Dr. Richard I. Horowitz MD, PLLC Consulting Services
Dr. Richard I. Horowitz
Thank you for considering the Dr. H's Consulting Services for your complex medical issues. This document will describe the scope of the consulting services that I can provide for you and your healthcare provider based on 41 years of diagnosing and effectively treating thousands of patients with complex medical problems. My patients have come from all over the United States and the world during the past 41 years of clinical practice looking for answers to relieve their suffering. Many had failed the diagnostic and treatment approaches of multiple mainstream/functional medicine physicians and subspecialists, otherwise excellent doctors. How is my approach different, and why is it so effective in the majority of chronically ill individuals?
About the Consultation
Schedule a personalized consultation with Dr. Richard Horowitz—renowned physician, researcher, and expert in complex chronic illness. Consultations are available for one or more hours at an hourly rate and are designed to provide in-depth guidance on topics such as tick-borne diseases (Lyme, Babesia, Bartonella, and more), chronic fatigue, immune dysfunction, detoxification, and integrative treatment approaches. These sessions are advisory in nature and meant to offer expert insight and direction—you must have a licensed healthcare provider to implement any recommendations discussed. This consultation provides direct access to Dr. Horowitz’s decades of experience in managing complex, chronic illness.
The 16 Point MSIDS Model
The 16 point model that I have developed over decades of scientific research and clinical practice, called MSIDS (Multiple Systemic Infectious Disease Syndrome) combines the best of classical and integrative medicine and uses a multipronged approach to determine why you are sick and remain ill. This model breaks down each patient’s symptom, creating a differential diagnosis, looking for where the multiple sources of inflammation may be coming from that underlie your illness. You can see a brief overview of the MSIDS Model in the chart below. The model was published in detail in both of my best-selling books, Why Can’t I Get Better? Solving the Mystery of Lyme and Chronic Disease (New York Times Bestseller 2013, St. Martin’s Press), ‘How Can I Get Better? An Action Plan for Treating Resistant Lyme and Chronic Disease (National bestseller 2017, St Martin’s Press), as well as in the journal Healthcare in 2018. You can access this article for free here: https://www.ncbi.nlm.nih.gov/pubmed/30400667
The majority of chronically ill patients that I have helped have gotten better and in many cases gone into full remission. Many who had failed traditional approaches (including my wife who is now 7 years in full remission) usually either did not get the right diagnoses and/or did not receive comprehensive treatment of all of the underlying sources of inflammation. As you see in the chart, these sources are infections (bacterial, viral, parasitic and fungal), environmental toxins (including mold, heavy metals, and environmental disrupting chemicals), gastrointestinal/microbiome imbalances, nutritional deficiencies, sleep disorders, hormonal/mitochondrial dysfunction, immune/autoimmune phenomenon, liver/metabolic abnormalities, deconditioning, autonomic nervous system dysfunction and/or neuropsychiatric issues. In many cases, all these factors were underlying their illness. It was like going to a doctor with 16 nails in your foot telling the doctor that you have foot pain and the doctor only found one nail and pulled it out telling you to come back one month later letting him/her know how you were feeling. Obviously, that approach will always be insufficient. Full healing when possible, requires getting to all the underlying sources of where the inflammation is coming from. That is why the 16 point MSIDS model has been so effective.
The Treatment of Chronic Lyme and Associated Tick-borne Disorders
In the case of Lyme and associated tickborne disorders, by following the medical research coming out of major universities like Johns Hopkins, Stanford, the University of New Haven and Northeastern University, I developed a novel treatment for Lyme and associated diseases which has been highly effective. This treatment protocol is called dapsone combination therapy. It is a 9 week oral, generic antibiotic protocol. It can require several two week antibiotic pulses later in the treatment if Bartonella is present and active, especially if mold toxins or immune deficiency are overlapping inflammatory factors. The success of dapsone combination therapy is based on the finding that Borrelia burgdorferi, the agent of Lyme disease, is what is called a “biofilm/persister bacteria” and resists standard treatments unless specific biofilm/persister drug regimens are used to eliminate the infection. The same situation exists for Bartonella. Please see the 2 documentaries listed below which were filmed when I was co-host of the Doctor Talks Healing Lyme Summit in 2024 and 2025, where 27 patients describe their success using this protocol:
You can also hear from 2 other physicians who have used this approach, describing the success of dapsone Combination Therapy in the Treatment of Chronic Lyme/PTLDs:
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We have 10 articles published in the peer review medical literature supporting this approach. They are listed below, and you can simply click on any of the links and review the articles and protocols with your healthcare provider.
10 Dapsone Articles on The Effective Treatment of Chronic LD & Associated Co-infections Including Bartonella: As of May 11, 2024
- Combining Double-Dose and High-Dose Pulsed Dapsone Combination Therapy for Chronic Lyme Disease/Post-Treatment Lyme Disease Syndrome and Co-Infections, Including Bartonella.
- Comparison of the Efficacy of Longer versus Shorter Pulsed High Dose Dapsone Combination Therapy in the Treatment of Chronic Lyme Disease/Post Treatment Lyme Disease Syndrome with Bartonellosis and Associated Coinfections.
- Efficacy of Short-Term High Dose Pulsed Dapsone Combination Therapy in the Treatment of Chronic Lyme Disease/Post-Treatment Lyme Disease Syndrome (PTLDS) and Associated Co-Infections
- Efficacy of Double-Dose Dapsone Combination Therapy in the Treatment of Chronic Lyme Disease/Post-Treatment Lyme Disease Syndrome (PTLDS) and Associated Co-infections.
- Effect of dapsone alone and in combination with intracellular antibiotics against the biofilm form of B. burgdorferi.
- Precision Medicine: retrospective chart review and data analysis of 200 patients on dapsone combination therapy for chronic Lyme disease/post-treatment Lyme disease syndrome: part 1. International Journal of General Medicine
- Precision Medicine: The Role of the MSIDS Model in Defining, Diagnosing, and Treating Chronic Lyme Disease/Post Treatment Lyme Disease Syndrome and Other Chronic Illness
- Are Mycobacterium Drugs Effective for Treatment Resistant Lyme Disease, Tick-Borne Co-Infections, and Autoimmune Disease?
- The Use of Dapsone as a Novel “Persister” Drug in the Treatment of Chronic Lyme Disease/Post Treatment Lyme Disease Syndrome
- Superior efficacy of combination antibiotic therapy versus monotherapy in a mouse model of Lyme disease
The full dapsone protocol is published in the journal Microorganisms in 2023, and if your doctor wants to try the protocol, the full explanation can be found there. You do not need to access the consultation model in that case! You can also find more information on this protocol in my Medical Detective Substacks, which are free to access:
A Multicenter, Placebo-controlled Randomized Trial of Dapsone and the MSIDS Model:
I am planning a multicenter, placebo-controlled, randomized trial of dapsone combination therapy and the MSIDS Model in the Treatment of Chronic Lyme disease/PTLDs for 2026 going forward as we are certain of our results. Mount Sinai Medical Center in New York City, and the University of California San Francisco are on board as sites to conduct the trial, with other universities considering joining us once the grant has been approved.
The MSIDS Model Is Also Applicable for a Broad Range of Chronic Diseases
The efficacy of the 16 point MSIDS model not only applies to the treatment of chronic Lyme disease and associated tickborne infections, where I have had considerable success, but also a broad range of other chronic medical illnesses. My new, 3rd science book that will be released by Simon & Schuster later in 2026 called ‘ENDING CHRONIC ILLNESS: A Revolutionary New Program to Reverse Inflammation and Heal Persistent Disease’ will outline this groundbreaking approach in greater detail. When the book is available for pre-order, there will a link on the www.cangetbetter.com website with updates on my Facebook page: https://www.facebook.com/drrichardhorowitz/
After such a deep dive into the medical literature for one year writing my latest book, with approximately 2000 scientific references backing up this approach, we have found that all 16 factors on the sixteen point MSIDS Model apply to diseases as varied as ADD/ADHD, Autism spectrum disorder, Alzheimer’s disease, allergies and asthma, autoimmune disease, cardiovascular disease, cancer, Chronic fatigue syndrome/myalgic encephalomyelitis, Long Covid, digestive disorders, Fibromyalgia, hormonal dysregulation as well as pain and mood disorders. Most healthcare providers are unaware of the multifactorial nature of these illnesses. This approach gives us an opportunity potentially to improve clinical outcomes going beyond the standard medical model of naming a disease and simply using medication to treat it. Although that approach can be effective in some cases, it is insufficient when multiple sources of inflammation are present which have not been adequately addressed. Even if medication is helping, treatment results may be improved by addressing underlying factors on the MSIDS model driving inflammation.
If you or a loved one suffers from a chronic fatiguing, musculoskeletal, cardiopulmonary, neuropsychiatric illness and have not been able to get help, consider using the Dr. H consultation model to help guide your healthcare team to find answers to support your healing process. In order for this model to work, since I will not be directly prescribing medications to you myself, we will need to create a partnership with your healthcare provider and team where they will work with me on your behalf. They will be following my diagnostic and treatment advice, working hand-in-hand to get you or your loved ones better and they will be the ones prescribing the medication.
Although the MSIDS model has been highly effective in multiple chronic health conditions, and we have not seen adverse long-term health outcomes using the protocols recommended, if strictly adhered to, of course no treatment is guaranteed to be 100% effective. Most people, however, will see significant improvements in their health, and in our experience, the improvements will depend on the number of MSIDS factors that have been properly diagnosed and treated. In many cases, those who have improved but not seen maximum improvement, still have active infections (e.g., Bartonella, Babesia, viruses), ongoing toxicity (mold, heavy metals), leaky gut/food sensitivities with mast cell activation, a history of trauma that needs vagal/limbic retraining, etc. If you watch the documentaries listed above, you can see the types of excellent results we have seen in a broad-range of patients, from young to old. Remember, however, healing takes time and patience, and compliance with our protocols.
Nutritional Supplements For the Protocols and Health Maintenance
All of the nutritional supplements required for the protocol, and for general health maintenance, are available at significantly discounted rates on our nutritional website if you choose to use it.
The Cost of the Consultation Service
The cost of the consultation service is $750 per hour. A minimum of a one hour consultation is needed to access our service, although if you have been chronically ill and have many years of medical records and lab testing, my initial consultation will usually run 2 hours or more. The time can be split into multiple sessions with your healthcare team as needed. All times booked need to be coordinated with your healthcare provider in advance, who must always be on the line during a consultation (I am functioning as a consultant, and will not be prescribing medication or testing, nor keeping notes, which is the responsibility of your treating doctor). Usually for an initial consultation with extensive records, you will want to pay for two hours of time (one hour for record review, and one hour which will involve meeting with your healthcare provider to discuss your symptoms, testing, potential treatments...). Questions and email responses after the consultation will be tallied as part of the consultation time where I will keep a strict time log. After the initial consultation, booking half-hour slots will usually be appropriate unless your case is extremely complex, and requires more time and discussion. In that case, early on in the consultation process, a one hour slot may be more appropriate for follow-ups. Check with us and your treating physician before scheduling follow-up consultations.
To Book A Consultation
Before booking a consultation using the Calendly link below, several criteria need to be met
- You have a treating physician who has agreed to follow my diagnostic and treatment plan, who will order testing, medication, etc. Do not send notes or a history until a consultation has been officially booked.
- Your physician will provide a complete overview of your case, including a recent history and physical, relevant treatment notes with diagnostic testing and treatments tried with results.
- Your treating physician will provide an overview of which aspects of the 16 point MSIDS map have been tested and treated (see above).
- You will fill out the HMQ screening questionnaire which has an overview of symptoms, and scan it back to us before each consultation.
- By clicking this link and setting up a consultation, you agree that medically-legally, I am held harmless regarding treatment outcomes, as I am not functioning as your treating physician. Performing a consultation does not substitute for seeing a patient in person, doing a full history and physical, regularly reviewing labs and responses to treatments, which is the responsibility of your treating healthcare provider. By signing up for a consultation, you therefore agree to sign a waiver absolving us of any responsibility for medical outcomes and absolve us of medical-legal consequences.
The email to contact us to set up an appointment is medical@hvhac.com.
Please do not send extensive emails detailing your symptoms, or send over laboratory results, clinical notes, etc until you have scheduled an official appointment which has been coordinated with your treating doctor. We get frequent emails and questions from patients and physicians across the world, and although I would like to help everyone, our email inbox is so busy that we can only help those who have an official consultation and a treating physician willing to work with me (apart from quick questions from physicians who require my help).
The link to schedule the appointment and pay in advance once you have a treating healthcare provider who is willing to follow my diagnostic and treatment protocols can be found here:
So, again, for clarification: for first time consultations with extensive records to review, we suggest paying for two hours, where one hour will be used to review records, and one hour will be used to discuss your case with your doctor(s), and any elucidate further testing, treatments, etc. In that case, you will pay for two hours, but only book a one hour slot (or half-hour slot if that is all the time your doctor can afford to give when we meet). Any time left over, will be carried over to future consultations. I keep a strict time log, which will include emails back and forth.
If you do not have extensive records, then the initial consultation can be booked for one hour, or less, again, always coordinating the date and time with your treating physician. They should help guide you regarding how much time will be needed for your consultation.
Follow up consultations later in the process, once you have gotten the essential diagnostic work-up and started treatment, can usually be booked in half-hour slots. If there are any questions regarding the process, please reach out to us at: medical@hvhac.com and supplements@hvhac.com
Other Important Things To Keep In Mind:
Your treating physician needs to send over in advance of consultations an update on your case. This would include for first time consultations, a recent history and physical with chief complaints, medical problem list with treatments tried and outcomes, present medication and supplements, and relevant labs and radiological reports. Follow-up consultations should similarly include your symptoms, recent labs and results of treatments with a running problem list.
You should also fill out the Horowitz MSIDS Questionnaire (HMQ) in advance of each consultation so your doctor and I also understand your primary symptoms. The HMQ can be downloaded here, filled out, and scanned back to us and your treating physician
It would also be beneficial for you and your healthcare provider to keep a running list of MSIDS factors (see the heading above listed 'The 16 Point MSIDS Model') so I understand what has been done and what still needs to be done in your healing process. We oftentimes find multiple MSIDS factors interfering with full healing (active co-infections like Babesia and Bartonella, environmental toxins like mold and heavy metals, hormonal dysregulation, etc).
Regarding Note taking:
We encourage you and your healthcare provider(s) to take notes on the Zoom call for future reference, and/or record the call via AI transcription, as I will not be keeping notes. This is why I recommend before consults, getting an overview of your case from your doctor, as discussed above. It is much more efficient for me to have an overview of symptoms, problem list, present medication and supplements, etc so I can review it during our Zoom call.
Payment Options
You can pay for the consultation via credit card or using a Venmo account, or sending us a check in advance of the consultation, and your healthcare provider will bill you separately for their services. We have had great success using this model and working with other healthcare providers to help their patients (and many times their families) and look forward to helping you too!
If you are a US veteran and need help, we will discount this service as an honoring of the service you have provided to our country, but please provide proof if accessing our discounted rates for veterans. Also, we do not charge for short calls or emails from physicians looking for guidance for their patients, independent of whether they/you use the consultation service. I am here to help you and your physician on your healing journey. However, for any calls/emails that require more than a few minutes of my time, I would encourage you and your team to please access the consultation model.
In the spirit of health and healing, I look forward to helping you get better!
Richard I. Horowitz, MD
CV can be found here.
Medical-Legal Addendum/Follow-ups During/After Treatment
Please be aware, since I will not be personally examining you to do a full history and physical (my initial history and physicals usually would run between 4-6 hours in length, sometimes more) nor directly following you during the treatment course, which is the responsibility of your doctors, that your healthcare team will be medically-legally responsible for all outcomes. By agreeing to this consultation service, you hold us harmless regarding long-term results. This service is being offered as guidance to help you or your loved ones regain your health but does not substitute for in-person history and physical examinations, nor regular review of all your medical problems. That is the responsibility of your healthcare team.
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Your healthcare provider(s) and/or you can always contact us if they/you have questions during or after treatment and I will provide my cell phone to your healthcare team and will be available to speak to them between the hours of 9 am and 5 pm Monday-Friday if any urgent questions arise. Otherwise, I will check the medical@hvhac.com email for any questions that they/you may have during or after the treatment course, which will be responded to usually within a 48 hour time frame. Any urgent questions, however, on symptoms or laboratory results should be referred to your healthcare team. International patients/healthcare providers are encouraged to set up follow-up Zoom calls for longer, detailed questions that do not require a simple response via email.
We encourage healthcare providers who have never used the dapsone protocol in the treatment of chronic Lyme disease/PTLDS to educate themselves regarding the benefits and potential side effects (which are all reversible). Although this treatment is highly effective in the vast majority of patients, and we have not seen long-term adverse effects when providers follow the treatment protocol exactly as it is outlined in our peer-reviewed publications (this is important), your healthcare providers should educate themselves and read the medical articles listed above and use the Medical Detective Substacks as complementary educational sources to best understand how to use this protocol in your healing process. A training course for physicians can also be found on our website, which we encourage them to review if they have not had prior experience using dapsone combination therapy and the MSIDS model.
Thank you again, and I look forward to serving you!
Order Now
Please click on the links below to pre-order the book, and feel free to forward this to your friends and family that may be suffering with Lyme and associated tick-borne diseases.
now available at:
