Taking Charge of Your Health

thanks so much everyone for watching
we’ve got an epic lineup tonight of speakers we’ve got an awesome panel here
amazing group of functional doctors technology activists for hear for a leap
forward in medicine this is a great gathering you know our goal is to make
it easy for practitioners to learn in community there’s a lot of community
happening tonight I want to say welcome to all the communities that are watching
at home this ecosystem that is being set up by the meetup groups we believe will
be the future ecosystem of this evolved primary care network that we are looking
to develop and it all revolves around you there’s an exponential potential to
the future of medicine this is an allopathic conversion machine that we
have just created then it has exponential potential because it can be
seen by a billion people at no extra cost that’s the beauty of the Internet hello and welcome to a very special
episode of the functional forum this is episode number 50 and it’s title is a
new vision for American medicine so before we get started what I’d like you
to do is just to feel into what that new vision is so if you close your eyes and
just take a moment to think about with me the kind of medicine that you always
knew was possible where functional medicine was the operating system for
the care where every person had access to a complete care team including a
health coach available via phone including a functional medicine doctor
locally when some deep issue came up and some root cause resolution was necessary
and the current medical system in its rightful place as sick care for
emergency uses only this system would be powered by an
evolved concept of insurance where groups of people would come together to
share their health costs in a super efficient way where everyone was
incentivized to help their fellow man their neighbor their fellow employee
their colleague this is the new vision for American medicine and over the next
hour we’re going to show you how we got there so let’s start the story right at
the beginning in the very first functional forum in February 2014 we
knew that we wanted 200 X the number of doctors and practitioners that were
trained in functional integrative holistic medicine to solve all kinds of
chronic diseases but there was one particular condition that dr. Brogan
reminded us was an important thing to deal with on the first functional forum
now her talk is still the number one talk on our whole youtube channel check
out this clip how many people here love their job yeah so that’s what I
anticipated seeing and I can certainly echo that sentiment I departed from
conventional medicine very abruptly after my fellowship and I often reflect
on how I used to think and I’m sure that there are many of you who have been you
know in the conventional fold for years if not decades and I wonder if you
reflect on the differences between the way that you think now and the way that
you used to think and I’m reminded of a term from my medical school neurology
clerkship which is a no cig no Gaea and it means lack of insight into a clinical
deficit and I think it’s very relevant to the way that our allopathic
colleagues are practicing because I think it’s you know they’re they’re
doing their best they’re struggling in a broken system and I think it’s very hard
for them to acknowledge that they’re applying acute care medicine to the
management of chronic disease for this endless whack Amole game of symptom
suppression that drives further pathology so now we skip forward to the
fourth functional forum in May 2014 and this was the first time that we got
the live stream working now most people when they think about that forum
remember this clip from dr. Mark Hyman so we’re we’re at a transition point a
serious transition point I’ve been doing this for over two decades and I see many
of you in the audience I recognize him and doing this for a long time and I
want to share with you a vision of what the future might look like because we’re
at the precipice of that and we don’t have to be apologetic anymore for what
we’re doing because we’re doing the type of medicine that will be the future of
healthcare a couple years ago at Davos I met Toby cosgrove who invited me for
dinner with a group of people that included the head of IDEO
the CTO of Microsoft it’s really extraordinary people and I wasn’t sure
why he asked me for dinner because like I know I’m a doctor I’m not exactly a
you know at that level so I began to realize what he was doing he was wanting
to explore bringing functional medicine into Cleveland Clinic and for two years
he’s been chasing me to try to get me to come to Cleveland now there’s no way I’m
moving to Cleveland but uh but we’ve been a conversation I
said okay what do you want and he really got that he was interested in looking at
innovation that was going to change the way we practice and deliver healthcare
and that he saw what was happening in the field of functional medicine and the
things that we were doing and realized that that’s where the future was and I
said Toby you don’t want me there because if I go there I’m gonna be very
disruptive I’m gonna tell you that most of what you’re doing is wrong then in
fact you’re harming people that I would want to implement programs that are
gonna empty out half your hospitals and clear out most your procedure rooms and
they’re gonna reduce hospital visits and hospital stays and doctor’s visits
dramatically are you okay with that I said what if I told you we could cut
your angioplasties and bypasses in half would you be okay with that because
that’s where you guys make your money he goes I know you’re right but medicine is
going in a different direction and I think they’re motivated in part by doing
the right thing and they’re also motivated in part by looking ahead and
seeing what’s happening with how reimbursements gonna shift to be
accountable for outcomes instead of volume so the amazing story is that
despite my tremendous resistance and my continual efforts to convince him why it
was a really bad idea to have me there we are going to start a functional
Medicine Institute at the Cleveland Clinic in September so that was clearly
a super exciting moment the Cleveland Clinic starting a functional Medicine
Center and being announced on our show but that night there was also another
big announcement and that was from dr. Geoffrey glad as he came on to share
with us his concept for what he called the micro practice revolution where
we’re headed look what we’ve done with food and giant
you know smalls and big box stores that have everything you can do and they’ve
kind of wiped out a lot of the mom-and-pop and small businesses and you
know now we have big insurance and so we’re moving toward big medicine you
know the holistic crowd doesn’t seem to be as employed as the non holistic crowd
but but certainly there’s been a mass exodus out of private practice and into
giant hospitals so we’re creating big medicine and the answer is well let’s
create medical homes you know and I think some of the principles of that
makes sense to me but it’s just a new twist on disease based care so I want to
create different medical homes and I want to use this model so we’ve got big
food but I don’t shop at grocery stores anymore
I shop at local farms I shop you know I go to the farmers houses and I pick up
what I need because that you know they do it in small batches they do it the
right way and I shop at farmer’s markets so let’s create a medical home heirloom
organic micro practices that are focused on empowerment okay
heirloom getting back to the roots the roots of medicine kind of like
Hippocrates right the whole food is medicine thing organic let’s grow it
naturally let’s do it the right way let’s do it how we want to do it and not
have that be dictated small practices low overhead don’t
charge exorbitant rates and be able to reach the masses and empowerment we
already know what that’s about and we’re already doing that here’s a map two
years ago a farmers markets in this country wouldn’t this be awesome if this
were the integrative clinics throughout the country and just kept spreading and
it probably is a much richer map two years later so now we were set with our
mission if doctor glad could build a micro practice in Fort Wayne Indiana
we knew that we can help hundreds of thousands of other doctors move out of
the health system and start their own functional and integrative micro
practice this set us on our mission for the evolution of medicine summit and so
that summer we set about building our audience in a massive way and so we came
up with the first evolution of Medicine summit and that debuted in September
2014 and we got all the biggest names from functional integrative medicine
into our summit check out the preview video the World Economic Forum recently
said that the single biggest threat to global economic development was chronic
disease the lessons the doctor of learn in medical school and their training
have very little to do with how to prevent treat those illnesses so we’re
at a crisis point where for the first time in medicine were recognizing that
the old paradigm isn’t working anymore a tremendously rapid change in our
understanding of the origin of chronic disease at the cellular level at the
biomechanical level is in a state of extraordinary flux there’s a huge huge amount of viral DNA
genetic material that is embedded in our genetic codes in our chromosomes and
that these viruses are impacted to activate or not activate depending on
the choices we make the tide has really shifted from thinking of gut bacteria
bacteria in general as something harmful and pathogenic to realizing that
bacteria are really a vital part of maintaining our health if we want to
talk about building health at its origins
well then frankly each of us needs to be in charge we do that in the places we
live and love and learn and work and pray and play the places we actually
live our lives and spend our time we now know that chips and consciousness can
cause shifts in the biology of a fundamental at the level of gene
activity he’s right there these technologies in a large way are gonna
make you know the tangibility of what your health means to you today present
in real time and it’s also gonna give medicine all these new touch points to
interact with you way before you’re really really sick the use of Technology has to be there
one of the things that I really really contemplated before I started my
practice was how can i connect and relate federalization how can I build
this relationship I really see a model that is much more integrative not just
between conventional medicine and naturopathic medicine but between
specialties and between patients and physicians to much more of a
conversation a dialogue as opposed to a monologue that a physician is having
with their patient there was so much excitement around the summit we had over
50,000 people register mainly because they even let us on TV so here’s dr.
Brogan talking about what this movement is all about and what is the name for it
there are so many names around this kind of medicine right we have holistic you
know there are these other sort of ideas about what this medicine actually is is
there a cohesive label dr. Brogan for what we actually call this you know is
is holistic enough I feel like that puts people off sometimes yeah and I think
perhaps even more distracting is the use of the term alternative medicine because
I think most of us who practice in this manner which i think is succinctly
represented by root cause resolution of symptoms sort of resent the alternative
placement right the marginalization of these concepts which really are an
effort to bring us back to very basics things like lifestyle changes diet
exercise movement meditation that have an impact on health that it’s almost too
sophisticated for us to even assess with modern technologies so I use the term
holistic because it references encompassing the entirety of the
person’s experience but I think functional medicine is probably the
technical term that’s being applied so that first summit gave us a huge amount
of momentum it was really exciting not only were tens of thousands of
practitioners tuning in to every episode and we were now the biggest media
channel in the practitioner space but also we started to see the emergence of
these meetup groups practitioners getting together to watch the monthly
show to discuss it and we encouraged it and
so in January 2015 around the evolved oncology functional
forum we saw the first meetup group forum at Mass General Hospital in Boston
now to have a functional or integrative medicine meetup in Mass General shows
that it could happen anywhere and that news spread and we started seeing meetup
groups all over the country now we were talking about all subjects
that could facilitate this transformation community direct primary
care as a business model we started talking about health coaching we started
talking about progressive care teams but the biggest thing that we really focused
in on was community I had an opportunity to give a TEDx talk in Guernsey and we
started to focus our content on community and then in July 2015 we
created our first episode of the functional forum in collaboration with
the Institute for functional medicine we actually travel to Austin Texas to their
annual conference and one morning I was sitting in the audience when George
Slavoj gave an incredible talk about the power of human social genomics and our
trajectory was changed forever check out this clip it’s a very interesting meta
analytic review of a bunch of different studies published in + medicine in 2010
they just looked at the odds ratio of all cause chronic disease related
mortality as a function of these traditional risk factors and in addition
high levels of social stress social stress compared to these traditional
risk factors was a stronger predictor of chronic disease related mortality than
physical inactivity excessive alcohol use smoking and a bunch of other things
that I’m not showing here now social environmental pattern patterning of
mortality risks is not totally new that’s not a new concept 20 years ago
house and colleagues published a really interesting and landmark paper in
science showing that across multiple countries and cultures mortality risk
decreases as social integration increases and this is cross-cultural
this is not a internationally as best we can tell social integration is really
important for health social isolation and other types of social stress are
really bad for health especially for health that involves immune system
activity and I’ll talked about that in a second we have found similar effects in
some of the research that we’ve done this is a study of 168 women with
histologically confirmed epithelial variant
answer we observe them over a period of seven years the best predictor of
longevity in this particular study when everything shook out social connection
after seven years 63% of women who are socially well-connected were still alive
compared to only 36% of women who were relatively socially isolated social
stress alone in this analysis accounted for 27% of the variance that differed in
women who lived longer with the Thiele ovarian cancer versus women who died
more quickly considered together these findings they point to two really
interesting and important questions for us to consider as doctors as researchers
number one how does social stress reach so deep inside of the body I mean in
this case we’re talking about cancer biology right so it’s presumably not
just that social stress or social integration is just leading to negative
thoughts or negative emotions I mean it’s probably doing that but if we see
these effects in certain models we start to wonder well could it be the case that
social stress is actually influencing something like the tumor
micro-environment or the immune system how deep is it that social stress
actually goes how deep can we see these signals and number two we know that
social stress is implicated not just in the experience of depressive episodes
and anxiety episodes PTSD experiences of social stress and rejection one of the
best proximal predictors of heart attacks epithelia very invariant cancer
just give you an example so how can it be that social stress exerts such broad
effects on health how why would that be the case
okay so answers to these questions we think can be viewed through the lens of
an exciting new field called human social genomics so now we had a real
justification clinically for building community not just communities of
practitioners around the country but helping practitioners build communities
around their practices human social genomics showed us what the Blue Zones
had you know showed us in a big scale which is that the power of peer-to-peer
interact was massive and we wanted someone who
could help us to take that to the rest of the world now by putting people like
dr. Geoffrey glad and dr. Kelly Brogan on the stage what we wanted to share was
aspirational doctors doctors who you know other practitioners would look at
and say I want to build a practice just like them and so we were looking for
doctors that could share this an exciting way and this is the first time
that we introduce you to dr. Rangan Chatterjee a doctor from the UK who as
well as being trained in functional medicine had a hit TV show called doctor
in the house and on doctor in the house he would go to families live with them
for 30 days and reversed their chronic conditions using functional medicine he
was featured in the August functional forum and then he came in September to
New York to talk about what the doctor of the future would be here’s a clip
from that talk if you take a step back for a minute you think how how have we
ended up here but as well as the clear financial imperative what about the
moral imperative what about the millions of lives that have been prematurely lost
each year the needless suffering by a lot of our patients and their families
what about that what about the fact that when I was in medical school I remember
and they announced me later we were told in year 1 look around you one in four of
you will get cancer and I thought that was pretty shocking back then now in the
UK it’s already one in three are we told within a few years it’s gonna be one in
two of us what about that see I believe that every doctor goes to medical school
wanting to make a difference they go there to learn how to make people better
but you’ve finished med school with your ideals and then year by year those
ideals start to get eroded away so you’re left with a saw a realization
that actually you become very good at suppressing symptoms but not so good at
resolving the root cause so I believe the torch for the future essentially
gonna work in a brand new healthcare system a system that allows them to have
time with their patients and talk and instead of being tired they’re going to
be inspired instead of feeling frustrated they’re
going to be motivated instead of feeling overworked they’re gonna have a pretty
reasonable work/life balance and show their patients that not only
can they talk the talk they can walk the walk as well see a doctor in the future
they may prescribe pharmacy schools but it will be as a last resort and only
when necessary because the doctor of the future is going to understand that
lifestyle and nutrition is the bedrock upon which all treatment the chronic
disease should be founded the torture of the future they’re gonna embrace
individuality and their patients and not be enslaved to the randomized control
trial the doctor of the future is going to value the therapeutic value the
patient-doctor relationship and actually realized that the patient’s views are
just as valid as the doctors views see that doctor of the future is gonna
ultimately realize that medicine is art as well as science but we can’t wait any
longer for that doctor of the future that daughter of the future cannot be
the daughter for the future that daughter of the future needs to become
the doctor of today so by the summer of 2015 we had a number of the key pieces
coming together we had aspirational doctors who could bring interest in
functional medicine to patients and doctors alike from around the world
we even showcased models like dr. shilpa saxena’s group visit model where she was
able to engage the power of peer-to-peer medicine by putting people in groups and
facilitating community to get people well but one big problem still remained
how could we get the masses into functional medicine when third party
payers like insurance and employers wouldn’t pay for it and that’s where Tom
blue first came in tom had pioneered a new business called Liberty direct which
brought together the power of health cost-sharing ministries and direct
primary care into a new product called Liberty direct
and we were so excited about this concept I signed up for myself and my
family and week and all the other sponsors for our second summit the
evolution of Medicine Summit healthcare from scratch and made it the only
sponsor and on the September 2015 functional forum Tom blue shared about
the health cost sharing ministry and its potential to transform medicine check
out this clip I started doing research on this at the end of last year I
started reading a book by a healthcare policy analyst on on essentially the
self-pay patient movement which as this is becoming a bigger and bigger problem
for more and more people is a topic that it’s more and more on the minds of folks
particularly those of us under 65 I come across a chapter on something called
healthcare cost sharing ministries and what I what I as I as I started to read
more about it what I discovered and and I’ve learned that most people are kind
of like me they’d never heard about this before although more and more of us are
hearing about it you know have you know all the time as this problem becomes
more and more acute but basically for generations literally certain circles of
people in the Christian community have been have been taking it upon themselves
to sort of share the burden of health care expenses and this is a practice
that sort of sprung up kind of informally and over the course of the
Latino OS by the end of the 1900s head had become fairly well organized and
there were a handful of different organizations that that sprung up to
kind of bring order to the practice and and and facilitate the movement of money
amongst people as healthcare needs arose and so along comes 2010 when we’re all
required by law to purchase health insurance and these folks very easily
kind of raised their hands and got and got an exemption to the ACA mandate to
purchase healthcare insurance and so and so in doing that they go very
unintentionally created what is a very interesting opportunity for for all of
us to to kind of revisit the way we manage the risk of healthcare expenses
and the way we manage these healthcare costs and the way it basically works the
experience as a consumer is is actually very familiar if you’ve ever
had had had health insurance before I mean you pay a monthly amount that is
that is called a monthly share amount into a into a essentially a pool that
money when medical expenses arise in someone else’s in someone else’s case
that money is moved just like it has worked for for generations although it’s
done all online and electronically kind of kind of transmitted invisibly to
yourself but anyway the movie the money moves around to people that have medical
needs in any given month and and this company Liberty health share that that
that has that has largely automated this experience has really perfected it to a
point that I have personally have found it to be quite elegant so anyway the you
know similar to having you know having met health insurance there is an amount
of money that you’re responsible for every year called an annual unshared
amount in some ways it’s analogous to yet to what we’ve experienced in the
ways of in the way of a deductible and once you hit that amount that the
expenses are covered by you through sharing and you know you you have a card
in your wallet you go to the doctor you present the card at least my experience
has been that that doctors offices are beginning to become aware of these
things recognize health care sharing organizations is actually pretty
favorable payers and and they and they will bill in this case Liberty directly
Liberty will then pay them reimburse them directly so it’s it’s it’s a very
comfortable and familiar experience in the event that it does not go to a
doctor’s office that doesn’t want a bill Liberty or what have you then you would
you would pay the the bill yourself at whatever the self pay rate is and simply
submit the invoice for reimbursement to yourself so so that’s kind of how it
works so that summit was a hit and tens of thousands of new practitioners and
people came into our ecosystem and the show continued to grow it was a really
exciting moment where sponsors now were interested we were curating the
technology at events like the integrated health symposium and some of the other
conferences around the country and we had some real momentum into the movement
practitioners were starting direct primary care practices people were
signing up for Liberty direct and we had a serious amount of momentum
side now one other thing that was happening was the growth of the meetup
groups so in 2016 I had left New York I moved to Los Angeles and so we took the
show on the road check out some of the places that we went in the first year we
are here at the integrated health care symposium in New York it’s great to be
here in San Francisco we are here at the AIC annual
international conference for the Institute for functional medicine we are
here in Orange County California in Boulder thanks so much for coming out we
have a poor house we’ve got an unbelievable show tonight this time
we’ve come to the I FM’s annual conference in Austin Texas
record attendance tonight great for y’all to be here I’ve got my pass let’s
get into it so on February 29th 2016 on leap day we
came back to New York back to new house and we put on one of my favorite
episodes of all time where we had a keynote from dr. Jeffrey bland it was a
partnership that we did with the Institute for functional medicine and we
started to think if we really think that functional medicine could be the winning
hand could be the solution for chronic disease then we need to start acting
like it and the idea of new medicine came together with dr. Kelly Brogan’s
keynote on that same episode so this is the new medicine right it invokes a
trust in the body a connection to the environment food as of course
information and a sense of community and in this type of medicine symptoms are a
message they are an invitation to begin to examine how far from that continuum
have you strayed and in this type of medicine we are looking to inspire an
experiential knowing right so what I do in my practice with patients is invite
them into a healing experience so that they can know intuitively what their
bodies are capable of so that they won’t need me anymore
so as Nik Gonzales once wrote me let the current system exist in a parallel
universe and start from scratch with a completely new system that’s based on
nutrition psychology and spirituality prescient man and the most important
message here is the one that I struggled with the most which is that this isn’t
about warring right if it’s not going to be about worrying it shouldn’t be about
warring so that means it’s also not about fighting the current system it’s
not about women as being dominant over men either
it’s about awakening a feminine principle in every person and also in
the systems that we engage so as Candace pert said the science I have come to
know is unifying spontaneous intuitive caring a process more akin to surrender
than to domination right and in many ways this is what I’m beginning to
understand is that as much as I love data and science science is really
intended to inspire a state of awe and Wonder that’s its only purpose so Thoreau said that it takes two to
speak the truth right it takes one person to speak and one person to listen
and it’s my passionate belief that more and more people then maybe ever before
in human history are ready to listen so inspired by the vision of a new era in
medicine we started to take our role really seriously in heralding that
vision and what we saw from the first IFM survey was that a lot of
practitioners were running really inefficient practices and it was no
surprise to us even though the sponsors that we had were helping to improve
efficiency and practices and reduce overhead we knew that we had to do more
and so through the rest of 2016 we really focused on creating resources to
help practitioners thrive in this new era of medicine first and foremost we
started the practice accelerator if you don’t know what the practice accelerator
is check out go Evo medCom slash brochure and you can find out about the
most innovative group of physician entrepreneurs on the planet that we
started to build a community of practitioners who could transform
medicine later on in that year I wrote a book called the evolution of medicine
and in the first week 50,000 practitioners downloaded this book now
you can still get a copy of this book today at go Evo medCom slash free book
or you can send one to a doctor and Pratt
in your area you know this has been such a journey it was such a pleasure to
write the book and the book is really a handbook on how practitioners can start
their own low-overhead practice so just before we announce the book we did our
biggest functional forum today in Chicago and dr. Jeffrey glad spoke at
that event Tom O’Brien spoke at that event but one of the most inspiring and
impactful moments was when dr. Terry walls made her debut on the functional
forum and she shared this incredible tip I have progressive MS spent seven years
going steadily downhill ended up in a took reclined wheelchair unable to sit
up had severe horrific pain but fortunately I did discover functional
medicine and within a year’s time I was able to be up walking again and in fact
able to do a twenty mile bike ride that of course changed how I understood
disease and health it changed how I practice medicine it would change the
type of research that I did and I now run a therapeutic lifestyle clinics at
the VA and I asked my vets to make incredibly hard lifestyle changes to
give up foods to which they’re addicted that are really quite yummy you and I
are all dicted to them to sugar white flour all that yummy stuff and the
addictions of inactivity but what my that’s taught me is that it will be much
easier for them if I address their resilience factors first so we talk now
a lot about what is the meaning of your life
what is your higher purpose and what is the meaning of your illness we talk
about Victor Frankel’s the off switch psychiatrist who saw horrific acts of
cruelty while he was imprisoned in those death camps and he also saw amazing acts
of love and courage and he said between every event in your life in your
response is a space and in that space you have a choice and it’s the choices
we make that define our character and so we talk about the fact you choose your
life you make a choice they’re gonna choose what you choose to eat you’re
going to choose your life’s mission and they’re going to choose the meaning you
ascribe to this illness and so for me developing my progressive MS
having years in a tilt recline wheelchair unable to set up years of
horrific pain was a tremendous gift because it made me who I am it gave me
this amazing story that I get to tell my patients and say look if I can come back
from that well so could you and it’s not about great drugs it’s not about great
surgeries it’s not about new procedures or fancy supplements or even organic
food but it is about knowing your purpose what is the meaning of your
illness and for me my meaning has become teaching the world that we can create an
epidemic of Health and teaching my clinical colleagues that we can create
an epidemic of health that we can help our patients understand the meaning of
their life that they make choices that they can have meaning to their illness
story and they can help spread this patient by patient by social media post
and we can spread out across the country through our social media that it is
possible through functional medicine through diet through eating these
radical things known as what vegetables and giving up things known as sugar and
white flour in doing things known as movement in having a social network
where you spend more time with people and family that nurture these health
promoting activities known as eating vegetables and moving your body in less
time with people who sabotage your efforts and try to keep convincing you
that one bite of gluten and dairy will not be a problem and you don’t really
have to do all that stuff reminding people that they have a choice that they
have can roll and it’s their heroes and it’s
their hero’s journey to make so I’m very thankful for my disability for my years
of pain and suffering because it gave me an amazing hero’s journey so now that we
were obsessed with building this new medical paradigm we had to face a
realization that was a little bit crushing despite all of our best efforts
and the best efforts of everyone in the ecosystem there weren’t a hundred
thousand functional medicine doctors ready to build the capacity of this
industry we realized that we needed to take better advantage of other
practitioners to do the heavy lifting on lifestyle and all the way through the
functional forum mainly because my business partner Gabe Hoffman was a
health coach we had featured a lot of content about health coaching we had
invited health coaches to be part of our meetups we had seen how practitioners
like dr. Frank Lippmann and dr. Robin Berzin and other practitioners were
using health coaches in their practice and so in December 2016 we got our
biggest guest ever on to the functional forum Robert F Kennedy jr. but although
he was the star of that event in New York we had also set up these events
called future of functional in five where we encouraged our community of
practitioners to come and give a five minute talk about how they saw the
future of functional and in December 2016 in New York Tracy Harrison came to
give a talk about her vision for the future of functional and her talk had a
massive impact on us you can see it here tonight I want to talk to you about the
future of the medical team we all know that when functional medicine wisdom is
actually implemented by a patient the effects can be truly transformative I
mentor and teach functional medicine practitioners and in the past two weeks
alone I’ve spoken with the practitioner who has helped a woman – who has chronic
vitiligo – experience the first repigmentation of her skin that she’s
ever experienced and as you might imagine she was so overcome with
gratitude and relief that she couldn’t even speak through her tears i spoken
with another practitioner in the past two weeks who has many times helped
individuals to overcome type 2 diabetes the latest in her success parade being a
very proud grandma whom she helped to reverse the insulin resistance that is
at the root of type 2 diabetes and now she’s off of her supplementary insulin
she’s off of metformin and who knows what type of downstream cardiovascular
complications she’s avoided and yet a third practitioner who has an expertise
in alleviating truly entrenched IBS the latest success being a victory with a
man in his 60s who for the first time in over a decade has daily bowel movements
and a cramp free medication free existence now if you’re a longtime
follower a practitioner of functional medicine nothing that I have shared with
you around the possibility of healing is a surprise you likely see this all the
time but what might surprise you is that the practitioner I’m referring to in
each of these cases is a health coach the evolution of medicine has created a
really wonderful model a progressive business model for the future of the
medical practice that finally I believe will allow functional medicine to be
affordable financially sustainable in terms of our time
commitment and running a practice so we still have a life and perhaps most
importantly maximally effective now there are plenty of wonderful examples
of the integration of functional medicine and health coaching in the
functional medicine world today in fact dr. Frank Lippmann dr. robbin Berzin are
two wonderful examples right here in New York but I want to share with you a new
way of looking at the future of the medical team because I believe that a
health coach is the key to unlocking all three of the tenants that the evolution
of medicine promotes first of all making a practice sustainable time wise
wonderful functional physicians do intakes they do reviews they do
assessments but a key part of the efficacy of functional medicine is
extensive patient education it’s follow-up explaining the dynamics of
biochemical interactions in the body it’s explaining how to implement
therapies it’s getting people back on track when they fall off the road it’s
doing follow-up QA health coaches can very responsibly take that burden away
from the physician so that they can spend more time doing patient intake and
assessment for the same reason health coaches in the modern medical practice
can also help the practice to be affordable allowing the physician to
focus more on new client assessment and also being a leader in the local
community and increasing new patient matriculation but perhaps most
importantly the health coach is really an opportunity for a medical practice to
be more effective because what a health coach brings to the team is a whole new
set of skills around rapport empathy empowerment and accountability that
truthfully is much greater skill set wise than the average physician can
provide and that’s because for the health coach it’s their expertise it’s
what they’re trained to provide and so I want to present an opportunity to
perhaps redefine the new modern medical team and I
believe we’re going to transform medicine by getting health coaches on
every medical team I think there’s an opportunity to educate health coaches in
order to help allow them to be more effective on the medical team and while
it might surprise you today many health coaches are using functional medicine
principles very competently and I think they can not only be a knowledgeable
member of your medical team who can speak the language and fit in well with
your team but they can actually be a treasured member of your clinical
perspective and how to maximize your patients results so I believe the future
of good medicine is the combination of functional medicine and health coaching
so we started 2017 with a bang taking the functional forum around to
the different cities but also having our first international functional forum at
the Royal Society of Medicine in London hosted by none other than dr. Rangan
Chatterjee it was really exciting to see the meetup groups expanding to UK to
other time zones across the world and we had a truly international presence now
in March 2017 we went to Detroit Michigan to talk about the evolution of
Cardiology and dr. glad was back to talk about a really important factor if we’re
gonna sell the world on functional medicine it can’t just be more valuable
at some point in the future he can’t be just saving money down the road is there
a way that functional medicine could be more valuable today and that’s what dr.
glad talked about in his incredible talk which we show you just a bit of right
now but now the new truths are this is a huge opportunity for us as providers who
want to see patients who want patients to come into our office and see not just
the long term worth but the short term worth so go learn how much things cost
go find out the opportunities that you can save patients money and so I’ve done
this and I continue to do this and find cost savings so the MRI at the hospital
is 2 to 3 grand but there’s a private MRI place in Fort Wayne Indiana our town
that do it for 4 or $500 cash seems simple
procedures nobody can tell you in our town how much a colonoscopy is gonna
cost you or how much an EGD is gonna cost you but most of the patients who go
have them done who have high deductibles 5 $6,000
I haven’t found anyplace local but I send somebody up here in the Detroit
area to a clinic up here it’s $1,500 cash biopsy sedation pathology 1,500
bucks you’ve saved them 35 to 45 hundred dollars right off the bat specialist I
took my son to an orthopedic surgeon who was out of network we called the office
before the appointment you have a cash rate we sure do if you pay $250 down
everything is 30% discounted it’s a charges less than 250 we give you back
the difference got to have these conversations for yourself but also for
your patients Labs is the big one that we’re going to talk about here in a
minute specific to cardiology serve as that financial adviser learn how much
things cost in your community and help patients save big money here is I show
this to patients day after day after day these are hospital charges for a
standard lab panel that we order and I’ve put arrows on the ones that are
specific to a cardiology workup so a fasting lipid profile an ultra-sensitive
c-reactive protein a homocysteine level I think I threw a CBC in there so this
is this is a conventional workup this is going to end up being $1400 1414 81
that’s the hospital rate for those labs yeah some insurances are gonna discount
that hers didn’t you know it hers did some but her out-of-pocket was still
very significant how how about the consult to tell you everything looks
good or the phone call from the AMA that says it’s all fine how does that help
anybody that costs 4 to $800 for that consult because it’s a specialist
appointment so your total visit cost in the
conventional realm for that patient is $1,800 now if they come to my office and
we have negotiated – labs that total cost of blood work
that was 1414 81 the exact data is 76 dollars in 10 cents we charge a $50
administrative fee because my staff has to process that order this patients
total lab cost is now 126 dollars and 10 cents that’s a savings I took out the
consult part just in labs of twelve hundred eighty eight dollars and seventy
one cents if you apply that money to the cost of my consults that’s over four
hours spent with me you don’t will need or want four hours spent with me right
so we’ll review this for an hour and you get to go home
with almost a thousand dollars in your pocket so become a healthcare consumer
seek out opportunities to offer things to patients that will save them money at
the point of care be worth it in the short-term as well as the long-term so
as we started to build new health we started to get interest from
organization and groups who would loving the concept of functional medicine for
everyone and some of these groups were employers but one of the major groups
that we spoke to that we were super excited about was the country of
Guernsey so for those of you who aren’t familiar Guernsey is a tiny country that
sits between England and France in the English Channel
it is a 60,000 person country and they were inspired by this concept of
functional medicine for everyone and so we did an event in June 2017 where we
brought across practitioners to Guernsey to talk about what it would take for
Guernsey to become the first country to get to life expectancy 100 it was a
really transformational event and you can watch all of the sessions from all
of that all-day livestream that we did on our YouTube channel but one of the
people that we brought across Tom blue really emphasized one particular power
the power of community and setting up a structure that facilitates and
incentivizes community and let’s take a clip
his talk right now a couple of years ago I had this an interesting opportunity to
to enter into this little world and create a product on the chassis of a
cost sharing community that was really deeply integrated and interwoven with
with a particular type of primary care it turned out to be a spectacular
experience it was the product works beautifully the concepts I’ve tried to
tease these apart why is this possible and I’ve thought of three things the
first of which is sort of science II it’s the concept that that the chairman
of the Institute for functional medicine a guy called Mark Hyman
has dubbed social genomics I think really accurately and so it plays off of
a piece of research done from the Framingham Heart Research cohort where
they looked at the effect of social networks on health and what they found
was is that taking something like obesity although it had to do with all
sorts of different things if my friend is obese I have a forty-five percent
greater chance of being obese myself if my friends friend is obese 25% chance
myself increased chance of being obese if my friends friends friend is obese
ten percent increased chance which revealed this idea that cultures and
communities are actually the carriers in many ways of either health or disease in
the chronic disease sense and to me really creates a scientific a fair and
quantitative basis for the importance of community the second idea community when
it really is done this way around financing health care activates
something I think is a rather innate in our wiring which is this law of
reciprocity if I do something for you you’re more likely to do something for
me which then multiplies again when we’re dealing with managing costs and
sort of stewardship of finances which is to say I’m way less likely in a
community of people sharing the the burden of health care costs to behavior
responsibly financially the last thing is is that communities I have discovered
I think activate maybe the most innate form of charity in our hardwiring which
is this concept of mutual aid which if you sort of follow the history of
charity whether it’s whether it’s immigrant commune
supporting one another religious communities in the case of cost-sharing
the concept of mutual aid at least in the US has been largely extinguished by
welfare and and commercial insurance but it’s something very real and when you
activate it it’s powerful and so this then brings me to my sort of concluding
thought which is what is in fact the characteristic of community and I just
made this up for my own observation so I don’t don’t pretend for a moment this is
definitive but in a community you basically have people that are in some
way connected or aligned could be by geography everyone lives here on this
island or everyone works in a place where everyone has sort of bound
together around a value system or religion the people are empowered
literally in the cost-sharing program that we were developing there was a
democracy about changing policy on this so they would vote on what we were or
we’re not going to cover so there’s an unbelievable degree of empowerment we
then informed the membership how much are we spending how are we doing there
is a feedback cycle that was transparent and then there was mutual accountability
not only through the law of reciprocity but through the mutual accountability of
holding the administrators accountable to how much they were spending how much
they were making everything was on the table
Jony to 100 was really a transformational event and if you go
back and watch all the episodes on our youtube channel you’ll just see how all
of those talks in their own way influenced the future of new health and
nothing more than Tom Blue who really reinforced to us that there is a real
power in the correct incentives when trying to control costs within a
community and so now we started all of our and focused all of our attention on
building new health so the first iteration of new health we took lessons
from the practice accelerator we took best advantage of health coaches we use
telemedicine we charged a $99 a month recurring revenue like a big virtual DPC
online practice and it was really successful we got a couple hundred
members in we put them through the system to see could we get people well
with mainly health coaches with there were physicians supervised and trained
in functional medicine and the results were really impressive for those people
who weren’t really sick who didn’t have polypharmacy
who weren’t on expensive medication we were able to get people well we were
able to track these outcomes do lab testing before and after to show the
transformation and we saw symptoms disappearing we saw inflammation going
down we saw hemoglobin a1c scores going down and it was really exciting to see
the kind of scale that we’d be able to deliver using health coaches at the
front and physicians at the back and so one of the companies that got in touch
when they heard about this was been a comp and been accomplished surance plans
to self-funded and fully insured employers alike now been a comp had a
new product that they had actually created ten years ago called in center
care and incentive care incentivizes people in a company to get healthy
financially incentivizes them and we knew that that was a really really
strong plan and so it fit nicely with functional medicine whose goal really is
to get people off medication I don’t think there’s any serious solution to
the future of medicine that doesn’t include getting people off expensive
medication if you really want to control costs we need to do that effectively and
so with functional medicine plus incentive care form together we created
this product and we’re really excited about it and if you want to hear more
about it we did two podcasts in February 2018 where I interviewed Doug from
Bennett comp to talk about incentive care and how it works and big companies
have already started to come forth saying if they won functional medicine
for their employees and we couldn’t be more excited so in 2006 2007 in center
care was a really strong idea and was actually featured on CBS News let’s take
a look at it now more Americans are overweight than ever and now some
employers are telling them shape up or pay up nearly half the nation’s large
employers now offer financial incentives for workers to adopt healthier
lifestyles if they fail some employers charge them up to thousands of dollars
more for health benefits tonight Dean Reynolds begins a special series forced
to for Kim Jackson exercises a way of life
now two years of a rigorous regimen have literally transformed her from this you
were 28278 you really do look like a different person
I mean a completely different person but Kim changed because she had little
choice for employer the Benton County Arkansas government told her and every
other out-of-shape worker to get healthy or be punished because the cost of
providing health care coverage for them was getting out of hand I have to tell
you that when our plan was hemorrhaging it was about a bottom-line issue but it
was about an employee’s bottom line the county raised its annual deductible from
750 dollars in 2004 to 2,750 in 2005 but it built an incentive into the plan
enabling County workers to cut that amount to as low as $500 if they were
able to pass yearly fitness tests cholesterol lower than 160 blue coats
lower than 126 blood pressure 140 over 90 and no nicotine get healthy save
money but many employees were offended initially and didn’t like it why not I
don’t want no one told me I’m that bad out of shape no one wants to be ever
denier face I think at first you’re a little skeptical like you know picking
on me because I’m fat you know what’s going on you’re forcing a lifestyle
on your workers we had to do something to protect the plan and protect their
access to health care and I think there’s a lot of companies out there
that are facing a war facing are facing the same thing we were she’s right a
growing number of companies are telling workers to get healthy or pay more for
insurance so is the plan working consider these numbers before the plan
started the county health care fund was nearly half a million dollars in the red
seventeen months after the plan took effect the County Health Care Fund was
more than a million dollars in the black healthier workers it seems our filing
less expensive claim how much weight did you lose
lost 22 pounds I lost 40 pounds 54 did you find it to be intrusive or get out
of my face but being told to lose weight or lose money has paid off and I feel so
much better Dean Reynolds CBS News Bentonville
Arkansas so you can see that with the right incentives we can really provide
an opportunity for the transformation of larger populations incentives plus
health coaching on the phone plus the network of functional medicine
practitioners and so at this moment I want to make a plea to any functional
medicine practitioners who are watching this if you’re a doctor for a nurse
practitioner and you’d like to get leads from us as we sign these employers we’re
going to need doctors in every state to be able to see these patients that
aren’t dealt with by the health coaches alone and so I’d like to invite you to a
webinar to talk about this with myself and dr. Jeffery glad starting in two
weeks time if you want to watch the webinar you can go to go Evo medCom /k p
oh that’s go evo medCom /k p oh and we’re going to share a webinar on
exactly what it means to be part of the new provider organization how we’re
going to send leads to your practice how we’re going to pay you and how we’re
going to be able to use practitioners in every state plus our network of health
coaches to be able to deliver functional medicine to employers all across the
country it couldn’t be a more exciting time to talk about employer health think
about what Amazon is doing what Apple’s doing this is a serious
conversation and country companies all across the country are looking for
innovation to reduce their costs and functional medicine is the solution to
that problem so go to go Evo medCom slash kpo and find out how you can join
our provider organization how we can refer to you in States either for
in-person visits or telemedicine check it out now just by the limitations of
working with an insurance company we’re only going to be able to take
practitioners of a certain license yet into the kpo however if you’ve been part
of our community for the last four years you know that we have been hyper
inclusive we have welcomed practitioners of all varieties into our courses into
our meetups and into our community and so I’m excited to announce that next
month we’ll be delivering part two of the new vision for American healthcare
and offering something that will be valuable to you and your family whether
you’re a doctor and nature path a nurse a nurse practitioner a chiropractor an
acupuncturist a nutritionist a dietician a health coach a dentist or any other
type of practitioner that I haven’t mentioned please tune in from Ashland
Oregon while we’ll be talking about interconnected medicine and launching
something that we’ve given a few hints on the show today but we believe that by
changing the way in which health costs are shared we can create the right
incentives at scale for big parts of the population
we’ll see you live from Ashland on April 2nd until then thanks so much for
watching it’s been such an honor to serve you in the last 50 episodes thanks
so much for watching and we’ll see you next time you

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