What Is Integrative Medicine?

Integrative Medicine is the practice of medicine that reaffirms the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals and disciplines to achieve optimal health and healing.  This focus on a state of complete physical, mental, and social wellbeing goes beyond simply the absence of symptoms and disease to understand and balance the underlying source of an illness or chronic condition. By understanding the patient’s unique set of circumstances, this approach seeks to restore and maintain health and wellness for a lifetime. Integrative Medicine combines the appropriate use of conventional medicine with the best of natural and global healing traditions to improve overall wellness, wellbeing and optimal healing outcomes. Healing therapies and support may include acupuncture, massage, yoga, meditation, biofeedback, healing touch, supplements, nutraceuticals and others combined with conventional medicine.

What kind of Healthcare Providers are on the Team at Guarneri Integrative Health Inc./Pacific Pearl La Jolla?

The team at Guarneri Integrative Health, Inc./Pacific Pearl La Jolla is comprised of Medical Doctors, including certifications in Cardiology, Internal Medicine, Functional Medicine and Holistic Integrative Medicine, with Naturopathic Doctors, Osteopathic Doctor,  Acupucturist/TCM, Hypnotherapists, Holistic Mental Health Psychologist, Integrative Nurse Coach, Massage Therapists, Healing Touch providers, and an Esthetician.

What is a Naturopathic Doctor?

Naturopathic Medicine is a distinct, licensed primary care health profession. The naturopathic approach emphasizes prevention, nutrition, the mind-body connection, natural supplements and lifestyle. However, it also includes pharmaceuticals and conventional approaches when needed or preferred. Naturopathic Doctors (ND) specialize in identifying the underlying cause of disease and imbalance in order to resolve a condition at its source. Naturopathic Doctors strive to stimulate the body’s innate healing capacity and to empower patients with knowledge so that they can take care of their own health. Naturopathic Doctors prescribe drugs, order tests and imaging, perform physical exams including gynecology and Paps, administer IVs, and make referrals.  Naturopathic Doctors do not perform surgery or obstetrics in California. Naturopathic Doctors attend four years of naturopathic medical college and pass Board exams prior to being licensed. The State of California licenses and regulates Naturopathic Doctors in the same manner as other health professionals such as Medical Doctors (MD) Doctors of Osteopathy (DO), Nurse Practitioners (NP) and Chiropractors (DC).

Reasons people may choose to work with naturopathic doctors:

  • Nutrition prescription and detailed diet analysis
  • Chronic disease management using natural medicine and lifestyle (diabetes, high cholesterol, high blood pressure, auto-immune diseases, etc.)
  • People seeking natural, non-drug options and programs to wean off medications
  • Bio-identical hormone therapy, and hormone balancing at all ages
  • Plans for prevention and optimal wellness
  • Anxiety, stress, and adrenal fatigue
  • Integrative additions to conventional options for cancer, heart disease, auto-immune disease, etc.
  • Unexplained digestive disorders including diagnosis, diet recommendations and other treatments
  • Unexplained fatigue
  • Mood imbalances
  • Epigenetic testing and personalized treatment of genetic variants
  • Reviews of dietary supplements for safety, efficacy and interactions
  • Pre-surgery preparation and post-operative healing and recovery

What is Functional Medicine?

Functional Medicine is a systems biology–based approach that focuses on identifying and addressing the root cause of disease. The goal is for your gut, hormones, heart, blood sugar and insulin,  mitochondria and energy production, and your immune system to work together in the best balance. Your Functional Medicine doctor (MD) will leverage your lifestyle to help find the balance and use supplements to complement. They look at genetics and your biochemistry to understand more of how your body works. This includes looking for root causes of disease, how that can be controlled now, and how to optimize and reverse the condition as much as possible based on a patient’s personal approach.

What is Integrative Nurse Coaching?

Our one-on-one Integrative Nurse Coaching Service is a key component to the successful implementation of lifestyle changes for health. Integrative Nurse Coaching is for patients/clients with chronic conditions or those that would like to prevent illness and promote wellness.  Explore mutual strategies and active engagement for reaching goals and maintaining focus. Our service is especially helpful for new patients following their Comprehensive Wellness Assessment when they begin their prescribed journey for healing and optimal wellness. Integrative Nurse Coaches handle questions, assist in establishing goals, provide support and encouragement, help establish strategies and build on patients’ strengths.  Integrative Nurse Coaches take an holistic approach and address body, mind, spirit and emotions when working with clients.  See more under Services & Treatments section

Do I have to see the doctor in person for my first appointment?

Yes.  Once we have met you in person and had the opportunity to perform a physical exam, we can continue to work with you via phone, Skype, etc.  We insist on meeting you in person because we care about you and your health. Nothing substitutes for the face-to-face experience of meeting you and understanding you as a person.  We require at least one annual face-to-face encounter for our members.

What Is A Comprehensive Wellness Assessment?

Comprehensive Wellness Assessments are the point of entry into VIP membership OR can be a stand-alone, one-time guest service with two doctors. More than a medical appointment, a Comprehensive Wellness Assessment is your opportunity to embark on a journey of health transformation.  It is unique. You will gain an understanding of the underlying causes of your health challenges and receive a personalized care plan – your road map to optimal health that addresses nutrition, sleep, hormone balance, physical strength and mind-body medicine.

This intensive appointment with two doctors includes an intake and physical exam, analysis of your lifestyle including diet, physical activity, sleep, and stress. Each appointment is tailored to your personal needs.

Plan on 2 hours for your initial visit.  A follow-up appointment is included where you will receive a written report summarizing our findings and mapping out your pathway to health over the next 3-12 months, including recommendations regarding the appropriateness of membership to our practice.

What Will My Comprehensive Wellness Assessment Include?

Your Comprehensive Wellness Assessment includes:

  • Review of medical records and labs
  • Physical examination
  • Body composition analysis, EKG, spirometry, screening DEXA (as indicated)
  • Medication and supplement recommendations
  • Ordering and analysis of advanced lab testing or imaging including cardiac, genetic, microbiome, hormones, and others as appropriate
  • Complimentary in-house phlebotomy
  • Lifestyle change recommendations and teaching materials to help you put your plan into practice
  • Written report with road map to achieve optimal health
  • Coordination of referrals as appropriate

Do you think you could help my friend/family member with their health problem?

Yes!  The power of a holistic, integrative medicine approach is that it addresses the foundations of health. By identifying and treating the underlying causes that lead to disease and strengthening the body’s own healing ability, our patients are in a better position to conquer their health challenges.  We partner with our patients, to empower them to understand the factors that contribute to disease whether they are physical, emotional, environmental, or multi-factorial. We help you find practical ways to improve your resilience to stress, increase your energy, and stimulate your vitality.  Of course, we also follow the latest scientific research and offer cutting edge, evidence-based treatments to reduce symptoms and reverse disease.  Your friends and family can expect a caring doctor, thorough assessment, uniquely personalized treatment options, and an easy-to-comprehend treatment plan.

How should I refill my supplement prescriptions?

Please call our office at (858) 459-6919 and request to have your supplements shipped. You also may order most supplements from our online shop by setting up an account there https://www.npscript.com/pacificpearllajolla

Can Dr. Guarneri be my primary care doctor?

Dr. Guarneri believes your best health outcomes will be achieved when you have a team of providers, each focusing on what they do best. To enable Dr. Guarneri to focus on healing your heart and heart disease, the primary care team focuses on the foundations of health and the day-to-day health concerns that may arise. Dr. Guarneri accepts patients for on-going care that are VIP members. As a VIP member you will have access to your own medical team. Non-members are welcome to have an annual Comprehensive Wellness Assessment with Dr. Guarneri and one of our Naturopathic Doctors or a Functional Medicine Doctor. It is a 2-doctor appointment. Dr. Guarneri is also available to provide a cardiology second opinion.

Do you prescribe bio-identical hormones?

Hormone levels decline naturally with age or pre-maturely due to a number of underlying causes.  Our approach to b-HRT is to thoroughly understand your goals and symptoms, measure your hormone levels, evaluate your history and prescribe the lowest possible doses to safely accomplish your goals. All decisions regarding your treatments are personalized and made after careful discussion and evaluation.

Will you work with my other doctors and healthcare providers?

Absolutely!  At the end of every appointment, we provide a care summary document and copies of any lab testing we have ordered and interpreted for you.  We encourage you to share these with all of the practitioners on your healthcare team.  Please ask us for extra business cards if you want to pass these on to your other healthcare providers. Let your healthcare providers  know they are welcome to call us to discuss your care.

Can I get my blood drawn at Pacific Pearl La Jolla?

Pacific Pearl La Jolla guests and members may use our in-house phlebotomy services. Please call for availability. 858-459-6919.

Whom do I contact at Pacific Pearl and Guarneri Integrative Health?

Our general phone number is: (858) 459-6919. You will reach our experienced front desk team between 9 AM and 5 PM, or leave a message. If your phone call during business hours goes to our message system, please leave a brief message with your phone number, and a team member will call you back as soon as their other call or client interaction is completed.

Our Fax: (858) 459-6933

Email: contact@pacificpearllajolla.com

You may contact us by telephone for an appointment. (858) 459-6919

Questions and concerns can be communicated via email to:

Manager of Operations: Ann Michelle Cosco, LAc. amcasco@pacificpearllajolla.com

Executive Director: Rauni Prittinen King, RN, MIH, CHTPI rking@pacificpearllajolla.com

How can I make the best use of my insurance coverage?

Some people opt for high-deductible health plans. In this choice, you may pay a lower monthly premium, freeing up your monthly healthcare budget for out-of-pocket expenses such as your Pacific Pearl membership or your dietary supplements (a Health Savings Account can help even more – see below). You can submit your superbills and lab bills to your insurance company which may start counting those expenses toward your deductible. Some of the lab companies we partner with have No-Balance-Billing guarantees, meaning you may never see the bill for the expenses that were subject to your deductible on your Explanation of Benefits (EOB) statement.  Of course, if something catastrophic does happen, and you haven’t reached your cap, you will have to pay out of pocket until your insurance kicks in. You should make sure you are comfortable with the out-of-pocket cost associated with these plans.  Your insurance may be used for most tests such as laboratory testing, scans, etc.

How can I take advantage of a Health Savings Account?

Most employers-offer high-deductible health plans that are paired with a tax-free Health Savings Account.  You can set one up yourself too – if you are shopping for a new plan make sure it is “HSA compatible.” Check with your employer to see to see how much pre-tax funding you can place in your HSA account by having funds automatically deposited into your HSA from your paycheck. Depending on your tax bracket, that can be 35% savings right away. Employers may match contributions, leading to further savings. HSA funds are also tax-free when you withdraw the funds (for example, for your annual Pacific Pearl membership) and the money is yours to keep if you don’t spend it all in the year. Money in your HSA can be used to pay for qualifying medical expenses which includes medical appointments, lab tests, prescribed supplements, over-the-counter products, and other medically necessary prescribed services, like massage for back pain. Some HSAs provide a debit-like card, others require you to submit receipts and will reimburse you.  You may ask us for a Letter of Medical Necessity detailing your dietary supplement prescriptions for reimbursement.

(link: http://www.irs.gov/uac/Affordable-Care-Act:-Questions-and-Answers-on-Over-the-Counter-Medicines-and-Drugs).

How can I take advantage of a Flexible Spending Account?

Flexible Spending Accounts are much like HSAs except you are at risk of losing your contributions by the end of the year.  Even so, they can be a good idea if you know how to budget your healthcare expenses. For example, you know the cost of your Pacific Pearl membership, plus you estimate you will need a massage every other month to manage chronic neck pain and you know you will be taking a multivitamin and 2 other supplements to prevent future disease and manage your cholesterol.  With that knowledge, you can have pre-tax contributions added to your FSA from your paycheck.  If you reach the end of the year and haven’t spent your set-aside funds, we can help you determine if there are pro-active steps you could invest in; for example, additional testing, health coaching, a gym membership or new glasses.

What Is The Financial Policy At Pacific Pearl La Jolla?

Fees for appointments are due at the time of service. As a courtesy, we can provide the necessary information (Superbills) for you to submit to your insurance company. When possible, lab testing and procedures are billed to insurance (including in-house diagnostics).

What is your Notice of Privacy Practice?

Please click here to review our Notice of Privacy Practice