Office Staff Guide

Three Step Wellness Program · How to Support the Physician and Patient

Internal Training · New Era Compounding Pharmacy

Educate

Support

Retain

Extend Youth. Expand Health. Embrace Life.

Extend Youth. Expand Health. Embrace Life.

Vitamins, Peptides and Hormones

Overweight/

Imbalanced

Imbalanced

Healthy Weight &

Balanced Hormones

6-9 Months

3 Months

Years

1

Foundation

2

Balance

3

Thrive

Thrive Stage

Optimal program for health,

body & longevity.

Discontinue Program

Risk of regaining excess fat mass

and inflammation.

THE PROGRAM IN 3 PHASES

The Patient in Each Phase

1

FOUNDATION

6–9 months

Rapid reduction of excess fat mass. Improved insulin sensitivity and reduced inflammation. Metabolic reset initiated. Physiological patterns established for long-term adherence. Mitochondrial energy restoration.

The physician reviews labs every 6–8 weeks. Staff prepares the patient for each visit.

2

BALANCE

3 months

Hormones are restored. The patient experiences a real transformation: more muscle, better sleep, fewer mood swings.

Staff explains that hormonal changes take 6–12 weeks. Patience is key in this phase.

3

THRIVE

Long-term

Lifetime maintenance. Annual labs. The patient in optimal condition is the program's best ambassador.

Leaving Thrive = excess fat mass regain and hormonal imbalance. Staff reinforces this message.

PATIENT LIFETIME VALUE · THE THRIVE EFFECT

The patient who reaches Thrive

transforms the practice.

CLINICALLY

​

A patient

optimized for life.

​

Hormones balanced. Metabolism reset. Body composition maintained. Labs confirming results visit after visit. This is the outcome the physician designed the program for.

COMMERCIALLY

​

A practice

built to grow.

​

A Thrive patient sustains ongoing protocol revenue, returns annually, and refers family and colleagues. One retained patient generates a chain of longevity relationships.

YOUR ROLE

​

The bridge that

makes it happen.

​

The physician defines the protocol. The patient is ready to change. You make the outcome possible.

THE PROGRAM

With the Program vs. Without the Program

WITH THE PROGRAM ✅

WITHOUT THE PROGRAM ✗

• Sustained reduction of excess fat mass + balanced hormones
• Energy, libido, cognition, and sleep restored
• The physician adjusts the protocol based on labs at each visit
• The patient becomes the program's best ambassador

• Predictable excess fat mass regain within weeks or months
• Hormonal imbalance returns: mood, energy, and libido decline
• Inflammation rises: cardiovascular risk and diabetes return
• Everything gained is lost — and this can be prevented

WHY IT WORKS

It's not just about weight

It's metabolism + hormones + nutrition working together. No isolated intervention achieves this.

The physician decides with clinical data and patient evaluation

Every phase decision is based patient indicators and clinical data.

Staff is the bridge

Staff keeps the patient informed, motivated, and prepared between visits.

Real Results

10–20% body mass reduction + documented hormonal improvement in labs.

RECEPTIONIST

Your role once the physician has enrolled the patient

WHAT YOU DO

WHAT YOU SAY TO THE PATIENT

• Confirm follow-up appointments (every 2 weeks in Foundation, monthly in Balance)
• Remind the patient to come fasting if labs are scheduled at the next visit
• Record weight and blood pressure before the physician enters the room
• If the patient cancels 2 consecutive times → notify the physician that same day
• Update the patient's phase in the file when the physician instructs it

• "The doctor wants to see you for follow-up next week to review your progress."
• "For your next appointment, please fast for 8 hours. The doctor will review your labs."
• "The doctor has noted that you're in the Three Step program. Is everything going well with your medications?"
• Never interpret lab results or make promises about the program.
• Escalate any clinical question to the physician immediately.

THE KEY MOMENT: THE PRESENTATION

What staff does before, during, and after

Before

Prepare the room

File ready: weight, labs, medications. The physician searches for nothing.

Before

Prepare the patient

If waiting >10 min: "The doctor is going to talk to you today about a special program."

During

The physician speaks

If the patient comes out with questions, escalate to the physician.

After

Deliver materials

Give brochure and instructions. "The doctor asked me to give you this."

That same day

Schedule follow-up

Next appointment BEFORE they leave. Foundation: 2 weeks.

Next day + W2

Labs + Week 2 Call

Confirm labs. Week 2: coordinator calls: "How have you been?" Document.

FOUNDATION · 6–9 MONTHS

Foundation — What You Tell the Patient

WHAT THE PATIENT MAY ASK

WHAT YOU SAY TO THE PATIENT

• "Does this really work?" → "Most patients notice changes in the first few weeks. The doctor reviews your labs to confirm progress."
• "How much weight will I lose?" → "The doctor personalizes the protocol based on your labs. Results vary by person."
• "I feel the same as always." → "That's normal in the first weeks. Metabolic change takes time. Is there any discomfort you'd like me to mention to the doctor?"
• "I want to quit." → Do NOT respond on your own. Notify the physician immediately.

• "The doctor wants you to know that Foundation is the most important phase of the program."
• "Changes start on the inside before they show on the outside."
• "Your next appointment with the doctor is [date]. Can you come in fasting?"
• "If you have any questions before your appointment, call us. We're here."
• NEVER say: "You're going to lose X pounds" or "In 4 weeks you'll look different."

BALANCE · 3 MONTHS

Balance — What You Tell the Patient

WHAT THE PATIENT MAY ASK

WHAT YOU SAY TO THE PATIENT

• "Why hormones now?" → "The doctor decided based on your labs that you're ready for the next phase. That's great news."
• "Is it safe?" → "Everything the doctor does is monitored with labs. Safety comes from the monitoring."
• "When will I notice changes?" → "Hormone therapy takes 6–12 weeks. The doctor reviews it at each visit."
• "Will I become dependent on the hormones?" → "It's not dependence — it's optimization. The doctor controls doses with labs."

• "This phase is where many patients feel the greatest transformation."
• "If you notice anything unusual with the medications, call us that same day."
• "The doctor will review your labs at your next visit. Come fasting if you can."
• "The program is working. The doctor sees it in your results."
• NEVER say: "The hormones are going to make you like this or like that." Every case is unique.

THRIVE · LONG-TERM · HIGHEST LTV

Thrive — Retention Is Revenue

WHAT THE PATIENT MAY SAY

WHAT YOU SAY

• "I want to pause it, I feel fine now." → NEVER respond on your own. Notify the physician that day.
• "Why continue if I'm already doing well?" → "The doctor wants to explain that to you personally. Can I schedule an appointment for you?"
• "It's very expensive to maintain." → "Talk to the doctor. There are options and he can adjust the protocol."
• "I'm going to take a break from it." → "I understand. Let me tell the doctor before you leave."
• A well-managed Thrive patient is the program's best promoter.

• "You're in the maintenance phase. That means the doctor achieved what he was looking for."
• "Visits are now once a year. The doctor's system will remind you."
• "If at any point you feel something has changed, call us before making any decisions."
• "Leaving Thrive without speaking with the doctor can reverse everything you've achieved."
• Record in the file: 'Patient in Thrive — active longevity patient — retention priority.'

WARNING SIGNS

Warning Signs — Every Dropout Costs LTV

PHYSICAL SIGNS — ESCALATE TODAY

DROPOUT SIGNS — BEFORE THEY LEAVE

ALWAYS FOLLOW THIS PROTOCOL

• Chest pain, difficulty breathing, or dizziness
• Swelling or reaction at the injection site
• Very rapid weight loss (more than 3 lb/week) or none in 8 weeks
• Severe headache, blurred vision, or extreme mood changes
• Any new symptom the patient associates with the program

• "I want to quit — it's not working for me."
• "It's very expensive, I can't continue."
• Cancels 2+ appointments without rescheduling within 48 hours
• Stops answering calls for more than 5 days
• "I feel fine now" and wants to pause

• Physical signs: notify the physician IMMEDIATELY
• Dropout signs: notify the physician BEFORE the patient leaves
• Never try to convince the patient to continue on your own
• The physician is the one who speaks — you prepare the conversation
• Record EXACTLY what the patient said — those words are clinical data

RETENTION STRATEGIES

Retention = Revenue — How to Prevent Dropout in Each Phase

IN FOUNDATION

IN BALANCE

IN THRIVE

• Week 2 call: "How have you been?" is enough. The goal is to know if there are concerns before the next visit.
• Record everything for the physician — don't interpret, just collect.
• If the patient says they haven't noticed changes → reinforce that internal changes come first.
• Confirm that medications are being taken as directed.

• When the patient says "I feel the same as before" → record it and say: "The doctor will review that at your next visit."
• Remember that hormonal changes take 6–12 weeks. Patience is key.
• Confirm hormonal labs before each Balance visit.
• If there are questions about the hormones → escalate to the physician, do not answer yourself.

• Thrive patients have the highest risk of silent dropout.
• Call 4 weeks before their annual visit. Don't wait for them to call.
• If they mention wanting to pause → connect with the physician before they leave.
• A Thrive patient retained for years is an active longevity patient — and the practice’s most valuable clinical relationship. Their referrals bring new longevity patients.

WEEK-BY-WEEK FOLLOW-UP

What Staff Does at Each Program Milestone

FOUNDATION (WEEKS 1–8)

BALANCE AND THRIVE

• Week 1: Confirm the patient filled their medications at New Era
• Week 2: Coordinator call: "How have you been feeling?" Record response for the physician
• Weeks 3–4: Confirm physician appointment. Remind about fasting if labs are scheduled
• Weeks 6–8: Control labs. Ensure results are in before the appointment
• Month 3–4: Physician evaluates transition to Balance. Staff updates the phase in the file

• Monthly Balance: Hormonal labs at 4–6 weeks from start. Remind the patient
• If the patient misses the monthly visit → call that same day
• Thrive: Annual visit. Proactive reminder 4 weeks in advance
• Thrive patient who does not respond → personal coordinator call, not just a message
• Two consecutive cancellations in any phase → notify the physician that day

FAQS PART 1

FAQs: Cost, Time, and Process

ABOUT COST

ABOUT TIME

ABOUT THE PROCESS

• "How much does it cost?" → The doctor sets the protocol price. He can clarify that at your next visit.
• Never quote prices. Never compare with other programs.
• "Does insurance cover it?" → The coordinator can guide you on available options.
• Golden rule: any cost conversation goes directly to the physician or coordinator.

• "When will I see results?" → The first changes occur in 2–4 weeks. The doctor reviews your progress at each visit with labs.
• "How many visits do I need?" → Every 2 weeks at the start, then monthly. The doctor wants to see you soon.
• "Is it forever?" → Foundation and Balance have an end. Thrive is maintenance. The doctor explains it.
• Never promise specific dates or pounds.

• "Can I take it with my other medications?" → The doctor reviews that specifically at your consultation. It's an important question to ask him.
• "What happens if I miss a dose?" → Notify the coordinator. Do not double the dose.
• Never respond about drug interactions.
• For any clinical concern: escalate to the physician without hesitation.

HANDLING OBJECTIONS

Objections: Price, Time, and Skepticism

Patient Objection

What You SAY

What You NEVER say

"It's very expensive."

"The doctor sets the protocol based on your needs. He can speak with you about the cost."

Compare prices with other clinics or say it's cheap.

"I don't have time for so many visits."

"Visits are every 2 weeks at the start, then monthly. The doctor wants to see you soon."

"Well, there are no other options." / Cancel visits without notifying the physician.

"I've tried everything and nothing works."

"What sets this protocol apart is that the doctor bases it on your labs, not assumptions."

"This time it will work." / Promising specific results.

"Does this really work?"

"The doctor has seen it work. The labs confirm progress objectively."

"Of course, everyone loses weight." / Citing other patients' cases.

NEVER SAY

For any clinical concern: escalate to the physician without hesitation.

"You're going to lose X pounds" / Promising specific dates, results, or timeframes.

LANGUAGE AND COMMUNICATION

Exact Phrases for Staff

Situation

What You SAY ✅

What You NEVER say ✗

Patient arrives at reception

"Good morning. The doctor is expecting you. Do you have any questions before going in?"

"How are you doing with the program?" (too generic)

Patient has a clinical question

"That's a great question for the doctor. Should I note it so he has it ready?"

"I think..." (personal clinical opinion)

Patient wants to cancel

"Let me notify the doctor before changing the appointment."

"No problem, we'll schedule it for another day." (without notifying the physician)

Patient reports a symptom

"I'm going to write down exactly what you're telling me so the doctor can review it today."

"That's normal with the program." (minimizing)

Patient says they feel well

"Great. The doctor will confirm that with your next labs."

"Then you no longer need visits as frequently."

Patient wants to leave the program

"Let me bring the doctor into that conversation."

"Well, it's your decision." (without escalating)

Follow-up call

"Hello [name], I'm calling from the doctor's office. How have you been doing with the program this week?"

"How do you feel?" (no structure or clear purpose)

COMMUNICATION WITH THE PHYSICIAN

How to Report to the Physician What You Observe

WHAT TO REPORT AND HOW TO SAY IT

WHAT YOU NEVER SAY TO THE PHYSICIAN

• Patient reported a symptom: "Doctor, the patient told me exactly this: [verbatim patient quote]."
• Patient wanted to cancel: "Doctor, [name] wanted to cancel and said [reason]. I asked them to wait to speak with you."
• Labs received: "Doctor, [name]'s labs have arrived. I placed them in the file."
• Patient hasn't filled their prescription: "Doctor, [name] hasn't filled their prescription in 10 days. Do you want to call them or should I?"
• Always report verbatim — do not summarize or edit what the patient said.

• "I think their labs look fine" — never interpret results
• "I think they should change their dose." — never suggest clinical adjustments
• "The patient looks fine." — that is not clinical data. Report facts, not impressions
• "I told them to keep taking the same." — never modify the physician's instructions
• If you're unsure what to report: report everything. The physician filters.

OPERATIONAL CHECKLIST

Daily and Per-Visit Checklist

Action

When

Who and How

Confirm next-day appointment

Day before closing

Receptionist — call or text message to patient

Record weight, blood pressure, and circumference

Before each program visit

Medical assistant — record in file before the physician enters

Verify labs are in the file

Before each control appointment

Coordinator — confirm with laboratory if not yet received

Week 2 follow-up call

Week 2 of each new patient in Foundation

Coordinator — "How have you been feeling this week with the program?"

Thrive annual visit reminder

60 days before annual visit date

Coordinator — personal call, not just an automated message

Notify physician if 2+ cancellations

Same day as the second cancellation

Receptionist or MA — before rescheduling without notifying

PHASE IDENTIFICATION SYSTEM

Color Code in the Patient File

Staff marks each file with the color of the current phase. When the physician changes the phase, staff updates the label that same day.

● FOUNDATION

6–9 months

PURPLE Label

• Patient in active metabolic adjustment phase
• Visits every 2 weeks → monthly
• Labs pending at weeks 6–8
• Coordinator week 2 call

STAFF ACTION:

Place purple label in the physical file and in the digital system.

● BALANCE

3 months

TEAL Label

• Patient on active hormone therapy
• Monthly visits
• Hormonal labs every 4–6 weeks
• Protocol adjustment by the physician

STAFF ACTION:

Remove purple label. Place teal label. Record date of change.

● THRIVE

Long-term

PINK Label

• Patient in annual maintenance
• Annual visit — complete labs
• Highest risk of silent dropout
• Proactive reminder 60 days in advance

STAFF ACTION:

Remove teal label. Place pink label. Schedule annual visit.

Key rule: Only the physician decides the phase change. Staff updates the label when the physician indicates it — never before and never unilaterally.

THE 5 GOLDEN RULES

The Office Staff Code

1. Support

• Your role is to support the physician and the patient
• The physician prescribes and diagnoses
• You prepare, document, and facilitate

2. Educate

• Use simple and positive language
• "The doctor designed this for your case."
• Never explain protocols or doses

3. Follow up, don't wait

• Proactive follow-up is your most powerful tool
• Week 2: you make the first call
• Don't wait for the patient to call

4. Escalate fast

• At any physical or dropout sign: physician first
• Don't solve on your own what is not yours to solve
• The physician decides, you facilitate

5. Document everything, always When in doubt about what to report: report everything. The physician filters. The patient's exact words are clinical data.

CHECKLIST BY POSITION

Checklist by Position — Team Daily Guide

RECEPTIONIST — DAILY

MEDICAL ASSISTANT — AT EACH VISIT

COORDINATOR — WEEKLY

• Confirm next-available appointments — call or message
• Verify that no program patient is left without a next appointment
• Patients without a follow-up appointment → notify the coordinator that day
• If patient cancelled: attempt to reschedule within 24 hours
• Record any patient comment about the program

• Weight, blood pressure, and circumference before the physician enters
• Document exact patient complaints in the SOAP
• Labs in file before the control appointment
• If patient mentions an adverse effect → notify the physician TODAY
• If patient wants to leave the program → notify the physician before they leave

• List of Foundation patients with pending 2-week appointments
• Ordered labs: verify that New Era has them in the system
• Week 2 call completed for all new patients
• Thrive patients: next annual visit within 60 days → reminder
• Report to the physician any patient with 2+ consecutive cancellations

The Commitment of the Office Staff

to the Program and the Patient

✓ I support — and I facilitate.

✓ I educate with simple, positive phrases. I never promise results.

✓ I follow up proactively. I don't wait for the patient to call.

✓ I escalate any sign to the physician quickly. I don't decide on my own.

✓ I document everything. The patient's words are clinical data.

Extend Youth. Expand Health. Embrace Life.