Hi everyone! I’m Dr. Stephenie Pisacano, a licensed naturopathic and functional medicine doctor living on the North Fork of Long Island. I practice virtually with Flora Naturopathics.
Naturopathic doctors often offer 15-minute discovery calls for people who are curious about naturopathic care and want to ask a few questions before deciding whether it’s the right fit.
But I also know that not everyone loves picking up the phone.
So I thought I’d do something a little different and write out what a typical first visit with me actually looks like—from the initial appointment through labs, the lab review, and the first steps of your care plan.
Consider this the written version of a discovery call.
First, we talk. A lot.
My initial visits are intentionally thorough.
Rather than starting with a single symptom or diagnosis, I want to understand the bigger picture of your health. We talk about your current concerns, previous health history, family history, lifestyle, nutrition, medications and supplements, and the things that may be influencing how you feel today.
We also talk about you.
What does your day-to-day life look like? What have you already tried? What do you feel is working—or not working? What are you hoping to understand or change?
Honestly, this is one of my favorite parts of practicing naturopathic medicine.
Every person is different, and I genuinely enjoy hearing someone's story and learning how they experience their own body. Patients often have a great deal of insight into their health; part of my job is helping put those pieces together and figuring out where to start.
Then, we put the pieces together.
At the end of the initial visit, we take everything we've discussed and begin organizing it into a plan.
Sometimes there are several things we want to address. Sometimes there is one issue that clearly needs to take priority.
We talk about what needs attention now, what can wait until later, and what information we may still need before making decisions.
This is also when we discuss laboratory testing that may be appropriate. Depending on the person and their individual history, that may include conventional bloodwork, functional testing, or a combination of both.
The goal isn't to order every test imaginable.
The goal is to gather the information that can actually help us understand what is going on and guide the next step.
By the end of the initial visit, we should have a preliminary roadmap.
After your visit, you get everything in writing.
Within 24 hours of your initial appointment, I send a written protocol outlining the next steps we discussed.
This may include laboratory recommendations, nutrition or lifestyle changes, supplements or botanical medicines, and other recommendations specific to your individual needs.
I also provide my email so that you have a place to send questions that come up as you work through the plan.
Please read your written recommendations carefully. There is often important information in there about timing, testing, supplements, and what we are planning to do next.
If laboratory testing was recommended, the orders are submitted and our clinic director will follow up with you regarding the labs that have been ordered and any logistics you need to know.
Then we look at the labs together.
Once your testing is complete, we schedule a laboratory review and assessment.
This is where things start to get more specific.
Rather than simply handing you a list of lab values and telling you whether they're "normal," we look at the results in the context of your symptoms, history, medications, lifestyle, and the other information we've gathered.
This helps us refine the initial plan and determine what makes sense as the next step.
Depending on your individual needs, that may include targeted nutritional support, supplements, botanical medicine, lifestyle changes, additional testing, or other therapies.
So what exactly might naturopathic care include?
It depends entirely on the person.
Recommendations may include a combination of:
Conventional laboratory testing
Functional laboratory testing
Nutrition and dietary changes
Lifestyle recommendations
Supplements and nutritional therapies
Botanical medicine
Mind-body approaches
Additional monitoring or testing when appropriate
Conventional medical care and prescription medications when indicated
I practice integrative medicine, which means I don't view naturopathic and conventional medicine as mutually exclusive.
Your existing diagnoses, medications, specialists, and conventional medical care are important parts of the picture. When appropriate, naturopathic recommendations are integrated alongside standard medical care with attention to safety, interactions, and continuity of care.
And then we keep going from there.
There isn't one universal schedule for follow-up care.
Depending on what we're working on, I may recommend returning in a few weeks, a few months, or after a particular set of labs has been completed.
We'll also discuss when certain testing should be repeated and what we are looking for over time.
The idea is not to overwhelm you with twenty things to change at once.
It's to understand the bigger picture, decide what matters most right now, and work through it one step at a time.
That's what seeing a naturopathic doctor looks like for me.
It's a lot of listening, a lot of questions, a lot of putting pieces together—and hopefully, by the end of that first visit, a much clearer idea of where we're going next.