Welcome to Optimum Health Kerrville, where Concierge Medicine meets the power of Functional and Preventive Medicine integrated with Wellness Coaching.  As a board certified doctor and certified coach by the International Coaching Federation, I bring professional, evidence-based coaching practices to complement your healthcare journey, ensuring a holistic approach to keep you out of the hospital and healthcare system as much as possible. 

My practice is uniquely designed to provide personalized, comprehensive healthcare services aimed at improving your health span and enhancing your overall quality of life. By integrating a wellness coaching model with concierge and functional medicine, I empower patients to actively engage in their health journey, making lasting changes that support their individual goals.

Why Concierge Medicine?

Concierge medicine represents a revolutionary shift in healthcare delivery, offering unparalleled personal attention and preventive care. By limiting the number of patients under my care, I ensure every individual receives detailed attention, longer appointments, and direct communication with me. The benefits of this approach are clear: patients enrolled in concierge medicine practices tend to have significantly fewer hospitalizations and emergency visits. A notable study published in The American Journal of Managed Care in 2019 highlighted that concierge patients experienced a 40% reduction in hospitalizations compared to traditional primary care.

This approach is particularly beneficial in promoting long-term health, preventing acute medical issues, and ensuring timely interventions. Patients within concierge practices also report higher satisfaction, better chronic disease management, and increased access to preventive care, leading to an overall enhanced health span.

At the heart of what I do is acknowledging that every patient is an individual whose personal goals and needs must be recognized. With my guidance as their Internal Medicine physician, patients have the right to live the most productive and healthiest life possible.

The patient-physician relationship works best when both parties work together as a team. This requires open communication, developing a personalized plan, and then executing that plan. I value your input greatly.

My Geographic Reach

At Optimum Health Kerrville, I serve an extensive community throughout the Texas Hill Country, including Kerrville, Fredericksburg, Boerne, San Antonio, and Leakey. Many of my patients reside not only in Texas but in other states and countries. My practice has become the beacon of preventive healthcare for individuals in these regions seeking personalized attention and effective, integrative medical solutions.

Integrative Medicine: The Best of Both Worlds

I have skillfully combined the strengths of traditional internal medicine with the comprehensive approaches of functional medicine. With over 25 years of experience in obesity medicine, I specialize in crafting personalized nutritional plans that not only facilitate sustainable weight loss but significantly enhance overall metabolic health.

The integrative medicine approach at Optimum Health Kerrville uniquely addresses the root causes of weight gain and obesity, emphasizing sustainable, long-term results rather than quick, temporary fixes. By deeply analyzing metabolic functions and individual lifestyle factors, I create custom plans designed specifically for each patient’s needs and goals.

Holistic Medicine and Whole Person Health

My holistic medicine approach treats individuals as complete persons, considering physical, emotional, mental, and spiritual health. This comprehensive perspective is vital in achieving sustained health outcomes and promoting a balanced, fulfilling lifestyle. By acknowledging and addressing every aspect of an individual’s health, I provide natural health solutions that foster resilience, well-being, and longevity.

Functional Medicine: Addressing Root Causes

Functional medicine at Optimum Health Kerrville dives deeper than conventional medicine by identifying and addressing root causes of chronic illnesses. My comprehensive evaluations look at genetic, biochemical, and lifestyle factors to understand the underlying reasons behind health issues. This tailored approach is critical in managing and preventing chronic diseases such as cardiovascular disease, metabolic syndrome, cognitive decline, and certain cancers.

One essential aspect of my functional medicine practice involves optimizing the gut microbiome. Recent research underscores the crucial role of gut health in managing obesity and preventing chronic diseases. A robust microbiome supports digestion, nutrient absorption, immune function, and even mental health. By enhancing microbiome health through personalized dietary guidance and targeted supplements, I significantly impact weight loss and chronic disease prevention.

Lifestyle Medicine: Promoting Health Through Daily Choices

Lifestyle medicine integrates nutrition, exercise, stress management, sleep optimization, and emotional well-being. At Optimum Health Kerrville, I empower my patients with actionable strategies to adopt and maintain health-promoting behaviors. My detailed lifestyle plans not only target weight management but also significantly reduce the risk of developing serious medical conditions like diabetes, cardiovascular events, cognitive impairment, and cancer.

Preventive Medicine

Prevention is key to good health, and it’s rarely too late to take action. I achieve prevention by getting to know you, your past medical and family history, and your personal goals and needs. I address lifestyle changes, educate you on the most likely threats to your wellbeing, and offer appropriate preventive screening tests.

Early Disease Detection

Throughout my training and career, I have witnessed the importance of early disease detection. Early detection usually results in better health outcomes, requires less medical attention, and saves you significant healthcare dollars. I accomplish early detection by performing comprehensive annual exams and applying noninvasive technology to assess your various organ systems for disease.

Rapid Response

When you become ill, it’s crucial to get you back on your feet quickly. I achieve this by offering same-day appointments and providing direct contact with me 24/7 for urgent medical needs. Email access is available for less urgent medical questions or issues. Additionally, telemedicine services are available to ensure enhanced treatment and convenience, especially when traveling or geographically challenged.

The Optimum Health Kerrville Difference

At Optimum Health Kerrville, my commitment is to help you achieve optimal health through personalized, integrative, and preventive healthcare strategies. My practice’s unique combination of concierge medicine, functional and lifestyle medicine, holistic care, and wellness coaching ensures that each patient receives attentive, customized care that addresses their specific health goals and challenges.

Join me in embracing a proactive approach to your health, designed to enhance your vitality, prevent illness, and improve your overall quality of life. Discover the profound benefits of concierge, functional, preventive, lifestyle, holistic medicine, and wellness coaching at Optimum Health Kerrville—where natural health solutions and whole person health come together to create lasting wellness.

Preventive Medicine

Prevention is key to good health and it’s rarely too late to take action.  We achieve prevention by getting to know you, your past medical and family history.  We spend the time to understand your personal goals and needs.  We address lifestyle changes, educate you on the most likely threats to your wellbeing and offer appropriate preventive screening tests.

Early Disease Detection

Throughout my training and career I have witnessed the importance of early disease detection.  Early detection will usually result in a much better health outcome, require less medical attention and save you tremendous amounts of health care dollars.

We accomplish early detection by performing a comprehensive annual exam and applying noninvasive technology to assess your various organ systems for disease.

Rapid Response

When you do become ill it’s important we get you back on your feet as soon as possible.  We achieve this by same day appointments or contacting Dr. Miloy 24/7 for urgent medical needs.  We also provide email access for less urgent medical questions or problems.  When traveling or geographically challenged, you will have access to telemedicine services for enhanced treatment and convenience.

On Becoming a Doctor

Growing up I had strong interests in sports, science and helping others.  At the age of 15 I lost a very close friend to a drowning accident.  It was sudden, unexpected and could have been prevented.  It profoundly affected my appreciation for life’s fragility and compelled me to question the purpose of my own life.  His father was our family doctor and though initially devastated, he held onto the thread of his life’s purpose – the practice of medicine.  With humor, grace and service to others he continued to practice for many years and was a major inspiration.  I’ve always dreamed of practicing medicine the “Old Fashioned Way” like he did by taking time to personally know each patient and treat them with respect and kindness.  That dream has become reality with Optimum Health.  It allows me to apply the art and science of Medicine to serve others with dignity and respect.

Education

I’m a native Texan and attended Texas A&M University where I earned a Bachelor of Science in Biology and Masters in Molecular Biology.  Afterwards, I attended medical school at Texas Tech University Health Sciences Center.  Internship and residency were completed at Providence Portland Medical Center in Portland, OR.

Medical Experience & Practice Interests

Throughout training I was very fortunate to have excellent mentors.  They each imparted wisdom and knowledge which has helped me to serve others.  The most important lesson was putting the patient first.

Internal Medicine was a natural practice choice as a holistic integrated approach to medicine resonated with me during training.  Respecting the mind-body connection is now at the core of my practice philosophy.

After graduating from residency I began applying this approach with an emphasis on lifestyle change and prevention. Working with other like-minded physicians my approach has continued to evolve.

I’ve been practicing Internal Medicine with a focus on prevention and wellness in Kerrville since 2002 and I’m committed to continue seeking ways to help people live the healthiest life possible.

Welcome,

David R Miloy MD

Optimum Health provides a more modern approach to helping to pay for Internal Medicine primary care called Direct Primary Care (DPC) that has been embraced by patients, physicians, employers, and policymakers across the United States.  The defining characteristic of DPC is a lasting and trusting relationship between a patient and his or her primary care provider.
Establishing this relationship is the key to achieving superior health outcomes, lower costs and an enhanced patient experience.

DPC accomplishes this by focusing on five things:

1.  Service:  The hallmark of DPC is adequate time spent between patient and physician.  DPC enables unhurried interactions and frequent discussions to assess lifestyle choices and treatment decisions aimed at restoring and promoting long-term health.  DPC practices have extended hours in which doctors can be reached, ready access to care, and patient panel sizes small enough to support this service commitment.

2.  Patient Choice:  Patients choose their own personal physician and are active partners in their healthcare. Empowered by transparency and accurate information at the point of care, patients are fully engaged in making their own medical and financial choices.

3.  Replacement of Fee-For-Service:  DPC eliminates the perverse  reliance on fee-for-service (FFS) incentives in primary care. These incentives distort healthcare decision-making by rewarding visit and procedure volume over value.  This undermines the trust that supports the patient-provider relationship and rewards expensive and inappropriate testing, referrals, and treatment. DPC is a simple monthly fee.  Fees must be adequate to allow for appropriately sized patient panels to support this level of care so providers can ignore the other financial incentives that distort medical decisions and compromise the doctor-patient relationship.

4.  Medical Advocacy:  DPC providers are committed advocates for their patient members within the healthcare system.  They have time to make informed, appropriate referrals and support patients when necessary outside of the primary care setting.  DPC providers accept the responsibility to serve as expert healthcare navigators for their members.

5.  Stewardship of Health and Healthcare Dollars:  DPC providers believe that healthcare must provide more value to the patient and the system.  Healthcare must be more patient-responsive, less invasive, and less expensive than it is today.  The ultimate goal is health and well-being, not simply the treatment and management of disease.