Michelle Middleton
Physician assistant · Integrative medicine
11–15 years of experience
Menopause Society Certified Practitioner
About SPOKEmed
SPOKEmed is Michelle Middleton's own telemedicine practice, which she founded in 2024 after years in orthopedics and a move into weight and hormone care in 2020. She is the only clinician there, so every consultation and treatment plan is hers, and patients can reach her directly between visits. Care starts with a short exploration call, then lab work and a plan that may mix hormone therapy, weight medication, nutrition and coaching. She prefers FDA-approved bioidentical estrogen, progesterone and testosterone, keeps compounded troches and creams for the cases where nothing commercial fits, and refuses pellets because the dose cannot be adjusted or removed. Advanced testing such as DUTCH hormone panels, stool analysis and genetic reports is available when symptoms are confusing, though she says most women can start hormone therapy on symptoms and history alone. Prescription care runs in Florida and New York, while the coaching side is open to women anywhere in the country.
Care
Treats
- Perimenopause
- Menopause
- Hot flashes
- Sleep problems
- Mood & anxiety
- Brain fog
- Vaginal dryness
- Low libido
- Irregular periods
Prescribes
- Hormone therapy
- Vaginal estrogen
- Testosterone
- Compounded hormones
- Weight medication
- Supplements & lifestyle
- Lab testing
Particular focus
- Early menopause
- Bone health
- Heart health
- Thyroid
- Bladder & UTIs
- Weight & metabolism
Cost and insurance
Insurance
Doesn’t accept insurance
Ask whether they provide receipts for out-of-network reimbursement.
Self-pay
Available — prices aren’t published, ask for rates
- Free consultation
- HSA and FSA accepted
Visits are direct-pay and an FSA or HSA card can be used, while lab testing is often billed to insurance by the lab itself, so lab coverage depends on the patient's own plan.
Verified October 2026.
Qualifications
PA-C, MSCP
