Schedule Appointment with Dr. Mitchell

 

Online scheduling

 

Who should see me? Who should not?
I work alongside men and women with autoimmune and rheumatologic disease.
 
Please note! I am not a board certified Rheumatologist. If you prefer an MD or DO with board certification and a fellowship, excellent! But, that is not me.
 
 
Who are the men and women presently on my patient roster?

The bulk of women and men I consult with come from larger rheumatology practices with positive antibodies, vague symptoms and they would like someone to take a second look.

These individuals often do not fit classification criteria for an autoimmune disease, but may have positive ANAs/ENAs, Rheumatoid Factors, other autoantibodies, inflammatory markers or and ongoing concerns that have been have not been approached sensitively enough.

That’s where I come in. My perspective is that the diagnosis of an early autoimmune problem is an art – we do not have great guidelines in approaching more vague presentations and early autoimmune diseases. This ultimately leads to patients being dismissed, led to believe they are somatoform, or treated inappropriately.

These early presentations are often incredibly difficult to firmly diagnose. Minimally, I am confident I can get a sense of whether a problem is autoimmune versus not in most cases. And the good news is despite precise specification, there is much we can trial.

The problem with many of the cases that are lower acuity disease who are not your “explosive” or obvious type inflammatory cases is absence of treatment for up to several years. Absent of treatment may mean gradual destruction of joints, organs, etc. Hence, sentiments of empiricism as above.

 
Please also note, some interventions I discuss with patients would be classified as non evidence based medicine. We do not have rigorous clinical trials for almost all of what we do in Naturopathic medicine, as we do for standard of care in rheumatology. Thus, the Naturopathic physician and patient are essentially putting their brains together, based off of the individuals history, translational research, and other ideas. Rather than wait for “evidence based medicine” to “catch up” my belief is act earlier rather than later. An ounce of prevention is worth a pound of cure.
 
In this way, I consider myself very unique. Unlike many providers out there, be they board certified conventional rheumatologists versus naturopathic, functional, or alternative providers – I do my best to balance our best practices from standard of care versus naturopathic and alternative approaches. In my estimation, many providers on either side are abducted by ideology. Bonus points if you’re familiar with the concept of “abduction by ideology” and it’s origins.
 
And old timer taught me this simple gem… the best answer with a very complex problem to solve like autoimmunity is going to be somewhere in the middle, and one should have a sense of when a patient will need to be approached with only medication versus only natural approaches versus a combination of both.
 

My primary goal is to help your body along with it’s capacity to heal itself, rather than work against it!

Who is Dr. Mitchell?

I’m nothing in particular. I subscribe to the eastern tenants of being formless, like water flowing and crashing, forever mutable. I’m also a westerner, originally from Tustin, California. Son of the modest Bill and Jan Mitchell. Brother to baby sisters Cassie, Teri and brother, Aaron. I love ruminating over philosophy, film, musical artists of old, athletics, anime and beyond, appreciating critical moments and performances of the best of the best in various dimensions. This is usually done over a dirty martini or two… or maybe three.

When I figured out I wouldn’t be a superstar athlete, had obsessive geeky tendencies, a very kind gentleman by the name of Mitchell encouraged me to explore health and wellness. Coupled with walking the path of thorns with history of chronic health concerns, I couldn’t say no. The rest is boring history.

Naturopathic Doctors are licensed health care providers able to diagnose and prescribe in the state of Arizona, who prioritize the manipulation of environmental factors in addressing your disease process and investigation geared towards finding the root cause of your illness. 

Primary symptoms investigated and diagnosed include:

Positive Antibodies/ANAs

Elevated Sed Rates/CRPs

Joint Pain, Back Pain

Fatigue and Brain Fog

Fevers/Chills

Dry Eyes/Dry Mouth

Headaches

Rashes, Skin Changes

Hair Loss

Muscle weakness and pain

Gastrointestinal issues

Conditions Dr. Mitchell treats in include:

Ankylosing Spondylitis

Centralized Pain Patterns aka “Fibromyalgia”

Hypermobility associated syndromes

Dysautonomia

Gout 

Thyroid Disease

Lupus 

Polymyositis and Dermatomyositis 

Polymyalgia Rheumatica

Psoriasis, Psoriatic Arthritis

Rheumatoid Arthritis

Sjogren’s Disease

Scleroderma 

Lab tests and treatments

Most patients I consult already carry a diagnosis of a rheumatologic or autoimmune disease. If they do not or I do not agree with another clinician’s conclusions (it happens), I work the patient up using guidelines established by the American College of Rheumatology. This means visiting the patients history, considering physical exam findings, blood counts, blood chemistries, disease activity markers and specificity markers (antibodies) and necessary referrals.

I differ a bit from some some of the local specialists in the area. For diagnostic testing I use:

  • The Avise antibody panel through Exagen Diagnostics (Lupus, Rheumatoid, Sjogren’s, Antiphospholipid Syndrome, Hashimoto’s)
  • Internal medicine studies outside the usual sphere of rheumatology

In seeking the cause of your illness, I use specialty laboratories that most medical doctors will not order. As my practice style has evolved over the past years, I’ve moved away from ordering of such tests, routinely But a complete list of considerations includes:

  • Food Intolerance Testing
  • Urine Organic Acids
  • Parasitology/Dysbiosis via Stool PCR and microscopy
  • Blood testing for Vitamin and Mineral status
  • Infectious Disease studies
  • Internal medicine studies as above
  • 24 hr Urine markers for Heavy Metal Burden

I’m sensitive to the fact that this second set of tests is may not covered by insurance. While some patients have the resources to order all of the tests, others do not. I do my best to strategize the ordering of the tests based on your history. I will always do my best to discuss tools for investigation that may be of significant cost to you and prioritize.

An overview of the therapeutic modalities I may use in your case:

  • Low dose naltrexone
  • Disease modifying anti-rheumatic agents
  • Allergy medications
  • Psychopharmacology
  • Antibiotics and antifungals
  • Antivirals
  • Vitamins, minerals and herbs
  • Nutritional modification
  • IV nutrient therapy
  • IV iron infusions
  • Homeopathy

Where are you located?

Presently, Dr. Mitchell is only available electronically (zoom, skype, microsoft teams applications) until further notice.

Insurance and Costs

Dr. Mitchell does not contract with any insurance companies and is an out of network provider. We can provide you with a receipt of services that you may submit to your insurance company complete with the doctors NPI #, EIN#, Diagnosis Codes, and Procedural codes. This applies only to patient who are seeking medical care.

Cost for medical services:

  • In depth history taking to identify triggers/perpetuators of autoimmune disease
  • Physical Exam
  • Ordering of labs and imaging
  • Routine Health Maintenance and monitoring
  • Prescriptions if we both agree and deem necessary
  • Development of treatment plan (prescription or nonprescriptions), modifications and reassessment

Initial Consultations (90-120 minutes): $295

Follow up (45 minutes): $175

I am sensitive to economic burden and am in this profession to help. If the fees above would compromise basic living requirements (rent, food, gas, clothing, etc.) I am open to dialogue for a sliding fee schedule.

Dialogue is the prospective patient’s demonstration of need in the setting of good financial health. This means that patients who will be accommodated will demonstrate evidence that their resources are not being spent (evidence by last six months of bank statements) on things that matter little. You may email infoazi[email protected] for scheduling of said dialogue free of charge.

For every $20 that is reduced from the fee schedule above, the accommodated patient will donate one hour of their time to any of the organizations in any capacity needed below six weeks from their last scheduled visit at our office. 

The Sjogren’s Foundation – https://sjogrens.org/

The Arthritis Foundation – https://www.arthritis.org/

The Lupus Foundation – https://www.lupus.org/

Let’s get going! Let’s get you healthier!

Please download and complete the new patient intake forms prior to your first visit.

AZIR New Patient Intake

You can call the clinic at (623) 632-1074 and schedule your office visit over the phone or easily schedule it electronically here

Have further questions? Before making a financial commitment it is advised that you set up a free 15 minute discovery visit.

Please respect your time and the physician’s time. Discovery visits are not for presenting your case and asking for medical advice. They are strictly to ask questions of the overall clinical approach, practice philosphy, practice logistics, economics, etc. Thank you!

schedule electronically here

Any labs or past records you have please fax to 833-643-4239 or email to [email protected]