Out-of-Town Consultations

Eating Disorder treatment is a specialty that often can become complicated and lead to inadequate or inappropriate treatment resulting in poor recovery and frequent relapses.

Dr. DeSarbo has been consulting across the country with other specialists, patients, and their families to provided assesments and treatment plans for those too far away to see an experienced specialist. Out-of-town consults are usually done through a client's treatment provider's request. Initial intakes are done at Dr. DeSarbo's office and with scheduled video conferencing to provide face-to-face interaction while bridging the geographical distance. A comprehensive analysis and 20+ page report detailing findings, diagnosis, and treatment recommendations will be provided. Dr. DeSarbo's office will arrage for all hotel accomodations and transportation.  

Consulting services are helpful for:

1) Other treatment providers who may not be specialists or who seek a consultation for additional
     recommendations for treatment care.

2) Client's and families who do not have access to specialsts in their area for an accurate assesment
     of a condition and diagnosis or development of a treatment plan.

3) Client's and families who seek a second opinion for diagnosis or treatment recommendations to
     improve recovery for difficult cases and to have a better understanding of a client's condition.

NOTE: This service is of a consulting nature and does not represent a physician-patient relationship. Dr. DeSarbo's assessment is for recommendations that may be considered by a client's treatment team and the final report will be released to the client's treatment professionals who will oversee care and make final treatment decisions.

"The Comprehensive Consult"

As a physician, psychiatrist and eating disorder specialist, Dr. DeSarbo will conduct a thorough intake and comprehensive work-up and provide a comprehensive full consult regarding the medical, psychiatric, nutritional, social and environmental assesment of a client's condition.  The consult includes:

1) Direct contact and interviews with Dr. DeSarbo. The initial intake interview is primarily information gathering and a "get-to-know-you" meeting. Subsequent meetings are to explore and assess the cognative-behavioral, existential and psychodynamic aspects of a clients's condition. 

2) Psychological testing including the Eating Disorder Inventory (EDI) III and other psychological and cognitative tests such as the Beck's Depression Inventory (BDI), the Hamilton Rating Scale for Anxiety (HAM-A), Montgomery-Asberg Depression Rating Scale (MADRS), Young Mania Rating Scale (YMRS), Bech-Rafaelsen Mania Rating Scale (MRS), Longitudunal Interval Follow-Up Evaluation - Range of Impaired Functioning Tool (LIFE-RIFT), Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), Beck Scale for Suicide Ideation Scale, Pittsburg Sleep Quality Index (PSQI), the  and other psychological tests that may be of benefit.

3) Request/obtain necessary blood work and laboratory tests, EKG, bone scans, and other other imaging work that may be beneficial to treatment planning. A physical exam from either the client's primary care physician or by one of our EDMG internists or pediatricians along with a report is required.

4) A medical-nutritional intake and analysis (conducted by video or in-person) by Michael Rosen, M.D. will be conducted to asses dietary and exercise behaviors to determine the overall impact on health and recovery. Recommendations by Dr. Rosen for a suitable dietary and exercise plan will be included with the report.

5) Family interviews (by video or in-person)may be included, where appropriate and with the client's permission, for additional information. Family sessions are also valuable to educate family members regarding the true nature of an eating disorder, expectations for treatment, ways to provide family support, and treatment options.

6) A finalized treatment plan consult with the client to discuss diagnosis, prognosis, and treatment recommendations given in the formal written report an includes but is not limited to:
     - Therapy approach and goals.
     - Type and frequency of individual,
        group, and/or family therapy.
     - Theoretical insight into the cause of
        onset and factors that perpetuate the
        eating disorder 
     - Possible medications, vitamins or
        supplements that may stablize
        health and mental well-being to
        support the recovery process.
     - Medical follow-up recommendations
        including "red flag" symptoms or
        findings that will require special
        physician monitoring.
     - A meal/exercise plan and approach
        that will likely work best for the client
        in a manner that is nutritionally and
        medically safe, and tolerable with
        realistic goals.
     - Recommendations regarding
        medications, medical treatments,
        therapies, interpersonal dialogues,
        nutritional approaches,
        environmental influences and other
        factors to be avoided or that could
        compromise treatment.

Copies of the final treatment report will be provided to the client's treatment team and follow-up consultations with providers will be arranged to discuss these findings and recommendations.

The Consult Process

Step 1. An initial 30 minute telephone consult with Dr. DeSarbo is arranged to breifly discuss a client's case and expectations of a complete consult. This initial consult is to determine suitability for the consult and to briefly answer any questions about the consult process.

Step 2. An Eating Disorder Medical Group (EDMG) intake packet is sent to the patient with program directions, informational intake forms, medical and treatment team releases, psychological tests to be completed.

Step 3. In-person interview and intake conducted with Dr. DeSarbo and possibly other EDMG professionals for initial assesment. Overnight stays for out-of-town client's and family can be arraged through our office.

Step 4. Up to 12 hours of follow-up consultations by telephone, and/or video conferencing and/or in-person for additional assessment and review of findings conduted over 2 week period.

Step 5. Final report with findings and treatment recommendations reviewed with client and sent to the client's treatment team for review and implementation as determined by the client's treatment providers.