is being made available.
Once again, welcome to our world of feeling, functioning, and even looking many years younger than we are if you are just willing to commit yourself to a few core principles. Come take the ride with me. It would be my pleasure to show you a personal roadmap in your journey to help make you the absolute best that you are committed to being! And it all starts with crafting a dream that you are willing to fight for. What could that be for you? If you’re interested I can show you how to find it.