Washington · Telehealth
Text the doctor before you give anyone a credit card.
That one sentence is the whole difference. At Summit you can ask Dr. Paul Miranda anything — about GLP-1s, about your labs, about whether this is even right for you — and get the answer from him, before you have paid a dollar or entered a card.
The application takes about three minutes. He reads them himself — Washington applications usually get a reply the same day.
Is this a real person or a chatbot
Real person. It’s Paul. I read these myself.
ok — do I have to do a video visit or can it all be messages?
First one’s a video visit with me. After that most of it can be messages.
and if I’m not a good candidate for this?
Then I’ll tell you that, and where I’d send you instead. Costs you nothing either way.
An example of how the line works. Texts are for general questions — not for emergencies, and not a substitute for a visit.
Four things that are true here and almost nowhere else
Every large telehealth weight-loss company takes your money before a clinician looks at your chart. That is the model — volume, a prescriber pool, a support queue. Summit is one physician with a capped patient panel, so it can afford to work the other way around.
You talk to him before you pay anything.
The consult is free and no card is required to have it. Most programs take payment at intake or at signup, before any clinician has read a word of your chart.
No contract. Cancel any month.
No enrollment fee, no minimum term, and no retention call you have to sit through to leave.
The price is published, right here, as a number.
Most weight-loss clinics publish no price at all — you find out after the appointment. Ours is further down this page, before you apply.
If you’re not a fit, he says so — and says where to go instead.
A physician with a capped panel has no reason to enroll someone who shouldn’t be enrolled. That is the part a volume model cannot copy.
Three time zones away, and why that is the whole design
Washington runs three hours behind me, which is the single hardest thing about running a text-your-doctor practice across the country. It is also the thing I was most careful to get right before opening the state.
Here is the honest version: a text you send during a Washington evening is usually answered that same night, and always by the next morning. It is answered by me, not by an answering service and not by a chatbot wearing my name. If that ever stops being true I will tell you rather than let you find out.
Scheduled visits get booked into your afternoon, not my early morning, so you are not taking a call at six a.m. to talk about your labs. And eastern Washington gets the same access as Seattle does — Yakima and Spokane are no farther from a video visit than Bellevue is.
Who has your money before a doctor sees your chart
| Card up front | Who answers you | Price before signup | |
|---|---|---|---|
| National telehealth apps | Yes — at intake or signup | A support queue, then an assigned prescriber | Often only after signup |
| Most local clinics | Deposit or visit fee | Front desk, then a provider | Rarely published |
| Summit | No — free consult, no card | Dr. Miranda, by text or video | Published on this page |
Practices change their terms; check any program’s current policy before you decide. Summit’s row is what we do today, and it is what we will do when you apply.
What happens after you hit apply
- 1
The application
About three minutes. Your goals, your history, your medications. No card, no fee.
- 2
He reads it
Not a triage bot. Washington applications usually get an answer the same day, from him.
- 3
A real video visit
You and Dr. Miranda. If it’s a fit, you start. If it isn’t, he tells you what would be.
- 4
Then you’re a patient
Message him between visits about dose changes, side effects, plateaus. Same doctor every time.
What it costs in Washington
Free, and no card required. You find out whether this is right for you before you spend anything.
Your visits with Dr. Miranda, your prescription, dose changes, and direct access to him in between.
When you’re at a stable weight or tapering off, the price drops and stays there. Cancel any month.
Billed separately by an independent licensed 503A compounding pharmacy, depending on what you’re prescribed.
That is the whole price. No enrollment fee, no lab fee, and no charge to ask a question.
Serving all of Washington
Dr. Miranda holds an active Washington medical license and sees Washington patients by video from the practice’s home base outside Chattanooga, Tennessee. Visits are by video, so the whole state is in range — Seattle, Spokane, Tacoma, Vancouver, Bellevue, Kent, Everett, Renton, Yakima, Federal Way, Spokane Valley and Bellingham, and everywhere in between. Washington runs three hours behind Eastern time, which is the one thing a text-your-doctor practice has to get right. Texts sent during a Washington evening are answered the same night or first thing the next morning — by Dr. Miranda, not by an overnight answering service. Washington physicians are regulated by the Washington Medical Commission, which holds a telemedicine visit to the same standard of care as a visit in an exam room — which is exactly why a questionnaire alone will never get you a prescription here.
Dr. Miranda is licensed in five states. If you move, split the year, or your family is spread across them, you keep the same doctor: Florida, Georgia, Ohio, Tennessee.
Written for Washington patients
Ask him something. It costs nothing to find out.
Apply and he reads it himself. Or skip that and just text — the number goes to his phone, not a queue.
Summit Metabolic Health is a telemedicine practice. Dr. Paul Miranda holds an active medical license in Washington. Compounded medications are prepared by an independent licensed 503A compounding pharmacy, are not FDA-approved products, and are not the same as brand-name medications. Individual results vary and no outcome is guaranteed. This page is general information, not medical advice, and does not create a physician-patient relationship. For a medical emergency, call 911.