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Welcome to Field Notes, an exploration of functional medicine. I’m Rob Downey, a family practice MD and Institute for Functional Medicine certified practitioner. I’m coming to you from Seaworthy Functional Medicine in Homer, Alaska. I want to thank everyone joining us today to learn and grow in whatever way they can from our time together.

We’re fortunate to have Dr. Jordanna Quinn with us today. She’s a functional medicine practitioner, physician, and physical medicine and rehabilitation doctor. She is also an athlete, helps other athletes, and practices regenerative medicine. She additionally offers patients a natural skin care line and select aesthetic treatments. That’s just a brief summary. 

Thank you for joining us! Is there anything else that you would like to add that I didn’t cover?

That about encompasses it! I come from a background in physical medicine and rehabilitation (PM&R) background. I went into sports medicine and then found regenerative medicine, which really spoke to me. Using your own body’s healing capacity to heal made sense to me as an athlete. I’ve always been more interested in natural medicine. I’m an osteopath, so I come from that background as well.

Once I got into regenerative medicine I fell completely in love with it! When you find the alternative medicine world, your mind is open to all of these other things. I had a mentor that was in anti-aging medicine. He was a functional medicine doc and taught me all kinds of new things, such as focusing on diet, hormones, and IV therapies. That’s also how I got into aesthetics. Having him be my mentor was probably the greatest thing that ever happened to me, because I call functional medicine “makes sense medicine.” 

Using your own body’s healing capacity to help heal made sense to me as an athlete. I call functional medicine “makes sense medicine.”

It just makes sense that we physicians should be trying to find root causes of disease, and trying to help people stay healthy as opposed to just treating disease. I do think there’s a time and a place to treat urgent disease when needed.

You and I both benefited from having mentors in functional medicine. Mine was a naturopathic doctor. When I started learning about and practicing functional medicine it was so common sensical, just eminently common sensical and beautiful!

I thought, “Oh my gosh. This is how medicine should be!” It seemed like that’s what David Jones and Jeff Bland and all those folks in on the ground floor 30 years ago were thinking of doing and saying this is how medicine would look from the ground up if it had a bigger tool kit.

Yes, yes! It’s amazing. I agree, and It’s fun to talk to someone who’s just as excited about it!

That’s definitely how I got this point of wanting to talk to thought leaders. Here in Alaska I’m close to some of my tribe, but a lot of my tribe is scattered around the United States and abroad. With every interview I do I feel like I’ve met another member of my tribe.

Yes, even here in Colorado. People think Colorado is an open state, but it’s actually very conservative from a medical standpoint. That has changed during the past five years or so. I’ve been practicing in this realm for a decade now and yes, it makes sense. When it speaks to you, it makes sense. I don’t know how to explain it.

I was an athlete and growing up my mom cooked all of our meals and always said,  “Don’t just drink juice. It has a lot of sugar. Eat the fruit.” We also ate a lot of whole vegetables. I honestly just assumed that we couldn’t afford juice because we were poor, or we couldn’t afford to go out to eat. Now I realize she was wise.

There was a real wisdom there, wasn’t there?

Totally, yes! When I found functional medicine it made sense to me, and it’s just fun! It makes going to work fun. When I first got out of residency, I was in pain management and doing spine and steroid injections. I dealt with a lot of spine and interventional pain patients. I would literally come home from work and complain to my husband because I felt like patients were just whining.

They were in pain because it was the world’s fault. I would talk to them about diet and exercise and things that I was passionate about. I would say, “Come on, just walk one block a day,” until I was blue in the face. I felt that people didn’t care and that they only wanted the magic pill, at least at the clinic I worked at.

It also made me very sad about the way PM&R was very much about pain management. I had already learned about regenerative medicine in residency, so it wasn’t a shock, but when I was actually able to find a mentor and practice it, it made sense. I go to work now and I seriously love every day of it. I love what I do!

My patients want to make positive changes in their life. We walk the healing path together.

It’s fun! I no longer have to go in and talk to people until I’m blue in the face, who don’t care what I’m saying. My patients care, and they want to make positive changes in their life. We walk the path together, which I love in the doctor-patient relationship.

I am 100% in, but my patients have to be 100% too. I can’t beg them to take care of themselves. If they end up in the hospital, I’ll come do a manipulation on them in the hospital. I want to be there for them. It’s fun!

Yes, I talk a lot with people about having skin in the game. That’s one of the hallmarks of being a functional medicine patient. I think a lot of people now know or intuit that as they connect with us. That’s often what they also want, so there is a resonance right out of the gate.

It’s a different form of medicine. I know you take insurance, and I would love to hear a little bit about how you do that. Because I don’t take insurance, I have the luxury of spending more time with my patients. As a specialist, I’ve always had that ability as well.

I’m not part of an insurance model, so I can talk about whatever I want. I don’t have to check those tabs, which is a great luxury, so it provides a different relationship. Even when I worked within an insurance model, I would do things like talk to patients about diet, exercise, or quitting smoking. These are all these things that you don’t get paid for, necessarily. Maybe people do now, but they didn’t at the time.

I find it so important to have those conversations with patients upfront. It totally changes the patient-doctor relationship. It sets the stage for a long-term relationship if you basically tell patients that you’re not going to put up with excuses, and that this is a 6-12 month process before you’re even going to feel better. I think people appreciate that.

I’ve had people cry in my office because I’m pretty blunt. I had a patient who smoked and was trying to exercise, and I basically told her there’s no point because you’re still smoking. I was very not kind about it. I think smoking is the least smart thing that anybody can do in the world.

I feel like I can be honest with my patients. It sets the stage for a long-term relationship.

Then she came back to me! I thought I literally just made her angry, and she returned two months later crying, “I quit smoking the day after I saw you, and thank you so much! My husband and my relationship is better. We both exercise now.”  She said all of these things that I wasn’t expecting. It was beautiful! It’s because I feel like I can be honest with my patients. I’m not trying to hide or gloss over anything.

I think it’s really important what you’re saying. I want to add to and underscore it, because I’m seeing the same trend in my practice. It’s also nice to get a chance to talk about practice models. I had a humbling moment three and a half years ago, when I was lucky enough to have the hospital support me opening a strictly functional medicine practice.

The functional medicine certified health coaches who were helping said, “We’ve talked to people that you cared for in Homer 6-7 years ago. Despite all of your best intentions, Rob, these folks still ended up in a pill and testing focused mindset.”

I learned from this that when I first saw patients as a functional medicine practitioner 6-7 years ago, I still had my MD hat on, but I didn’t know it. I would begin the first visit with, “Here’s the food plan. Here’s the mindfulness plan. Here are the supplements. Here’s the testing.” I also think that because I was an American doctor talking to American patients, what they heard was, “Here’s the testing, here’s the pills.”

Yes. That’s so interesting.

We are able to bill through insurance by having honesty and transparency about billing. For long visits we implement time-based billing. If people are 100% self pay, it’s a pretty significant investment. They’ve got skin in the game.

Our patients have skin in the game. Once they get better, the support they’ve provided helps other people get better.

If they have insurance, it’s covered as a time-based billing code for 25 or 40 minutes. We are just now changing our supplement prices to 10% off the manufacturers’ suggested retail, as opposed to 35% off. We charge an $80 lab interpretation fee. Those fees are the only changes I needed to implement when working with my business coach Dan Kalish to make my business model viable. We let patients know they have some skin in the game to support the practice through supplements. Once they get better, the support they’ve provided helps other people get better.

Amazing, it’s simple!

Mind blowing! So, we’re transitioning now into proof of concept. It all pencils out on the Excel spreadsheet, but we need to turn the corner and do the education and proof of concept around the state of Alaska. I think it helps that I’ve been in functional medicine for 14 years, and I’ve had a brick-and-mortar practice here for 7 years.

I’ve got much of the shakedown cruise done in the other areas, so I’m not trying to do seven moonshots at once. I’ve got six things figured out, so I’m trying to only do one moonshot in terms of expansion of practice and clarification of model.

Yeah. What branch or realm of functional medicine do you like to focus on?

My mentor was Hillery Daily, a naturopathic doctor from Hamilton, Montana. She was really good at fatigue, gut issues, botanicals, inflammation, and autoimmune issues so those folks tend to gravitate to us.

The number one diagnosis in my practice is fatigue. Second, third and fourth would be insomnia, arthralgia, and myalgia. Others include low mood, unhappy gut, hormonal imbalance, menopause, perimenopause, andropause, adrenals tied to sex hormones. I’ll test them all at once with one snapshot. I’ve certainly found that there’s a plenty big audience in those domains, and I want to be really honest about my areas of expertise.

I’ve also focused on making sure that younger people know that functional medicine’s really nice for them to do. They get a higher yield on investment if they’re more proactive.

I want younger people to know that functional medicine’s really great for them. They get a higher yield on investment if they’re proactive. They will have more joy and vitality and less suffering later on.

I love all my patients, of course, and I’ve had a blast with every step of the journey. It’s been great when I get a chance to help a 25-45 year old, and they get better so quickly. They’re so happy and relieved! I just know all of the joy and vitality they’re going to get, and all the suffering they’re going to save themselves.

It’s often simple steps, such as dietary changes, or taking a supplement for a while, or something like that.

Oh yes, it’s incredible. Two things that really stood out to me about how the Institute for Functional Medicine used to market itself. Their old marketing phrase was, “Re-enchant yourself with clinical medicine.” That’s when I took the class back in 2006. Even then, I think I had a little disenchantment with traditional medicine. I felt like, “Oh my gosh, I’m sure people can be better. I’m sure there’s more they can do.” When I went to apply functional medicine in my clinical practice with my mentor, it was like the head exploding emoji every night, in a good way.

The second thing that’s never changed was that I knew I had to do functional medicine because in 2005, a woman with psoriasis and arthritis came to this integrative clinic where I had been hired. I didn’t yet have an integrative toolbox yet. She had hand deformities, and the immuno-modulatory drugs were causing recurrent bacterial infections. It was just a really poignant situation.

I said, “I don’t have the toolbox that you need, but the naturopathic doctor at the clinic has a very good reputation with autoimmune.” Six months later this same woman was walking down the hallway with upright posture. Her skin color was vital, her eyes were bright, and she looked at ease. She just had that glow, like somebody has who has fallen in love.

 When I started applying functional medicine in my practice, it was like the head exploding emoji every night, in a good way!

She looked so happy and at ease and said she had a 50% reduction in her symptoms. I asked, “What did you do with Dr. Daly?” She replied, “I’m on an anti-inflammatory food plan. I take probiotics and I use Boswellia, Bromelain, and Quercetin.”

I thought, “Wow, you failed Enbrel, and you failed two other big gun immuno-modulatory drugs. Now you’re 50% better on just a little handful of items, including a lifestyle change by following an anti-inflammatory food plan.” I just never looked back after that point.

It makes so much sense, but people have to put in the time because it’s definitely not a quick fix. It’s not like ibuprofen, as though you have a headache, take a pill, and feel better. It involves months of putting in the time, which I think isn’t conducive to our lifestyles or desires. Americans tend to be very fast paced, and we want immediate results. We want to move on to the next thing. The average human attention span is estimated to be around seven seconds now.

I tell patients that it took years for your body to get to this place, so it’s not going to resolve quickly. Americans tend to be very fast paced and want immediate results.

As a physician I take time to explain that to patients. I tell them that it took your body years to get to this place, so it’s not going to resolve quickly. If you want to fix the problem or at least reverse time as much as possible, it’s going to take time. From a regenerative medicine standpoint, that’s how I describe my procedures.

Let’s delve into that a little more. I love what you’re saying! I need to be really honest and transparent, though, and say I think the light only came on for me big time last year.

I took Dan Kalish’s business class in functional medicine. He said, “You practitioners out there are a living example of what you want people to have. You need to be doing anything and everything to be absolutely vital.” I was about 85% of the way there, but I had my little housekeeping items or pet habits that I’d always kept. 

Kalish reiterated that, “You need to be a living example of what you want people to experience.” And, I had around 15% left to do to clean up some bad habits that I had never gotten serious about. It was neat to feel that, “Okay, I’m going to try to be a living embodiment of this. I’ll ride my bike to work, clean up the gluten and dairy, and clean up the refined sugar.”

Yeah, no one is perfect and we have to remember that. I’ve been an athlete my whole life. I was a high school and college athlete. As you become an adult and have kids, important things can fall out of priority. That’s okay, because if we beat ourselves up about it we can get into a negative catch-22 of maybe never getting back into a healthy lifestyle. It’s never too late.

There’s a time and a place for indulgence. As a former athlete, I feel lazy if I don’t exercise four or five times a week. Exercise is my mental health and it’s part of who I am. My “lazy” is maybe different from a lot of other people’s. We eat at home 13 out of 14 days. We spend a lot of money on food and health, but I believe I’m putting the investment on this side of the equation. It’s important for people not to beat themselves up about not being perfect. I like a glass of wine sometimes, and I go on vacation. I think cigarettes are always the most terrible thing in the world, but nobody’s perfect.

A patient came to see me a couple of years ago. He was in his mid-late 40s and very overweight. His wife is a physician and also very overweight. They had young kids around the ages of five, six or seven. He was truly in tears and said, “I can’t keep up with my kids and I want to be around for my kids.”

I‘ve been an athlete my whole life. I’ve eaten healthy my whole life, and every single day it’s a struggle for me to maintain that.

He was young and had plenty of life left, but he just figured for most of his adult life that he was out of shape, and he was done. As I mentioned, I am very blunt. I looked at him and said something to the effect of, “I’ve been an athlete my whole life. I’ve eaten healthy my whole life, and every single day it’s a struggle for me to maintain that.”

I didn’t even know I had said that, because I was just talking, blah, blah, blah. Six months later he came back to me and had lost a bunch of weight. He was so grateful, and told me that I had really helped him change his life. He said, “You know, what really stuck in my mind was the fact that you’ve been doing it your whole life and every day is a struggle.”

It isn’t always a huge struggle, but sometimes the struggle is having to cook dinner. I’m the breadwinner for my family, I’m tired, and when I come home from work and have to cook dinner it’s a struggle. To be fair my husband is usually the cook, but sometimes we just don’t feel like doing it. Preparing food takes effort. So does going on a bike ride. It takes effort.

Prior to me saying that, he had just assumed that it was easy for healthy people to stay healthy. I pushed through his misconception.  I let him know that I put in a lot of effort because health is my priority. It was so cool to hear his feedback. I didn’t realize at the time that what I said made an impact on him. I’m so glad because it’s true. Every day is an effort, but I choose to make health a priority in my life. I think that it’s so important for people to realize this.

I can’t imagine any other way to reach patients anymore. It seems to me that when we invite folks into our practice we’re being vulnerable and confident at the same time. It’s important that we say and model for them that this isn’t easy, but that it matters and it’s real. 

People often fall into the trap of never starting their healing journey, or thinking they need to become an Olympian athlete. They can see amazing results without turning their lives upside down.

I find that when people avoid taking action, there are  two common traps. One trap is to never start the journey. When some patients come into the room there is a fatalism that you and I can sense. They’re fatalistic and feel they can never get better. That’s one trap.

The other trap is that people think they need to become an Olympian or a monk. Coaching conversations often need to center around who the patient is, and what they believe. You don’t need to throw your pantry out. If breakfast is your big challenge, then what about just making chia pudding this week.

Often they’ll come back and say things like, “Oh my gosh. I can’t believe how much better I feel just eating a healthy breakfast. I’m starting to get a little snowball rolling at the top of my functional medicine improvement hill.” It doesn’t take too long for the lights to come on and the fatalism to fade when they understand that it’s real, it’s for them, and it’s incremental. They’ve got skin in the game, but they don’t have to turn their lives upside down.

That’s right. I have a patient right now who came to me because she saw the amazing results that her friend had gained in my practice. When she came to me she was very hypothyroid, so we did mostly hormones and also some dietary modifications. 

She made great progress and that was an easy win for me. When she first came to me, though, she said, “I want thyroid medicine. My friend did really well.” It was that same kind of mentality of, “I need this pill to make me better.” I remember during our first meeting, I said, “Okay, we’ll check your thyroid,” and we had to have the whole talk about her needing to bring some skin into the game.

Fast forward, her thyroid’s fine, and I’m not going to give her thyroid medicine! She was pretty mad about that for a while, but we are treating her hormones. She’s a newer patient and she’ll say, “These hormones aren’t working, they’re too high, too low. I don’t feel great.” 

A pill isn’t going to change your life. You are going to change your life. 

From our conversation you’re reminding me that I need to sit back down with her and say, “From a clinical standpoint your hormones have gone up and they’ve gone down. We’ve been playing this game for about six months. Let’s talk about your diet again.” She had no interest in talking about her diet. She says, “Oh my diet’s fine, and we do this and that.” But she is overweight, and her whole family is overweight. She has teenage kids, and so I think we need to talk again and address that.

Now that she’s feeling a little better from hormones. and maybe seeing that I have skin in the game for her as well will get her attention. Maybe she will see that this is serious, and a pill isn’t going to change your life. You are going to change your life. I could prescribe some pills that might help get you to the next level, but we need to have the discussion about diet again.

The thread that you’re invoking is the same thread that mastery level providers are invoking over and over again. If you look at Mark Hyman, Aviva Romm, Isabella Wentz. There’s hundreds of people we could cite, thankfully, that are up there. They really have their act together in functional medicine.

I’ve reflected on how I’d like to be similar to them. I find that there’s this honesty at the beginning of the plan, particularly around food. Like you I’m so candid at the beginning, and say, “The lifestyle factors are the key areas where we need to find the imbalances. They are your momentum forward. Your lifestyle is your momentum, and when you have some momentum, then the testing and the supplements are going to be game changers. Without the lifestyle change, your plan has no gas in the tank.”

Lifestyle factors are the key areas where we need to find the imbalances. They are your momentum forward.

I tell them that “You don’t need to be eating like an Olympian, but it needs to be whatever you believe in, working with the coach, reflecting for yourself, or looking at your food plan.” I’ve had people not come back after that conversation, which tells me that it’s honest. It’s honest because some people say, “Hey, this isn’t for me,” and I’m like, “Respectfully, it’s good that we identified that.”

One of my funnest patients came back three and a half years later and had lost 100 pounds! He also dropped half of his medications and half of his medical diagnoses. He said that our whole first conversation was on a delayed fuse, just burning in his psyche for three and a half years!

It’s so important. Even if he never came back, you were responsible for starting that in his mind. Sometimes you have to see something 20 times before you buy it, and hear something 20 times before you believe it.

That’s the beautiful thing about what you do. You don’t know when that conversation lights a spark, even if you never saw that patient again. He could be out at the grocery store and suddenly get it, or his knees might start hurting and he can’t ride bikes with his kids, or whatever. He may think, “Oh my gosh. I didn’t care two years ago, but now suddenly all of these bad symptoms of being overweight are coming together and that doctor made sense.

If you are honest with your patients, your conversation makes a difference. Even if it takes one or two more doctors saying the same thing, you provided an integral step for them to get to the next stage.

If you are honest with your patients, even if they never come back, your conversation made a difference somewhere in their cerebral cortex. Your conversation becomes ingrained, even if it’s in their subconscious. If they meet another doctor or a friend who says the same thing and that’s the light that lights them up, you put in an integral building block or step for them to get to the next stage. 

It’s so cheesy, but so true, and I really wish the world would believe this. When you eat healthy and exercise you feel good, and you spread that around. It’s contagious and it’s infectious. You walk around with a smile on your face, and people smile back at you. Even if you’re in a bad mood and you smile anyway, you feel better internally. It also affects other people. 

If we focused on our personal health in this country, the world would be a happier place. Not that it would be perfectly happy in la-la-land all the time, but you would feel better. It’s true! I’m jazzed up right now because I went on a bike ride. I’m not always this jazzed up. I have good days and bad days.

When you eat healthy and exercise you feel good, and you spread that around. It’s contagious and it’s infectious.

It’s using vitality as a clinical tool, isn’t it? Our cup spills over, pathways heal, things reboot. That’s what’s different about it.

Right! I’ve had patients look at me and say, “Oh, you don’t understand. You’re skinny!” or whatever. And I reply, “No, I do understand. I just work at it.” I’ve been an athlete my whole life, but I put in the time to exercise every day. I wake up 1-2 hours early to go for a bike ride or to the gym because I prioritize it. I’m no different. If I don’t do it, I gain weight.

Yes, that’s what Dan Kalish said as well. He rides his bike to work, he works out, he tries different food plans, and he’s always learning and growing. He started meditating in Thailand over 20 years ago, and now meditates for two hours every morning. I do yoga with my wife every day, and there’s definitely days I don’t feel like doing it. I’m probably on track to get in 300-330 days of yoga this year.

Congratulations!

Yes, thanks! It took me a long time to get there. On the days that I don’t do it, I don’t beat up on myself, but it’s a devotion and a commitment. I love it, and it’s changed my relationship with my back and my shoulder. It’s meditation and strength at the same time. 

When I ask people to download a mindfulness app, I’m able to look at them in what I think is clear-eyed peaceful fashion and say, “I think you’re going to dig this! I think there’s going to be a peace and ease when you breathe slowly 10 times in a row, listening to this person’s voice. You’re going to feel some of that bound up, tight, constricted, fatalistic feeling start to let go.

I’ve actually started meditating pretty consistently since September. I was doing a little bit before, then I opened my own business just over a year ago. Even though I was still trying to do it then, all I could think about were all the things I needed to do to start my business, so I wasn’t really there.

With this whole coronavirus that’s happening right now, people are very stressed out and very anxious. I support my family and I just started my practice, so it could’ve been a mental downward spiral for me very quickly. Instead, I’ve been weirdly optimistic. I can only attribute it to meditation.

I don’t do it every day. I don’t beat myself up if I don’t do it, but I’ve been trying to be very consistent. I have good weeks where I will do it every day, and bad weeks where I skip a week or so. I really think meditation has been helping me to not be pessimistic about life. I’m generally not a pessimist, but I’m also not an optimist. I’m definitely what I would call a realist.

For the first time in my life, the only thing that I can honestly attribute my optimism to is meditation. It’s kept me grounded and balanced. I haven’t changed anything else in my life. Coronavirus could have been a real issue where I could just have a negative spiral second guessing why I started a business by myself, that I need to support my family, that this was a stupid idea, and so on. But it’s not there, and it’s cool! 

The only thing that I can honestly attribute my optimism to is meditation. It’s kept me grounded and balanced, and I feel I have handled the stress of COVID-19 much better than I would have. 

I meditate for 15-20 minutes once or twice a day, not two hours a day, but it’s enough to just take a minute and breathe. That’s it, really, just calming the breath down. I always tell my patients about it because I’m on this meditation ‘kick’ although Ithink I’m going to keep doing it forever. I tell them that it’s also not an overnight fix. It’s like exercise. You can do it for two weeks and not notice any improvement. Then you quit exercising, or start eating poorly again, and you don’t get the results you wanted. It really takes 3-6 months before you notice a big difference in your body from exercise. That’s how meditation has been, at least for me.

It took nine months of meditating consistently for me to see a gain. I didn’t notice an obvious difference day-to-day until this tragedy of COVID-19 happened. I feel that because of meditation I’m probably able to manage it better than I would have otherwise. I think it’s all relevant and all encompassing. Our stress levels are a huge cause of disease, dysfunction, and mental health issues. We don’t address the impact of stress enough in medicine at all.

Americans go through life so quickly, at such a fast pace. I am 100% one of those people. I’m the kind of person who slams 26 hours into a 24 hour day. I also meditate, so it’s often good things, but it’s still too much. We don’t value rest in our country, or even just taking a step back. Stress is a killer!

I want to endorse a couple of things that you shared, because there’s so much good there. I think it’s so wonderful that what we put out comes back to us. It can sound a bit like playing Pollyanna, but I’ve witnessed it so much in the last year or two, especially shifting into a really intensively positive focus.

In today’s interview you’ve reiterated a number of times that there’s 3-6 months work needed with almost any habit to gain momentum and traction, and that helps people reframe their expectations and not be intimidated.

I heard a couple of years ago that the Institute of Functional Medicine research clinic in Gig Harbor, Washington has a standard mantra. They tell patients that it’s three months right out of the gate before taking any measurements at all, if not six. I think that honesty is really helpful to people. It’s a chance to say, “As a patient, am I going to try this for a while and get past that first hurdle of looking for instant gratification?”

A lot of people can resonate with this, because when they played football in high school, learned to play an instrument, tried to master a skill, or learned to speak in public, they had to put some hours in.                      

I think setting the expectation is important. I try to keep the expectation bar low so that I can exceed it. I usually tell patients it will be 6-12 months. I don’t want to get into politics, but I really believe that the American model of healthcare breeds blame. It sets up a climate of people feeling that we deserve to be healthy, and that we have a right to be healthy. I believe we have a right to be healthy and that everyone deserves it, but we have to work for it, and I think there’s a disconnect there. It’s as though people feel it should be a passive part of our lives.

You can be anything you want in America, but we’re so focused on money. In many people’s eyes, to be successful means financial success. In my opinion success is also determined by health success. There are multiple facets of success. 

Many people feel that success means financial success. In my opinion success is also determined by health success. There are multiple facets of success. 

When I started my business I told myself that I could stay healthy even with all of the other stress that I have in addition to the business. It was my priority, though, to stay healthy, so my business will grow slower because I prioritize a bike ride in the middle of the day, or whatever. I also prioritize my family, so when I come home at night I’m a mother. I don’t do patient care. I still hold the belief that I can do it all and achieve financial success. We’ll see!

I think Jeff Bland would say it’s the “disease delusion.” It’s the idea that we’re either perfectly healthy, or we have some disease. And, this whole spectrum of health, from disease to optimal vitality isn’t binary. I was really blown away thinking about Jeff Bland saying that penicillin is where the idea came from. From the advent of penicillin onward, there has been this whole love affair with “one problem-one fix” because of this enthusiasm for penicillin. The science got off track with that a little bit.

The beauty of the American model is that it’s great for broken bones, brain tumors, killing pneumonia and stabilizing congestive heart failure. We are missing 80% of why people come to see us, though, if the complex chronic back story and the genesis of lifestyle in disease isn’t part of what we do. I’m sure you and I both experience it.

People come in. They intuit this, they’ve read a lot about it, and they’ve got this. They know probiotics and gut health matters. They intuit that their stress is getting them down, and I’m so happy now compared to even five or eight years ago. The lights are on when most of my new patients come in. They want to orchestrate, prioritize, sort the wheat from the chaff. A lot of them are ready to rock!

It’s amazing, isn’t it?

Yes, it’s such a blast! I can never get enough! As a 52-year-old doctor , with the amount of my career that I have left, I just can’t get enough of this. I can’t imagine stopping practicing. Kalish has become not my business guru, but a life example. He said, “Hey everybody out there. You can’t burn out. There aren’t a whole bunch of you out there.” He also said, “You can’t build a business model where you’re working 80 hours a week. Practice what you preach because you’ll get depleted.”

Kalish said, “You’re only going to have a certain number of hours a week to see patients. You need a viable business model, you need time to build your practice, and the rest of your time is for your exercise, sleep, meditation, family, and food.”  I was like, “Wow, okay! I’ll try to figure it out!”

This has been great, and I want to make sure that people know they can connect with you at  koremedicine.com. You also offer information on skin care and aesthetics under biohackmybody.com, so can you explain more about that?

Yes, and I think that link leads to a discount code for the products. I got into aesthetics through the regenerative medicine aspect. I was already doing regenerative medicine for orthopedics, and my patients would ask things like, “Can you do platelets on my face? I’ve heard about these vampire facials.” I looked into it, and started offering some services from that perspective. For my patients coming in from rehabilitation facilities, we honestly do Botox for headaches and other neurologic conditions.

We’re trained in residency to do a ton of Botox for cervical dystonia. As I’ve gotten older and my patients follow my age, they’ve said, “Oh, well you could do Botox. Can you do it on me?” So, I started doing it that way. I don’t do a ton of aesthetics, but that’s how I went from an orthopedics, sports medicine background to also offer aesthetics.

Once you start doing aesthetics, patients ask you about skin care. I’m not a dermatologist, I’m probably the farthest thing from it, I did some research and found that just having natural ingredients is important. I met a pharmacist who does all natural skin care, and I love everything about him.

His wife had cancer, so he found all natural ingredients to use. He also found functional medicine essentially on his own as well, and so he developed a skin care line that is all natural. He offers glutathione and other things that are good for the skin, such as vitamin A and C. You feel good putting it on. Again, it’s outside in and inside out. You don’t want any toxins in your body.

I was using his skin care line myself for years, and I decided that I wanted to offer it to my patients. We private-labeled a skin care line for our patients, because again, everything you put in and on your body is important.

That’s really cool, and it goes back to something you said at the beginning of the interview. A lot of us who started our careers in the conventional model can end up compartmentalizing or treating the body as a machine. There’s an algorithmic aspect of conventional medical training. The nerves are like wires. The organs are like parts of a machine.

In functional medicine, we realize all these parts are interconnected and talking to each other all the time. The things we put on our bodies can have profound implications for our toxicity pathways. The beneficial things we put on our skin, which is our biggest organ, might not only help our skin but may also have downstream benefits and be safe for the whole body.

Yes, and again it just feels good on your skin. You want to look good and feel good. So, that’s where that comes from.

For folks that live near your practice in Golden, Colorado, is your practice open? Do you do telemedicine? Are you mainly brick-and-mortar practice?

It is a cash practice, meaning that I don’t take insurance, but I do provide super bills for people. I’m considered an out of network provider, and so some insurances may cover a portion of the bill. I am happy to do telemedicine. I prefer to see my patients in person, but we offer telemedicine or phone visits as well. My practice has been open this whole time during COVID-19 whole time. 

Congratulations, by the way! There’s something from Thoreau that applies here, “If one advances confidently in the direction of his dreams, and endeavors to live the life which he has imagined, he will meet with a success unexpected in common hours.”

Thank you so much for having me here today!