The method
Baseline. Titrate. Verify. Maintain.
Four stages, each with a defined output. This is what medication management looks like when it's treated as clinical work instead of a refill calendar.
1 — Baseline
Before we change anything, we establish what "now" actually looks like: current regimen and its history, validated rating scales from home and school, sleep, appetite and growth trajectory, cardiovascular check, side-effect inventory, and what the family is solving for — mornings, homework hours, the afternoon crash, weekends. If the diagnostic workup itself looks thin, we'll say so and offer assessment confirmation first.
2 — Titrate
Dose changes are planned, single-variable, and time-boxed. One change at a time, a defined observation window, and defined measures collected during that window — not "see how it goes and tell me next month." Where formulation is the problem (duration of coverage, afternoon rebound, appetite timing), we adjust formulation before chasing milligrams.
3 — Verify
A dose is not "working" because the refill got picked up. We verify against the measures set at baseline: repeated scales, structured parent and teacher input, and — where appropriate — objective data. We are candid that objective tools are aids, not verdicts; verification is a physician's synthesis of all of it.
4 — Maintain
Once optimized, the goal is the least intrusive schedule that keeps it that way: planned re-checks tied to growth, school transitions, and dose-relevant events rather than an arbitrary monthly appointment. Less of your time, less cost, and a standing plan for what triggers a re-look.