Agenda November 2020

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Wednesday November 4th

Practice Management Workshop: Launching and Growing a Successful Age Management Practice

Many attendees of the AMMG conferences are attracted to the field of Age Management Medicine, but do not feel qualified, or empowered with the necessary tools, to successfully transition from the well-established structure of disease-based medicine or from the traditional insurance-based reimbursement system into a system which relies to a significant degree upon direct pay. This workshop is for those physicians and management staff. Attendees will be guided through the process of evaluating their professional goals, and then be helped to create a successful strategy to achieve those goals. Our goal is for the attendee to be equipped with the basic tools for making the decision whether to consider moving into an Age Management Medicine practice, and if so, to create a successful transition into this exciting field.

Non-CME Course

Time
Presentation
1:00 – 1:45 pm What Does Direct Pay Practice Ownership Mean?
Kenneth Janson, M.D., FACS
Chief Medical Officer, Precision Health by Science
Attendees will be asked to create their vision of the ideal Age Management Practice they wish to develop. Understand what Direct Pay actually is, learn the best practices for this type of practice and transcend the fear of moving from insurance-based to direct pay practice.
1:45 – 2:30 pm Creating the Effective Business Map for One Year, Three Years, and Beyond: The Medical Services and Procedures Planning Process
Kent Rilling, PA-C
Chief Executive Officer, Precision Health by Science
Practice Business Models: Legal and Operational Considerations You Don’t Want to Get Wrong
2:30 – 3:15 pm Location Can Make or Break Your Practice
Kent Rilling, PA-C
Chief Executive Officer, Precision Health by Science
Critical Considerations When Choosing a Clinic Site
3:15 – 3:30 pm Break
3:30 – 4:15 pm Developing the Branding and Internal Marketing of Your Center
Cynthia Rilling, M.A.
Chief Operating Officer, Precision Health by Science
Culture of Excellence Starts with The Right Team: Clinical Staffing Model Determination – Engaging your team in the promotion to your current patients and prospects of your practice objectives, products and services.
4:15 – 5:00 pm External Marketing: Promotion and Branding of Your Services
Cynthia Rilling, M.A.
Chief Operating Officer, Precision Health by Science
What Business Are You Really In? Understanding and defining your practice scope of services utilizing social media, marketing, advertising, and public relations in order to generate greater demand for your products and services with the objective of increasing revenue and profits.
5:00 – 6:30 pm Working Dinner
Clinic Startup: “I Want Only the BEST but NOT to go Broke”

Dinner provided by Universal Arts Compounding Pharmacy & DEXAPLUS

  • DEXA, Equipment, Supplies, and Other Patient Care Service Options – Tony Orlando, President,DEXAPLUS
  • Choosing the Right Compounding Pharmacy to Partner with Your Practice – Tyler Harrold, PharmD, Universal Arts Compounding Pharmacy
  • Choosing the Appropriate Laboratory Services – Cynthia Rilling, M.A., Chief Operating Officer, Precision Health by Science
6:30 – 6:45 pm Break
6:45 – 7:45 pm Bringing It All Together
Kenneth Janson, M.D., FACS
Chief Medical Officer, Precision Health by Science
Kent Rilling, PA-C
Chief Executive Officer, Precision Health by Science

  • Business Plan and Pro Forma Development: Strategies for Pricing and Staying Compliant
  • Geometric Growth of Your Practice: Three Ways to Strategically Grow your Business
  • Building a National Professional Support Network of Like-minded Physicians
7:45 – 8:30 pm WATCH OUT! Practice Landmines to Avoid
Kenneth Janson, M.D., FACS
Chief Medical Officer, Precision Health by Science
Kent Rilling, PA-C
Chief Executive Officer, Precision Health by Science
Cynthia Rilling, M.A.
Chief Operating Officer, Precision Health by Science

  • 5 Risk Management Dangers You Must Prevent
  • 5 Marketing Landmines
  • 5 Top Reasons Age Management Centers Fail and How to Best Position Your Practice for Success
8:30 – 9:00 pm Open Forum Q and A

Thursday, November 5th

Advanced Course: BHRT Practical Clinical Applications

So, you have attended lectures, talked to colleagues and studied the literature. Now you are ready to jump into the fray of actually wanting to implement BHRT into your clinical practice. This course will provide you with very practical and concise information to be able to properly evaluate your patients and determine the best course of action to balance or replace the much-needed hormones; testosterone, estradiol, progesterone. This is a nuts and bolts series providing understanding on laboratory interpretation and optimal levels, pros and cons of different hormone delivery systems, how to properly dose each system and the knowledge to properly manage inevitable complications of BHRT.  Lastly, you will be given a basic framework of best practices in protecting your license while practicing in the area of hormonal medicine. 

* In conjunction with the Hormonal Health Institute

Course Pre-Requisite
Completion of Online Education Track Clinical Use of Hormones in Age Management Medicine: Module 2”, 9.5 hours of CME
Complete this home self-study at your own pace prior to the conference.

Time
Presentation
7:00 – 7:45 am Treating Adult Growth Hormone Deficiency
Presented by Mark Gordon, M.D.
Open to all attendees and includes a complimentary breakfast
Non-CME symposium sponsored by University Compounding Pharmacy
8:00 – 9:15 am Proper Clinical Evaluation of Patients, Including Lab Interpretation
Angela DeRosa, D.O., MBA, CPE
Founder & President, Hormonal Health Institute, Scottsdale, AZ
The lecture will provide the framework of how to properly evaluate patients to determine who will benefit from hormone replacement as well as which hormones, and when. The elusive laboratory assessment will be covered giving simple foundational understanding to be able to assess the hormonal status of your patient as well as the degree of deficiencies. Attendees will also learn what are the “optimal laboratory targets” when treating with BHRT and how to assess clinical response.
9:15 – 10:00 am Pros and Cons of Different BHRT Therapy Systems
Melissa Loseke-Ablett, D.O.
Chief Medical Officer, Limitless Male Medical, Omaha, NE
Medical Director, Trillion, Omaha, NE
There are different advantages and drawbacks to each BHRT delivery system. This lecture will address the pros and cons of each system as well as notable uniqueness that providers should consider when tailoring treatments to each individual patient.
10:00 – 10:15 am Break
10:15 am – 11:15 am Prescribing & Dosing BHRT
Melissa Loseke-Ablett, DO
Chief Medical Officer, Limitless Male Medical, Omaha, NE
Medical Director, Trillion, Omaha, NE
This lecture will provide basic “golden rules” which should be applied when prescribing BHRT as well as specific guidance on the starting doses and ways to adjust accordingly to clinical response to BHRT. Attention will be given to the differences in prescription writing for compounded hormones as well as understanding of industry standards of application.
11:15 am – 12:00 pm Prescribing & Dosing Using Pellet Therapies
Angela DeRosa, D.O., MBA, CPE
Founder & President, Hormonal Health Institute, Scottsdale, AZ
Hormone pellet replacement has increased in popularity for both men and women because of the convenience, consistent delivery of hormone, superior clinical outcomes as well as higher compliance rates for patients.  Providers will learn the best way to achieve optimal results by properly dosing pellets based on appropriate clinical parameters, understanding of the pharmacokinetics of pellets and physiologic differences of the various implanted hormones. 
12:00 – 1:30 pm Lunch Break
12:00 – 1:00 pm TBD
Presented by TBD
Open to all attendees and includes a complimentary lunch
Non-CME symposium sponsored by T.B.D.
1:30 – 2:15 pm Management of Adverse Events & Complications
Melissa Loseke-Ablett, DO
Chief Medical Officer, Limitless Male Medical, Omaha, NE
Medical Director, Trillion, Omaha, NE
Prescribing hormones for women and men is half the battle. Providers must be understanding how to address the most common side effects, adverse events and possible complications associated with BHRT; including the pellet insertion procedure risks. This lecture will address how to best manage these issues as well as how to avoid them in the first place. The role of progesterone and how to properly evaluate uterine bleeding/spotting while on hormone therapies will also be addressed.
2:15 – 3:00 pm Basic Protections / Legal
Angela DeRosa, D.O., MBA, CPE
Founder & President, Hormonal Health Institute, Scottsdale, AZ
This lecture is designed to review practical steps you can take to protect your medical license while practicing in the space of anti-aging medicine as well as utilizing BHRTs. We will review the Federation of State Medical Boards guidance on the “standard of care” as it applies to complimentary/alternative medicine as well as best practices in documentation, consenting and operational pitfalls. 
2:30 pm Exhibits Open
3:15 – 4:00 pm Break / Visit Exhibits
4:00 – 4:30 pm Video Demonstrations of Pellet Insertions (Male and Female Patients)
Angela DeRosa, D.O., MBA, CPE
Founder & President, Hormonal Health Institute, Scottsdale, AZ
Videos will demonstrate actual pellet insertion procedures performed on actual patients.  These demonstrations will review the proper techniques for pellet insertion as well as the differences between the male and female pellet procedure techniques. 
4:30 – 5:30 pm 4:30 pm – 5:30 pm
Complex Case Discussion
Angela DeRosa, D.O., MBA, CPE
Founder & President, Hormonal Health Institute, Scottsdale, AZ
Melissa Loseke-Ablett, DO
Chief Medical Officer, Limitless Male Medical, Omaha, NE
Medical Director, Trillion, Omaha, NE
Attendees will be given an opportunity to review complex patient case scenarios as well as specific clinical questions related to BHRT application with presenters. 
5:30 – 7:00 pm AMMG Welcome Reception
Open to all conference attendees, spouses, and guests
Held in Conference Networking and Exhibits Center

Thursday, November 5th

Pre-Conference Track 1: Introduction to Core Issues in Age Management Medicine

Course is designed to familiarize physicians and healthcare professionals with the basics of Age Management Medicine. Covers evidence-based use of nutrition, supplements, fitness, hormones—including a specialized lecture on hGH and assessment protocols—and legal basics, with some of the newest medical science on aging that may be in use now or in the near future; including relevant case presentations and discussion.

Time
Presentation
7:00 – 7:45 am Treating Adult Growth Hormone Deficiency
Presented by Mark Gordon, M.D.
Open to all attendees and includes a complimentary breakfast
Non-CME symposium sponsored by University Compounding Pharmacy
8:00 – 9:00 am Basic Hormone Replacement/Replenishment for Men
Neal Rouzier, M.D.
Director, The Preventive Medicine Clinics of the Desert, Palm Springs, CA
Prescribing hormones for men is simple and straightforward. However, dealing with the problems and complications is not. This lecture will address common problems, complications, side effects, monitoring, understanding levels, erythrocytosis vs. polycythemia, prostate cancer and elevated PSA, use of 5 alpha reductase inhibitors, and aromatase inhibitors.
9:00 – 10:00 am Hormone Supplementation for Women
Kathryn Retzler, N.D.
Private Practice, HormoneSynergy Clinic LLC, Portland, OR
There are many periods in a woman’s life that challenge her physiologically, mentally, and spiritually, the most notable often being the times of greatest hormonal fluctuations such as with menarche, post partum and menopause. These hormonal fluctuations can be a simple transition or cause for many symptoms, physical complaints, sexual dysfunction, medical illness, and other challenges. As a healthcare provider, this can be challenging. Necessary tools to alleviate and ease hormonal transition include appropriate diagnostic tools, physical exam, and an armamentarium of treatments to recreate hormonal balance on many levels, including the sex steroids, adrenal and neurotransmitter support, as well as dietary and lifestyle modifications.
10:00 – 10:15 am Break
10:15 am – 11:15 am Use of Supplements: Are They Effective?
Rebecca Murray, APRN, FNP-BC, CDE
Endocrine Nurse Practitioner, Institute for Hormonal Balance, Orlando, FL
Medical Director, Ward-Murray HealthCare Consulting, Groton, CT
Scientific Advisory Board, Designs for Health
As practitioners in functional medicine and “age management,” our patients expect that we have and utilize the best options to guide them to optimize their health and protect them from the common problems associated with aging such as heart failure, stroke, osteoporosis, and cognitive impairment. Contrary to the standard RDA for nutrients, various factors that contribute to a person’s actual needs include: decreased ability to absorb nutrients, medications that many deplete the body of certain nutrients, and environmental factors that contribute to a greater need. This presentation will provide an overview of the mechanism of action of nutraceuticals and supplements in the protection from the untoward effects of inflammation, oxidative damage, endothelial dysfunction and how they can be applied in your practice for the prevention and treatment of common medical conditions seen in the aging population.
11:15 am – 12:00 pm Improving Growth Hormone With and Without Growth Hormone
Edwin N. Lee, M.D., FACE
Assistant Professor of Internal Medicine, University of Central Florida, College of Medicine, Orlando, FL
Founder, Institute for Hormonal Balance, Orlando, FL
Member, AMMG Conference Planning Committee
Co-Founder, Clinical Peptide Society
The fetal body’s production of growth factors (GH, IGF-1, IGF-II) allow for the development and growth of each organ system from brain to bones. As our body takes on a more adult form the production of Growth Hormone diminishes over the years. Once thought to be the sole benefactor to linear growth (gigantism) has been found to participate in the optimal production and functioning of all hormones as well as 450 different cell types. Growth hormone works with vitamin D in the kidneys to independently produce 25 (OH) Vitamin D, GH provides a stimulus for the conversion of T4 to T3, GH working with Testosterone enhancing memory at the level of the hippocampus, GH and Testosterone as well as Estradiol improve upon endothelial functioning and repair of the basilar membrane, IGF-1 produced by GH signaling improves protein synthesis by up regulating the 40-70S unit of the Ribosomes, rebuilds the tau protein based microtubules destroyed by Amyloid-Beta in Alzheimer’s disease, lowers homocysteine, cytokines and interleukins thereby reducing inflammation. In 2017, research showed that 61% of individuals with treatment resistant depression had a Growth hormone deficiency which resolved when corrected. Knowing how best to detect alterations in growth hormone and its by-products will allow for comprehensive preventative programs of wellness to be developed. Understanding the legal requirements for justifiable prescribing of growth hormone will allow the physicians to provide uncompromising services to and for the patient. In this lecture you will learn (1) the importance of GH and its related growth factors in body functioning, restoration, and protection, (2) how to detect deficiency and perform a Glucagon Stimulation Test, and (3) the myth about GH causing cancer, and (4) treatment protocols using secretagogues and growth hormone in combination.
12:00 – 1:30 pm Lunch Break
12:00 – 1:00 pm TBD
Presented by TBD
Open to all attendees and includes a complimentary lunch
Non-CME symposium sponsored by TBD
1:30 – 2:15 pm Use of Fitness & Exercise in an Age Management Medicine Practice
Mary Corry, R.N.
Medical Education Specialist, Worldlink Medical, Salt Lake City, Utah
Member, AMMG Conference Planning Committee
Member, Sigma Theta Tau International Honor Society of Nursing
One of the key components to Age Management Medicine is exercise. During this presentation, we will discuss the benefits of exercise and how to build an effective exercise program for beginner and advanced patients.
2:15 – 3:00 pm Compliance with Federal and State Regulations as You Begin Your Age Management Practice
Paul D. Werner, Esq.
Member, Buttaci, Leardi & Werner Law Firm, Princeton, NJ
Recognize when relevant Federal and State regulations are implicated within your age management practice and measure and evaluate necessary steps to ensure compliance with these statutes and regulations. This workshop will focus on one essential element; compliance as an ongoing process. Compliance with Federal and State regulations depend entirely upon a provider’s willingness to be motivated, alert, and self-critical. Compliance and compliance plans are a risk management tool that should address each and every area of potential exposure. Good faith efforts to focus on and implement thorough compliance mechanisms evidences a provider’s commitment to compliant and ethical practice and therefore undermines any allegation of intentional malfeasance. Compliance with Federal and State regulations is not only important when beginning a new practice, but is an essential element to the ongoing success of that practice. Continual monitoring of compliance “hot spots,” which requires a comprehensive understanding of the relevant regulatory framework, helps identify issues before they escalate into problems that could result in liability.
2:30 pm Exhibits Open
3:00 – 3:40 pm Break / Visit Exhibits
3:40 – 4:30 pm Age Management Medicine Clinical Recommendations for Diet and Weight Loss
Rob Kominiarek, D.O., FACOFP 
Member, AMMG Planning Committee
Director, ReNue Health, Springboro, OH
Assistant Clinical Professor, Ohio University College of Osteopathic Medicine
Obesity has gained epidemic proportions and is now the leading cause of chronic medical illnesses that occur as we age. Correcting obesity should therefore be paramount for every physician who practices age management medicine. Old concepts of weight-loss, such as low-fat diets, have been shown to actually increase cardiovascular risks. The Mediterranean diet has been proven to have beneficial effects on health but, per se, may not provide a good option for losing weight. Newer concepts such as higher fat diets, ketogenic diets and fasting mimicking diets have accumulated a plethora of evidence that suggests these appear to be preferred options for patients to lose weight. Physicians should consider this new evidence when recommending weight-loss options.
4:30 – 5:30 pm Assessing the Age Management Patient
Michale “Mickey” Barber, M.D.
CEO & CMO, Better Life Carolinas, Charleston, SC & Charlotte, NC
This lecture will focus on the many aspects of a patient’s health and fitness that should be evaluated as part of the initial assessment. This assessment should provide the patient and clinician with information about the patient’s health and disease history, nutritional patterns, sensitivities and supplement history. An assessment of fitness, strength and balance are also considered to be essential to setting up goals for a healthy aging program. The measurement and interpretation of key aging biomarkers including hormones will be discussed. The impact of stress on our health and longevity is well known and should also be assessed from day one of beginning an age management program. Attendees should leave this lecture with a good understanding of a basic as well as advanced age management assessment protocol.
5:30 – 7:00 pm AMMG Welcome Reception
Open to all conference attendees, spouses, and guests
Held in Conference Networking and Exhibits Center

Thursday, November 5th

Pre-Conference Track 2: Complex Case Studies and Discussion in Age Management Medicine

This session is designed for clinicians currently practicing Age Management Medicine either full or part time who would benefit from in depth, interactive discussions of cases involving various areas and clinical aspects of Age Management Medicine. This session will not include didactic lecture but focus exclusively on case presentations and interactive discussions. Presenters will be asked to provide a basic SOAP Note history of the patient case, and work through initial laboratory assessments, laboratory results, possible diagnoses, and development of an individual treatment plan of action.

Time
Presentation
7:00 – 7:45 am Treating Adult Growth Hormone Deficiency
Presented by Mark Gordon, M.D.
Open to all attendees and includes a complimentary breakfast
Non-CME symposium sponsored by University Compounding Pharmacy
8:00 – 9:00 am The Difficult Testosterone Patient
Rob Kominiarek, D.O., FACOFP 
Member, AMMG Planning Committee
President & Medical Director, ReNue Health, Springboro, OH
Assistant Clinical Professor, Ohio University College of Osteopathic Medicine
This lecture will explore the basics of testosterone therapy for men, starting with initial laboratories and exploring the numerous treatment options available to the physician for resolution of symptoms associated with partial androgen deficiency. We will further explore how to deal with unanticipated, new, awful, frightening, and frustrating anxiety disorders, panic attacks and their often-disabling symptoms. What happened after you started therapy? This lecture will explain the mechanisms by which underlying, unexposed anxiety issues can be manifested after the addition of testosterone. Dealing with the increase of serotonin re-uptake transporter protein, decreasing magnesium levels, MOA snp’s and progesterone, DHEA and pregnenolone decline. Attendees will be able after this lecture to implement these strategies in their daily practice to immediately benefit their patients.
9:00 – 10:00 am Complex Case Studies – Remarkable Healing of Incurable Diseases with High Dose Testosterone
Eugene Shippen, M.D.
Author, “The Testosterone Syndrome”
The remarkable story of the Jens Mohler Medical Clinic in Denmark. Mohler used very high doses of Testosterone in men and women to halt the progression and promote healing in serious cases of diabetic gangrene. Pictorial proof of these remarkable cases. And Induction of full remission in poorly controlled Ulcerative Colitis cases with Testosterone treatment. Case presentation and discussion.
10:00 – 10:15 am Break
10:15 am – 12:00 pm Complex Cases for Male and Female Patients
Neal Rouzier, M.D.
Director, The Preventive Medicine Clinics of the Desert, Palm Springs, CA
Prescribing testosterone to men and women is easy in 90% of the time. However, it is the other 10% that requires skill, experience, insight, and command of the medical literature to appropriately treat complex cases. This lecture will review several complex cases and scenarios that will enable the experienced clinician to handle those difficult cases. A literature review will be provided to support why we do what we do in complex cases. Critical thinking and command of the literature is required to understand treatment of these complex cases.
12:00 – 1:30 pm Lunch Break
12:00 – 1:00 pm TBD
Presented by TBD
Open to all attendees and includes a complimentary lunch
Non-CME symposium sponsored by TBD
1:30 – 2:15 pm Healing the Most Difficult and Complex Cases with Nutritional Supplementation, Peptides, and Exosomes
Rebecca Murray, APRN, FNP-BC, CDE
Endocrine Nurse Practitioner, Institute for Hormonal Balance, Orlando, FL
Medical Director, Ward-Murray HealthCare Consulting, Orlando, FL
Scientific Advisory Board, Designs for Health
I will take my most difficult cases (ones that I have seen that have not found answers through conventional  medicine) and will walk through their history (including risk factors), the work- up and evaluation process, targeted replacement of nutrient deficiencies, utilization peptide therapy to act as signaling molecules and immune modulators, and when exosomes would be beneficial for the healing process.
2:15 – 3:00 pm “I’m Losing My Mind”: Finding the Treatment for Early Dementia, and “I’m Afraid I’ll Get Prostate Cancer”: Putting it in Perspective
Michale “Mickey” Barber, M.D.
CEO & CMO, Better Life Carolinas Charleston, SC & Charlotte, NC
Complex cases with patients that have early onset dementia and those afraid they may be at higher risk for prostate cancer will be discussed.
2:30 pm Exhibits Open
3:00 – 3:40 pm Break / Visit Exhibits
3:40 – 4:35 pm Treating the Sex Reassignment Surgery Patient
Cesar Pellerano, M.D.
Preventive Cardiologist, Miami, FL
President, Founding Partner and Chief Medical Officer, Hillstar Health LLC, Miami, FL
Gender Identification Disorder is becoming a more common diagnosis. It is estimated that 1 million people in the USA suffer from this disorder. In some of these patients Sex Reassignment Surgery is performed, and this procedure is becoming more commonplace. There is very little in the literature about the hormonal treatment of these patients. The few “guidelines” that are available, appear blurry at best. For physicians in the Age Management field, this is a topic that is bound to reach most of your practices at some point. Yet there is very little information in the literature to light the way. In this presentation I will discuss the treatment of a Male to Female Sex Reassignment Surgery patient in my practice. The discussion will involve how I approached the patient and my thinking behind the therapy. I will be happy to hear from other participants on possible different ways of treating and approaching this patient.
4:35 – 5:30 pm Complications of Hormone Therapy: Focus on Physical Exam & Nutrient Deficiencies
Derrick DeSilva, Jr., M.D.
Teaching Faculty, JFK Medical Center, Edison, NJ
Co-Chair, Department of Complimentary Medicine and Senior Attending Staff, Raritan Bay Medical Center, Perth Amboy, NJ
Sometimes the obvious is not so obvious. How many of you have forgotten how to do a physical exam and really look at obvious clinical signs of disease and various nutrient deficiencies? We give our patients hormones BUT do we really know how to manage the complications of hormone therapy? During this case presentation we will look at the physical signs of various nutrient deficiencies. We will also look at some simple ways to treat some of the complications from hormone therapy.
5:30 – 7:00 pm AMMG Welcome Reception
Open to all conference attendees, spouses, and guests
Held in Conference Networking and Exhibits Center

Thursday, November 5th

Traumatic Brain Injury Workshop: A Clinical Approach to Diagnosis and Treatment

This full day program, TBI – A Clinical Approach to Diagnosis and Treatment, will provide to the attendees overwhelming information culled from peer-reviewed articles on Traumatic and Non-Traumatic Brain Injuries as causative factors for personality changes, cognitive impairment and mood disorders leading up to suicide. The attendees will be walked through the literature discussing the effects of primary traumas and the secondary effects of inflammation and oxidative stress on functionality. The rising cases of post-Covid neurological complications will also be discussed as a new entry into non-traumatic brain injury due to the “Cytokine Storm”. This program will prepare you for the treatment. 

Course Faculty (all sessions in this track)
Mark L. Gordon, M.D.
Medical Director, Millennium-TBI & The Millennium Health Centers, Encino, CA; CBS Studios;
USC, Keck School of Medicine, Department of Family Medicine, Los Angeles, CA
Medical Director of Education,
Access Medical Laboratories, Jupiter, FL
Member, AMMG Conference Planning Committee

Time
Presentation
7:00 – 7:45 am Treating Adult Growth Hormone Deficiency
Presented by Mark Gordon, M.D.
Open to all attendees and includes a complimentary breakfast
Non-CME symposium sponsored by University Compounding Pharmacy
8:00 – 9:00 am An Introduction to Traumatic Brain Injury
A 60-minute overview of trauma and non-traumatic brain injuries and the social and medical impact and the need for a paradigm shift in evaluation and treatment.
9:00 – 10:15 am The Laboratory of Traumatic Brain Injury 
The assessment of neurotrauma using trophic, neurosteroids, and neuroactive steroids as markers for hormonal deficiencies that are caused by both the primary and secondary injuries associated with neurotrauma (TBI). The literature supported view that the “standard reference” ranges and “normal” reference ranges are not relative to the patient. Interpretation of the lab results using the Median Theory of optimal levels.
10:15 – 10:30 am Break
10:30 am – 11:30 am Traumatic Brain Injury and Neurobehavior 
The impact of neurosteroid deficiencies on both personality and mental abilities is clearly discussed in peer-reviewed articles. Those same articles provide support for mood and anxiety disorders developing from loss of the regulatory effects of many of the neurosteroids that are produced in the brain.
11:30 am – 12:00 pm Neuroinflammation and Oxidative Stress, the Foundation for Treating Traumatic Brain Injury, Part I
The major impact of trauma is the production of secondary injury precipitated by free radicals and oxidative stress. The use of specific anti-oxidants and the regeneration of the glutathione system in the brain can help to regain a neuro-permissive environment that can allow for cellular repair and regeneration.
12:00 – 1:30 pm Lunch Break
12:00 – 1:00 pm TBD
Presented by TBD
Open to all attendees and includes a complimentary lunch
Non-CME symposium sponsored by TBD
1:30 – 2:30 pm Neuroinflammation and Oxidative Stress, the Foundation for Treating Traumatic Brain Injury,  Part II
Continuation of the 5th lecture with specific application and treatment of traumatic brain injury. A number of cases will be discussed.
2:30 – 3:30 pm Putting It All Together with Case Studies 
10 comprehensive cases will be dissected and presented with attendees’ participation as a means of consolidating the information that will be shared throughout the day.
2:30 pm Exhibits Open
3:30 – 4:10 pm Break / Visit Exhibits
4:10 – 5:30 pm Case Studies & Q&A
Continuation of the cases with attendee participation and Q & A. The goal of these cases is to allow the audience an opportunity to work out with the lecturer the initial evaluation of the patient, laboratory testing, interpretation of the test results, and selection of an optimal treatment protocol.
5:30 – 7:00 pm AMMG Welcome Reception
Open to all conference attendees, spouses, and guests
Held in Conference Networking and Exhibits Center

Friday, November 6th

General Session Curriculum

Time
Presentation
7:00 – 7:45 am TBD
Presented by TBD 
Open to all attendees and includes a complimentary breakfast
Non-CME symposium sponsored by TBD
8:00 – 8:05 am Opening Remarks
8:05 – 8:30 am Presentation of the Alan P. Mintz, M.D. Award for Clinical Excellence in Age Management Medicine
8:30 – 9:15 am Food as Medicine
Arden Andersen, Ph.D., D.O., MSPH
Family and Occupational Medicine Physician, McDonough Medical Center, Gladstone, MO
Medicine is most often thought of strictly as manufactured synthetic substances limited to 1 or 2 specific physiologic functions, e.g. blood pressure or blood sugar. Food, though specific foods can target specific physiologic functions, e.g. ginger for gastritis, is generally thought of as related to the entire organism physiology or no physiology at all, just food. However, the Standard American Diet is the most disease causing diet on earth, is highly inflammatory – the initiating mechanism for most all chronic disease – and is rare discussed in the context of “medicine.”  Further, just as we are finding more and more medicines carrying/contaminated with undesirable substances – e.g. metformin and losartan – we find foods, especially conventionally grown foods to be contaminated with pesticides, heavy metal, and other undesirable contaminants that further adversely the consumer. Just a food causes chronic disease, different food can reverse and ameliorate chronic disease just as can “medicine.” Lastly, the third leading cause of death in the US is the medical system itself. A corollary would be that conventional agriculture – including the processing industry – is the number one contributor to death and disease via its lobbying and imposition of the SAD.
9:15 – 10:00 am Food as Medicine:Updated Research on Carnosine, Beta-alanine
Jay R. Hoffman, Ph.D., FNSCA, FACSM
Professor, Dept of Molecular Biology,  Director of Health & Sport, Ariel University, Israel
β-alanine is a non-proteogenic amino acid that combines with histidine to form the dipeptide molecule carnosine. β-alanine is the rate-limiting precursor of carnosine formation, and supplementation with β-alanine increases muscle carnosine. Carnosine is found in high concentrations in both meat and fish. Carnosine is a H+ buffer that has an important role in muscle function and may impact ischemic events. In addition, carnosine has been suggested to have various other roles in the body, including acting as an antioxidant, antiglycating agent, and ion-chelator, which may have significant effects on aging and other health benefits. β-alanine supplementation has been shown to improve mood and reduce anxiety in both human and animal studies. This presentation will provide an overview of the health benefits known, and potential other benefits associated with elevations in both muscle and brain tissue carnosine levels.
10:00 – 10:30 am Break / Visit Exhibits
10:30 – 11:15 am Nutrigenomics and Epigenetics: How environmental factors and nutrient deficiencies affect our genetic expression
Derrick DeSilva, Jr., M.D.
Teaching Faculty, JFK Medical Center, Edison, NJ
Co-Chair, Department of Complimentary Medicine and Senior Attending Staff, Raritan Bay Medical Center, Perth Amboy, NJ
Epigenetics is the study of heritable phenotype changes that do not involve alterations in the DNA sequence. Epigenetics has controls over our genes. This is achieved through (a) nature: epigenetics is what determines a cell’s specialization (e.g., skin cell, blood cell, hair cell, liver cells, etc.) as a fetus develops into a baby through gene expression (active) or silencing (dormant); and (b) nurture: environmental stimuli can also cause genes to be turned off or turned on. What you eat, where you live, who you interact with, when you sleep, how you exercise, even aging– all of these can eventually cause chemical modifications around the genes that will turn those genes on or off over time. Additionally, in certain diseases such as cancer or Alzheimer’s, various genes will be switched into the opposite state, away from the normal/healthy state. During this presentation we will look at how environmental facts and various nutrient deficiencies affect gene expression.
11:15 am – 12:00 pm One for the Ages: a practical lifestyle plan/protocol for everyone
Michele L. Neil-Sherwood, D.O.
Mark Sherwood, N.D.
When discussing protocols, many practitioners may be wondering “where to start”. Do you start in the gut, with hormones, or adrenal management? What about sleep, nutrition, and exercise? Age management protocol prescriptions can be a bit overwhelming. However, there are several principles that truly fit for everyone. By examining “what we do know” and considering what the majority of persons can/can’t do, there is much common ground. Understanding this common ground, combined with systems biology and functional medicine principles, one is able to deliver a general protocol in which everyone can benefit. When developing a protocol, it is important to look at all aspects of life – physical, emotional, intellectual, and spiritual. When one includes all of these critical factors, development of a protocol is both possible and actionable. This lecture will provide the explanation for and rational behind a foundationally sound protocol that nearly everyone can employ immediately. The protocol includes nutrition, supplementation, stress management, sleep, and hormone optimization. Moreover, measurables (biomarkers) will be detailed along with a very clear “how to” program describing all aspects of the “one for the ages” age management protocol with the clear objective being able to functionally and fully employ on Monday morning.
12:00 – 12:15 pm Why Undergo Certification in Age Management Medicine
Derrick DeSilva, Jr., M.D.
Teaching Faculty, JFK Medical Center, Edison, NJ
Co-Chair, Department of Complimentary Medicine and Senior Attending Staff, Raritan Bay Medical Center, Perth Amboy, NJ
12:15 – 1:30 pm Lunch Break / Visit Exhibits
12:15 – 1:15 pm TBD
Presented by TBD
Open to all attendees and includes a complimentary lunch
Non-CME symposium sponsored by TBD
1:30 – 2:30 pm Systems Approach to Age Rejuvenation
Daniel L. Stickler, M.D.
Co-Founder, Apeiron Center for Human Potential, Austin, TX
CME & Co-Founder, Apeiron Academy Medicine Education and Technology
Reverse aging is no longer science fiction. Leading edge science and technological advancements have provided unprecedented discoveries in the field of aging and age rejuvenation. Recently, nine hallmarks of aging were identified—genomic instability, telomere shortening, epigenetic alterations, loss of proteostasis, dysregulated nutrient sensing, mitochondrial dysfunction, cell senescence, stem cell loss, and altered intercellular communication. These discoveries provide us with an opportunity to create interventions which mitigate the ravages of aging and importantly, provide the ability to rejuvenate the aging system to a place of youthful longevity. In order to achieve optimal age rejuvenation outcomes, a synergistic, stepwise approach is required.
2:30 – 3:15 pm Keynote Presentation
Legislative Update from Washington, D.C. by Congressman Buddy Carter, the Only Pharmacist in Congress
Congressman Earl L. “Buddy” Carter (R-GA)
U.S. Representative Georgia 1st Congressional District, 2015 to Present
Only Pharmacist in Congress
3:15 – 4:00 pm Break / Visit Exhibits
4:00 – 4:45 pm Viagra Surprise, 2.0: Biggest Breakthrough in Age Management Diseases and Mortality in the History of Medicine, an Encore Lecture with Expanded Discussion
Eugene Shippen, M.D.
Author, “The Testosterone Syndrome”
The PDE5 Inhibitors were developed initially for cardiovascular effects. The use for ED was discovered during the initial trials and the drugs were approved for this indication. However, multiple uses for these drugs were discovered over the many years since they were released. Amazingly, cardiovascular benefits included phenomenal improvement in function and reduction in both cardiovascular diseases and mortality. These reported findings were documented in several observational studies and showed greater benefits and mortality reduction than ever reported in the medical literature! The presentation will outline these studies and other aging disease benefits, including dementia, and will outline the basic science behind these remarkable benefits. This information can be utilized immediately in your practices for health and longevity in both men and women.
4:45 – 5:30 pm Igniting Libido in Men & Women: Beyond Testosterone
Kathryn Retzler, M.D.
Private Practice, HormoneSynergy Clinic LLC, Portland, OR
Low libido or sex drive is a common complaint in men and women. With half of single people having weekly sex vs only one-third of married people, and more single people being satisfied with their sex lives than those who are married, how does a couple keep the sex sizzle going? This lecture will cover the causes of low libido and options to help individuals and couples regain lost sexual interest.
5:30 – 7:00 pm Reception for AMMG Members, Faculty and VIPs
Please come and meet a distinguished member of our AMMG Faculty, Georgia Congressman Earl L. “Buddy” Carter, the only Pharmacist in Congress

Saturday, November 7th

General Session Curriculum

Time
Presentation
7:00 – 7:45 am TBD
Presented by TBD
Open to all attendees and includes a complimentary breakfast
Non-CME symposium sponsored by TBD
8:00 – 8:15 am In Memory of Dr. Robert Willix, Jr.
8:15 – 8:55 am Current Applications of Senolytics and Their Role in Age Management Medicine
Luis Martinez, M.D., MPH
President, XanoGene Clinic, San Juan, Puerto Rico
President, Regenera Global, Ponce, Puerto Rico
Will discuss interventions including the use of rapamycin, metformin and more recent approaches such as the dasatinib/quercetin combo. A senolytic (from the words “senescence” and “lytic” – destroying) is among the class of small molecules under basic research to determine if they can selectively induce death of senescent cells. The goal of those working to develop senolytic agents is to delay, prevent, alleviate, or reverse age-related diseases.
8:55 – 9:35 am Is Gene Therapy the Future of Anti-Aging Medicine? “It’s Here… and Now”
Patrick Ellison Sewell, Jr., M.D.
Founder, Owner, Sapheneia
Medical Consultant
Director of Clinical Trials, Integrated Health – Gene therapy
For millennia, people have dreamed of eternal youth and searched for elixirs to counteract the ravishes of age. This quest was seen as a fruitless fantasy until recently, but faith in modern science and technology is altering the public consciousness. Slowly, people are becoming more aware of efforts to combat aging. There is a growing expectation that a cure for aging may be within reach, and that in the near future significant and even radical life extension may be possible. Gene therapy is viewed as an essential tool in bringing this future about. We contend that this technology is mature enough to start turning back the clock today, and given proper informed consent, no one should be denied access to treatment with gene therapy because of the overly cautious regulatory environment in the U.S. and Europe. Gene therapies are being used to add copies of important genes, like follistatin, hTERT, and Klotho, to human cells in vivo. This results in increased production of youthful proteins which tend to diminish as we age, leading to:

  • Enhanced muscle mass and bone strength to combat frailty
  • Lengthened telomeres and protected chromosomes capable of replicating for longer periods of time
  • Improved kidney functions
  • Improved cognitive functions
  • Better quality of life

Gene editing techniques are also being employed, which use the CRISPR/Cas9 system to make changes to genes that are already present in cells. As of the first quarter of 2019, 372 clinical trials in humans were in progress to study gene therapies, and that number is expected to skyrocket over the next decade.

9:35 – 10:20 am Epigenetics and its Clinical Implications in Cardiovascular Aging and Precision Medicine
George Shapiro, M.D.
Adjunct Assistant Professor Clinical Medicine, New York Medical College, Valhalla, NY
Founding Partner, Cenegenics, New York City
Member, AMMG Conference Planning Committee
This lecture will begin with a brief summary of epigenetic basics. This lecture will review the evolving landscape of epigenetic research related to the cardiovascular system and the aging human. Then I will discuss epigenetics and the environment and how lifestyle modifications can influence epigenetic change from one generation to the next and affect individual epigenetics and health. Clinical applications of epigenetics will also be reviewed along with selected case studies.
10:20 – 10:50 am Break / Visit Exhibits
10:50 am – 11:30 am Introduction to Traumatic Brain Injury
Mark L. Gordon, M.D.
Medical Director, Millennium-TBI & The Millennium Health Centers, Encino, CA; CBS Studios;
Consultant – Medical Board State of California
Medical Director of Education, Access Medical Laboratories, Jupiter, FL
Member, AMMG Conference Planning Committee
The fetal body’s production of growth factors (GH, IGF-1, IGF-II) allow for the development and growth of each organ system from brain to bones. As our body takes on a more adult form the production of Growth Hormone diminishes over the years. Once thought to be the sole benefactor to linear growth (gigantism) has been found to participate in the optimal production and functioning of all hormones as well as 450 different cell types. Growth hormone works with vitamin D in the kidneys to independently produce 25 (OH) Vitamin D, GH provides a stimulus for the conversion of T4 to T3, GH working with Testosterone enhancing memory at the level of the hippocampus, GH and Testosterone as well as Estradiol improve upon endothelial functioning and repair of the basilar membrane, IGF-1 produced by GH signaling improves protein synthesis by up regulating the 40-70S unit of the Ribosomes, rebuilds the tau protein based microtubules destroyed by Amyloid-Beta in Alzheimer’s disease, lowers homocysteine, cytokines and interleukins thereby reducing inflammation. In 2017, research showed that 61% of individuals with treatment resistant depression had a Growth hormone deficiency which resolved when corrected. Knowing how best to detect alterations in growth hormone and its by-products will allow for comprehensive preventative programs of wellness to be developed. Understanding the legal requirements for justifiable prescribing of growth hormone will allow the physicians to provide uncompromising services to and for the patient. In this lecture you will learn (1) the importance of GH and its related growth factors in body functioning, restoration, and protection, (2) how to detect deficiency and perform a Glucagon Stimulation Test, and (3) the myth about GH causing cancer, and (4) treatment protocols using secretagogues and growth hormone in combination.
11:30 – 12:15 pm The Estrogen Controversy: Estrogen vs No Estrogen in Men. What all clinicians should know about estrogen in men but don’t; a literature review in the use of aromatase inhibitors in men
Neal Rouzier, M.D.
Director, The Preventive Medicine Clinics of the Desert, Palm Springs, CA
It has become customary to use aromatase inhibitors to block formation of estrogen in men. Even though the use of AI’s is commonly taught, the utilization is not supported by the medical literature and can have significant adverse consequences on men’s health. The purpose of this lecture is to present the lack of need to block estrogen in men and the consequences of doing so. Using the medical literature, we will come to understand the importance of optimizing estrogen instead of blocking it. The medical literature, as it pertains to the harm of blocking estrogen and importance of optimizing E2, will be emphasized. The importance of following evidence-based standards, and not public opinion, will be explained and demonstrated.
12:15 – 1:30 pm Lunch Break / Visit Exhibits
12:15 – 1:15 pm

TBD
Presented by TBD
Open to all attendees and includes a complimentary lunch
Non-CME symposium sponsored by TBD

1:30 – 2:15 pm Why Patients Choose BHRT
Daved Rosensweet, M.D.      
Testifying Expert, National Academy of Science, Engineering and Medicine (NASEM) Committee on the Safety and Efficacy of cBHRT 2019
There’s nothing like the horrible sucking sound of silence! Sure some patients start coming in the door, but that practice-changing, catch-on-fire word-of-mouth, moment never seems to arrive. Why? We’re at a unique moment in time. 5 million women seek menopause treatment in America today, down from 18 million at its peak. That leaves 45 million more that would benefit! The change that the world may be on the verge of is that the fear-tsunami caused by the WHI may finally be subsiding. The National press, right now, is talking about the truth about risk. Yay! What if your entire practice is about to change? What if a new way of looking at your menopause practice and presenting it to the world, could lead you to more satisfaction, less burnout, healthier, happier patients, more time and a stronger bottom line! Today, we dive in.
2:15 –3:00 pm COVID 19, Inflammation and the Role of HRT
Cesar Pellerano, M.D.
Preventive Cardiologist, Miami, FL
President, Founding Partner and Chief Medical Officer, Hillstar Health LLC, Miami, FL
The COVID 19 pandemic has dominated the news and or lives over the last few months. This is a brand new disease that affected the entire world, so we have had to try and fight it and learn about it at the same time. One theme is consistent, that this is a highly “inflammatory virus” when it affects and kills the at risk population. We have documented severe effects in the lungs, heart , kidneys and brain. Most of this damage seems to be mediated by inflammation. While this virus is more dangerous to the elderly and immunocompromised, it has also affected and killed younger people. Metabolic Syndrome and obesity appear to be a common finding when this disease affects the younger population, that we did not expect to be at risk. Estrogen and testosterone deficiency are being looked at as possible “at risk scenarios” for this disease. This presentation will give the audience the available clinical data of the relationship between COVID 19, Metabolic Syndrome and Obesity. It will also present the possible role of HRT in the fight against this disease.
3:00 – 3:45 pm Break / Visit Exhibits (exhibits close 3:45 pm)
3:45 – 4:45 pm What is Robbing My Patients of Hormonal Health
Andrew W. Campbell, M.D.
Editor-in-Chief, Alternative Therapies in Health and Medicine Medical Journal & Advances in Mind-Body Medicine Journal
Editorial Board, Integrative Medicine: A Clinician’s Journal
Medical Editor, Natural Solutions and Alternative Medicine Magazines
In this evidence-based lecture, I will discuss how aromatase, an enzyme responsible for catalyzing the last steps of estrogen biosynthesis from androgens such as testosterone, is affected by the chronic inflammation from molds and mycotoxins. Furthermore, I will review that certain mycotoxins are mycoestrogens, binding estrogen receptors, thereby confusing the pituitary gland and lowering the production. Adequate stores of estrogen are necessary for proper brain function, gut function, and sugar regulation in addition to the normal glandular requirements. In addition, too much estrogen causes estrogen dominance and progesterone deficiency, which can result in a host of problems, including weight gain, fatigue, brain fog, depression, and others. Lastly, the cause and treatment for non-thyroidal illness syndrome (NTIS) will be reviewed.
4:45 – 5:30 pm Using Mortality Science as the New Marker for Longevity 
Gary Brecka, Human Biologist
CEO, Streamline Wellness Anti-Aging & Rejuvenation Clinic
Director, NFL Alumni Association Signature Athletica, Health Initiatives Board
This lecture will, in only 45 minutes, identify and define the 3 largest root causes of accelerated mortality, explaining why they are the same causes of decreased biometric function and how to diagnose, treat and remove them from our patient population. The physiology behind our “state, mood, energy level, cognitive function, immunity, methylation, waste elimination and mitochondrial function all have one common physiological root, OXYGEN, which is commonly overlooked in our quest to improve the health and biometric function of our patients. Using case studies and data to demonstrate how to use, (1) blood labs, (2) hormones and (3) common nutrient levels to stop and even reverse these deficiencies and improve the oxygen profile of our patients.

Sunday, November 8th

General Session Curriculum

Time
Presentation
7:00 – 7:45 am TBD
8:00 – 8:45 am Hair Rejuvenation
Joseph Greco, Ph.D., PAC
Greco Medical Group, Sarasota, FL
Faculty, George Washington University
A comprehensive review and updates of biologic therapy for the treatment of hair loss and hair loss diseases. The goal is to review the evolution of biologic treatments and share the latest protocols for Androgenic Alopecia, Alopecia Areata and Cicatricial Alopecias. Newer therapies include the use of exosomes and birth tissue including Amniotic Cells, Wharton’s Jelly and Medicinal Signaling Cells.
8:45 – 9:30 am Dangers of Vaping
Jordan Tishler, M.D.
Instructor of Medicine, Harvard Medical School
President, Association of Cannabis Specialists
CEO, InhaleMD
Vaporizing (or vaping) both cannabis and nicotine has been getting some scary press in recent months. As our patients use these substances and devices, it’s important that we understand the benefits and risks involved for them. It’s just not as simple as advising them not to do it (and that sort of advice undermines our credibility as trusted practitioners). We will discuss what is known about vaporization, how the substance and the device affect safety, and how to minimize risk for our patients.
9:30 – 10:15 am Cannabis Metabolomics
Betty Wedman-St. Louis, Ph.D.
Licensed Nutritionist & Environmental Health Specialist, St. Petersburg, FL
Cannabis metabolomics takes a look at the unique chemical fingerprint of Cannabis sativa with over 421 chemical compounds. A major focus will be on cannabidiol (CBD) and its “non-intoxicating” diverse benefits. Misconceptions have resulted from Merrick, et al. (2016) claim that CBD can be converted into THC. Grotenherman, et al. (2017) refuted this biological study. Health care professionals need to understand the functional properties of cannabis products in order to appropriately recommend and dose. Selecting full-spectrum, broad spectrum or isolate products can make significant difference in patient outcome. Physicians need to be aware of drug interactions and SAMHSA recommendations when discussing cannabis with their patients. Clinical Pearl: There is NO legal definition of “medical marijuana”.
10:15 – 10:30 am Break
10:30 – 11:15 am The Benefits and Dangers of Hyperbaric Oxygenation for Neurological Injury
James Raniolo, D.O., AOBFP, ABAARM, FAARFM  
Owner, Wyoming Center for Optimal Health, Jackson, WY
Founder, Chairman, CEO, Personalized Medical Group
Hyperbaric oxygen is one of the most promising therapies available for the treatment of localized neurological injury from both trauma and vascular insult, and can potentially help our clients to regain lost neurological function. Like any other therapy, a fundamental understanding of the underlying mechanisms of how intermittent hyperbaric therapy leads to permanent return of lost function will be reviewed. Additionally we will discuss the primary mechanisms of toxicity of hyperbaric oxygenation, so that prudent clinical decisions can be made including who are the best candidates for therapy, what is the proper timing, dose, and duration of therapy.
11:15 am – 12:00 pm Clinical Roadmap for the Treatment of Difficult or Recalcitrant SIBO Cases
Chris A. Kleronomos, FNP, DAOM, MSc
Comprehensive Pain and Functional Medicine Specialist
SIBO is an emerging problem gaining attention within the standard biomedical community though lack of in-depth clinical knowledge, lack of response to treatment, and high recurrence rates remain problematic. This presentation will provide an evidence based detailed protocol for therapeutic intervention outlined in an easy to follow, detailed, step by step process. It will include specific information on diet strategy (including elemental), supplements, prescription and herbal motility, and antimicrobial agents (pharmaceutical and natural), as well as novel therapies such as Peptides and Electro-Acupuncture for Vagal modulation. This is not a research update (though it is inclusive of current state of science) but specifically designed for clinicians to have a framework to reduce symptoms, address SIBO, associated secondary infections (dysbiotic flora, candida etc.), as well as Biofilms to improve outcomes.
12:00 – 12:45 pm The Top Ten Pellet Insertion and Dosing Mistakes: How to Avoid Common Pitfalls and Optimize Your Treatment
Angela DeRosa, D.O., MBA, CPE
Founder & President, Hormonal Health Institute, Scottsdale, AZ
Bio-identical hormone replacement therapy is a powerful tool in a clinician’s toolbox in treating patients’ symptoms of hormonal imbalances and deficiencies but also preventing chronic illness; addressing the desire for not only longevity but quality of life in our patients. Subcutaneous hormonal pellet therapy, specifically, provides the highest efficacy and most physiologic hormone response when properly dosed and implemented. In order to ensure proper response to these therapies, it is important to have proper training not only on the insertion techniques of pellets but the unique pharmacokinetic, physiologic and idiosyncratic nature of pellets and common pitfalls to avoid. This presentation will address the top ten most common mistakes clinicians make when inserting pellets procedurally (which affect extrusion and infection rates) but also the more important dosing considerations that can affect the patient’s overall response to therapy. In addition, the presentation will address how to best address consenting and documentation to protect one’s license from board actions and ensuring strong patient advocates.
12:45 – 1:30 pm Introduction to Bioidentical Hormone Replacement 
William Clearfield, D.O., FAAMA, DABMA, FAARFM
Medical Director, Clearfield Family Medicine, Reno, NV
Executive Director, American Osteopathic Society of Rheumatic Diseases
Lecture will review, and refute with peer reviewed literature, the 2009 position paper, review the rationale for a comprehensive BHRT program for men and women and review the three latest FDA approved BHRT medications released since 2016.