Best Practice: Park Avenue Endocrinology & Nutrition
Partner, Dr. Clifton Jackness, on collaborating with his team to evolve their practice.
Park Avenue Endocrinology is New York City’s largest endocrinology-only practice. With four board-certified endocrinologists and a dietitian, the team brings focused, yet diverse care to patients. Park Avenue Endocrinology’s mission is to not just treat the thyroid, but also the whole body. Thus, the practice is committed to providing high-touch personalized care to everyone who comes to the office. Learn more from partner, Dr. Clifton Jackness, about how this leading practice has grown and adapted over the last 38 years.
In 1981, my uncle Dr. Dennis Gage founded Park Ave Endocrinology & Nutrition. At that time, he was a solo practitioner. When I decided to go to medical school, I thought I wanted to become a surgeon (which changed as soon as I saw my first surgery). But I soon realized that I loved seeing and counseling patients when they’re awake. As I continued my training, I gravitated toward endocrinology because there’s a lot of research to be done and a lot of approaches to care.
When I was doing my endocrine fellowship at Columbia University, my uncle’s practice was growing rapidly, and he invited me to join him to help keep up. Within my first four months, my schedule was jam-packed. From there, the practice continued to grow. Two years went by and we hired Dr. Gillian Goddard to join, followed by Dr. Shira Eytan. We also had a really great dietitian join our team. Her name is Jordana Turkel, and she’s been with us for almost two years. We are the largest endocrinology-only private practice group in NYC. We have four board-certified endocrinologists, so we are a busy place. It’s important to us to provide high-touch, high-quality personalized care to our patients and to utilize technological advancements to help prevent disease and keep our patients coming back.
What was Dr. Gage’s vision when he first started the practice and how has that evolved?
Park Avenue Endocrinology was started in a different era of healthcare. There weren’t as many treatments as there are now. Dr. Gage wanted to build a practice that helped the people in the surrounding community. As time went on, and healthcare became more complex, Dr. Gage honed in on weight loss and obesity medicine. It’s really his specialty — he even wrote a book on it, called The Thinderella Syndrome. When he brought me on as a partner, he was mostly seeing patients for weight management. Other physicians weren’t really referring to him for general endocrinology cases. Thus, it was my goal to bring that back into the central focus of the practice, so we could be seen as the leader in endocrinology in NYC. Dr. Gage had built a great practice in an amazing location — I knew we could provide well-rounded care for all endocrinology conditions, not just obesity.
At our practice, we focus on our patients every step of the way — from how our staff interacts with them, to the role we play in helping them navigate insurance and pharmacy experiences, to how they feel at the end of the day.
Tell me more about providing high-touch personalized care.
We review everybody’s case before they come in so that we’re prepared. We want to know ahead of time what tests we need to order so we can decrease the wait time. Every single time that a patient comes in, we sit down with them in our offices to listen and counsel so we can help them get to the root of their problem. This one-on-one time is so crucial to understanding our patients’ lifestyle, and it does so much more than just giving a physical examination.
For example, I’ve been seeing a female patient in her early 30s for weight management and polycystic ovarian syndrome, which is like pre-diabetes. During one of her visits, we were sitting down in my office and she expressed to me that she really needed to share something. She had revealed that she is an alcoholic and had half a bottle of vodka that morning. She was aware that she had a problem and needed help. We took the necessary steps to initiate care for her. I don’t think that would’ve happened if I had just seen her in the exam room. Our encounters in our offices are high intensity and highly personal. I feel very fortunate that my patients are comfortable sharing things that like with me; it’s really that type of relationship that I strive for as a doctor.
How does technology play a role in your practice?
We have a diverse group of patients. They come from all over the tri-state area, and some even come from abroad. Our main focus is on prevention. We welcome people who have fluctuating blood sugars, borderline diabetes, or who are gaining 10–15 pounds out-of-the-blue. This is when we should see the patient, not after when they have numbness in their toes and they’re on dialysis. Encouraging patients to come in for prevention testing can be difficult. Oftentimes, people feel fine or think they feel fine. However, there are tests we can run to see their neuropathy, which is numbness of the nerves, or we can look at their internal workings called the autonomic nervous system, both of which help us see how their body is being affected by blood sugars. Also, doing these tests can inform our approach to counseling patients who feel fine, but internally their bodies are changing.
Additionally, Dr. Gage has created a permanent weight management system to be delivered through an app. Through the app, patients are guided on how to lose weight. It gives them instructions on how to weigh themselves, when to eat, and when to come in for an appointment if there’s too much weight loss or gain. It’s a great tool that we use in our practice. Hopefully, someday we’ll be able to market it if so more people can use it!
How does your team collaborate and what are the benefits of having a diverse team?
Each member of our team has a different style. It’s nice for us to be able to work together to discuss complicated cases or how to better explain treatment plans to patients who are more reluctant to start. We all work very closely with Jordana for weight loss, detoxes, Hashimotos thyroid conditions, diabetes, and polycystic ovaries. She sets everyone who needs them up with insulin pumps and glucose monitors. She’s excellent at working with the patients to get all that started.
Dr. Eytan was trained in her fellowship to do thyroid ultrasounds. If a patient is worried about a thyroid nodule, we are able to get the results right away because she can do it right then in our office. Dr. Gage’s experience in obesity and weight management continues to be his focus, but he also works with a lot of diabetic patients. Dr. Goddard is a mother of four, so she sees a lot of patients who are struggling with fertility. She works closely with patients during pregnancy and also with those with gestational diabetes. In addition, she sees postpartum mothers to help them lose weight or to help with breastfeeding.
As for me, I have Hashimoto thyroiditis, so I have a keen interest in that. I’ve completed research in type 2 diabetes and obesity, and I’ve become artful in medication management and helping people get in control of their diabetes. We all have different strengths that allow us to work together well and provide the best possible care.
How are you working to modernize the practice?
Patients today are really different from patients forty years ago — if you went to the doctor and didn’t hear anything back, everything was fine and there was total trust in the medical system. It’s not that way anymore. It’s a give-and-take between doctor and patient, where we function more like consultants. People want our advice and instruction, but many also have a lot of existing knowledge from a variety of other sources — everything from naturopathic doctors to Dr. Google. We have to stay up-to-date on all the trends in healthcare and we have to be open to listening to patients.
As doctors, we have to be conscious of the distrust and skepticism in medicine. We’re respectful of that, and try our best to use evidence-based medicine. We do provide nutritional supplements, diet counseling, and detoxes because a lot of people feel better from those methods as well. Patients are looking to fine-tune their health and we want to do everything we can to support that.
Vital Signs
Best patient amenity: the thoroughness of our examination and the accessibility of good one-on-one time with the doctor.
Favorite local restaurant? Joe the Art of Coffee, BLT Prime
Sports team: I’m a diehard Mets fan.
NYC activity: Museum of Natural History, Bronx Zoo, Victoria Gardens
Learn more about Park Avenue Endocrinology & Nutrition here!
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