Frequently Asked Questions

Premier Internal Medicine takes a comprehensive, root-cause approach that goes beyond traditional symptom management. We combine internal medicine expertise with advanced functional medicine, hormone optimization, and regenerative therapies. Our practice focuses on understanding and addressing the underlying factors contributing to health concerns rather than simply prescribing medications for symptoms. We invest significant time in each patient relationship, utilize cutting-edge diagnostic testing including epigenetic analysis, and create highly personalized treatment protocols. This integrative approach allows us to help patients achieve optimal wellness, not just the absence of disease.

Our primary internal medicine practice is currently at capacity with established patients managing chronic conditions and preventive care. However, we maintain limited availability through special request for primary care services. We are actively accepting new patients for our specialized services including hormone optimization, medical weight management, functional medicine consultations, peptide therapy, and regenerative treatments with exosomes and stem cells. Many patients begin with one of our specialized programs and then transition to comprehensive care as their health goals evolve. Please contact our office to discuss your specific needs and current availability.

We accept most major insurance plans for traditional internal medicine services including office visits, preventive care, and chronic disease management. However, many of our specialized services—including hormone optimization, peptide therapy, functional medicine protocols, and regenerative treatments—are considered elective or wellness services and are typically not covered by insurance. We provide transparent pricing for all services and can provide detailed receipts and documentation for patients who wish to submit claims to their insurance carriers for possible out-of-network reimbursement. Our team will work with you to understand coverage options and create a treatment plan that aligns with your budget and health goals.

Your initial consultation is a comprehensive, unhurried appointment typically lasting 45-60 minutes. We begin by thoroughly reviewing your complete health history, current symptoms, previous treatments, medications, and wellness goals. Dr. Zelenka takes time to listen to your concerns and understand how your health challenges are affecting your daily life and long-term objectives. We'll discuss which diagnostic tests and assessments would be most valuable for uncovering the root causes of your concerns. You'll leave with a clear understanding of our approach, recommended next steps, and realistic expectations for your treatment journey. Many patients appreciate that we focus on partnership and education rather than rushing through appointments.

You can request an appointment by calling our office directly or by submitting a consultation request through our website contact form. When you reach out, please let us know which service you're interested in—whether hormone optimization, weight management, functional medicine, peptide therapy, or another specialized treatment—as this helps us schedule adequate time and ensure you're matched with the right resources. For established patients, we also offer an online patient portal for convenient appointment scheduling and communication. We strive to accommodate scheduling preferences and typically can arrange initial consultations within one to two weeks depending on service type and current availability.

Hormone optimization, including bio-identical hormone replacement therapy, addresses hormonal imbalances that can affect energy, mood, metabolism, sleep, sexual function, and overall quality of life. This treatment is appropriate for both men and women experiencing symptoms of hormone decline—often beginning in the 40s and 50s but sometimes earlier. Common symptoms include fatigue, weight gain, decreased libido, brain fog, mood changes, sleep disturbances, and reduced muscle mass. We utilize comprehensive hormone testing to establish your baseline levels and then create personalized protocols using bio-identical hormones that match your body's natural hormones. Treatment options include pellet therapy, topical applications, and other delivery methods tailored to your preferences and physiology.

Yes, we offer comprehensive medical weight management programs that include Semaglutide peptide therapy when appropriate. Semaglutide is a highly effective medication that works by regulating appetite and improving metabolic function. However, we don't view it as a standalone solution—our programs combine medical supervision, nutritional counseling, metabolic optimization, and lifestyle modification strategies to address the underlying factors affecting your weight. Each program is personalized based on your medical history, current health status, and weight loss goals. We monitor your progress closely with regular follow-ups and adjust your treatment plan as needed to ensure safe, sustainable results. Many patients also benefit from addressing hormonal imbalances and other metabolic issues that can interfere with weight loss success.

Our functional medicine approach is particularly effective for chronic conditions that haven't responded well to conventional treatment, including autoimmune disorders, chronic fatigue, digestive issues, hormonal imbalances, metabolic syndrome, chronic inflammation, and persistent symptoms without clear diagnosis. Functional medicine excels at addressing complex, multi-system health challenges by investigating root causes such as nutritional deficiencies, gut microbiome imbalances, environmental toxin exposure, chronic infections, and stress-related dysfunction. We utilize advanced diagnostic testing including comprehensive metabolic panels, food sensitivity testing, gut health analysis, and epigenetic assessments to understand the underlying mechanisms driving your symptoms. Treatment protocols are highly individualized and may include targeted supplementation, dietary modifications, detoxification support, and lifestyle interventions designed to restore optimal physiological function.

Peptides are short chains of amino acids that act as signaling molecules in the body, instructing cells to perform specific functions. Different peptides can enhance tissue repair, improve immune function, support cognitive performance, promote fat loss and muscle growth, reduce inflammation, improve sleep quality, and support anti-aging processes. We use therapeutic peptides to optimize various body systems and address specific health goals. For example, certain peptides can accelerate injury healing and recovery, others can improve metabolic function for weight management, and some support neuroprotection and cognitive clarity. Peptide therapy is highly targeted and can be customized to your individual needs. During your consultation, we'll discuss which peptides align with your health objectives and create a protocol that integrates seamlessly with your overall treatment plan.

Exosomes and mesenchymal stem cell treatments represent cutting-edge regenerative medicine that harnesses your body's natural healing mechanisms. Exosomes are tiny vesicles released by stem cells that contain powerful growth factors, proteins, and genetic material that promote tissue regeneration, reduce inflammation, and support cellular repair. These treatments are used for joint injuries, chronic pain, tissue damage, anti-aging protocols, and various degenerative conditions. Unlike some stem cell procedures, exosome therapy doesn't require harvesting cells from your own body and offers a less invasive approach to regenerative medicine. The treatments work by signaling your body's cells to initiate repair processes and optimize healing. Many patients experience significant improvements in pain, function, and tissue health with these innovative therapies.

Low Dose Naltrexone is an innovative therapy that modulates the immune system and reduces inflammation through a unique mechanism distinct from traditional immunosuppressants. We use LDN to treat various autoimmune conditions including Hashimoto's thyroiditis, rheumatoid arthritis, multiple sclerosis, and Crohn's disease, as well as chronic pain syndromes and inflammatory disorders. At low doses, naltrexone temporarily blocks opioid receptors, which triggers a compensatory increase in endorphin production and beneficial immune system regulation. Many patients experience reduced pain, decreased disease activity, improved energy, and better overall function with minimal side effects. LDN is particularly valuable for patients seeking alternatives to conventional immunosuppressive medications or those who haven't achieved adequate symptom control with standard treatments. Treatment is carefully monitored and adjusted based on your individual response.

We utilize comprehensive diagnostic testing to understand the complete picture of your health status and identify root causes of dysfunction. Testing options include advanced hormone panels assessing all major hormones including thyroid, sex hormones, adrenal function, and metabolic markers; comprehensive metabolic and nutritional assessments measuring vitamins, minerals, amino acids, and oxidative stress; gut health analysis including microbiome mapping and intestinal permeability testing; food sensitivity and allergy panels; heavy metal and environmental toxin screening; and epigenetic testing that reveals how your genes are expressing and what nutritional interventions may optimize genetic function. We carefully select testing based on your symptoms, health history, and treatment goals to provide actionable insights rather than unnecessary or redundant data. All testing is explained thoroughly and results are reviewed in detail during follow-up consultations.

Timeline for results varies significantly based on the specific treatment, your individual physiology, and the complexity of your health concerns. Some patients notice improvements within days to weeks—for example, many people feel increased energy and improved mood within 2-4 weeks of starting hormone optimization. Weight management programs with Semaglutide typically show measurable results within the first month. Functional medicine protocols addressing chronic conditions may require 8-12 weeks or longer as we work to restore underlying physiological balance. Regenerative treatments with peptides, exosomes, or stem cells often show progressive improvement over several months as tissue healing occurs. We set realistic expectations during your initial consultation and monitor your progress with regular follow-ups, adjusting treatment protocols as needed to optimize your response and achieve your health goals.

Yes, we offer telehealth appointments for appropriate services including follow-up consultations, treatment monitoring, nutritional counseling, and medication management. Telehealth provides convenient access to care without travel requirements and is particularly valuable for established patients who need regular check-ins to monitor treatment progress. However, initial consultations for most specialized services and certain procedures such as hormone pellet insertion, IV therapies, and regenerative treatments require in-person visits. We use secure, HIPAA-compliant video conferencing technology to ensure your privacy and the quality of your care. During your initial contact with our office, we'll discuss whether telehealth is appropriate for your specific needs or if an in-person visit would be more beneficial.

We require at least 24 hours notice for appointment cancellations or rescheduling to avoid a cancellation fee. We understand that unexpected circumstances arise, and we do our best to accommodate scheduling changes when possible. However, last-minute cancellations and no-shows prevent other patients from receiving care and disrupt our practice operations. Late cancellations may result in a fee equal to the appointment cost or a portion thereof depending on the service scheduled. For procedures requiring special preparation or materials—such as regenerative treatments or hormone pellet therapy—we may require longer notice periods. We ask that you contact our office as soon as you know you need to change your appointment so we can accommodate your needs while maintaining access for other patients.

Established patients have access to a secure online patient portal where you can view test results, review visit summaries, communicate with our care team, request prescription refills, and schedule appointments. We review all test results personally and contact you to discuss findings and recommendations—you will never receive results without context and explanation. For patients who prefer alternative communication methods, we're happy to discuss results by phone or during scheduled appointments. Medical records can be requested at any time, and we provide copies for your personal files or to share with other healthcare providers. We believe in transparency and patient education, so we take time to ensure you understand your test results and how they inform your treatment plan.

We accept all major credit cards, debit cards, HSA (Health Savings Account) cards, and FSA (Flexible Spending Account) cards for services and treatments. Many of our specialized wellness services qualify for HSA/FSA reimbursement, making them more accessible and affordable. Payment is typically expected at the time of service for specialized treatments and wellness programs. For insurance-covered services, we'll collect any applicable copays or deductibles at your appointment and bill your insurance carrier for covered services. We provide detailed invoices and receipts that you can submit to your insurance company if you're seeking out-of-network reimbursement for specialized services. Our team is happy to discuss payment options and answer questions about costs before you schedule your appointments.

We understand that investing in your health is a significant commitment, and we want to make our specialized services as accessible as possible. While we don't offer in-house financing, we work with third-party medical financing companies that provide flexible payment plans with various terms and interest rates based on creditworthiness. These options allow you to spread the cost of treatments over several months, making comprehensive programs more manageable. We also offer package pricing for certain services that provide cost savings compared to individual treatments. During your consultation, we'll provide transparent pricing information and discuss all available options so you can make informed decisions about your care. Our goal is to help you access the treatments that will make the most meaningful difference in your health and quality of life.

Yes, as a internal medicine physician, Dr. Zelenka can prescribe medications when clinically appropriate for your treatment plan. For established patients, prescription refills can be requested through our patient portal, by phone, or during appointments. We typically require regular follow-up visits to monitor chronic medications and ensure treatments remain safe and effective. For controlled substances and certain specialized medications, more frequent monitoring may be required based on medical guidelines and regulations. Many of our specialized treatments—including bio-identical hormones, peptides, and innovative therapies—are prescribed through specialized compounding pharmacies that we work with directly. We coordinate all aspects of your medication management to ensure safety, efficacy, and convenience while optimizing your treatment outcomes.

Absolutely. While we provide comprehensive care for a wide range of conditions and specialize in treatments that address root causes and optimize wellness, we recognize the value of collaboration with other specialists when appropriate. If your care would benefit from additional expertise—such as cardiology, endocrinology, rheumatology, or surgical consultation—we'll coordinate referrals to trusted specialists in our network. We maintain communication with your other healthcare providers to ensure continuity of care and integrated treatment plans. Many patients appreciate our role as a hub for their overall health management, coordinating various specialists and therapies into a cohesive approach. We can also provide specialized complementary care if you're already working with other physicians and seeking our expertise in hormone optimization, functional medicine, or regenerative treatments.

If you are experiencing a medical emergency, call 911 immediately or go to your nearest emergency room. Do not wait for a callback or attempt to reach our office for emergency situations such as chest pain, difficulty breathing, severe bleeding, stroke symptoms, loss of consciousness, or other life-threatening conditions. Our practice is designed for comprehensive outpatient care, wellness optimization, and chronic disease management—not emergency medicine. For urgent but non-emergency concerns that arise outside office hours, you may leave a message with our answering service, and someone will return your call as soon as possible. We provide guidance during your enrollment about when to seek emergency care versus when to contact our office, and we're always available to support you in making appropriate decisions about your health needs.

Come prepared with a list of current symptoms, medications (including supplements), previous medical records if you're a new patient, and specific questions or concerns you want to address. Consider keeping a symptom journal for a week or two before your appointment to identify patterns and triggers. Bring a list of your health goals—both immediate concerns and long-term wellness objectives. Be open and honest about your lifestyle, challenges, and preferences, as this helps us create realistic, personalized treatment plans. Take notes during your appointment or ask if you can record the conversation for later review. Don't hesitate to ask questions or request clarification about anything you don't understand. The more engaged you are in the process, the more successful your treatment outcomes will be. We view healthcare as a partnership and value your active participation in your wellness journey.