A Physician With Over 35 Years of Experience
Welcome to Our Practice
James DeStephens, MD
Internal and Anti-Aging Medicine
Noninvasive Cardiology
Undergrad
The Ohio State University, 1973, BA Biology
Medical School
Medical College of Ohio at Toledo
Residency
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
Female Health & Hormone Expertise
Extensive 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 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.
Patient-Centered Consultation & Oversight
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.
Navigating Complex Medical Decisions
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.
Upholding Standards
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.
Your Advocate in the System
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 keep an eye on your evaluation and treatment process if you insist that I be contacted whenever a critical decision is being offered to you.
Avert Unnecessary Procedures
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.
A Commitment to Safety
Gainesville is blessed with tremendous talent in the various medical specialties. My long service in Gainesville has allowed me to get to know many of these folks. But regardless, if the patient wishes that I be involved in any decision making with the specialist then they merely need to ask the specialist to share his/her thoughts with me so that I can resolve any potential differences of opinion making sure we are all on the same page. This was the approach that was able to avoid the removal of half of the above mentioned 88 year old gentleman’s kidney for a cancer that he was proven not to have.
Collaborative Care & Continuous Learning
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.
Questioning for Your Best Care
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.
Beyond Traditional Internal Medicine
Though the range of expertise in General Internal Medicine training is extremely broad, it has largely not focused in any significant way on so called Homeopathic or Naturopathic approaches. If I feel that such an ap. proach may be uniquely beneficial to you, I may mention it to you or you may mention one to me for my comment. But my training has taught me to always look for evidence that such an approach is worthy. Unfortunately, most of this is based upon anecdotal evidence, some of which is compelling and some clearly not. For a chuckle, ask me about the “Beverly Hillbilly” example of an anecdotal reference that the Clampett clan was 100% committed to. So I won’t recommend something that I have no evidence of its effectiveness. And yet, over the years, I have learned on occasion from my own patients’ research and I will in certain circumstances occasionally recommend one.
Anti-Aging Medicine
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 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.
“HIFU” (High Intensity Focused Ultrasound) therapy
ii. HIFU has been around for at least a couple of decades. Versions of it is currently being used for the treatment of various cancers to include both prostate and brain since the depth and range of treatment is highly programmable. More recently, a superficial HIFU device has been developed to treat aging skin issues with the treatment being programmable for how deep one wishes to go. The first 3-5 mm can be targeted for treating aging skin which can destroy old worn out collagen and stimulate the growth of new collagen that can help to tighten the skin. It is designed for mild to moderate looseness. But for the more severe cases, the plastic surgeon is still the proper choice if you can find a good one. HIFU is used often for media people to maintain youthful appearing skin rather than to wait too long when HIFU is unable to tighten the skin enough. It should be properly thought of as optimal for people who have a history of taking good care of themselves and wish to have their face to reflect that as well.
A Different Perspective
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 emergencies. 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.
Interventional Cardiology
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 because the report suggests that the severity of the blockage is worse than it 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.
The Truth About Stents
If placing a coronary stent were 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 on 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 less with the placement of the stent than if the individual is treated medically.
Healing Your Heart Naturally
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 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 many patients who discuss how it has helped them.
Rapid & Permanent Weight Loss
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.
Your Journey to Optimal Health Starts Here
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.