A kNew Vision for American Medicine: March 2018

Thanks. So much everyone for watching we've, got an epic lineup, tonight off 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.

2018-03-10 05:35

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