185. The Functional Medicine Revolution That Went Wrong | Nisha Chellam, MD

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Welcome to Medicine Redefined, a
podcast focusing on helping you

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reclaim ownership of your
health.

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I'm Doctor Darsha.
And I'm Doctor Ultima Shraja,

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we're your hosts here to
challenge conventional practices

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and uncover the stories behind
pioneers shaping the future of

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medicine.
Our conversations not only focus

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on the individual level to
dissect common practices for

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health optimization, but also
zoom out to enhance systemic

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change.
Join us as we look to break the

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status quo, move the needle
forward and put the help back in

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healthcare.
Hey guys, before we dive into

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today's conversation, I have an
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this podcast.
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All right, on to today's
episode.

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Our guest today is Doctor Nisha
Chellam, a board certified MD

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who calls herself a recovery
physician who has chosen to move

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away from medication being the
only option for sick patients.

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Using the principles of
functional medicine, she helps

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her patients understand how
their body works to help them

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optimize their health.
She was board certified in

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internal medicine from Wayne
State University.

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She was an associate teaching
clinician at Michigan State

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University and Wayne State
University with 21 years of

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practice and teaching
experience.

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She is certified in functional
medicine, having undergone

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extensive training from the
Institute of Functional

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Medicine.
She's also a lifetime member of

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the American Lipid Association
and Doctor Chellam has completed

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her residency in internal
medicine from Wayne State

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University and was a chief
resident at Detroit Receiving

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Hospital.
Her current and active interest

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is in peptide therapy for the
resolution of obesity and

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metabolic syndrome.
In this episode, we're going to

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start out by talking about how
Doctor Chellam went from

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internist to functional
medicine, the revolving door of

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chronic disease, and the moment
functional medicine clicked for

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her.
We'll then discuss the root

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causes without the dogma, how
she blends evidence based care

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meds when needed, and targeted
lifestyle change versus chasing

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protocols and pills.
Most interestingly, to me at

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least, we'll talk about why she
stopped going to functional

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medicine conferences.
She'll have a candid critique of

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supplement driven protocol heavy
teaching and the consumer

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marketing forces behind it.
Last but not least, we'll have

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actionable takeaways.
We'll talk about real world

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cases and data, talk about mold,
hypertension, Hashimoto's and

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how we can use labs in
functional medicine.

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We'll tie it all together and
talk about how we can put the

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health back into healthcare.
I hope you enjoy the episode.

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All right, Doctor Nisha Chellam,
thanks so much for hopping on

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here on Medicine Redefined with
us.

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Oh, thank you for the invite.
Absolutely.

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So we're going to be talking
about functional medicine and

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maybe a different angle of it,
right?

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Because you wrote a very
thoughtful LinkedIn post about

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why you're going to stop going
to functional medicine

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conferences.
But I think every provider who

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decides to go into the lifestyle
medicine realm, the functional

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medicine realm, has a different
story.

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They might have similar themes
as to why we join or, you know,

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think that side of medicine is
attractive.

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And I would love to hear your
story.

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First, you start out with
internal medicine.

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How did you first learn about
functional medicine, and what

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made you really take that leap
into practicing it?

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Yeah, thank you.
So I will say I have practiced

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now medicine for 31 years.
This would be my 31st year.

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That was a hardcore internist
from, I will say, teen 90 till

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about 2000.
Internal medicine was something

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that really attracted me because
when I finished medical school

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in India, I hated medicine.
I had only one goal.

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I wanted to marry and settle
down.

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That's it.
And I wanted to marry a doctor

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so I could make use of my
medical degree, maybe run his

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clinic and just settle down.
This was just the only ambition

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I had.
Practicing, I guess.

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So I don't know, somewhere
around that time I, my first job

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was in an industrial setting.
So it was a cement factory.

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I don't know if you guys know,
there's a blue chip company in

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India called Larsen and Tebro.
They mean tractors.

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So I actually, my father worked
there, so I got a job there.

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Nepotism.
So I did and I did my very first

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job as a primary care in this
vintage setting and I had no

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freaking clue what I was doing.
I finish in BBS.

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You do an internship and then
you start seeing patients.

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I used to be scared seeing every
patient because I had no clue.

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Because you know, when somebody
comes in with fever, you're

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thinking about malaria and what
they have is urinary tract

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infection.
So I felt very ill equipped.

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I knew I needed to do a post
graduation.

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So that's how it came to the
United States.

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And the very first day I was on
the floor and you know what an

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internal medicine floor is like?
It's like either you're going to

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get one code, you're admitting
patients.

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And those were the days when we
didn't have a night float.

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You start call, you do 36 hours
of call.

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And I remember falling in love
with medicine.

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And what I realized is one of
the things in India is when you

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see a patient and you make a
diagnosis and I don't know if

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you guys ever seen like an
Indian professor, traditional

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Indian professor, he's like the
king and we're all standing

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around him like peasants waiting
for the pulse of wisdom that

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fall out of this mouth.
So, you know, they would do a

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diagnosis.
At that time, we didn't have CAT

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scan ultrasound.
Patients will just walk in and

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he'll say coroner syndrome.
And I'm we're like, how the hell

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did he know the guy is Ted Seat
away?

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And how did he know it was
Hornets?

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And in India, you know, it's
hot, people are sweating and

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they wear this holy ash, the
booty on their forehead.

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And on one side it was dry and
the other side it was gone

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because the sweat had taken it
the wind and Horner syndrome.

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You don't sweat on one side.
And then when he came closer,

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you see the meiosis and we were
all like, you know, that's the

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image we wanted to be as good
diagnosticians with clinical

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medicine.
So a lot of the training in

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medicine is about the disease
we'll have, we'll surround the

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patient, we'll talk about all
his symptoms, signs and

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symptoms, give a differential
diagnosis.

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It was so much fun learning
medicine, but I it never, I

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never connected with it because
you give a treatment for a

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patient, they couldn't afford
it.

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But when I came to the US, you
ordered a CAT scan.

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You could do a CAT scan.
You give a prescription, they

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get a prescription because there
was this notion of insurance or

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Medicaid or whatever that might
be.

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So I really fell in love with
medic medicine and I wanted to

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be a hospitalist for the rest of
my life.

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And two years into my
hospitalist job, I found it was

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the same patients coming through
the revolving door.

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So the first time they come in
with congestive heart failure,

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you treat them, you consult
nephrology, you consult

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neurology, you consult
cardiology and you have all

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these consultants, you
coordinate the care, you get

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them walking out of the hospital
and the next time they're coming

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in wheelchair and in about 6
months they go out in a Gurney

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and it's the same thing.
You're treating the same issue

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and the patient continues to
decline.

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Doesn't matter what might be the
cost, it may be they are non

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compliant with the medicines,
whatever that might be.

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It's medicine became a job where
you go every day to fail.

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And I don't know how many
professions you can say that I

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go to work, I solve this problem
and the problem is never solved.

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And I continue to solve the
problem tomorrow and just gets

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worse, but the numbers get
better.

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And that's how medicine, it was
one of those things where I

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hated Mondays.
I didn't want to go see my

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patients.
And I had joined the VA by then.

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And the veterans are a very,
they're a very unique

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population.
I loved taking care of them,

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right.
They'll come and say, doc, I

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know you want me to change my
diet.

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It's not going to happen.
So just give me the medication.

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And half the time they won't
take the medicine either.

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My bonus was staged to their
LDL.

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So if they didn't have an LDL of
less than 100, I didn't get the

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bonus at the end of the Yeah.
So we were spending all this

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time trying to get them to be
complied with their medication.

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So you started with a blood
pressure medicine, you give them

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a diuretic, then they get gout
and you say, oh, this is coming

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from the blood pressure
medicine.

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So I'm going to give you an
answer for your pain.

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Now you have a kidney problem,
so you're going to see the

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nephrologist.
And then he says you need to

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give up another blood pressure
medicine to control the kidney

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failure.
And we're going to start him on

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statin because his cholesterol
is going up.

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And before you know, he's on
this 25 medicines.

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His list of diseases have
increased.

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All his numbers are under good
control.

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Blood pressure's under control,
LDL is under control, A1C is

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under control, but he's feeling
lousy.

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And this is where I think you
kind of get frustrated after

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some time.
What do you need to do in order

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to get people that are obviously
medications were not the answer.

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So around this time I had a
patient, a 50 year old, I just

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think I still remember his face.
He had a ponytail.

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He had, he came from Hawaii, he
moved from Hawaii and he had a

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colostomy back.
So he had his colostomy back but

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way back in his 20s because he
had ulcerative colitis and his

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skin was rough, his hair was
falling and he was concerned of

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his hair falling.
His vitamin DI remember was 6

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and I remember giving him
vitamin D and then I also asked

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him to get a bone density.
This was like in 2003, maybe

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2003, 2004, and he had severe
osteoporosis.

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And at that time Foscomax was
the only medication that was

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available for osteoporosis.
He refused to take it because of

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the osteonecrosis, you know,
usually with pulse radiation.

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But he didn't want to take a
medicine.

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I asked him to see the
endocrinologist.

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He said, doc, you give me a
couple of months, I'll come

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back.
And he disappeared from my

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clinic for two years.
He came back and his bone

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density had improved.
So I asked him what we didn't

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take Fosamax, how did it
improve?

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And he gave me this list of
supplements, and he told me all

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the exercises he was doing, and
he showed me the kind of yoga

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poses that he did that actually
improved his bone strength.

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And he felt phenomenal.
And to me, that was the first

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time I realized there's a
different aspect of medicine

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that I've never learned.
What are these supplements?

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And I remember going on off hunt
trying to find out what

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integrative medicine was at that
time.

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And so I got exposed to
integrative medicine.

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I will say I loved it the very
first time because for the first

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time I they were asking
questions about why a person is

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ill rather than what it is.
They emphasize so much on why

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someone has it.
And I remember going to my very

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first functional medical
conference too.

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And for the functional medical
conference, I will say the very

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first day, I thought it was all
because he said we got to take

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out gluten, we got to take out
dairy.

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And I'm like, Oh my God, what
are these guys talking about?

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It's a fad.
But I remember Mark Hyman was

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the keynote speaker and he, I
think he said give the same

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talk, by the way, with every
functional medical conscience,

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because he's a keynote speaker.
It's the same patient who has

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asthma, dermatitis, and he shows
a picture of her evolving and

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getting better and getting off
medications.

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I remember that particular
evening, I literally cried

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00:11:37,560 --> 00:11:41,480
because for the first time I
realized how medicine should be

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00:11:41,480 --> 00:11:47,160
practiced because a lot of times
we focus so much on the disease,

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00:11:47,440 --> 00:11:52,320
we don't realize why the disease
develops in an individual at

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00:11:52,320 --> 00:11:55,680
that given time.
So I remember that was the first

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00:11:55,680 --> 00:12:00,840
time I decided I needed to get
into functional medicine and

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00:12:00,840 --> 00:12:04,240
make it a way of my practice.
I was in private practice by

235
00:12:04,240 --> 00:12:07,360
then.
And I will say I was my first

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00:12:07,360 --> 00:12:13,240
patient and in about 6 months of
doing all the things I was

237
00:12:13,240 --> 00:12:16,640
supposed to do, doing the task,
changing my diet, taking the

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00:12:16,640 --> 00:12:20,840
supplements, my migraines, which
started, I had started

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00:12:20,840 --> 00:12:22,560
developing them at the age of
11.

240
00:12:23,240 --> 00:12:27,720
My eczema, which I started at
the age of eight, I was 42 when

241
00:12:27,720 --> 00:12:29,360
I got exposed to functional
medicine.

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00:12:29,840 --> 00:12:32,120
Literally in six months, I had
none of them.

243
00:12:33,040 --> 00:12:35,160
Everything might.
I didn't have to use Flonase.

244
00:12:35,720 --> 00:12:39,040
I never had a headache.
And it's been 17 years now and I

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00:12:39,040 --> 00:12:42,960
haven't touched any of those.
It it just altered my life.

246
00:12:42,960 --> 00:12:45,920
And after that, how do you
practice conventional medicine?

247
00:12:45,920 --> 00:12:49,200
But I don't know.
Thank you.

248
00:12:49,280 --> 00:12:51,480
Thank you for sharing that.
That really is awesome.

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00:12:51,480 --> 00:12:53,760
A couple of follow-ups.
What year was it that you came

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00:12:53,760 --> 00:12:55,520
and you were hospitalized in the
States?

251
00:12:56,400 --> 00:13:02,600
1993 to 19 to 2000.
Yeah, yeah, yeah.

252
00:13:02,920 --> 00:13:08,200
So, so 90s again, probably at
that time, yeah, No, 25 years

253
00:13:08,200 --> 00:13:10,920
later, like the system in terms
of reimbursements and all that

254
00:13:10,920 --> 00:13:12,880
stuff, I think, is that still
considered?

255
00:13:13,120 --> 00:13:15,520
Is that when that stuff was
being rolled out for you?

256
00:13:15,520 --> 00:13:18,720
Were you seeing the first wave
of that type of stuff?

257
00:13:19,480 --> 00:13:24,160
Nope, actually that was the I
would call the golden era of

258
00:13:24,160 --> 00:13:28,560
practicing medicine in the US.
Yes, it's 93 to I will say

259
00:13:28,560 --> 00:13:30,360
almost 98.
I had no trouble.

260
00:13:30,560 --> 00:13:33,760
And then I was 10 years at the
VA where you never, I mean,

261
00:13:33,760 --> 00:13:35,240
it's, it's a whole different
system.

262
00:13:35,520 --> 00:13:36,840
Yeah.
And so you mentioned you were

263
00:13:36,840 --> 00:13:40,400
hospitals, but you also pointed
out, you know, certain metrics

264
00:13:40,880 --> 00:13:43,360
worked tightly correlated with
your bonus, at least in the

265
00:13:43,360 --> 00:13:45,400
positive sense.
So you were also seeing patients

266
00:13:45,440 --> 00:13:47,800
outpatient?
Yes, we had out.

267
00:13:47,880 --> 00:13:52,240
So the metrics where was when I
left my job as a hospitalist

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00:13:52,240 --> 00:13:54,720
went to the VA.
So the VA has metrics.

269
00:13:54,720 --> 00:13:56,480
Yeah.
So I was in our patient there.

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00:13:56,760 --> 00:14:00,120
Yeah, I didn't do hospital
assessor the veterans at the

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00:14:00,120 --> 00:14:02,560
veterans.
So what I find interesting is

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00:14:02,560 --> 00:14:04,720
here, so we had three brown
people here on this podcast

273
00:14:04,840 --> 00:14:07,000
talking.
And most of us just by the

274
00:14:07,000 --> 00:14:09,560
nature of our background, you
know, our parents talking about

275
00:14:09,640 --> 00:14:12,360
like, OK, you hurt yourself.
The first thing that's going on

276
00:14:12,360 --> 00:14:14,080
there is, you know, we all call
it haldi, right?

277
00:14:14,080 --> 00:14:16,360
It's it's turmeric, right?
You're putting that what we're

278
00:14:16,360 --> 00:14:19,120
putting it.
And so you said that you really,

279
00:14:19,120 --> 00:14:21,400
this world of supplements was
novel to you.

280
00:14:21,680 --> 00:14:25,160
So surely you, you were familiar
with some of those things, you

281
00:14:25,160 --> 00:14:27,360
know, growing up in your family.
Is that was that not part of

282
00:14:27,360 --> 00:14:30,360
your culture in terms of some of
those supplementation, some of

283
00:14:30,360 --> 00:14:32,040
the quote UN quote, alternative
things?

284
00:14:32,400 --> 00:14:37,360
Or was that new to you as well?
No, I've always been grace with

285
00:14:37,400 --> 00:14:40,400
Ayurveda, right?
I've had hepatitis C, I've had

286
00:14:40,400 --> 00:14:42,800
measles, I've had moms.
I never went to see a doctor.

287
00:14:42,800 --> 00:14:46,160
My grandmother treated me and
she would just you know where

288
00:14:46,160 --> 00:14:49,560
and we went to the where you get
the Ayurvedic treatment.

289
00:14:49,560 --> 00:14:50,960
I didn't know what I was
getting.

290
00:14:51,080 --> 00:14:53,200
I just had it and I would come
back home.

291
00:14:53,560 --> 00:14:59,560
So to me, we didn't consider.
So illness was something nobody

292
00:14:59,560 --> 00:15:02,360
was chronically I'll these are
all acute illnesses, right?

293
00:15:02,360 --> 00:15:04,680
And they even naturally will get
better.

294
00:15:05,280 --> 00:15:08,640
It was just more of symptomatic
treatment when he went to go to

295
00:15:08,640 --> 00:15:12,320
Ayurveda or get the Ayurvedic
herbs, but didn't even consider

296
00:15:12,320 --> 00:15:16,480
that as a treatment.
But interestingly, when you say

297
00:15:16,480 --> 00:15:19,120
that, I will say this.
When I was in medical school,

298
00:15:19,840 --> 00:15:24,640
people will come to us with a
broken seamer almost six weeks

299
00:15:24,640 --> 00:15:27,720
after they broke it because they
would have gone to the Ayurvedic

300
00:15:27,720 --> 00:15:32,280
hospital and had some herbs
wrapped around that.

301
00:15:32,280 --> 00:15:34,920
And we would be yelling at them
and telling, why would you do

302
00:15:34,920 --> 00:15:37,840
something like that?
A lot of our patients, we would

303
00:15:37,880 --> 00:15:40,400
shoot them because we would go
to Ayurvedic practitioner.

304
00:15:40,400 --> 00:15:42,440
We would tell them that was not
real medicine.

305
00:15:42,720 --> 00:15:46,040
They needed to come and see us.
Do you understand, like how much

306
00:15:46,040 --> 00:15:49,640
the brainwashing of what is
English medicine?

307
00:15:50,000 --> 00:15:53,160
And many of them would come and
say they would gather their

308
00:15:53,360 --> 00:15:56,640
daily wages to get this English
medicine so they can feel

309
00:15:56,640 --> 00:15:58,840
better.
So there was that.

310
00:15:59,240 --> 00:16:03,040
I mean, you're almost, it's a
form of, I don't know, I would

311
00:16:03,040 --> 00:16:06,800
say medical training is almost
dehumanizing us.

312
00:16:07,160 --> 00:16:10,120
We are.
So it's, you know, what is the

313
00:16:10,120 --> 00:16:14,800
235 causes of cirrhosis of liver
that's more important than how

314
00:16:14,800 --> 00:16:17,600
do you help a person with
cirrhosis of liver get better?

315
00:16:18,400 --> 00:16:22,080
And that's what our whole
concept was.

316
00:16:22,080 --> 00:16:26,840
So yes way it never occurred to
me at that time the supplements

317
00:16:26,840 --> 00:16:30,880
could be connected to our radar.
Let me push back on that one a

318
00:16:30,880 --> 00:16:33,120
little bit.
Don't you kind of need to

319
00:16:33,120 --> 00:16:35,680
understand one to be better do
the other?

320
00:16:35,680 --> 00:16:38,960
For instance, you said if you
can't understand what the

321
00:16:38,960 --> 00:16:43,080
possible reasons for a potential
diagnosis are, 'cause you

322
00:16:43,080 --> 00:16:47,440
emphasize the importance of why.
If you don't know all the what

323
00:16:47,480 --> 00:16:50,480
in terms of the background
information and the foundations,

324
00:16:51,480 --> 00:16:53,600
aren't you going to be less
likely to arrive at the Y

325
00:16:53,600 --> 00:16:57,240
sooner?
So so I've since I've practiced

326
00:16:57,240 --> 00:16:59,760
for 30 years, I don't know how
many editions of Harrison's

327
00:16:59,760 --> 00:17:03,600
there have been.
If you look at the 1984 edition

328
00:17:03,600 --> 00:17:08,560
of Harrison's, I'm really aging
myself here, but the first any

329
00:17:08,560 --> 00:17:13,119
chapter would have etiology
would be 4 or five chapters and

330
00:17:13,119 --> 00:17:19,280
the RX was one page.
Now the RX is 10 pages, that

331
00:17:19,280 --> 00:17:25,119
etiology is 1 paragraph.
So the way we it's more of signs

332
00:17:25,119 --> 00:17:29,640
and symptoms and arriving at the
right diagnosis in clinical

333
00:17:29,640 --> 00:17:33,800
medicine was the focus.
It was never about treatment

334
00:17:33,800 --> 00:17:35,920
because our treatments were very
limited.

335
00:17:36,040 --> 00:17:40,280
It's more of symptomatic.
You have drop C or edema, you

336
00:17:40,280 --> 00:17:43,080
give them digoxin.
At that time, it was digoxin and

337
00:17:43,080 --> 00:17:46,120
some kind of a diuretic.
It was just simple.

338
00:17:46,120 --> 00:17:49,240
But we're not talking to the
patient about why did you get

339
00:17:49,240 --> 00:17:51,160
this congestive heart failure at
that time?

340
00:17:51,160 --> 00:17:55,120
It used to be rheumatic fever
and mitral stenosis, and you had

341
00:17:55,120 --> 00:17:59,160
to change the valve.
So you have those very specific

342
00:17:59,280 --> 00:18:02,720
conditions.
It's now, it's later on in 2000,

343
00:18:02,720 --> 00:18:06,360
we started seeing chronic
diseases for which it is pretty

344
00:18:06,360 --> 00:18:09,960
much the stressful lifestyle,
the foundational, you know,

345
00:18:10,000 --> 00:18:13,840
diet, a lack of exercise, lack
of sleep, chronic stress that is

346
00:18:13,840 --> 00:18:16,400
driving.
So I've seen a shift in how

347
00:18:16,400 --> 00:18:21,480
disease has evolved.
And cardiovascular disease is

348
00:18:21,480 --> 00:18:25,840
something that we used to see
before as like you're almost

349
00:18:25,840 --> 00:18:27,960
dead once you have a heart
attack where it's now it's a

350
00:18:27,960 --> 00:18:31,640
completely, the only condition
that's completely reversible.

351
00:18:32,280 --> 00:18:35,240
Yeah.
So I will say, yes, you need to

352
00:18:35,240 --> 00:18:39,400
understand the reason, but we
are not taught to focus on the

353
00:18:39,400 --> 00:18:41,920
reason.
I've never asked my patients

354
00:18:42,240 --> 00:18:44,960
what they eat for breakfast,
lunch and dinner till I became a

355
00:18:44,960 --> 00:18:47,920
functional medical doctor.
And I can tell you a story.

356
00:18:48,040 --> 00:18:52,200
Really the most interesting
part, this was a patient of mine

357
00:18:52,200 --> 00:18:54,360
I saw in my conventional medical
practice.

358
00:18:54,520 --> 00:18:58,400
So I've gone to this AFMC, the
five day functional medical

359
00:18:58,400 --> 00:19:02,040
training came back and I felt
like I just need to practice

360
00:19:02,040 --> 00:19:04,600
this kind of medicine.
So they give you something

361
00:19:04,600 --> 00:19:07,880
called a timeline where they'll
say you got to identify the

362
00:19:07,880 --> 00:19:10,240
triggers and you have to
identify the mediator.

363
00:19:10,240 --> 00:19:15,000
So what started the disease and
what is promoting the disease

364
00:19:15,400 --> 00:19:16,880
now?
Even if this was a young girl,

365
00:19:17,280 --> 00:19:22,120
she was only in her late 20s,
but had high blood pressure and

366
00:19:22,120 --> 00:19:25,360
she was of East Eastern Asian
origin.

367
00:19:25,440 --> 00:19:28,560
I don't know if it was Vietnam
or Korea, but she would come and

368
00:19:28,560 --> 00:19:30,800
see me regularly.
She and her husband would come,

369
00:19:30,800 --> 00:19:33,120
and I would take their blood
pressure give her the medicine

370
00:19:33,120 --> 00:19:35,080
she was on five blood pressure
medicines.

371
00:19:35,080 --> 00:19:38,280
I'm not even kidding.
And I could not figure out why

372
00:19:38,280 --> 00:19:41,080
she had a high blood pressure.
So when I did the functional

373
00:19:41,080 --> 00:19:42,760
medicine, she was my first
patient.

374
00:19:42,760 --> 00:19:45,880
That afternoon when I came back
from the conference and I told

375
00:19:45,880 --> 00:19:47,960
her, you know, I've gone to this
functional medical conference.

376
00:19:47,960 --> 00:19:50,840
Can I try taking a history a
little differently?

377
00:19:51,400 --> 00:19:55,000
And I took a history and for the
first time in my life, I

378
00:19:55,000 --> 00:19:58,520
realized she was adopted.
When I went back to my original

379
00:19:58,560 --> 00:20:02,600
medical history it says adopted
family history not relevant but

380
00:20:02,600 --> 00:20:04,480
now.
When I was taking the function

381
00:20:04,480 --> 00:20:08,080
medicine medical history, she
actually told me how she was

382
00:20:08,080 --> 00:20:10,720
adopted, how she was hiding
behind the table, how her

383
00:20:10,720 --> 00:20:13,080
adoptive mother came and picked
her up.

384
00:20:13,440 --> 00:20:16,240
And when she came here and
recently her adoptive mother had

385
00:20:16,240 --> 00:20:18,840
died and that's when her blood
pressure started going up.

386
00:20:19,600 --> 00:20:23,440
And every visit she would come
with her husband and I would go

387
00:20:23,440 --> 00:20:25,360
over the history.
But this is the first time I

388
00:20:25,360 --> 00:20:29,040
started identifying reasons why
she was stressed.

389
00:20:29,760 --> 00:20:32,320
And I'm not kidding you.
Three months later, I asked you

390
00:20:32,320 --> 00:20:34,960
to come back.
I made her do some dietary and

391
00:20:34,960 --> 00:20:37,440
lifestyle changes.
I gave her blood work.

392
00:20:37,920 --> 00:20:39,960
She came for the first time
alone.

393
00:20:40,360 --> 00:20:41,960
Her husband didn't accompany
her.

394
00:20:42,200 --> 00:20:43,680
And I said, oh, what happened to
him?

395
00:20:43,720 --> 00:20:47,280
And she said I divorced him.
We are separated.

396
00:20:48,040 --> 00:20:51,920
And I'm like, what happened?
So she said when you took the

397
00:20:51,920 --> 00:20:56,720
history of the other time, I
realized why I was stressed and

398
00:20:56,720 --> 00:20:59,680
I knew I needed to quit this
relationship.

399
00:20:59,680 --> 00:21:03,840
It was too toxic for me.
It was mind blowing because that

400
00:21:03,840 --> 00:21:06,760
was the first time I spoke to
her about her life.

401
00:21:07,640 --> 00:21:11,960
And this is where functional
medicine gets into so much of

402
00:21:12,040 --> 00:21:16,400
depth of an individual's life.
It literally shifts their

403
00:21:16,400 --> 00:21:18,080
health.
And I was able to send her home

404
00:21:18,080 --> 00:21:20,760
with just two medicines because
her blood pressure was dropping.

405
00:21:21,760 --> 00:21:24,400
Do you understand?
So when you talk about etiology

406
00:21:24,400 --> 00:21:26,560
and treatment, that's where the
difference is.

407
00:21:26,960 --> 00:21:29,040
This is very curious.
I want to go back to what you

408
00:21:29,040 --> 00:21:32,080
were talking about maybe in the
1st 5 minutes about India versus

409
00:21:32,240 --> 00:21:34,520
US, right?
Because the way you described

410
00:21:34,520 --> 00:21:37,360
what you were learning in India
where you have somebody kind of

411
00:21:37,360 --> 00:21:39,840
pointing out the obvious that
isn't obvious, right?

412
00:21:39,840 --> 00:21:43,040
When you talk about foreigner
syndrome, that to me sounds like

413
00:21:43,040 --> 00:21:46,720
the Sherlock medicine of or
Sherlock Holmes of medicine,

414
00:21:46,720 --> 00:21:48,440
right?
And so many pre medical students

415
00:21:48,480 --> 00:21:49,960
write about that in their
personal statement.

416
00:21:49,960 --> 00:21:53,040
That's what they think of
medicine is going to be, but

417
00:21:53,040 --> 00:21:56,760
yet, but in but in the US, it's
a lot more social work, right?

418
00:21:56,760 --> 00:21:59,360
I mean, a lot of it's like you
said, it's how do you set up the

419
00:21:59,360 --> 00:22:01,560
environment at home so that they
don't come back.

420
00:22:01,560 --> 00:22:04,800
But without a doubt, they're
coming back with an issue that

421
00:22:04,800 --> 00:22:06,640
was greater than what we even
try to treat them with.

422
00:22:07,240 --> 00:22:10,960
So I'm curious about what was it
about the training in India that

423
00:22:10,960 --> 00:22:12,960
you didn't like?
Because it almost seemed like

424
00:22:12,960 --> 00:22:16,000
functional medicine is more
relevant to what you were

425
00:22:16,000 --> 00:22:18,560
learning in India with what that
Sherlock Holmes mindset and

426
00:22:18,560 --> 00:22:20,720
really digging and trying to
find out the pieces.

427
00:22:21,760 --> 00:22:24,720
Yeah, yes.
So I will say when I look back,

428
00:22:25,720 --> 00:22:29,160
the way medicine was practiced,
it was almost like there was

429
00:22:29,160 --> 00:22:35,560
this God like figure, your
professor and how he examined

430
00:22:35,560 --> 00:22:37,400
the patient, how we diagnosed
the patient.

431
00:22:37,400 --> 00:22:42,320
That was more important than
actually making a patient feel

432
00:22:42,320 --> 00:22:45,880
better.
It was almost the diagnosis was

433
00:22:45,880 --> 00:22:50,880
the IT was the pinnacle of your
connection with the patient.

434
00:22:50,880 --> 00:22:52,760
I've made a diagnosis and that's
it.

435
00:22:53,480 --> 00:22:56,800
Now, whether the patient got
better or not, they didn't use

436
00:22:56,800 --> 00:22:59,880
any Ayurvedic or, you know,
healing thing.

437
00:22:59,880 --> 00:23:03,280
They would just say, you know,
white medicine, the medicine

438
00:23:03,280 --> 00:23:05,200
with the line medicine that's
blue.

439
00:23:05,200 --> 00:23:07,960
Take this on my in the morning,
take this in the afternoon, take

440
00:23:07,960 --> 00:23:09,120
this in the evening.
That was it.

441
00:23:09,560 --> 00:23:12,200
There wasn't there was no
conversation with the patient

442
00:23:12,200 --> 00:23:14,680
about what they needed to do,
why they had it.

443
00:23:15,040 --> 00:23:18,400
They just took that and went
home and started taking those

444
00:23:18,400 --> 00:23:20,320
medicines when they ran out,
they didn't know they had to

445
00:23:20,320 --> 00:23:23,680
come for a refill.
So it was a very it's a very

446
00:23:23,680 --> 00:23:28,240
detached way of practice.
So much of showmanship rather

447
00:23:28,240 --> 00:23:32,440
than medicine.
And in USI agree with you.

448
00:23:32,440 --> 00:23:36,520
It's a lot of the social work
and more of documentation.

449
00:23:36,520 --> 00:23:38,680
Don't get sued.
Make sure you put all your

450
00:23:38,680 --> 00:23:41,320
councils one of those
mentalities.

451
00:23:41,800 --> 00:23:45,640
And so the being a doctor is no
longer a joy.

452
00:23:45,960 --> 00:23:50,280
You have to find a different way
to have that relationship with

453
00:23:50,280 --> 00:23:52,160
the patient.
And I think for me, functional

454
00:23:52,160 --> 00:23:55,080
medicine created that kind of a
space.

455
00:23:55,760 --> 00:23:56,480
Gotcha.
Awesome.

456
00:23:56,480 --> 00:23:57,960
Yeah, it's funny.
And it's it still holds true

457
00:23:57,960 --> 00:23:59,680
today in India.
I'll talk to my relatives who,

458
00:23:59,720 --> 00:24:01,760
you know, might have back pain
and call me and say, hey, what

459
00:24:01,760 --> 00:24:03,320
can I do?
And I said, well, what have you

460
00:24:03,320 --> 00:24:04,520
got done?
And they said, I don't know.

461
00:24:04,520 --> 00:24:06,560
A doctor just wrote a script and
said, take this three times a

462
00:24:06,560 --> 00:24:10,160
day, exactly what you said.
So I guess it's still happening.

463
00:24:10,560 --> 00:24:12,600
It's a.
Very authoritative, very

464
00:24:12,600 --> 00:24:14,760
paternal magician like medicine,
right?

465
00:24:14,760 --> 00:24:19,200
So very cool.
Well, let's transition to the

466
00:24:19,200 --> 00:24:21,960
post you wrote on LinkedIn.
So you wrote a very eye opening

467
00:24:21,960 --> 00:24:24,800
post, which you know, prompted
my attention and asked you to

468
00:24:24,800 --> 00:24:27,360
come on to this podcast.
And so tell us a little bit

469
00:24:27,360 --> 00:24:30,280
about why you will no longer be
going to functional medicine

470
00:24:30,280 --> 00:24:31,720
conference.
What prompted that for you?

471
00:24:32,680 --> 00:24:35,040
Yeah.
So my first functional medical

472
00:24:35,040 --> 00:24:38,760
conference was in 2012, and
since then I've gone to every

473
00:24:38,760 --> 00:24:41,960
functional medical conference
and I've seen a transition.

474
00:24:42,560 --> 00:24:45,800
When I went for the first
functional medical conference,

475
00:24:45,800 --> 00:24:48,200
there was so much of
biochemistry, Physiology,

476
00:24:48,200 --> 00:24:51,320
understanding, You know, the
foundation of this is the

477
00:24:51,320 --> 00:24:54,360
lifestyle that you need to.
What are the modifiable risk

478
00:24:54,360 --> 00:24:56,240
factors?
So what are the five pillars of

479
00:24:56,240 --> 00:25:00,560
modifiable risk factors, which
is your nutrition, movement,

480
00:25:00,680 --> 00:25:04,600
stress, your sleep, and who do
you hang out with?

481
00:25:05,280 --> 00:25:08,880
Are you hanging out with people
who respect health or are they

482
00:25:09,040 --> 00:25:12,320
drinking alcohol every evening
and that's what your life is

483
00:25:12,320 --> 00:25:18,640
about.
So as I somewhere in the 2000

484
00:25:18,640 --> 00:25:24,120
teens later, like I would say
1718, I started noticing there

485
00:25:24,120 --> 00:25:26,360
was a lot of emphasis on the
treatment.

486
00:25:26,360 --> 00:25:29,160
They'll say you got to always
address the lifestyle.

487
00:25:29,160 --> 00:25:32,400
And then suddenly there was all
these protocols and these

488
00:25:32,400 --> 00:25:37,680
protocols got so complex, right?
You know, you want to give this

489
00:25:37,680 --> 00:25:40,480
at this time and then you want
to follow it up with this.

490
00:25:40,480 --> 00:25:43,240
And we want to give so many
pills of this and you want to

491
00:25:43,240 --> 00:25:45,760
give it at night.
And by the end you can see the

492
00:25:45,760 --> 00:25:49,240
whole chat because we had a lot
of online and all everybody was

493
00:25:49,240 --> 00:25:50,920
asking, So what did he say?
What should you give?

494
00:25:50,920 --> 00:25:54,160
How many milligrams?
And we were doing just the same

495
00:25:54,160 --> 00:25:56,560
thing as we did in medicine.
It's like all about the

496
00:25:56,560 --> 00:26:01,720
treatment and no one was asking
why is the patient having this

497
00:26:01,720 --> 00:26:05,480
problem When you do a case study
And a lot of it started moving

498
00:26:05,480 --> 00:26:08,240
more towards what are the
different supplements that will

499
00:26:08,240 --> 00:26:11,560
support bringing down your blood
pressure, bringing down your

500
00:26:11,560 --> 00:26:16,680
cholesterol, your blood sugar,
but not enough about the

501
00:26:16,680 --> 00:26:20,720
lifestyle, the stress factors
that drove that individual to

502
00:26:20,720 --> 00:26:25,400
have a specific complex medical
problem that is now chronic.

503
00:26:26,080 --> 00:26:29,960
So I would come back after every
functional medical conference

504
00:26:29,960 --> 00:26:33,160
and you know, in our group, we
will discuss because many of us

505
00:26:33,160 --> 00:26:34,760
would have gone for the
conference and we'll discuss,

506
00:26:34,760 --> 00:26:38,280
hey, let's share notes.
Let's see, we can spend three

507
00:26:38,280 --> 00:26:43,040
weeks on how much calcium to
give for osteoporosis, right?

508
00:26:43,360 --> 00:26:46,040
Just literally what brand of
calcium are you going to give

509
00:26:46,040 --> 00:26:49,520
for osteoporosis?
But I'm like, is this patient

510
00:26:49,520 --> 00:26:52,160
drinking wine every evening?
Are they doing any strength

511
00:26:52,160 --> 00:26:54,640
training?
What is their stress factor?

512
00:26:54,640 --> 00:26:57,120
How do they eat?
None of that seems to be

513
00:26:57,120 --> 00:26:59,760
relevant because we say, oh, the
health coach will take care of

514
00:26:59,760 --> 00:27:03,080
that.
So once again, we have become

515
00:27:03,120 --> 00:27:06,520
reductionist in our approach.
And I'm noticing this more and

516
00:27:06,520 --> 00:27:08,640
more with functional medicine.
And then the other thing which I

517
00:27:08,640 --> 00:27:12,280
was talking about before we
started recording is that

518
00:27:12,560 --> 00:27:15,280
functional medicine is not like
a certificate together.

519
00:27:15,280 --> 00:27:17,600
It's not a degree that you get
in medical school.

520
00:27:17,880 --> 00:27:20,640
Somebody told me this, right?
It's not a degree, it's a

521
00:27:20,640 --> 00:27:22,640
certificate.
So anybody's a functional

522
00:27:22,640 --> 00:27:26,800
medical practitioner.
So what makes me unique, what

523
00:27:26,800 --> 00:27:30,160
makes me stand out amongst the
CEO of functional medical

524
00:27:30,160 --> 00:27:33,200
practitioners?
And that's going to be how I

525
00:27:33,200 --> 00:27:35,360
approach it.
And the depth of my knowledge,

526
00:27:35,360 --> 00:27:40,720
my experience, my knowledge of
the five years of medical school

527
00:27:40,720 --> 00:27:44,400
that I did and working on the
Physiology, technology and

528
00:27:44,600 --> 00:27:48,120
biochemistry, rather than just
saying, OK, here are the 10

529
00:27:48,120 --> 00:27:52,400
supplements, take these at this
time of the day.

530
00:27:53,320 --> 00:27:55,720
Yeah.
Yeah, you said a health.

531
00:27:55,720 --> 00:27:56,960
Does that answer the?
Question.

532
00:27:56,960 --> 00:27:58,080
Yeah, no, it does.
It does.

533
00:27:58,120 --> 00:27:59,600
I there's a lot to unpack here
too.

534
00:27:59,600 --> 00:28:01,920
I think you said a health coach
will take care of it.

535
00:28:02,080 --> 00:28:04,480
Is it pretty regular that
providers work with health

536
00:28:04,480 --> 00:28:07,640
coaches that will deal more with
that behavioral change and

537
00:28:07,640 --> 00:28:10,240
therefore the provider to make
themselves unique will probably

538
00:28:10,240 --> 00:28:11,880
do more the protocols and
supplementation?

539
00:28:12,960 --> 00:28:16,280
Yeah, So I will say when I
started functional medicine,

540
00:28:16,280 --> 00:28:18,200
I've always worked with a health
coach.

541
00:28:18,200 --> 00:28:20,880
I've never done functional
medicine without a health coach

542
00:28:21,360 --> 00:28:25,280
because I'm not trained.
And keep in mind, I come from

543
00:28:25,280 --> 00:28:28,040
India, right?
I'm going to say I'm going to

544
00:28:28,040 --> 00:28:30,720
call the spade.
I don't know how to tell you.

545
00:28:31,000 --> 00:28:32,480
Does this feel comfortable for
you?

546
00:28:32,560 --> 00:28:34,720
That's not me, right?
I'm just going to say you're

547
00:28:34,720 --> 00:28:36,160
going to stop.
You're going to have to stop

548
00:28:36,160 --> 00:28:39,280
smoking and you're going to
start eating healthier.

549
00:28:39,440 --> 00:28:42,160
And that doesn't fly in a place
like this.

550
00:28:42,160 --> 00:28:43,760
You got to build that
relationship.

551
00:28:43,760 --> 00:28:46,160
So I always had a health coach
that was my buffer.

552
00:28:46,440 --> 00:28:48,800
But I will tell my patients now
my job.

553
00:28:48,800 --> 00:28:50,560
I'm the visionary of your
health.

554
00:28:50,880 --> 00:28:53,160
I'm going to tell you this is
where you need to go.

555
00:28:53,600 --> 00:28:56,800
The health coach will take you
from kindergarten to PhD level,

556
00:28:57,520 --> 00:28:59,680
but this is where you need to
go.

557
00:28:59,800 --> 00:29:02,520
It's.
That's my approach to that.

558
00:29:02,520 --> 00:29:04,920
Ultimax and I just talked about
this literally in our last

559
00:29:04,920 --> 00:29:08,520
episodes.
Meeting people's expectations

560
00:29:08,520 --> 00:29:09,520
and how they want to get
coached.

561
00:29:09,520 --> 00:29:12,240
Yep.
Yeah, well, we on one hand we

562
00:29:12,240 --> 00:29:15,640
tell patients should be their
own decision maker.

563
00:29:15,640 --> 00:29:18,760
And then the next time when you
get have you noticed like you

564
00:29:18,800 --> 00:29:21,520
did you, you get a, you get a
letter from Lacrosse Blue Shield

565
00:29:21,520 --> 00:29:24,720
saying, hey, your patient has
had not had a mammogram.

566
00:29:24,800 --> 00:29:27,640
What are you doing about it?
I'm like, what am I supposed to

567
00:29:27,640 --> 00:29:29,200
do about it?
I gave a script.

568
00:29:29,680 --> 00:29:32,880
I'm done.
Like it's their free will to go

569
00:29:32,960 --> 00:29:35,560
do the mammogram or not, but you
got dinged for it.

570
00:29:35,960 --> 00:29:38,640
So on one hand, you don't want
to be a, you know, have a

571
00:29:38,640 --> 00:29:41,640
patriarchal system, but on the
other hand, you want to give

572
00:29:41,640 --> 00:29:44,760
them the freedom.
And then when they don't do the

573
00:29:44,760 --> 00:29:46,720
right things, you're held
responsible.

574
00:29:46,720 --> 00:29:50,960
So there's a lot of confusion in
medicine, so I can say.

575
00:29:52,320 --> 00:29:55,280
Not being a primary care
provider in the conventional

576
00:29:55,280 --> 00:29:57,680
system at this point, I will say
I think that might be a very.

577
00:29:58,360 --> 00:30:00,320
That might be a regional thing
as well.

578
00:30:00,520 --> 00:30:04,200
For instance, if you are in one
of those large systems on the

579
00:30:04,200 --> 00:30:06,520
West Coast, Kaiser being the
first one that comes to mind, I

580
00:30:06,560 --> 00:30:09,080
find those primary care doctors
get dinged a lot more.

581
00:30:09,640 --> 00:30:12,000
I don't see that on the East
Coast as much.

582
00:30:12,000 --> 00:30:15,240
And now I know you're, I guess,
Michigan, secondly, Midwest,

583
00:30:15,240 --> 00:30:18,360
Midwest.
OK, so, so, so, so I wonder how

584
00:30:18,360 --> 00:30:21,080
much of, or maybe we're shying
away from that.

585
00:30:21,080 --> 00:30:22,560
I mean, I don't.
Do you have a pulse on that?

586
00:30:22,560 --> 00:30:25,480
Do you talk to your colleagues a
lot who are not or still in the

587
00:30:25,480 --> 00:30:27,840
conventional model?
Are they still being dinged to

588
00:30:27,840 --> 00:30:30,880
that extent for that stuff?
Oh yeah, yeah, absolutely.

589
00:30:31,440 --> 00:30:35,080
Most of the majority of the
lawsuits I used to sit on the

590
00:30:35,080 --> 00:30:40,520
insurance of the peer review and
many of them were the patient

591
00:30:40,520 --> 00:30:43,280
was given a colonoscopy issue if
they were bleeding by giving a

592
00:30:43,280 --> 00:30:45,440
colonoscopy referral, but nobody
followed through.

593
00:30:45,440 --> 00:30:49,960
Like who is supposed to follow
through, But we are supposed to,

594
00:30:50,360 --> 00:30:53,440
so we are supposed to make sure.
So my patients, I used to have a

595
00:30:53,440 --> 00:30:56,320
texting line and my staff would
text them every week.

596
00:30:56,320 --> 00:30:58,760
And one of my patients called
and said, can you stop bugging

597
00:30:58,760 --> 00:31:00,080
me?
I know what I have to do.

598
00:31:00,600 --> 00:31:05,000
So but without doing that and we
document all of these things.

599
00:31:05,200 --> 00:31:09,400
So our time goes in
documentation and covering our

600
00:31:09,400 --> 00:31:13,400
asses to not get sued.
But at the same time, we talk

601
00:31:13,400 --> 00:31:15,880
about, you know, giving the
patient the freedom to do

602
00:31:15,880 --> 00:31:19,760
whatever they want, which should
include all of this, too, in my

603
00:31:19,800 --> 00:31:24,440
opinion.
Yeah, I read come to mind.

604
00:31:24,640 --> 00:31:28,280
I forget where I was listening
to this and this psychologist or

605
00:31:28,280 --> 00:31:31,560
she's a professor talking about
how, you know, responsibility

606
00:31:31,560 --> 00:31:33,480
and, and, and blame are
different things like you might

607
00:31:33,480 --> 00:31:37,280
not be, you might not
necessarily be responsible of

608
00:31:37,280 --> 00:31:39,760
where you are in life in terms
of your genetics and the

609
00:31:39,760 --> 00:31:41,120
circumstances that you had in
life.

610
00:31:41,120 --> 00:31:43,320
That patient's story that you
shared in terms of her

611
00:31:43,320 --> 00:31:46,320
adoptions, It sounds to me like
perhaps you stayed in a

612
00:31:46,320 --> 00:31:49,400
relationship longer than she had
to because she felt like she

613
00:31:49,400 --> 00:31:50,920
owed something to the mom,
right.

614
00:31:50,920 --> 00:31:53,920
So I don't know if that was your
assessment as well, but it is

615
00:31:54,040 --> 00:31:57,200
your responsibility to take care
of where it is that you're

616
00:31:57,200 --> 00:32:00,040
going, right?
So within that person's

617
00:32:00,040 --> 00:32:04,000
instance, cutting off the ties
that she identified as toxic, I

618
00:32:04,000 --> 00:32:05,920
want to come back to your
definition of functional

619
00:32:05,920 --> 00:32:09,040
medicine.
And towards the end, I'm going

620
00:32:09,040 --> 00:32:11,040
to ask you to try to convince me
to go down that road and I'll

621
00:32:11,040 --> 00:32:13,160
tell you what my hesitancy with
it is.

622
00:32:13,520 --> 00:32:17,000
But when you laid those 5
foundations out, to me, that

623
00:32:17,000 --> 00:32:20,240
sounds like lifestyle medicine,
what we recognize as modern day

624
00:32:20,240 --> 00:32:22,560
American College of lifestyle
medicine where you can be board

625
00:32:22,560 --> 00:32:25,440
certified.
So two thoughts that come to

626
00:32:25,440 --> 00:32:29,120
mind with that is like, one,
does functional medicine need to

627
00:32:29,120 --> 00:32:32,960
be rebranded, right?
And where more people will feel

628
00:32:32,960 --> 00:32:34,920
comfortable, such as myself
saying that's what they do?

629
00:32:35,480 --> 00:32:39,200
And two, I'm also curious now to
really understand the why behind

630
00:32:39,200 --> 00:32:43,120
it truly went towards more
protocol based stuff and siloed,

631
00:32:43,160 --> 00:32:45,640
so to speak, where as in you
were the visionary and kind of

632
00:32:45,640 --> 00:32:48,160
actually, you know, guiding the
patient through that journey.

633
00:32:48,520 --> 00:32:51,320
Whereas now it was like you're
going to go see the nutritionist

634
00:32:51,320 --> 00:32:53,440
for that, you'll see the
strength and conditioning coach

635
00:32:53,440 --> 00:32:55,360
for that.
I will write the prescriptions

636
00:32:55,360 --> 00:32:57,560
because only I am legally able
to do that.

637
00:32:58,280 --> 00:33:02,720
Because it almost makes me think
that if there was a reason we

638
00:33:02,720 --> 00:33:05,760
could identify that, then we can
prevent, you know, American

639
00:33:05,760 --> 00:33:07,880
College of Lifestyle Medicine
from doing amazing things right

640
00:33:07,880 --> 00:33:09,320
now to head down the same road,
right?

641
00:33:09,320 --> 00:33:11,720
Repeat our mistakes.
We're all prone to do that.

642
00:33:12,520 --> 00:33:15,080
Any thoughts on that?
Yeah, I can tell you.

643
00:33:15,240 --> 00:33:19,720
So I did ACLM too, and I, I
didn't get both certified.

644
00:33:19,720 --> 00:33:22,720
I almost sat for the exam and
then I decided I would not

645
00:33:22,720 --> 00:33:26,400
because a lot of it was how to
coach, how to make sure you

646
00:33:26,400 --> 00:33:29,040
convey these lifestyle changes
to a patient.

647
00:33:29,600 --> 00:33:33,040
I will say this again, I can
give you an example, a story

648
00:33:33,040 --> 00:33:35,560
where lifestyle medicine
wouldn't have helped this

649
00:33:35,560 --> 00:33:38,560
patient.
So this was a young lady.

650
00:33:38,640 --> 00:33:41,040
When I say young, she's in her
50s.

651
00:33:41,040 --> 00:33:45,640
She's been on 3 inhalers for
asthma for the last five years.

652
00:33:45,960 --> 00:33:48,480
She's been on four block
pressure medicines.

653
00:33:48,760 --> 00:33:52,600
She can't sleep at night.
She's not slept in her bed for

654
00:33:52,600 --> 00:33:56,760
eight years.
And she says, I have a feeling

655
00:33:56,760 --> 00:33:58,440
it's because I was exposed to
mold.

656
00:33:59,280 --> 00:34:03,880
And I said, how do you know?
And she said during COVID, we're

657
00:34:03,880 --> 00:34:07,360
working from home.
I felt a little better the

658
00:34:07,360 --> 00:34:11,080
minute I walked into my office.
I had an asthma attack and I

659
00:34:11,080 --> 00:34:16,120
know that there was a sewage
pipe that broke and the carpet

660
00:34:16,120 --> 00:34:20,880
was cleaned out and changed.
I know there's smold and this

661
00:34:20,880 --> 00:34:23,000
was my first exposure.
This is what you know, I was

662
00:34:23,280 --> 00:34:26,239
somewhere halfway through the
training and I just had started

663
00:34:26,239 --> 00:34:28,960
learning about mold related
illness.

664
00:34:29,320 --> 00:34:33,159
So I was 1 foot in conventional
medicine, 1 foot in functional

665
00:34:33,159 --> 00:34:36,320
medicine, and the neurologist
said there is no mold related

666
00:34:36,320 --> 00:34:39,400
illness.
So I remember learning about

667
00:34:39,400 --> 00:34:42,199
mold and I said I don't know
much about mold, but we'll work

668
00:34:42,199 --> 00:34:45,159
through this.
I have people I can consult and

669
00:34:45,159 --> 00:34:48,960
I can help you through this.
And I remember doing the

670
00:34:49,000 --> 00:34:53,400
specific lifestyle changes made
her change her diet.

671
00:34:53,760 --> 00:34:56,360
She was already very sick.
She liked to exercise, but she

672
00:34:56,360 --> 00:34:59,200
couldn't sleep.
And I started adding the mold

673
00:34:59,200 --> 00:35:02,680
binders and doing, you know,
first of all, we did the

674
00:35:02,680 --> 00:35:04,800
testing.
So what kind of mycotoxin?

675
00:35:04,800 --> 00:35:07,000
And then started doing the mold
binders.

676
00:35:07,360 --> 00:35:10,760
I still remember we started the
treatment in September, in

677
00:35:10,840 --> 00:35:14,680
December, around Christmas, she
said I just wanted to thank you.

678
00:35:14,720 --> 00:35:17,520
I'm not.
I haven't used my inhaler by

679
00:35:17,520 --> 00:35:19,320
March.
She said my husband wants to

680
00:35:19,320 --> 00:35:22,520
thank you because I've gone back
to bed and I'm sleeping in bed

681
00:35:22,520 --> 00:35:25,040
now and I actually sleep at
night.

682
00:35:25,720 --> 00:35:28,680
That will not happen if you do
lifestyle medicine.

683
00:35:29,720 --> 00:35:32,800
So mold related illness, Lyme
disease.

684
00:35:33,200 --> 00:35:36,360
When it comes to even
metabolicism though, the

685
00:35:36,680 --> 00:35:41,040
testing, what really attracted
me to functional medicine is the

686
00:35:41,040 --> 00:35:48,240
depth of testing the genetics,
genetic snips and connecting the

687
00:35:48,240 --> 00:35:53,520
blood work to the genes and then
creating a lifestyle protocol

688
00:35:53,520 --> 00:35:55,240
that actually works for the
patient.

689
00:35:56,200 --> 00:35:58,360
And it's very different.
So in lifestyle medicine, a lot

690
00:35:58,360 --> 00:36:00,920
of it is plant based right in
here.

691
00:36:01,440 --> 00:36:05,960
Most of our patients have been
eating meat, they come from some

692
00:36:05,960 --> 00:36:08,240
farms, they've been drinking
milk.

693
00:36:08,560 --> 00:36:11,880
You can switch them over.
So you have to work with them in

694
00:36:11,880 --> 00:36:14,560
a different way.
And I have to connect them to

695
00:36:14,560 --> 00:36:17,520
their blood work.
Most of them do become planned

696
00:36:17,520 --> 00:36:21,760
forward Mediterranean
eventually, but there's no one

697
00:36:22,360 --> 00:36:24,360
one protocol that fits
everything.

698
00:36:24,360 --> 00:36:27,840
And to me lifestyle medicine
seemed like everybody needs to

699
00:36:27,840 --> 00:36:30,520
be on a plant based diet, then
everybody would be good.

700
00:36:30,520 --> 00:36:32,680
I think plant based diet is
great for cardio metabolic

701
00:36:32,680 --> 00:36:36,160
health.
But the rest of it there, there

702
00:36:36,160 --> 00:36:38,760
are a lot of nuances and
function Medicine really taught

703
00:36:38,760 --> 00:36:43,480
me how to deal with those
complex conditions where these

704
00:36:43,480 --> 00:36:44,840
people have no other place to
go.

705
00:36:45,920 --> 00:36:47,680
I mean when you have mold and
light.

706
00:36:48,280 --> 00:36:50,800
Yeah, I, I buy that.
I, you know, earlier we were

707
00:36:50,800 --> 00:36:52,360
talking about the why behind the
disease.

708
00:36:52,800 --> 00:36:56,360
So the buzz phrases root cause.
People would throw a root cause

709
00:36:56,360 --> 00:36:58,040
around a lot.
Yes.

710
00:36:58,440 --> 00:37:00,760
Always gives me a little bit of
pause and I'll tell you why.

711
00:37:01,040 --> 00:37:06,040
I do think that sometimes we do
get obsessed in finding behind

712
00:37:06,040 --> 00:37:09,160
the why.
And I find, and it might just be

713
00:37:09,520 --> 00:37:12,600
a, a bias with respect to the
type of patients that I see, the

714
00:37:12,600 --> 00:37:16,520
type of problems that I see.
But the question I asked my

715
00:37:16,520 --> 00:37:19,800
patients, I'll ask them, I was
like, is it important to get

716
00:37:19,800 --> 00:37:23,400
better or is it important to
understand why you're

717
00:37:23,400 --> 00:37:24,840
experiencing what you're
experiencing?

718
00:37:25,440 --> 00:37:27,480
It's a bit of a catch 22
question because they don't feel

719
00:37:27,480 --> 00:37:29,520
comfortable answering it either
way, right?

720
00:37:29,520 --> 00:37:33,040
And so they'll look at me and
say both in a question format

721
00:37:33,640 --> 00:37:35,680
and of course, I want to do
both, right?

722
00:37:35,680 --> 00:37:39,120
But the strategy might change in
terms of what comes before the

723
00:37:39,120 --> 00:37:40,760
next, right?
Are we going to go down this

724
00:37:41,000 --> 00:37:44,880
extensive deep panel that you
described first and maybe that

725
00:37:44,880 --> 00:37:48,280
means advanced diagnostic
imaging, Mris, etcetera, and

726
00:37:48,440 --> 00:37:52,160
wait to see And then there is a
lag between when we get these

727
00:37:52,160 --> 00:37:55,120
results back again, This is
using the conventional model,

728
00:37:55,120 --> 00:37:57,400
right?
That and you, we might not have

729
00:37:57,400 --> 00:37:59,840
this conversation again two
months from now or are we going

730
00:37:59,840 --> 00:38:04,120
to intervene now and either use
medication supplementation?

731
00:38:04,640 --> 00:38:06,880
And I also want to actually just
highlight this because I think

732
00:38:06,880 --> 00:38:10,320
that those listening to this and
whatever title this episode's

733
00:38:10,320 --> 00:38:12,560
going to have are going to have
some type of confirmation bias

734
00:38:12,920 --> 00:38:14,680
for functional medicine.
And it's the greatest drug in

735
00:38:14,680 --> 00:38:17,120
the world.
I know you mentioned that in

736
00:38:17,120 --> 00:38:19,960
your earlier journey that when
you found out that medicine

737
00:38:19,960 --> 00:38:23,600
wasn't the solution, I think
even most functional pred can

738
00:38:23,600 --> 00:38:26,160
correct me if I'm wrong, it can
be part of the solution, right?

739
00:38:26,160 --> 00:38:28,200
We're not completely saying the
medicine is completely out and

740
00:38:28,200 --> 00:38:30,760
it's only supplementation.
I think that's sometimes where

741
00:38:30,760 --> 00:38:32,960
people get tripped up and that's
the conversation that I have.

742
00:38:32,960 --> 00:38:38,720
Like people will say I will take
37 supplements for non reputable

743
00:38:38,720 --> 00:38:41,920
companies, but I refuse to take
Tylenol, right, because it

744
00:38:41,920 --> 00:38:45,000
causes autism, you know, or
something crazy, right?

745
00:38:45,320 --> 00:38:48,240
Like even like a gram a day
something crazy because well,

746
00:38:48,240 --> 00:38:49,360
no, that's gonna affect my
liver.

747
00:38:49,360 --> 00:38:52,480
But oh, these other
supplementation with, you know,

748
00:38:52,720 --> 00:38:57,280
non FDA approved, non CGMP, not
NSF, nothing like that that I'll

749
00:38:57,280 --> 00:39:00,560
pick up off of Amazon.
So that cognitive dissonance is

750
00:39:00,560 --> 00:39:03,280
very interesting to me.
But to come back to the original

751
00:39:03,280 --> 00:39:07,200
question, sometimes I feel like
we perseverate over the why too

752
00:39:07,200 --> 00:39:10,080
much.
I mean, the reality is the

753
00:39:10,080 --> 00:39:12,560
Physiology is incredibly
complex.

754
00:39:12,960 --> 00:39:15,040
We don't really have a lot of
doctor houses walking around

755
00:39:15,040 --> 00:39:16,280
nowadays.
We certainly don't.

756
00:39:16,280 --> 00:39:19,280
I know that my physical exam
skills are shit compared to the

757
00:39:19,280 --> 00:39:22,040
docs 20 years from now doing
muscular scuttle medicine in

758
00:39:22,040 --> 00:39:23,200
India that you're talking about,
right?

759
00:39:23,680 --> 00:39:26,520
So, you know, sometimes it's the
best that we have.

760
00:39:26,680 --> 00:39:28,760
So you know, any thoughts on
that?

761
00:39:29,440 --> 00:39:32,800
Yeah, for sure.
Do you know what is the what I

762
00:39:32,800 --> 00:39:34,360
do?
Almost literally, this is a

763
00:39:34,360 --> 00:39:38,080
prescription I give 3 or 4 times
every day today.

764
00:39:38,520 --> 00:39:41,400
I know you guys can guess it.
Take a deep breath, I.

765
00:39:41,720 --> 00:39:43,720
Was going to say breathing.
That's funny.

766
00:39:44,040 --> 00:39:48,040
No GLP one I.
OK, right, right, right, right,

767
00:39:48,320 --> 00:39:50,440
right.
So I'm a functional medical

768
00:39:50,440 --> 00:39:55,040
doctor but honestly my patients
have tried just about everything

769
00:39:55,040 --> 00:39:58,840
to lose weight and I give them a
low dose GLP.

770
00:39:59,040 --> 00:40:03,520
They'll lose all that extra £20
that they could not lose because

771
00:40:03,520 --> 00:40:07,000
it literally shifted their the
food noise.

772
00:40:07,000 --> 00:40:11,360
Now I will say this function
medicine is not like dissing

773
00:40:11,360 --> 00:40:13,320
conventional medicine.
It is not at all.

774
00:40:13,600 --> 00:40:16,480
It is.
It's saying medicines are not

775
00:40:16,480 --> 00:40:20,720
your only option.
It is an option, but it's not

776
00:40:20,720 --> 00:40:23,400
your only option.
A conventional medical doctor

777
00:40:23,400 --> 00:40:27,800
says this is your only option.
I know I was trained to say tell

778
00:40:27,800 --> 00:40:31,400
people to take metformin.
If you don't take metformin,

779
00:40:31,600 --> 00:40:34,080
your kidneys are going to fail,
you're going to be on dialysis,

780
00:40:34,080 --> 00:40:36,600
you're going to go blind, and
you will be amputating your

781
00:40:36,600 --> 00:40:38,080
toes.
I've said this to my patients

782
00:40:38,080 --> 00:40:40,760
because that's what I've stopped
because we need to make them

783
00:40:40,760 --> 00:40:43,240
compliant.
That is no way to practice

784
00:40:43,240 --> 00:40:44,800
medicine.
This is like going to church and

785
00:40:44,800 --> 00:40:47,480
say Jesus will take out your
eyes if you sin.

786
00:40:48,200 --> 00:40:49,840
Who's going to go to church
after that?

787
00:40:50,200 --> 00:40:53,840
So it's, I mean nothing to, you
know, I'm sorry, my husband's

788
00:40:53,840 --> 00:40:55,400
Catholic.
I go to the temple.

789
00:40:55,440 --> 00:40:59,000
I mean, there's nothing against
anything, but it's just you need

790
00:40:59,000 --> 00:41:00,800
to have a conversation with the
patient.

791
00:41:00,800 --> 00:41:05,720
The patient has to read their
health care, but they also need

792
00:41:05,720 --> 00:41:08,720
to know they have choices.
They have options.

793
00:41:09,200 --> 00:41:10,920
I asked my patients several
times.

794
00:41:10,920 --> 00:41:12,680
I'll say, you know, I used to
ask them, so how many

795
00:41:12,680 --> 00:41:14,400
vegetables?
Oh, I need a lot of vegetables.

796
00:41:14,640 --> 00:41:16,840
So now what do I do?
I know that they're not eating

797
00:41:16,840 --> 00:41:18,880
vegetables because they're
coming to me with Constipation.

798
00:41:19,520 --> 00:41:22,400
I tell them, do you eat a pound
of vegetables a day?

799
00:41:22,640 --> 00:41:25,560
And is that, oh, a pound?
No, no, I don't.

800
00:41:25,680 --> 00:41:26,880
OK.
I want you to eat a pound of

801
00:41:26,880 --> 00:41:29,160
vegetables a day.
And here's the list I want.

802
00:41:30,080 --> 00:41:32,480
I know it's not a lot.
Actually, it's not a lot.

803
00:41:32,680 --> 00:41:34,880
Have you heard of the pound of a
pound of cure?

804
00:41:35,200 --> 00:41:38,280
It's actually a very accurate
surgeon who's written that book.

805
00:41:38,520 --> 00:41:39,680
Oh, really?
Yeah.

806
00:41:39,760 --> 00:41:42,320
He gives only a pound of
vegetables to patients after

807
00:41:42,320 --> 00:41:44,840
bariatric surgery instead of
asking them to drink a lot of

808
00:41:44,840 --> 00:41:47,040
protein.
And they keep their weights off,

809
00:41:47,040 --> 00:41:49,400
weight off.
So anyways, you.

810
00:41:49,840 --> 00:41:53,960
The thing is, most patients
don't realize their day-to-day

811
00:41:53,960 --> 00:41:57,160
habits are treating their health
problems.

812
00:41:57,600 --> 00:42:00,640
They're not genetically wired.
So I come from a family.

813
00:42:00,640 --> 00:42:03,080
All nine of my aunts and uncles
are diabetics.

814
00:42:03,760 --> 00:42:06,480
Five of them are dead from
complications of diabetes,

815
00:42:06,480 --> 00:42:09,000
gangrene and end stage renal
disease, stroke and heart

816
00:42:09,000 --> 00:42:13,000
attack.
My hemoglobin A1C was 6 when I

817
00:42:13,000 --> 00:42:15,920
started at the age of 42, when I
started functionalized, and now

818
00:42:15,920 --> 00:42:19,640
it's 5 and I have an insulin of
five and I maintain it that way.

819
00:42:20,280 --> 00:42:23,000
What runs in my family are
eating habits.

820
00:42:23,720 --> 00:42:27,280
I used to eat a rice three times
a day even when I moved to the

821
00:42:27,280 --> 00:42:28,640
United States.
Right?

822
00:42:28,880 --> 00:42:33,120
You have to shift certain things
based on your environment.

823
00:42:33,120 --> 00:42:35,480
I'm sitting 8 hours a day seeing
patients.

824
00:42:36,440 --> 00:42:38,920
What have I done to earn a bowl
of rice?

825
00:42:39,680 --> 00:42:43,480
Nothing.
So the conversation is very

826
00:42:43,480 --> 00:42:45,560
different.
You have to really connect with

827
00:42:45,560 --> 00:42:48,360
the patient.
You have to lay down the options

828
00:42:48,360 --> 00:42:50,040
for them.
Now if a patient comes to me

829
00:42:50,040 --> 00:42:52,040
with high blood pressure, I tell
them we'll get your blood

830
00:42:52,040 --> 00:42:54,200
pressure down naturally, but
you're going to have to take a

831
00:42:54,200 --> 00:42:57,200
blood pressure medicine.
I never because there are

832
00:42:57,200 --> 00:43:00,240
certain conditions you don't
play around with.

833
00:43:00,240 --> 00:43:02,240
You don't wait.
Like you said, two months.

834
00:43:02,240 --> 00:43:04,960
Let's go try this diet and I'll
measure your blood pressure in

835
00:43:04,960 --> 00:43:07,240
two months.
No, you do start medications,

836
00:43:07,480 --> 00:43:10,480
but at the same time, I also
telling them to eat beets and

837
00:43:10,480 --> 00:43:14,400
try trying to add something
that'll raise their nitric

838
00:43:14,400 --> 00:43:17,400
oxide, something that will, you
know, DASH diet or the

839
00:43:17,400 --> 00:43:19,760
Mediterranean diet.
So everything is being done

840
00:43:19,800 --> 00:43:22,600
together.
And then as they lose weight, as

841
00:43:22,600 --> 00:43:24,920
their blood pressure that what
they monitor is coming down,

842
00:43:24,920 --> 00:43:26,960
then we start weaning off
medication.

843
00:43:27,760 --> 00:43:32,440
I've done that too.
So I think medicine is almost an

844
00:43:32,640 --> 00:43:34,160
art.
It's there's a science to it,

845
00:43:34,160 --> 00:43:38,120
but it's an art and every
individual is an individual

846
00:43:38,120 --> 00:43:42,560
piece of art because they have
brought in their, you know,

847
00:43:42,560 --> 00:43:45,920
there's a reason why they are
the way they are and you have to

848
00:43:45,920 --> 00:43:49,440
address that.
It's a nice echo at the back.

849
00:43:49,800 --> 00:43:51,600
Sorry, the cruise ships are
going off.

850
00:43:53,480 --> 00:43:54,840
So.
There you go again.

851
00:43:54,840 --> 00:43:57,760
So I want to bring it back to
the protocols and the

852
00:43:57,760 --> 00:43:59,240
supplementation that you're
talking about.

853
00:43:59,640 --> 00:44:01,800
I mean, I think I understand
that the history of functional

854
00:44:01,800 --> 00:44:04,440
medicine and where it started, I
wouldn't say, you know, root

855
00:44:04,440 --> 00:44:05,960
cause.
I think as Ultimar said is kind

856
00:44:05,960 --> 00:44:08,000
of, I think where it kind of all
started.

857
00:44:08,280 --> 00:44:10,760
And now we're seeing more of
this supplementation.

858
00:44:10,760 --> 00:44:13,400
Like you said, Ultimar and I
were just, I mean, Ultimar sent

859
00:44:13,400 --> 00:44:16,240
me a link the other day about
examine.com and they have a pro

860
00:44:16,240 --> 00:44:19,840
version now where you can build
out protocols through their, you

861
00:44:20,280 --> 00:44:22,000
know, different supplements so
that you can give that to

862
00:44:22,000 --> 00:44:24,160
patients, right?
So it seems like, and it's a,

863
00:44:24,160 --> 00:44:26,560
it's a well trusted website that
does their own research and

864
00:44:26,560 --> 00:44:28,200
everything.
So definitely seems like we're

865
00:44:28,200 --> 00:44:31,040
headed down that way at these
conferences.

866
00:44:31,680 --> 00:44:34,160
Who is setting these agendas for
the protocols?

867
00:44:34,160 --> 00:44:35,720
Are they independent
researchers?

868
00:44:35,720 --> 00:44:38,920
Are they companies?
Are they just providers like us?

869
00:44:39,120 --> 00:44:41,480
Where is this coming from?
Yeah.

870
00:44:41,640 --> 00:44:45,240
So when you look at the talks,
they actually do evidence based

871
00:44:45,240 --> 00:44:48,000
medicine.
They will say, hey, this is what

872
00:44:48,000 --> 00:44:51,080
has been studied or this herb
has been studied or this

873
00:44:51,080 --> 00:44:54,440
supplement has been studied.
It'll be a very small, it's less

874
00:44:54,440 --> 00:44:56,360
than 100.
So it's not like a big study.

875
00:44:56,360 --> 00:44:58,720
It's not like 1000 people took
the supplement.

876
00:44:59,040 --> 00:45:04,560
And so it's a lot of it is
evidence based and it is by

877
00:45:04,560 --> 00:45:09,080
people who have tractors this
way for several years.

878
00:45:09,080 --> 00:45:13,400
It's more of anecdotal and they
do actually have a grading

879
00:45:13,400 --> 00:45:17,200
system where they have an ABC
where they'll say this is

880
00:45:17,200 --> 00:45:18,640
evident based, this is
anecdotal.

881
00:45:18,640 --> 00:45:21,240
So you know what is anecdotal
and what is evident based.

882
00:45:21,320 --> 00:45:23,040
They're very good about
organizing it.

883
00:45:23,480 --> 00:45:27,440
But you know, one of the things
about what I've noticed is the

884
00:45:27,720 --> 00:45:31,840
wave of questions that come is
always about the supplement.

885
00:45:31,840 --> 00:45:34,680
So This Is Us providers, our
minds are like that.

886
00:45:35,320 --> 00:45:39,000
This is not a so once you go to
a conference and people are

887
00:45:39,000 --> 00:45:41,360
asking more, I want to know more
about the treatment, more about

888
00:45:41,360 --> 00:45:43,240
the treatment.
That's what you're going to give

889
00:45:44,000 --> 00:45:48,200
and which is so my posts are
about telling because I see

890
00:45:48,200 --> 00:45:50,600
these patients, they come to me
with this 25 pages of

891
00:45:50,600 --> 00:45:54,360
supplements and I'm like, who
put you on this?

892
00:45:54,600 --> 00:45:57,560
Oh, is this a problem, Darsh?
No, no, you're fine.

893
00:45:57,560 --> 00:45:59,080
I'm just thinking I had a follow
up but go.

894
00:45:59,080 --> 00:45:59,760
Ahead.
Yeah, yeah.

895
00:45:59,760 --> 00:46:04,640
OK, so that's what I I find that
they come in with these 25 pages

896
00:46:04,640 --> 00:46:08,320
of supplements and they'll tell
me how they are taking it.

897
00:46:08,320 --> 00:46:10,360
Like this has to be taken with
food.

898
00:46:10,360 --> 00:46:12,920
This has to be taken away from
food that has to be taken away

899
00:46:12,920 --> 00:46:16,880
from the thyroid.
My mind just explodes when I

900
00:46:16,880 --> 00:46:19,640
listen to that.
And I'm like, So what do you eat

901
00:46:19,640 --> 00:46:24,000
for breakfast?
Oh, I just, I grab a bagel on my

902
00:46:24,000 --> 00:46:28,880
way out and I'm like, well,
let's clean that up first before

903
00:46:28,880 --> 00:46:31,320
we go to these complex
protocols.

904
00:46:31,920 --> 00:46:34,080
And I think that's where I'm
coming from.

905
00:46:34,520 --> 00:46:37,320
Talk to the patient about what
is the life that they live every

906
00:46:37,320 --> 00:46:40,160
day because the if food is
medicine and they're taking it

907
00:46:40,160 --> 00:46:43,200
four to five times a day.
Let's look at the quantity of

908
00:46:43,200 --> 00:46:46,040
that first before we throw all
these supplements.

909
00:46:46,880 --> 00:46:49,400
I think just to kind of follow
up actually first I want to

910
00:46:49,400 --> 00:46:53,160
know, have you directly asked
that question of these

911
00:46:53,160 --> 00:46:57,160
clinicians, these providers, why
do they want to know about

912
00:46:57,240 --> 00:47:01,320
implementation?
Who is driving that curiosity

913
00:47:01,320 --> 00:47:03,080
that they have?
Is it the patients and that's

914
00:47:03,080 --> 00:47:06,760
what they want to?
Know 100% it is a consumer the

915
00:47:06,760 --> 00:47:12,960
consumer comes and says I, I
have adrenal fatigue what should

916
00:47:12,960 --> 00:47:17,840
I be taking can I get my full
point cortisol done and I'm like

917
00:47:17,840 --> 00:47:20,160
the full point cortisol you
drink a cup of coffee it's going

918
00:47:20,160 --> 00:47:25,720
to go up I you'd 299 for that I
can tell you what your cortisol

919
00:47:25,720 --> 00:47:31,200
is right So yeah a lot of it is
let me put it this way there's a

920
00:47:31,200 --> 00:47:33,280
lot of marketing in functional
medicine.

921
00:47:33,800 --> 00:47:37,840
The labs are marketing their
labs, the supplement companies

922
00:47:37,840 --> 00:47:41,800
are marketing their supplement.
They have webinars so patients

923
00:47:42,440 --> 00:47:47,320
gather what they listen to, what
they feel resonates for them and

924
00:47:47,320 --> 00:47:50,400
say, Oh my God, if I don't take
the blood pressure medicine that

925
00:47:50,400 --> 00:47:53,800
is causing my diabetes right
now, this supplement might

926
00:47:53,800 --> 00:47:57,120
actually be better.
I have currently a patient who

927
00:47:57,120 --> 00:48:00,000
has hip pain.
She's had this hip pain for like

928
00:48:00,000 --> 00:48:02,960
6 months and every time she
says, oh, it's just intimidated.

929
00:48:02,960 --> 00:48:05,160
Nothing.
I said I need you to get an MRI.

930
00:48:05,560 --> 00:48:08,800
You cannot walk around with a
hip pain, go to physical therapy

931
00:48:09,080 --> 00:48:11,880
and she doesn't want to do an
MRI because of the radiation.

932
00:48:11,880 --> 00:48:15,040
She doesn't want to take any
medication because of the, you

933
00:48:15,040 --> 00:48:19,000
know, because it's a medicine.
It took me so much time to

934
00:48:19,000 --> 00:48:22,400
convince her, like, we need to
make sure nothing pathological

935
00:48:22,400 --> 00:48:25,120
is happening and then we can
work on the inflammation part.

936
00:48:25,560 --> 00:48:30,200
So I think we as clinicians have
to be very careful how we guide

937
00:48:30,200 --> 00:48:31,880
our patients.
But when the patient comes and

938
00:48:31,880 --> 00:48:35,560
pressurizes you and says I want
a bunch of supplements, we seem

939
00:48:35,560 --> 00:48:39,000
to be succumbing to that and
saying OK, let me give a quick

940
00:48:39,000 --> 00:48:41,360
fix.
I love this thought that we're

941
00:48:41,360 --> 00:48:42,920
going down, Darsha.
Sorry, I don't want to jump in

942
00:48:42,920 --> 00:48:44,800
here.
I I'm just kind of wondering as

943
00:48:44,800 --> 00:48:47,000
you're talking about this, who's
responsible for steering this

944
00:48:47,000 --> 00:48:51,360
conversation, right?
Because having that everything

945
00:48:51,360 --> 00:48:53,800
bagel with cream cheese that I
would love so much and taking

946
00:48:53,800 --> 00:48:56,640
some berberine to blood my
glucose response sounds a lot

947
00:48:56,640 --> 00:48:58,240
easier.
And I know it's a lot easier

948
00:48:58,680 --> 00:49:01,000
than not having the bagel when
I'm craving the bagel.

949
00:49:01,800 --> 00:49:06,200
And we're lazy and we want the
easiest path between point A to

950
00:49:06,200 --> 00:49:09,560
point B between my, you know,
current journey and my weight

951
00:49:09,560 --> 00:49:11,120
loss journey.
And that's the path that seems

952
00:49:11,120 --> 00:49:14,920
easiest to me.
So when I go as a consumer who

953
00:49:14,920 --> 00:49:18,680
is not necessarily knowledgeable
about medicine and lifestyle and

954
00:49:18,680 --> 00:49:23,760
sustainable change, I, I propose
the easiest path 'cause I read

955
00:49:23,760 --> 00:49:27,640
it and somebody out out there,
like you said, is advocating for

956
00:49:27,640 --> 00:49:30,640
it on social media.
It sounds to me like you're

957
00:49:30,640 --> 00:49:33,840
arguing that it is that
provider, that practitioner's

958
00:49:33,840 --> 00:49:36,800
duty to help reframe that
person's thinking.

959
00:49:37,800 --> 00:49:40,800
And so then the question
becomes, and I don't remember

960
00:49:40,800 --> 00:49:43,800
exactly the post is, you know,
at that point when that

961
00:49:43,800 --> 00:49:46,400
provider, rather than doing
that, goes to the conferences

962
00:49:46,400 --> 00:49:50,280
and tries to give their consumer
what they want, should it be the

963
00:49:50,280 --> 00:49:53,520
organization?
Is it their duty at that point

964
00:49:53,520 --> 00:49:57,680
as, hey, we are kind of
governing this functional

965
00:49:57,680 --> 00:50:01,520
medicine field and this is how
we should be thinking about it.

966
00:50:01,520 --> 00:50:03,840
So or is that not going to
happen, right.

967
00:50:03,840 --> 00:50:05,840
As a saying goes, nobody's
coming to save you, so you have

968
00:50:05,840 --> 00:50:09,680
to do it yourself.
Yes, I actually, the last few

969
00:50:09,680 --> 00:50:12,400
functional medical conferences
that I did attend, I started

970
00:50:12,400 --> 00:50:15,720
bringing that up in the small
focus groups that we were part

971
00:50:15,720 --> 00:50:17,520
of.
It's like we got to talk about

972
00:50:17,520 --> 00:50:19,320
the diet.
And then when it, when you talk

973
00:50:19,320 --> 00:50:21,960
about diet, everybody wants to
go on a carnivore diet or a keto

974
00:50:21,960 --> 00:50:25,160
diet, which again blows my mind,
right?

975
00:50:25,400 --> 00:50:30,360
And so there's a lot of this,
what the consumer wants, what is

976
00:50:30,360 --> 00:50:34,160
a fad and unfortunately the
organization is trying to get

977
00:50:34,160 --> 00:50:38,160
the evidence to support that
particular sad.

978
00:50:38,200 --> 00:50:42,040
That's what I'm noticing.
And it lost its charm for me.

979
00:50:42,200 --> 00:50:44,640
Let me put it that way.
It really lost its charm for me

980
00:50:44,640 --> 00:50:47,760
where I didn't even like when I
go to the, I am part of the

981
00:50:47,760 --> 00:50:51,160
National Lipid Association
because I'm very interested in

982
00:50:51,280 --> 00:50:54,760
cardio metabolic health.
And when I go there, when I'm

983
00:50:54,760 --> 00:50:58,080
talking to them about, hey, did
we talk about diet?

984
00:50:58,080 --> 00:51:01,240
And they also say that they went
and saw the dietitian and then

985
00:51:01,240 --> 00:51:03,640
they talk about all the
different various cholesterol

986
00:51:03,640 --> 00:51:05,640
lowering medications that are in
the market.

987
00:51:06,280 --> 00:51:08,800
We're all doing the same thing.
That's the problem.

988
00:51:09,760 --> 00:51:14,400
We're just doing it differently.
I feel on a individual level,

989
00:51:14,400 --> 00:51:18,080
the best bets for the patient is
to find a clinician who will

990
00:51:18,080 --> 00:51:20,880
give them, who will actually
call them out on their bullshit.

991
00:51:21,080 --> 00:51:24,080
Like, yeah, you can do all this
and expect to be healthy.

992
00:51:24,320 --> 00:51:27,600
And I will say this, the company
that I work for, I'm very

993
00:51:27,600 --> 00:51:30,760
blessed because patients seek us
out and they're ready for

994
00:51:30,760 --> 00:51:33,480
change.
Some of them will write what she

995
00:51:33,480 --> 00:51:35,240
said.
Was it totally impractical for

996
00:51:35,240 --> 00:51:37,760
me?
And I'm like, well, your leg

997
00:51:37,760 --> 00:51:39,440
pain is also impractical for
you.

998
00:51:39,520 --> 00:51:42,840
Your back pain is impractical.
Your headaches are impractical,

999
00:51:42,840 --> 00:51:46,240
right?
But and then I've seen the same

1000
00:51:46,240 --> 00:51:50,120
patient actually evolve and tell
me six months later, I don't

1001
00:51:50,120 --> 00:51:53,080
know why I was kicking up such a
fuss to do this, right.

1002
00:51:53,800 --> 00:51:58,640
So people do evolve, but you
asked the clinician and I think

1003
00:51:58,680 --> 00:52:02,440
the word provider, I think that
we've all earned our name as

1004
00:52:02,440 --> 00:52:05,360
physicians.
And I will say, me as the

1005
00:52:05,360 --> 00:52:09,800
physician, my job is to be
patient and help the patient see

1006
00:52:09,800 --> 00:52:13,760
that they had a huge
responsibility in their health

1007
00:52:13,880 --> 00:52:16,520
journey.
And I tell them it's your daily

1008
00:52:16,520 --> 00:52:19,720
habits.
Your body never creates disease.

1009
00:52:20,080 --> 00:52:22,720
I've never known a body to just
create a disease.

1010
00:52:23,000 --> 00:52:25,680
It responds to a trigger that it
receives.

1011
00:52:26,600 --> 00:52:29,080
So if you're chronically
stressed, you're putting an

1012
00:52:29,080 --> 00:52:32,160
inflammatory suit, you're not
sleeping, you're scrolling at

1013
00:52:32,320 --> 00:52:36,440
midnight, you have an
interrupted sleep, you're eating

1014
00:52:36,440 --> 00:52:41,040
sugary juice first thing in the
morning, you're metabolically on

1015
00:52:41,040 --> 00:52:43,800
fire, you're not going to feel
well.

1016
00:52:43,800 --> 00:52:48,040
So let's change that.
Then a small dose of supplement,

1017
00:52:48,040 --> 00:52:50,280
the smallest dose of medicine
will actually work.

1018
00:52:50,760 --> 00:52:52,960
So that's how my conversation
goes with that.

1019
00:52:53,920 --> 00:52:57,000
You mentioned brainwashing the
conventional system.

1020
00:52:57,400 --> 00:52:59,720
How much of it?
I know consumers are an issue

1021
00:52:59,720 --> 00:53:01,560
right when they come and they
ask you for the supplementation,

1022
00:53:01,560 --> 00:53:05,000
but how much is it the providers
quote UN quote fault because

1023
00:53:05,000 --> 00:53:07,640
they're brainwashed from a
system and they jump into the

1024
00:53:07,640 --> 00:53:10,920
functional medicine world?
I probably need to understand

1025
00:53:10,920 --> 00:53:12,560
that question better when you
say.

1026
00:53:13,600 --> 00:53:15,840
Brainwashed in terms of thinking
about treatment, thinking about

1027
00:53:15,840 --> 00:53:19,040
protocol and not getting so much
into the coaching right.

1028
00:53:19,040 --> 00:53:21,880
I think the idea is you joined
functional medicine.

1029
00:53:21,880 --> 00:53:25,040
You want to practice this way of
medicine because you were so

1030
00:53:25,040 --> 00:53:26,800
brainwashed by conventional, you
felt like you were doing the

1031
00:53:26,800 --> 00:53:30,000
same thing over.
But it seems like the normal

1032
00:53:30,000 --> 00:53:32,640
trajectory of these fields,
maybe a functional medicine,

1033
00:53:32,640 --> 00:53:35,080
maybe it's naturopathic,
whatever it might be, is moving

1034
00:53:35,080 --> 00:53:38,720
towards a standardization.
So how much is of that is, you

1035
00:53:38,720 --> 00:53:42,240
know, on the provider itself to
say, oh, you know, to to catch

1036
00:53:42,240 --> 00:53:45,080
themselves and realize that
they're taking their brainwashed

1037
00:53:45,080 --> 00:53:48,280
fleece and now putting it into
what provisionally they did not

1038
00:53:48,280 --> 00:53:50,520
want to do.
Yeah, Yeah.

1039
00:53:50,680 --> 00:53:55,880
I will say a lot of that is
that's why it's an individual

1040
00:53:55,960 --> 00:53:59,040
individualized medicine.
It is really based on your

1041
00:53:59,040 --> 00:54:03,560
clinician if they are a part of
a group and like you, if you see

1042
00:54:03,680 --> 00:54:07,080
someone who's doing host a line
protocol, like there are some

1043
00:54:07,080 --> 00:54:10,720
clinicians when I get transfer
of patients, every patient of

1044
00:54:10,720 --> 00:54:14,800
them has a line test done and
every patient help them has had

1045
00:54:14,800 --> 00:54:17,560
mycotoxins and had metals tested
for.

1046
00:54:18,080 --> 00:54:20,800
We're looking for zebras where
we should be looking for horses,

1047
00:54:20,800 --> 00:54:22,560
right?
And so these patients are coming

1048
00:54:22,560 --> 00:54:26,480
in and saying I have this NTHFR
gene, so I don't methylate

1049
00:54:26,480 --> 00:54:28,640
properly.
And I'm like, I am not even sure

1050
00:54:28,640 --> 00:54:32,480
that matters honestly.
But I don't say that loud,

1051
00:54:32,560 --> 00:54:33,960
right?
I mean, I used to say that loud

1052
00:54:33,960 --> 00:54:35,880
before, but now I don't say that
loud.

1053
00:54:35,880 --> 00:54:39,080
And then explain to them, you
know, actually 70% of people

1054
00:54:39,080 --> 00:54:42,000
have it and I have it too, but
there's a way to bypass it.

1055
00:54:42,000 --> 00:54:43,320
And these are the things you
need to do.

1056
00:54:43,880 --> 00:54:49,360
So I think, again, it is for me,
I fell in love with functional

1057
00:54:49,360 --> 00:54:54,160
medicine because it addressed
the connection with the patient.

1058
00:54:54,160 --> 00:54:57,480
It addressed the responsibility
of the patient.

1059
00:54:57,480 --> 00:55:00,040
Like your health is your
responsibility.

1060
00:55:01,000 --> 00:55:05,360
It is not my responsibility.
My job is really to coach you

1061
00:55:05,360 --> 00:55:10,120
back to the health that you can
achieve for the decade of life

1062
00:55:10,120 --> 00:55:12,960
you are in.
I'm not trying to make you 20.

1063
00:55:13,240 --> 00:55:16,800
If you're 30, I'm going to make
you the best 30 you've ever be.

1064
00:55:17,200 --> 00:55:21,880
That's all I can do.
But it's not my job to, you

1065
00:55:21,880 --> 00:55:24,640
know, address every little
problem that you have.

1066
00:55:24,640 --> 00:55:27,280
I always ask my patients, when
they tell me, you know what?

1067
00:55:27,280 --> 00:55:29,280
I I've been having stomach
issues.

1068
00:55:29,280 --> 00:55:30,920
I'll say, why do you think
you're having it?

1069
00:55:30,920 --> 00:55:34,560
What changed?
100% they'll tell you what

1070
00:55:34,560 --> 00:55:36,360
changed.
Yeah.

1071
00:55:36,520 --> 00:55:38,720
Before it was like, you know,
they just come and complain when

1072
00:55:38,720 --> 00:55:40,400
you say, what's your chief
complaint today?

1073
00:55:40,600 --> 00:55:42,800
I have diarrhea.
I have Constipation or irritable

1074
00:55:42,800 --> 00:55:44,960
Bilbil, Here's your Bentil.
You're done.

1075
00:55:45,280 --> 00:55:47,320
But if you ask them why do you
think it's happening, they'll

1076
00:55:47,320 --> 00:55:50,240
tell you.
And after that you could have

1077
00:55:50,240 --> 00:55:51,840
that conversation.
That's how I have.

1078
00:55:51,840 --> 00:55:54,400
That's why we have to be take
time with our patients.

1079
00:55:54,840 --> 00:55:57,560
And I don't know if that's
happening now.

1080
00:55:57,560 --> 00:56:00,280
And I haven't gone to functional
medical conferences in about 3

1081
00:56:00,280 --> 00:56:03,840
or 4 years now.
Yeah, I probably need to go back

1082
00:56:03,840 --> 00:56:05,480
to see if they've changed
something.

1083
00:56:05,840 --> 00:56:09,440
But so far the feedback has been
It was fun to meet other people,

1084
00:56:09,440 --> 00:56:11,840
but I've never hear much about
the conference itself.

1085
00:56:12,720 --> 00:56:16,080
Yeah, that's unfortunate.
Yeah, I can see here the last

1086
00:56:16,080 --> 00:56:18,640
hour, I get hints of how you
practice, right, and the way you

1087
00:56:18,640 --> 00:56:22,960
coach and the way you talk.
When patients come with a mind

1088
00:56:22,960 --> 00:56:25,440
set up, they already knowing
what type of protocol they need,

1089
00:56:25,440 --> 00:56:27,120
right?
They're using AI at this point

1090
00:56:27,120 --> 00:56:31,480
to kind of figure it out.
How do you distinguish yourself

1091
00:56:31,560 --> 00:56:33,480
as a functional medicine
provider then?

1092
00:56:33,480 --> 00:56:36,280
How do you keep getting clients?
How do you stay in business when

1093
00:56:37,160 --> 00:56:39,320
you know you obviously are
coaching in a different way?

1094
00:56:40,360 --> 00:56:44,440
OK, I wouldn't mention the lab,
but there's a big direct to

1095
00:56:44,440 --> 00:56:46,360
consumer lab for functional
medicine.

1096
00:56:46,960 --> 00:56:49,360
People go get their functional
medical labs done.

1097
00:56:49,400 --> 00:56:52,920
They get AI Reg results.
They panic and come to us.

1098
00:56:53,640 --> 00:56:55,960
They'll say I think I'm going to
have a heart attack.

1099
00:56:55,960 --> 00:56:57,520
My nearest positive.
What do I do?

1100
00:56:57,760 --> 00:57:01,800
Your is 1 is to 20.
You're not having any problems.

1101
00:57:01,800 --> 00:57:03,840
Trust me.
You're not dying of autoimmune.

1102
00:57:04,680 --> 00:57:08,240
They need us so we do.
I will say I love my patients

1103
00:57:08,240 --> 00:57:11,120
who in fact I worked with.
I don't know if you don't need

1104
00:57:11,120 --> 00:57:14,160
shop from Carrier.
He he's a start up.

1105
00:57:14,160 --> 00:57:17,840
He's on LinkedIn.
He he I worked with his team and

1106
00:57:17,840 --> 00:57:20,960
we created an app called
Evidentia, which is only for

1107
00:57:20,960 --> 00:57:24,520
functional medicine, which will
I tell give it to my patients.

1108
00:57:24,520 --> 00:57:27,040
I tell them if you want to run
all of your supplements there,

1109
00:57:27,040 --> 00:57:30,320
you can run it because I want my
patients to be well educated

1110
00:57:31,160 --> 00:57:33,880
when they come to me.
I know I'm going to know better

1111
00:57:33,880 --> 00:57:36,800
than AII know for a fact I'll
know better than AI.

1112
00:57:37,240 --> 00:57:41,080
That's number one #2 when they
do, like I recently had a

1113
00:57:41,080 --> 00:57:44,400
patient who had SIBO and she
sent me a lot of pub Med

1114
00:57:44,400 --> 00:57:46,160
articles.
She wanted most supplements than

1115
00:57:46,160 --> 00:57:48,840
what I had given her.
I said, listen, I've practiced

1116
00:57:48,840 --> 00:57:51,760
this for so many years.
Yes, those studies exist, but

1117
00:57:51,760 --> 00:57:54,600
all of my patients complain.
But if you wish to try, go ahead

1118
00:57:54,600 --> 00:57:57,000
and try it.
That's the thing about function

1119
00:57:57,000 --> 00:57:58,320
medicine.
It's not like conventional

1120
00:57:58,320 --> 00:58:01,080
medicine where you're dogmatic
and you just tell them, OK, no,

1121
00:58:01,080 --> 00:58:03,080
this is my protocol and you'll
just follow it.

1122
00:58:03,320 --> 00:58:05,960
I let my patients experiment and
they'll come back and say, Oh

1123
00:58:05,960 --> 00:58:09,120
no, that didn't work for me.
And I'm like, I've done this

1124
00:58:09,120 --> 00:58:12,520
before, so just take what I will
tell and I'll tell I'll give

1125
00:58:12,520 --> 00:58:15,240
them a China and I'll say in two
weeks, if you're not better,

1126
00:58:15,640 --> 00:58:18,400
we'll make an iteration to your
plan.

1127
00:58:19,040 --> 00:58:21,120
So this is not like a perfect
science.

1128
00:58:21,120 --> 00:58:23,600
It's really trying to get the
patient to be better.

1129
00:58:23,600 --> 00:58:26,680
But the patient has to do their
job too.

1130
00:58:27,080 --> 00:58:30,360
They have to shift how they
sleep, what is their stress?

1131
00:58:30,400 --> 00:58:32,000
What do they eat on a daily
basis?

1132
00:58:32,000 --> 00:58:35,760
How you know how they if you're
in a toxic job?

1133
00:58:35,760 --> 00:58:38,520
How many times I've made
patients quit their jobs because

1134
00:58:38,520 --> 00:58:40,760
like you said, root cost.
What is root cost?

1135
00:58:40,760 --> 00:58:43,880
Root cost is your job.
I can't tell you the number of

1136
00:58:43,880 --> 00:58:47,080
people who quit their job.
They stop drinking because

1137
00:58:47,080 --> 00:58:50,760
they're not going out for the
evenings, gatherings with their

1138
00:58:50,920 --> 00:58:53,280
tea.
Yeah, the happy hour.

1139
00:58:53,520 --> 00:58:56,280
They have time to run, They have
time to cook.

1140
00:58:56,280 --> 00:58:59,680
They took a pay cut, went to a
different jobs and like none of

1141
00:58:59,680 --> 00:59:02,760
their symptoms exist.
That is the root cause.

1142
00:59:02,760 --> 00:59:05,960
Sometimes it's hiding in plain
sight, but that's the

1143
00:59:05,960 --> 00:59:08,720
conversation we need to have
with our patients, otherwise

1144
00:59:08,720 --> 00:59:12,080
they're clueless.
I love this.

1145
00:59:12,560 --> 00:59:14,840
Go ahead, Darsh.
So, yeah, quick question there.

1146
00:59:14,840 --> 00:59:16,960
Quick follow up, how do you
convince people that their

1147
00:59:16,960 --> 00:59:20,680
health is more important than
their job or whatever it is at

1148
00:59:20,680 --> 00:59:23,880
that point?
Because I mean, it's we all hear

1149
00:59:23,880 --> 00:59:25,480
it, right?
Without without your health, you

1150
00:59:25,480 --> 00:59:27,600
don't have anything.
I think it all hits for maybe

1151
00:59:28,000 --> 00:59:30,520
all 5 to 10 minutes, but then
you get back to chasing the

1152
00:59:30,520 --> 00:59:33,520
money and, you know, having to
impress your boss and going to

1153
00:59:33,520 --> 00:59:36,200
that happy hour.
So how do you convince people?

1154
00:59:37,240 --> 00:59:39,560
I asked them the question.
I'll tell them, what do you

1155
00:59:39,560 --> 00:59:43,440
think needs to change?
And most people are so smart.

1156
00:59:43,640 --> 00:59:46,880
We're not dummies.
They'll tell me, I know I need

1157
00:59:46,880 --> 00:59:49,320
to get a new job.
So I said, till you get a new

1158
00:59:49,320 --> 00:59:52,440
job, how can you change what
you're experiencing?

1159
00:59:53,400 --> 00:59:58,480
And we have to make our patients
think, I don't know if you've

1160
00:59:58,480 --> 01:00:01,080
experienced this for me, you
know, in conventional medicine.

1161
01:00:01,440 --> 01:00:04,760
I should think there's no other
way to practice medicine, right?

1162
01:00:04,760 --> 01:00:07,080
Everybody needs to be on
metformin and aspirin and a

1163
01:00:07,080 --> 01:00:09,880
statin and all of that.
I never asked the question why,

1164
01:00:09,880 --> 01:00:11,840
he said.
Studies have shown, And I'm

1165
01:00:11,840 --> 01:00:14,600
like, oh, studies have shown.
I was just vomiting everything

1166
01:00:14,600 --> 01:00:17,480
that I was told in conferences.
That's what we did.

1167
01:00:18,480 --> 01:00:22,040
But when someone opened my mind
to functional medicine, asked

1168
01:00:22,040 --> 01:00:24,480
the question why?
And it's suddenly like a whole

1169
01:00:24,480 --> 01:00:28,400
channel in my brain opened and I
realized why I hated medicine

1170
01:00:28,400 --> 01:00:31,320
all this while because I was not
successful in making anybody

1171
01:00:31,320 --> 01:00:34,360
better.
Now I know I have to ask the

1172
01:00:34,360 --> 01:00:36,600
right question.
Similarly, with our patients, we

1173
01:00:36,600 --> 01:00:38,480
need to learn to ask the right
question.

1174
01:00:38,960 --> 01:00:41,640
They've never thought about
their job.

1175
01:00:41,640 --> 01:00:44,240
They've always thought, like,
I'm stuck with this job.

1176
01:00:44,800 --> 01:00:48,000
They don't realize that there's
a toxicity to it, that their

1177
01:00:48,000 --> 01:00:53,280
daily habits are driving this.
And when you help them see that,

1178
01:00:53,920 --> 01:00:57,640
they completely transform.
But I will say this, first of

1179
01:00:57,640 --> 01:01:00,800
all, when patients come to
functional medicine, they know

1180
01:01:00,800 --> 01:01:02,120
that they have to make some
changes.

1181
01:01:02,120 --> 01:01:04,520
If they're not ready to make
some changes, they will not

1182
01:01:04,520 --> 01:01:06,160
join.
I've never seen anybody.

1183
01:01:06,160 --> 01:01:09,160
I mean, if I have to convince
someone they need to take care

1184
01:01:09,160 --> 01:01:12,240
of their health, I don't think
that's the right way to approach

1185
01:01:12,240 --> 01:01:14,560
it.
They know that their health is

1186
01:01:14,560 --> 01:01:19,840
important.
And #2 you shouldn't have to

1187
01:01:19,840 --> 01:01:22,840
sell health to them.
You, you have to.

1188
01:01:23,560 --> 01:01:25,560
We always ask them, what's your
goal?

1189
01:01:25,560 --> 01:01:27,360
Why did you join functional
medicine?

1190
01:01:27,360 --> 01:01:28,880
Oh, I want to get to the root
cause.

1191
01:01:28,880 --> 01:01:30,920
And I want a holistic approach.
Now.

1192
01:01:30,920 --> 01:01:33,080
I'll tell them, no, functional
medicine is not holistic.

1193
01:01:33,080 --> 01:01:35,720
I hope you know that.
And everybody's shocked.

1194
01:01:35,760 --> 01:01:37,200
It's like, what do you mean by
it's not holistic?

1195
01:01:37,200 --> 01:01:38,720
I said it's just a different way
of thinking.

1196
01:01:39,680 --> 01:01:43,640
At the end of the year, my job
is to make you your best doctor

1197
01:01:44,320 --> 01:01:46,440
because you're the only one
who's with you.

1198
01:01:46,480 --> 01:01:50,640
You know all the shenanigans you
do, so you know how to catch

1199
01:01:50,640 --> 01:01:52,680
yourself.
My job is to help you understand

1200
01:01:52,680 --> 01:01:58,400
what your body responds to.
So I'm very clear about the role

1201
01:01:58,400 --> 01:02:02,080
of the patient in their own
healthcare, and I don't think we

1202
01:02:02,080 --> 01:02:05,320
should ever miss that.
At the same time, you cannot,

1203
01:02:05,360 --> 01:02:10,200
like, you know, you mentioned
their will where you cannot wait

1204
01:02:10,200 --> 01:02:12,440
for eight weeks.
You can say, OK, go do these

1205
01:02:12,440 --> 01:02:13,840
tests.
We'll wait for these tests.

1206
01:02:13,840 --> 01:02:15,560
I give them.
I'll tell them, hey, listening

1207
01:02:15,560 --> 01:02:17,680
to your story, these are the
changes.

1208
01:02:17,680 --> 01:02:19,680
I would like you to work with
your health coaches.

1209
01:02:19,680 --> 01:02:21,400
But these are the things you can
do on your own.

1210
01:02:21,720 --> 01:02:24,680
Like if it might be a sauna, I
might tell them, you know, can

1211
01:02:24,680 --> 01:02:28,440
you go to a sauna, go to go from
massage to give them the time

1212
01:02:28,440 --> 01:02:31,840
away from that stress.
And also hire a babysitter for

1213
01:02:31,840 --> 01:02:35,680
four hours on a Sunday and go
out for a coffee or a walk.

1214
01:02:35,920 --> 01:02:39,080
These are the simple stuff that
I tell them to do.

1215
01:02:39,080 --> 01:02:43,320
And they are able to hear their
own voices and realize what they

1216
01:02:43,320 --> 01:02:46,120
need to change.
And sometimes it's just giving

1217
01:02:46,120 --> 01:02:48,560
them the space and the
permission to do that.

1218
01:02:49,520 --> 01:02:51,720
I'd love that.
And I know we've touched on

1219
01:02:51,720 --> 01:02:55,320
tests a little bit here and
there and that seems to be

1220
01:02:55,320 --> 01:02:57,360
another big one, right?
So you used a couple of really

1221
01:02:57,960 --> 01:03:01,040
keywords which you talked about
at conferences.

1222
01:03:01,040 --> 01:03:03,920
They're saying that there is
evidence and it's evidence based

1223
01:03:03,920 --> 01:03:06,240
medicine.
That's a phrase, anecdotal.

1224
01:03:06,240 --> 01:03:11,160
We talked about that too.
I think some of the people who

1225
01:03:11,160 --> 01:03:14,480
are gonna be opposing the
functional medicine philosophy

1226
01:03:14,480 --> 01:03:17,480
or I would argue, probably don't
understand it super well.

1227
01:03:18,160 --> 01:03:18,640
That's.
Correct.

1228
01:03:18,640 --> 01:03:21,400
At least not as as eloquently as
you've described it.

1229
01:03:22,160 --> 01:03:27,200
But others will say, well, you
know, that extensive panel, that

1230
01:03:27,200 --> 01:03:29,560
comprehensive panel that you
highlighted, you know, a little

1231
01:03:29,560 --> 01:03:33,880
while back, there isn't enough
data to support us getting that

1232
01:03:34,840 --> 01:03:37,720
aside from these principles that
have packed them about.

1233
01:03:38,000 --> 01:03:42,720
I'm also very interested in cost
conscious medicine, right?

1234
01:03:42,720 --> 01:03:45,640
I again, you're an immigrant.
I'm an immigrant.

1235
01:03:45,640 --> 01:03:48,520
We, you know, come from at least
I personally come from like

1236
01:03:48,600 --> 01:03:50,040
probably lower medical class
growing up.

1237
01:03:50,040 --> 01:03:52,280
And so I'm very cost conscious
and the patient population I

1238
01:03:52,280 --> 01:03:55,760
have, they can't afford a lot of
these additional testing and

1239
01:03:55,800 --> 01:03:58,520
things that the company pays
for, the insurance company

1240
01:03:58,520 --> 01:04:02,120
doesn't pay for.
So I guess how do you reconcile

1241
01:04:02,120 --> 01:04:04,960
those things, right.
So I think I have a famous

1242
01:04:05,040 --> 01:04:06,840
physician, I think it's Doctor
Spencer and Dolski and his

1243
01:04:06,840 --> 01:04:08,800
brother Carl and Dolski.
I'm a big fan of them.

1244
01:04:09,040 --> 01:04:11,880
At some point, I didn't used to
be because they would say

1245
01:04:12,280 --> 01:04:14,840
functional medicine docs are
quacks and that would really rub

1246
01:04:14,840 --> 01:04:18,880
me the wrong way that word
because in my experience there,

1247
01:04:19,280 --> 01:04:23,360
I've had conversations with
multiple docs on here off here

1248
01:04:23,360 --> 01:04:26,320
and that like that word is just
seems to have very.

1249
01:04:27,560 --> 01:04:29,760
It's harsh.
It is harsh, It is harsh, right,

1250
01:04:29,760 --> 01:04:32,440
'cause it's an immediate way to
disgrace somebody and discredit

1251
01:04:32,440 --> 01:04:35,680
somebody.
But I think part of the reason,

1252
01:04:35,720 --> 01:04:37,440
when I look at it from their
perspective, they're probably

1253
01:04:37,440 --> 01:04:38,680
coming back.
As you know, they would say, oh,

1254
01:04:38,680 --> 01:04:41,520
look, alternative medicine,
Ayurvedic medicine or

1255
01:04:41,520 --> 01:04:44,200
integrative medicine.
If this actually had evidence,

1256
01:04:44,240 --> 01:04:46,840
it would just be medicine.
And I put that in quotes 'cause

1257
01:04:46,840 --> 01:04:49,480
that's what they would say.
And I can see what they're

1258
01:04:49,480 --> 01:04:51,200
trying to say.
Cause Darsh and I have talked

1259
01:04:51,200 --> 01:04:53,600
about this.
I don't like, I don't know how I

1260
01:04:53,600 --> 01:04:57,040
feel about functional medicine,
acupuncture, this type of

1261
01:04:57,040 --> 01:04:58,480
medicine.
I just think that there's good

1262
01:04:58,480 --> 01:04:59,680
medicine and there's bad
medicine.

1263
01:05:00,120 --> 01:05:03,360
What you described to me, your
experience, the first, you know,

1264
01:05:03,360 --> 01:05:06,160
nine years or eight years that
you were practicing, what you

1265
01:05:06,160 --> 01:05:10,000
had to do was a way of practice
that didn't align with your

1266
01:05:10,000 --> 01:05:11,360
values.
And that was like, you know,

1267
01:05:11,360 --> 01:05:13,520
this is not good medicine.
And I'm going to step outside.

1268
01:05:13,800 --> 01:05:17,480
Is that fair to say?
Yeah, for sure is as far as the

1269
01:05:17,480 --> 01:05:23,160
comprehensive panel that we do,
I will say this, it's expensive.

1270
01:05:23,160 --> 01:05:27,640
When you go with insurance, if
you pay cash, it's anywhere from

1271
01:05:27,640 --> 01:05:32,480
200 to $400.00 and we can you
know kind of customize it to

1272
01:05:32,640 --> 01:05:36,360
meet the patients need.
You know how much your GLP one

1273
01:05:36,360 --> 01:05:39,280
agonist cost today, none of the
insurances cover it.

1274
01:05:39,960 --> 01:05:46,120
It's 375 to 500 a month.
Does any doctor hesitate to

1275
01:05:46,120 --> 01:05:48,920
write that prescription?
Does any patient hesitate to pay

1276
01:05:48,920 --> 01:05:50,000
for it?
Why?

1277
01:05:50,000 --> 01:05:51,880
Because they there is value in
it.

1278
01:05:52,160 --> 01:05:56,600
There's a lot of value for the
patient in this comprehensive

1279
01:05:56,600 --> 01:05:58,320
panel.
Do you think that when I see a

1280
01:05:58,320 --> 01:06:00,920
patient, I can't find out that
they have insulin resistance?

1281
01:06:00,920 --> 01:06:04,120
They have skin tags, they have
the darkening of their skin.

1282
01:06:04,200 --> 01:06:06,840
They're morbidly, I know that
they have insulin resistance,

1283
01:06:06,840 --> 01:06:11,040
but when I show them their
fasting insulin is 25, I've

1284
01:06:11,080 --> 01:06:13,160
connected them with their own
health.

1285
01:06:13,720 --> 01:06:18,000
That is invaluable.
You can, when will we stop this

1286
01:06:18,000 --> 01:06:21,040
dogmatic medicine where it says,
OK, I'm only going to do the

1287
01:06:21,040 --> 01:06:25,920
test that I think I need to know
to make a diagnosis for you.

1288
01:06:26,200 --> 01:06:28,320
I need you involved in your
care.

1289
01:06:28,800 --> 01:06:31,840
So if I can show you have
insulin resistance, I can show

1290
01:06:31,840 --> 01:06:34,520
you have Hashimotors and
Hashimotors is connected to your

1291
01:06:34,520 --> 01:06:38,240
gut help.
And therefore we need to address

1292
01:06:38,240 --> 01:06:40,480
your gut help, which means we we
need to address what you're

1293
01:06:40,480 --> 01:06:43,680
eating.
It's really explaining to the

1294
01:06:43,680 --> 01:06:48,800
patient what that lab test mean.
A lot of times, what do doctors

1295
01:06:48,800 --> 01:06:49,880
say?
Your cholesterol is good.

1296
01:06:50,840 --> 01:06:53,680
That's it.
I'm talking to them about the

1297
01:06:53,680 --> 01:06:56,080
LP, literally I'm talking to
them about what the

1298
01:06:56,080 --> 01:06:59,080
Apolipoprotein be.
It's the bus that carries all

1299
01:06:59,080 --> 01:07:01,600
the cholesterol that's going to
lay the plaques in your

1300
01:07:01,600 --> 01:07:05,600
arteries.
They have this visual and they

1301
01:07:05,600 --> 01:07:09,360
will now my facial say my April
B went down even before they see

1302
01:07:09,360 --> 01:07:10,320
me.
They'll send me an e-mail.

1303
01:07:10,320 --> 01:07:13,480
I'm so glad my April B went up
because now it's connected them

1304
01:07:13,480 --> 01:07:17,680
to their labs.
So people who say that we're

1305
01:07:17,680 --> 01:07:20,880
over testing do not know what
they're talking about.

1306
01:07:21,440 --> 01:07:25,880
I always tell before you
criticize me, walk with me,

1307
01:07:26,080 --> 01:07:28,880
shadow me one day and tell me
what I'm doing.

1308
01:07:28,880 --> 01:07:32,360
It's not real medicine.
I really like that, you know,

1309
01:07:32,360 --> 01:07:35,040
it's, it's obviously different
than conventional medicine where

1310
01:07:35,040 --> 01:07:37,800
we're taught don't order
something unless it's going to

1311
01:07:37,800 --> 01:07:40,440
change management.
And I honestly did not.

1312
01:07:40,440 --> 01:07:41,800
You don't learn that in
residency training.

1313
01:07:41,800 --> 01:07:43,760
But now that I'm a year out as
an attending, it's definitely

1314
01:07:43,760 --> 01:07:45,440
ingrained in my head, right?
Because you don't want to get

1315
01:07:45,600 --> 01:07:47,880
caught in something in the
legality and then you own it.

1316
01:07:48,200 --> 01:07:50,040
But I think there is nuance to
it, right?

1317
01:07:50,040 --> 01:07:52,480
Just like you said, if you need
to show a lab value to change

1318
01:07:52,480 --> 01:07:55,800
behavior, maybe it is worth it
to get that test, even though it

1319
01:07:55,800 --> 01:07:59,000
won't change anything but change
the perceptions of that patient.

1320
01:07:59,320 --> 01:08:02,600
So I really do like that.
Maybe a little bit of a hot

1321
01:08:02,600 --> 01:08:04,600
topic to put you in the hot seat
here.

1322
01:08:04,920 --> 01:08:10,040
Aside from commercial medicine
being very good at urgent and

1323
01:08:10,080 --> 01:08:12,640
emergent life threatening
conditions and treating patients

1324
01:08:12,640 --> 01:08:15,680
for that, is there anything that
commercial medicine does better

1325
01:08:15,720 --> 01:08:18,880
than functional medicine?
I will see.

1326
01:08:19,880 --> 01:08:23,279
I'm really trying.
I mean, so for instance, so

1327
01:08:23,279 --> 01:08:28,240
surgically, like, you know, when
you take away somebody's pain,

1328
01:08:28,240 --> 01:08:31,240
that's amazing when you take
away cancer and stuff like that.

1329
01:08:31,240 --> 01:08:34,359
I really think in natural
medicine does a lot of things

1330
01:08:34,399 --> 01:08:36,560
but good, but does it do it
better?

1331
01:08:37,240 --> 01:08:40,680
I think it's very organized.
So, you know, in functional

1332
01:08:40,680 --> 01:08:42,760
medicine and like I said, it's
more arts.

1333
01:08:43,720 --> 01:08:45,680
Everybody is doing their own
thing.

1334
01:08:46,359 --> 01:08:48,920
And even in a, you know, in a
group that I'm practicing, we

1335
01:08:48,920 --> 01:08:51,960
all have our own favorite
supplements.

1336
01:08:51,960 --> 01:08:55,720
We give up patients and so I can
see when my patient goes to see

1337
01:08:55,880 --> 01:08:58,640
another another doctor because
I'm not available that

1338
01:08:58,640 --> 01:09:00,560
particular day, they come back
with a like a list of

1339
01:09:00,560 --> 01:09:03,359
supplements.
I'm like I don't want to use any

1340
01:09:03,359 --> 01:09:05,200
of these but I don't say
anything.

1341
01:09:05,399 --> 01:09:06,880
Example there.
Let me just jump in there not

1342
01:09:06,880 --> 01:09:08,640
not to throw anybody our
colleagues in the.

1343
01:09:08,800 --> 01:09:11,399
Phone an example of like.
For a specific indication, you

1344
01:09:11,399 --> 01:09:13,160
might like something where
somebody else doesn't.

1345
01:09:13,680 --> 01:09:15,359
Yeah.
So for instance, for gut

1346
01:09:15,359 --> 01:09:19,479
healing, there are there's a
which have L Glutamine in them

1347
01:09:19,600 --> 01:09:23,880
that actually feel the gut.
And I like a specific brand

1348
01:09:23,880 --> 01:09:26,560
because I like the herbs and the
enzymes that are present in

1349
01:09:26,560 --> 01:09:29,520
that.
Depending on where you're in

1350
01:09:29,520 --> 01:09:32,840
your functional medical
training, I find that's some

1351
01:09:32,840 --> 01:09:36,680
folks will use different
supplements which have the same

1352
01:09:36,680 --> 01:09:39,760
L Glutamine but different kind
of herbs in it.

1353
01:09:40,080 --> 01:09:43,240
And I just find I've not had
success with it in the past.

1354
01:09:43,680 --> 01:09:46,279
So now I at the same time, I
don't want to tell the patient

1355
01:09:46,279 --> 01:09:47,760
no.
And like, you know, I don't like

1356
01:09:47,760 --> 01:09:49,640
to.
I just asked him, do you feel

1357
01:09:49,640 --> 01:09:52,279
like it's working for you?
They say, I really don't know.

1358
01:09:52,279 --> 01:09:54,320
It's made a difference.
I'd say once you're done with

1359
01:09:54,320 --> 01:09:55,880
that, I'm going to give you
something different.

1360
01:09:55,880 --> 01:09:57,560
Let's see that makes a
difference for you.

1361
01:09:57,800 --> 01:10:02,480
So I actually switch it over.
So I have to, I will say you

1362
01:10:02,480 --> 01:10:05,480
this, it's not very organized
functional medicine.

1363
01:10:05,480 --> 01:10:07,520
It's not organized.
But then again, you don't want

1364
01:10:07,520 --> 01:10:09,360
it organized, right?
You don't want it to be that

1365
01:10:09,560 --> 01:10:12,760
protocol based structure like
everybody comes, hey, this is

1366
01:10:12,760 --> 01:10:14,200
the box we're all going to fit
you in.

1367
01:10:14,440 --> 01:10:16,000
That's why I like functional
medicine.

1368
01:10:16,000 --> 01:10:19,080
You could do whatever you want,
but the ultimate goal is to get

1369
01:10:19,080 --> 01:10:22,480
the patient better.
You have to, as far as possible,

1370
01:10:22,480 --> 01:10:26,000
resolve the problem they cage.
Nisha, you know, what protocols

1371
01:10:26,000 --> 01:10:30,240
are really good for is to
eliminate deep level thinking

1372
01:10:30,240 --> 01:10:32,840
that you're describing.
So you know, we've been talking

1373
01:10:32,840 --> 01:10:34,360
for a little over an hour at
this point.

1374
01:10:34,360 --> 01:10:37,800
And what I think probably the
listener can gather is your

1375
01:10:37,800 --> 01:10:41,480
approach is, you know,
comprehensive would be one word

1376
01:10:41,920 --> 01:10:43,560
deep reasoning.
If I can describe you, you're

1377
01:10:43,560 --> 01:10:47,320
like an O3 from chat JPT, right,
O3 pro at this point, right?

1378
01:10:47,560 --> 01:10:51,920
I mean, that is a compliment.
If I am, if I'm not pursuing

1379
01:10:51,920 --> 01:10:54,600
medical training and I'm not
pursuing extensive residency

1380
01:10:54,600 --> 01:10:57,880
training and I'm going getting a
two years master's or whatever

1381
01:10:57,880 --> 01:11:00,760
level training is in other
profession, some of the allied

1382
01:11:00,760 --> 01:11:03,320
professions and I still want to
practice functional medicine

1383
01:11:03,320 --> 01:11:05,200
'cause that's you highlighted
anything you can get and get a

1384
01:11:05,200 --> 01:11:08,040
certificate.
I will not have the wisdom.

1385
01:11:08,360 --> 01:11:11,480
I'll use that word to be able to
tease that out like you

1386
01:11:11,480 --> 01:11:14,520
describe.
And therefore our protocol is

1387
01:11:14,520 --> 01:11:17,440
really good 'cause you know, so
like from.

1388
01:11:17,440 --> 01:11:18,960
So when I look at is it the A FM
A?

1389
01:11:19,200 --> 01:11:22,880
FM A FM C Yeah.
So if I look at AFMC, I'm like,

1390
01:11:22,880 --> 01:11:27,720
OK, well we have a lot of non
physician practitioners, we'll

1391
01:11:27,720 --> 01:11:30,840
need these Cheat Sheets, so to
speak for protocols.

1392
01:11:31,440 --> 01:11:34,800
So I don't know if this is, you
know, exempting them in any

1393
01:11:34,800 --> 01:11:38,680
regard, but that just clicked
for me and and I'm wondering how

1394
01:11:38,680 --> 01:11:41,280
much that has to do with it.
Yeah, I think you should have a

1395
01:11:41,280 --> 01:11:44,760
framework like you know how you
would approach if you have

1396
01:11:44,760 --> 01:11:46,920
somebody with Hashimoto's, how
do you approach it?

1397
01:11:47,320 --> 01:11:52,320
And there is a framework, but
how I'm going to be using the

1398
01:11:52,320 --> 01:11:55,200
supplements when that framework
is going to be dependent on the

1399
01:11:55,200 --> 01:11:58,120
patient's history, the patient's
blood test.

1400
01:11:58,120 --> 01:12:01,120
So I change a lot of those
things and the patient's

1401
01:12:01,120 --> 01:12:03,280
willingness to take supplements.
I have some patients who come

1402
01:12:03,280 --> 01:12:05,000
and say I don't want any
supplements.

1403
01:12:05,120 --> 01:12:07,840
I will not take any supplements.
They will take.

1404
01:12:07,840 --> 01:12:11,560
They will be on Ajaral, they'll
be on Xanax, they'll be on

1405
01:12:11,560 --> 01:12:14,440
Ativan, they'll be on Vyvanse,
but they will not take a

1406
01:12:14,440 --> 01:12:16,840
supplement, right?
You get those kind of patients

1407
01:12:16,840 --> 01:12:19,280
too.
So I'm just letting you know you

1408
01:12:19,280 --> 01:12:22,520
have both ways.
So for me, I feel like my

1409
01:12:22,560 --> 01:12:26,840
experience, knowing the patient,
where they're coming from helps

1410
01:12:26,840 --> 01:12:29,840
me choose the right kind of
supplements.

1411
01:12:29,840 --> 01:12:31,760
And then there are other
patients who'll come to me as

1412
01:12:31,760 --> 01:12:34,760
like give me as many supplements
as possible because I really

1413
01:12:34,760 --> 01:12:37,120
want to feel good.
I've and they take their own

1414
01:12:37,120 --> 01:12:39,240
longevity supplements.
They go to these longevity

1415
01:12:39,240 --> 01:12:42,360
talks.
Everybody feels like they know

1416
01:12:42,360 --> 01:12:43,640
what they should do for their
health.

1417
01:12:44,520 --> 01:12:50,000
The blood test is the only one
that sets sets apart how we

1418
01:12:50,000 --> 01:12:51,800
approach it.
Like when they come in, they

1419
01:12:51,800 --> 01:12:54,720
said, I went to this conference
and I got these 10 supplements.

1420
01:12:54,720 --> 01:12:56,880
And when I'm doing that blood
work and I'm telling them, you

1421
01:12:56,880 --> 01:13:00,480
know what, your vitamin B12 is
2500.

1422
01:13:00,480 --> 01:13:03,360
I don't think you need to be
taking Homocysteine Supreme B

1423
01:13:03,360 --> 01:13:05,800
complex.
And Sammy, we're going to cut

1424
01:13:05,800 --> 01:13:07,800
these things down.
This is where I come in.

1425
01:13:08,240 --> 01:13:12,320
And so in many ways, yeah, I
agree with you.

1426
01:13:12,480 --> 01:13:15,360
Maybe the framework is there,
but I don't think we should be

1427
01:13:15,360 --> 01:13:19,120
practicing protocol based
medicine at all when it comes to

1428
01:13:19,120 --> 01:13:26,560
an individualized approach.
Is it possible to extract these

1429
01:13:26,560 --> 01:13:31,480
principles from functional
medicine and practice them in

1430
01:13:31,480 --> 01:13:35,920
the conventional model with
taking insurance, taking pairs?

1431
01:13:37,160 --> 01:13:39,640
How would you?
How would you guide your younger

1432
01:13:39,640 --> 01:13:43,000
self or a doctor to do that?
Parsley does that right now.

1433
01:13:43,120 --> 01:13:48,200
So I work for Parsley Health in
New York and in California we

1434
01:13:48,200 --> 01:13:51,320
take Blue Cross Blue Shield,
Aetna and United Health.

1435
01:13:51,800 --> 01:13:54,280
We pre negotiated with the
insurance.

1436
01:13:54,640 --> 01:13:58,400
So Robin, who is the CEO, you
did a very smart thing.

1437
01:13:58,400 --> 01:14:02,440
She created what is called the
medical symptom questionnaire or

1438
01:14:02,440 --> 01:14:04,560
we call it the Parsley Symptom
Index.

1439
01:14:04,640 --> 01:14:06,640
And I think it's available for
people to buy it.

1440
01:14:06,640 --> 01:14:09,880
They can actually use it in
their clinic, but you patients

1441
01:14:09,880 --> 01:14:12,520
fill these forms, they give us
their symptoms.

1442
01:14:13,320 --> 01:14:17,960
About 85% of our patients when
they come with an MSQ of say out

1443
01:14:17,960 --> 01:14:22,680
of 200, they come at 189.
By the time it's the 9th month

1444
01:14:22,680 --> 01:14:26,760
with us, they are at 20.
Most of their issues have

1445
01:14:26,760 --> 01:14:29,880
resolved.
She took that data, negotiated

1446
01:14:29,880 --> 01:14:35,200
with the insurance and created
like a reimbursement for one

1447
01:14:35,200 --> 01:14:38,360
hour of new visit.
So we actually see our patients

1448
01:14:38,360 --> 01:14:42,280
for an hour, we see them in the
second visit also for an hour

1449
01:14:42,680 --> 01:14:46,280
and the remaining visits are 30
minutes and we get reimbursed

1450
01:14:46,280 --> 01:14:51,360
for that because you have to
show value added because most of

1451
01:14:51,360 --> 01:14:54,600
our patients seem to be
subjective data definitely

1452
01:14:54,600 --> 01:14:58,000
improves objective findings also
improve a lot of people, their

1453
01:14:58,000 --> 01:15:01,840
A1C reverses, their insulin is
back to normal, their

1454
01:15:01,840 --> 01:15:05,400
inflammation markers are gone.
They're getting off of what do

1455
01:15:05,400 --> 01:15:10,040
you call the immunomodulators
getting down on their blood

1456
01:15:10,040 --> 01:15:11,960
pressure medicine.
Like I said, this one patient I

1457
01:15:11,960 --> 01:15:15,520
treated for a mold, she was on
one blood pressure medicine by

1458
01:15:15,520 --> 01:15:18,560
the time she left the refinished
her mold treatment.

1459
01:15:18,560 --> 01:15:22,800
So you have to show the data.
So I think what I wish I had

1460
01:15:22,800 --> 01:15:25,920
done that at that time, the
cross machine had what is called

1461
01:15:25,920 --> 01:15:28,120
patient centered medical home.
They would give you more

1462
01:15:28,120 --> 01:15:32,560
reimbursement if you make sure
your patient was referred and

1463
01:15:32,760 --> 01:15:34,960
you got the referral and all of
this communication.

1464
01:15:34,960 --> 01:15:39,080
But actually we showed results
like our patients actually lost

1465
01:15:39,080 --> 01:15:41,320
weight, our patient's blood
pressure got under control with

1466
01:15:41,320 --> 01:15:45,080
less medications.
I think you can get reimbursed.

1467
01:15:46,040 --> 01:15:47,600
You just have to collect that
data.

1468
01:15:48,560 --> 01:15:51,080
Awesome.
Where does functional medicine

1469
01:15:51,080 --> 01:15:52,920
go from here?
How does it expand?

1470
01:15:53,120 --> 01:15:57,360
And I guess I'll preemptively
ask you too when it comes to

1471
01:15:57,360 --> 01:15:59,840
trainees.
And again, a lot of trainees are

1472
01:15:59,840 --> 01:16:02,480
interested in this holistic,
again, like funk for myself,

1473
01:16:02,480 --> 01:16:04,920
holistic, but just to kind of
branch it in there, Sherlock

1474
01:16:04,920 --> 01:16:07,800
Holmes type medicine.
Where does functional medicine

1475
01:16:07,800 --> 01:16:10,520
go from here?
How does it continue to market

1476
01:16:10,520 --> 01:16:12,600
brand itself, maybe up brand
rebrand?

1477
01:16:12,840 --> 01:16:16,040
How does it get more noticed?
I think people are trying

1478
01:16:16,040 --> 01:16:18,800
different things.
I will say Doctor Andrew Weil

1479
01:16:18,800 --> 01:16:22,080
with this integrative medicine,
I think there are about 25

1480
01:16:22,080 --> 01:16:25,040
medical schools across the
country who have an integrative

1481
01:16:25,040 --> 01:16:28,760
medical tract track and there's
some places that have functional

1482
01:16:28,760 --> 01:16:32,400
medical track.
I will say that we need to bring

1483
01:16:32,400 --> 01:16:35,280
it into our residences.
I think medical students should

1484
01:16:35,280 --> 01:16:37,560
have that option.
If I want to do a primary care,

1485
01:16:37,560 --> 01:16:40,440
can I go into, there's something
called preventive medicine, can

1486
01:16:40,440 --> 01:16:45,120
I go into functional medicine?
And if so, how do we get a

1487
01:16:45,120 --> 01:16:48,520
rotation or maybe a six month
rotation in functional medicine?

1488
01:16:48,520 --> 01:16:50,880
And then you continue to learn.
I mean, none of us stopped

1489
01:16:50,880 --> 01:16:54,400
learning after medical school.
In fact, I think what I learned

1490
01:16:54,400 --> 01:16:56,520
in medical school is
kindergarten version of medicine

1491
01:16:56,520 --> 01:16:59,920
that I practice now, right?
We continue to evolve.

1492
01:16:59,920 --> 01:17:03,320
We learn with every every year.
And the number of articles and

1493
01:17:03,320 --> 01:17:05,840
studies that are coming out, I
can't even keep up.

1494
01:17:06,080 --> 01:17:11,080
So I think it should start in
medical school once you start

1495
01:17:11,080 --> 01:17:14,160
practicing.
I think to me, Parsley has done

1496
01:17:14,160 --> 01:17:19,960
a fantastic job of branding and
we don't do many of these.

1497
01:17:19,960 --> 01:17:23,800
What do you call cheesy
marketing like what your doctor

1498
01:17:23,800 --> 01:17:28,520
has not told you and the
pharmaceuticals are to get your

1499
01:17:28,520 --> 01:17:31,760
thyroid and you know you're
going to be dying when you take

1500
01:17:31,760 --> 01:17:33,680
these medicines.
So like your teeth are going to

1501
01:17:33,680 --> 01:17:35,440
rot because you're on GLP one
agonist.

1502
01:17:35,440 --> 01:17:38,960
We don't do any of that.
We follow whatever is evidence

1503
01:17:38,960 --> 01:17:42,640
based and it's just built
initially built word of mouth

1504
01:17:43,040 --> 01:17:45,240
and now there's a little bit
there has to be a little

1505
01:17:45,240 --> 01:17:46,760
marketing.
We all have to do a little

1506
01:17:46,760 --> 01:17:49,400
marketing.
I can't imagine medicine going

1507
01:17:49,400 --> 01:17:52,400
forward.
I think the number of medical

1508
01:17:52,720 --> 01:17:55,080
systems that are closing down
because they don't have enough

1509
01:17:55,080 --> 01:17:59,160
patience is ridiculous, right?
With Medicaid and with Medicare,

1510
01:17:59,360 --> 01:18:02,280
probably because they're not
getting reimbursed.

1511
01:18:02,280 --> 01:18:04,880
But in general, we shouldn't
have to.

1512
01:18:05,320 --> 01:18:09,440
You cannot just sit there, open
your shop and say I'm going to

1513
01:18:09,440 --> 01:18:11,440
get patience.
And if that's going to happen,

1514
01:18:11,440 --> 01:18:13,200
it's going to take you five
years to build a practice.

1515
01:18:13,200 --> 01:18:16,440
I've done my own private
practice and I will say if I

1516
01:18:16,440 --> 01:18:18,760
couldn't afford myself, that's
how much I was charging.

1517
01:18:19,120 --> 01:18:21,400
Functional medicine should not
be a luxury.

1518
01:18:21,400 --> 01:18:23,880
It should be the way medicine is
practiced.

1519
01:18:24,520 --> 01:18:27,520
But functional medicine should
be something that the patient

1520
01:18:27,520 --> 01:18:30,400
has a choice.
You don't push them into

1521
01:18:30,400 --> 01:18:34,280
functional medicine.
You don't tell them like at the

1522
01:18:34,280 --> 01:18:35,600
VAI.
Remember, I used to tell my

1523
01:18:35,600 --> 01:18:38,560
patients when I first learned
about lifestyle medicine, and

1524
01:18:38,560 --> 01:18:41,880
then I can give you the diet or
I can give you the statin, four

1525
01:18:41,880 --> 01:18:43,920
months of diet and then we can
try the statin.

1526
01:18:43,920 --> 01:18:46,280
Say don't tell me doc, just give
me the statin.

1527
01:18:46,280 --> 01:18:49,120
I'm not changing my diet.
So not everybody.

1528
01:18:49,400 --> 01:18:54,000
Functional medicine is not for
everyone, but patients need to

1529
01:18:54,000 --> 01:18:56,800
have a choice.
And I think insurances should

1530
01:18:56,800 --> 01:18:59,320
cover.
But the funny part about

1531
01:18:59,320 --> 01:19:01,840
insurance is what they'll
coverage in New York and

1532
01:19:01,840 --> 01:19:03,640
California.
But every state, you have to go

1533
01:19:03,640 --> 01:19:07,200
and sit with the board, the
insurance to be covered in each

1534
01:19:07,200 --> 01:19:10,280
state.
We're in 50 states, but we're

1535
01:19:10,280 --> 01:19:14,440
not covered everywhere, right?
Nisha, I have a question for

1536
01:19:14,440 --> 01:19:19,080
you.
I do you think that if you were

1537
01:19:19,120 --> 01:19:23,400
first introduced to the concept
of functional medicine through

1538
01:19:23,400 --> 01:19:26,840
your medical training and even
earlier in your career and then

1539
01:19:26,840 --> 01:19:28,880
fell into the quote UN quote
conventional model?

1540
01:19:28,880 --> 01:19:31,640
And I know we're kind of putting
them as these diametrically

1541
01:19:31,640 --> 01:19:33,720
opposed things.
And I don't think there are, I

1542
01:19:33,720 --> 01:19:35,040
don't think any of us are saying
that they are.

1543
01:19:35,040 --> 01:19:37,880
But again, just to make it
clear, very for the listener.

1544
01:19:38,680 --> 01:19:42,680
But do you think if you had your
origins, were there today, you

1545
01:19:42,680 --> 01:19:45,760
wouldn't necessarily be calling
it 2 separate things?

1546
01:19:46,200 --> 01:19:50,280
I'm concerned that this
polarizing nature, these

1547
01:19:50,280 --> 01:19:53,440
conversations that people
continue having, you know, which

1548
01:19:53,440 --> 01:19:57,560
type of medicine is better, like
you highlighted earlier with the

1549
01:19:57,560 --> 01:20:00,760
cardio, the lipid association,
those folks there, like in every

1550
01:20:00,760 --> 01:20:02,880
silo people are having doing the
same exact thing.

1551
01:20:03,280 --> 01:20:07,600
And in the end, the only person
who suffers really or suffers

1552
01:20:07,600 --> 01:20:09,840
the greatest is the patient,
right?

1553
01:20:09,840 --> 01:20:12,120
We're all having these debates,
so to speak.

1554
01:20:12,800 --> 01:20:17,880
So I'm just wondering if it's
helpful or not to actually even

1555
01:20:17,880 --> 01:20:20,840
just talk about them as they're
completely separate things.

1556
01:20:21,680 --> 01:20:25,360
You know, I thought about this a
lot and when people, when

1557
01:20:25,360 --> 01:20:28,160
medical students used to ask me,
I want to do just functional

1558
01:20:28,160 --> 01:20:33,680
medicine, I always tell them,
know the beast before you go

1559
01:20:33,680 --> 01:20:38,000
into functional medicine.
So I liked the way I learnt it.

1560
01:20:38,280 --> 01:20:40,800
I really love the fact that I
spent so much time learning

1561
01:20:40,800 --> 01:20:44,320
about the disease and then when
I learned functional medicine,

1562
01:20:44,320 --> 01:20:47,680
it just clicked just like a
passing piece that I couldn't

1563
01:20:47,680 --> 01:20:49,080
put together.
I couldn't, I didn't know what

1564
01:20:49,080 --> 01:20:52,880
was missing, but it clicked if I
note only functional medicine

1565
01:20:52,880 --> 01:20:56,640
and never did the hardcore
internal medicine, you know, the

1566
01:20:57,040 --> 01:21:01,080
ICU rotations, the ER rotations,
I don't think I would have so

1567
01:21:01,080 --> 01:21:06,720
much of what do you call
appreciation for both convention

1568
01:21:06,720 --> 01:21:08,480
because I respect conventional
medicine.

1569
01:21:08,480 --> 01:21:11,200
I'm not one of those doctors who
says don't listen to it.

1570
01:21:11,200 --> 01:21:14,000
Like people come and say my
cardiologist said I don't need a

1571
01:21:14,000 --> 01:21:15,600
statin.
I'm the one who will pick up the

1572
01:21:15,600 --> 01:21:17,840
phone and tell the cardiologist
I think she needs a statin.

1573
01:21:17,840 --> 01:21:19,880
Why did you say she doesn't need
a statin?

1574
01:21:20,400 --> 01:21:23,680
That's where I am.
But I do love conventional

1575
01:21:23,680 --> 01:21:26,440
medicine because I think I love
the studies, though it's very,

1576
01:21:27,000 --> 01:21:30,800
you know, the evidence basis of
1 drug and you know, it has its

1577
01:21:30,800 --> 01:21:33,480
own problems.
But then doing functional

1578
01:21:33,480 --> 01:21:38,880
medicine, I feel I was able to
understand the journey to

1579
01:21:38,880 --> 01:21:41,960
Wellness because it's almost
like knowing the signs of

1580
01:21:41,960 --> 01:21:45,160
illness and then understanding
the art of healing.

1581
01:21:45,960 --> 01:21:48,600
I think that's how you should do
it if you're not just the art of

1582
01:21:48,600 --> 01:21:50,720
healing.
I don't know if my mind would

1583
01:21:50,720 --> 01:21:53,320
have been open to disease
because disease is a delusion.

1584
01:21:53,400 --> 01:21:54,760
Truly.
It's a delusion, right?

1585
01:21:55,120 --> 01:21:57,960
Disease is what we develop
because of our day-to-day

1586
01:21:57,960 --> 01:22:01,720
habits.
Literally show me one disease,

1587
01:22:01,720 --> 01:22:06,000
chronic disease, that happened
because it was just genetic.

1588
01:22:06,120 --> 01:22:09,880
I don't know, maybe sickle cell
disease, but that's again, you

1589
01:22:09,880 --> 01:22:14,240
know, we see it very early, but
diabetes or high blood pressure,

1590
01:22:14,320 --> 01:22:18,280
these are all things that evolve
over the decades.

1591
01:22:18,400 --> 01:22:21,200
You develop these diseases, you
don't get them, you get a

1592
01:22:21,200 --> 01:22:23,400
pneumonia, you get a urinary
tract infection.

1593
01:22:23,600 --> 01:22:27,080
So one drug will sure that, but
the rest of the diseases are

1594
01:22:27,080 --> 01:22:30,440
stated diseases.
You evolve because you've done a

1595
01:22:31,080 --> 01:22:34,960
10 or 15 things wrong on a
consistent basis for 10 years.

1596
01:22:34,960 --> 01:22:37,400
One doughnut is not going to
kill you, but every a doughnut

1597
01:22:37,400 --> 01:22:42,240
every day for 35 years with and
I think that's what that's where

1598
01:22:42,240 --> 01:22:44,200
I see it.
I want to quickly jump in there

1599
01:22:44,200 --> 01:22:46,960
because I understand this is not
what you're saying, but just for

1600
01:22:46,960 --> 01:22:50,120
the layperson, I I like the
distinction you made between

1601
01:22:50,120 --> 01:22:53,120
developing and getting and and
it does take time.

1602
01:22:53,680 --> 01:22:57,240
That being said, though, I think
certainly there are people who

1603
01:22:57,240 --> 01:22:59,480
are more predisposed to certain
things.

1604
01:22:59,480 --> 01:23:02,400
And as the saying goes, right,
the genetics load the gun, but

1605
01:23:02,800 --> 01:23:05,360
you know, however it goes in
epigenetics, we understand.

1606
01:23:05,360 --> 01:23:08,000
So I just want to so so people
aren't like, Oh my God, this is

1607
01:23:08,000 --> 01:23:09,720
all my fault.
And you know, like if you.

1608
01:23:10,200 --> 01:23:13,880
If both your parents heart.
Attacks at 45 like you you

1609
01:23:13,880 --> 01:23:16,240
might, or if you're LP, you're.
Much higher risk.

1610
01:23:16,640 --> 01:23:20,640
No, for sure you're but then if
at 20 you said, hey, my dad had

1611
01:23:20,640 --> 01:23:24,880
a heart attack at 40, at 20 you
started getting evaluated and

1612
01:23:24,880 --> 01:23:28,200
started making the changes.
You can make the change is what

1613
01:23:28,200 --> 01:23:32,720
I'm trying to say.
So a lot have a space for health

1614
01:23:33,320 --> 01:23:36,240
as you do for wealth.
Unfortunately, health and wealth

1615
01:23:36,240 --> 01:23:40,720
builds up at the same time,
right in your 20s and 30s and

1616
01:23:40,760 --> 01:23:43,120
even in the 40s and 50s, you can
still build your health.

1617
01:23:43,200 --> 01:23:46,280
That's what I tell my patients.
I tell them all I need is the

1618
01:23:46,280 --> 01:23:49,160
desire to get healthy and you
will be able to.

1619
01:23:49,160 --> 01:23:52,280
I had my oldest patient, now 70,
and the first thing she asked

1620
01:23:52,280 --> 01:23:55,200
me, she think she told me, do
you think it's too late for me?

1621
01:23:55,200 --> 01:23:57,840
And I said, what if it's not too
late, if you don't think it's

1622
01:23:57,840 --> 01:24:00,880
too late.
And within about 3 months she

1623
01:24:00,880 --> 01:24:05,200
brought down her A1C by two
points is she just didn't know

1624
01:24:05,200 --> 01:24:09,160
how to do it.
So I think at no time it's it's

1625
01:24:09,600 --> 01:24:12,080
is it wrong?
And again, the development

1626
01:24:12,080 --> 01:24:16,280
happens without our knowledge.
I was a pre diabetic when I

1627
01:24:16,280 --> 01:24:19,720
started this journey, not that,
you know, I wasn't doing

1628
01:24:19,720 --> 01:24:21,200
anything.
I was eating salads, I was

1629
01:24:21,200 --> 01:24:24,920
exercising, but I wasn't doing a
lot of things right.

1630
01:24:25,480 --> 01:24:29,560
So I think it's really
understanding that most chronic

1631
01:24:29,560 --> 01:24:34,120
diseases, there are a lot of
triggers and meaty just we are

1632
01:24:34,120 --> 01:24:38,000
feeding the evolution of the
disease without our knowledge.

1633
01:24:38,280 --> 01:24:41,840
And what functional medicine
does is educates you on how you

1634
01:24:41,840 --> 01:24:45,800
can change your epigenetics.
I love it Nisha.

1635
01:24:45,800 --> 01:24:49,680
I'm so excited to share this
with people, but I do want to

1636
01:24:49,680 --> 01:24:51,600
give them something actionable
to take away so.

1637
01:24:51,960 --> 01:24:53,560
Yes.
As you've highlighted, not all

1638
01:24:53,560 --> 01:24:55,040
functional medicine is created
equal.

1639
01:24:55,040 --> 01:24:57,720
Not all clinicians, physicians
who are created equal, who are

1640
01:24:57,720 --> 01:25:00,200
practicing any type of medicine
for that matter.

1641
01:25:00,680 --> 01:25:05,400
That's great.
So what are some ways that the

1642
01:25:05,400 --> 01:25:10,640
consumer to use that word again
can tease out who is going to be

1643
01:25:10,640 --> 01:25:14,880
a good functional medicine
clinician versus somebody who is

1644
01:25:14,880 --> 01:25:17,920
just going to follow the cookie
cutter protocol, push

1645
01:25:17,920 --> 01:25:20,760
supplements kind of things that
we're not all fans of?

1646
01:25:21,760 --> 01:25:24,640
Yeah.
So I think it it depends on your

1647
01:25:24,640 --> 01:25:27,520
goal, right?
If you may be unbiased, because

1648
01:25:27,520 --> 01:25:31,800
I'm a physician, I think you
start with someone who's trained

1649
01:25:31,800 --> 01:25:34,600
in function of physician, who's
trained in functional medicine

1650
01:25:35,160 --> 01:25:40,240
and let them tell you, OK,
listen, I do need you to see the

1651
01:25:40,240 --> 01:25:42,840
pharmacist because you're on a
bunch of who's also trained in

1652
01:25:42,840 --> 01:25:44,640
functional medicines in T second
medicine.

1653
01:25:44,640 --> 01:25:47,760
But I think you need the first
thing is the encounters.

1654
01:25:48,240 --> 01:25:51,000
See number one, have they read
your history?

1655
01:25:51,520 --> 01:25:56,080
Are they asking you questions
about your lifestyle before they

1656
01:25:56,080 --> 01:25:58,760
push supplements?
And I'll be explaining that

1657
01:25:58,760 --> 01:26:03,520
thought process.
I have never ordered a test with

1658
01:26:03,520 --> 01:26:07,200
my patient without telling them.
I don't say I'm going to order a

1659
01:26:07,200 --> 01:26:08,960
blood test.
I'm going to tell them what

1660
01:26:08,960 --> 01:26:11,600
blood test I'm ordering and why
I'm ordering, what my thought

1661
01:26:11,600 --> 01:26:13,800
process is.
And I asked them to repeat, do

1662
01:26:13,800 --> 01:26:15,720
you understand where we're going
with this?

1663
01:26:15,720 --> 01:26:17,240
And they will actually tell me
that.

1664
01:26:17,240 --> 01:26:20,480
So it should be almost like a
conversation because this is the

1665
01:26:20,480 --> 01:26:22,160
health.
It's almost like, you know, when

1666
01:26:22,160 --> 01:26:24,680
you buy a house and you're
building a house, you tell the

1667
01:26:24,680 --> 01:26:27,600
builder do whatever you want.
No, you're going to give them

1668
01:26:27,960 --> 01:26:30,600
what you want.
So I think it should be that

1669
01:26:30,600 --> 01:26:32,840
kind of conversation.
You're building your health.

1670
01:26:33,520 --> 01:26:36,240
You need to tell me what is
practical for you.

1671
01:26:36,240 --> 01:26:38,800
And I'm going to tell you what
my thought process is from what

1672
01:26:38,800 --> 01:26:40,440
you've told me where I think I
should.

1673
01:26:40,560 --> 01:26:42,760
Which rabbit hole do I need to
go?

1674
01:26:43,000 --> 01:26:46,680
And I usually tell them, I'll go
down this rabbit hole, we'll fix

1675
01:26:46,680 --> 01:26:48,400
this.
But we may need to address these

1676
01:26:48,400 --> 01:26:51,080
other things also that are
hanging or they may get better

1677
01:26:51,080 --> 01:26:54,720
as we work on this.
So that's why we got, we need

1678
01:26:54,720 --> 01:26:58,720
that one hour.
So the conversation is such that

1679
01:26:59,040 --> 01:27:03,480
the patient walks away with
clarity about what's going on

1680
01:27:04,080 --> 01:27:06,640
with them and what the next
steps are.

1681
01:27:07,440 --> 01:27:10,800
But if you're walking away with
or they ordered some blood tests

1682
01:27:10,800 --> 01:27:13,160
and she gave me some supplements
because she thinks it's

1683
01:27:13,160 --> 01:27:16,880
irritable bowel, you've already
lost it there.

1684
01:27:17,840 --> 01:27:21,680
I love that it puts the power in
the hands, the patient provider

1685
01:27:21,680 --> 01:27:24,400
and the system as a whole.
So, you know, all three people

1686
01:27:24,440 --> 01:27:27,560
connect there, so that's good.
Sunisha, you work at Parsley

1687
01:27:27,560 --> 01:27:30,280
Health at the household name.
I've been following you guys for

1688
01:27:30,280 --> 01:27:32,120
a long time.
I love the educational content.

1689
01:27:32,400 --> 01:27:34,840
Where can our listeners go to
follow you specifically?

1690
01:27:35,800 --> 01:27:37,520
It'll be only on Latin right
now.

1691
01:27:38,000 --> 01:27:41,440
I don't, I'm not on any of the
other social media platforms.

1692
01:27:41,440 --> 01:27:46,920
I'm there, but I'm not active.
And so see, follow my posts,

1693
01:27:46,920 --> 01:27:49,800
please like my posts on Latin,
share them.

1694
01:27:50,240 --> 01:27:53,400
It's always about functional
medicine, and of course, at

1695
01:27:53,400 --> 01:27:55,440
Parsley Health, too.
Awesome.

1696
01:27:55,440 --> 01:27:57,600
Well, love it because that's
where we found you and your

1697
01:27:57,600 --> 01:27:59,640
awesome post.
So we can double down on that.

1698
01:27:59,640 --> 01:28:02,160
And we'll be sharing clips and
things like that to promote you

1699
01:28:02,160 --> 01:28:03,720
as well.
So if anyone wants to check out

1700
01:28:03,720 --> 01:28:06,920
some snippets from this episode,
we'll post on LinkedIn and tag

1701
01:28:06,920 --> 01:28:09,480
you so it'll be easy to find.
Before.

1702
01:28:10,560 --> 01:28:12,800
Before we ask the last question,
Nisha, we just want to thank

1703
01:28:12,800 --> 01:28:14,320
you.
I mean, you've really brought a

1704
01:28:14,320 --> 01:28:17,960
lot of nuance, a lot of reality
to this conversation.

1705
01:28:17,960 --> 01:28:20,640
And I think that's something
that is much needed in this

1706
01:28:20,640 --> 01:28:23,080
space, especially with so much
of the noise that's going on

1707
01:28:23,080 --> 01:28:25,360
social media.
So I'm really excited not only

1708
01:28:25,360 --> 01:28:27,000
for our listeners, but also
other providers.

1709
01:28:27,000 --> 01:28:30,280
I can't wait to share this with
them 'cause I think it's just, I

1710
01:28:30,280 --> 01:28:33,040
mean, it's, it's everything you
said, honestly, it was just

1711
01:28:33,040 --> 01:28:35,320
enlightening and it was, it's
good to hear that there are

1712
01:28:35,320 --> 01:28:38,080
people out you like there that
are sending this message.

1713
01:28:38,080 --> 01:28:39,400
So I just want to thank you
again for.

1714
01:28:39,400 --> 01:28:42,760
That.
Our final question is how do we

1715
01:28:42,760 --> 01:28:44,280
put the health back into
healthcare?

1716
01:28:45,360 --> 01:28:49,560
I think it really comes down to,
first of all, fashion medicine

1717
01:28:49,560 --> 01:28:51,920
should become mainstream.
I don't know how we're going to

1718
01:28:51,920 --> 01:28:54,680
make it, but we're going to try.
We're going to keep trying at

1719
01:28:54,680 --> 01:28:58,480
least partially held wealth.
The only way to put health into

1720
01:28:58,480 --> 01:29:02,280
Healthcare is to have an
awareness that you can actually

1721
01:29:02,280 --> 01:29:04,760
be healthy.
You know, we're a community that

1722
01:29:04,760 --> 01:29:09,160
will wear ribbons, go marching
for breast cancer and cervical

1723
01:29:09,160 --> 01:29:12,840
cancer and prostate cancer, But
when somebody says I'm going to

1724
01:29:12,920 --> 01:29:16,200
exercise and I'm going to go for
a triathlon, I'm not eating

1725
01:29:16,200 --> 01:29:20,040
gluten or I don't want to drink
alcohol, we make fun of them.

1726
01:29:20,480 --> 01:29:23,280
We really need to celebrate
health and not disease.

1727
01:29:24,080 --> 01:29:28,400
So the only way to get health
into Healthcare is to actually

1728
01:29:28,400 --> 01:29:31,880
respect health when you have it,
not after you lose it.

1729
01:29:32,760 --> 01:29:36,560
I love the no bullshit approach
on the fan, thanks Doctor Nisha.

1730
01:29:37,640 --> 01:29:39,360
Thank you.
Thank you guys for this

1731
01:29:39,360 --> 01:29:42,040
opportunity.
Thanks for listening to another

1732
01:29:42,040 --> 01:29:45,040
episode of Medicine Redefined.
If you enjoyed this episode,

1733
01:29:45,080 --> 01:29:47,280
please be sure to check out some
of the additional resources in

1734
01:29:47,280 --> 01:29:49,960
the show notes.
Please also check out our social

1735
01:29:49,960 --> 01:29:52,920
media platforms where you can
find more content like this.

1736
01:29:53,400 --> 01:29:57,080
You can follow us on Instagram,
Twitter, and TikTok at Med

1737
01:29:57,120 --> 01:29:59,640
Redefined.
We also want to thank our team

1738
01:29:59,640 --> 01:30:02,320
for the production of this
podcast, specifically Aretha Ya

1739
01:30:02,320 --> 01:30:05,280
for your social media, Zenab
Lugmani our research, and Saira

1740
01:30:05,280 --> 01:30:08,160
Hahn for newsletter.
If you enjoy the show, please be

1741
01:30:08,160 --> 01:30:10,520
sure to subscribe, review and
share with anyone who you think

1742
01:30:10,520 --> 01:30:11,800
will gain value from this as
well.

1743
01:30:12,720 --> 01:30:15,760
Now time for the ever so
important disclaimer.

1744
01:30:16,560 --> 01:30:19,400
This podcast is intended for
general public use and it's for

1745
01:30:19,400 --> 01:30:22,160
educational purposes only.
It does not cost you the

1746
01:30:22,160 --> 01:30:24,000
practice of medicine.
No should be construed as a

1747
01:30:24,000 --> 01:30:26,040
medical advice.
No physician patient

1748
01:30:26,040 --> 01:30:28,080
relationship is formed and
anything discussed in this

1749
01:30:28,080 --> 01:30:30,680
podcast does not represent the
views of our employers.

1750
01:30:31,160 --> 01:30:33,600
We recommend that you seek the
guidance of your personal

1751
01:30:33,600 --> 01:30:36,120
position regarding any specific
health related issues.

1752
01:30:36,840 --> 01:30:36,960
None.