Integrating Personalized Nutrition Into Your Healthcare Business

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Stewart Gandolf (Healthcare Success)

Hello, and welcome to our podcast again today. And again, I get to talk to one of my friends from many years ago.

Mark Tager is a thought leader in healthcare and in medicine. I first met him when he was heavily involved in the aesthetic world and into anti-aging frequent author, including co-author with me.

We put book on cash-based practice, which, by the way, Mark, we need to update that one and promote it again better this time.

Every year I get my royalty check from that, Mark, and I love it. I just can’t spend it all in one place. It’s so large. But at any rate, it’s really fun to have you mark welcome.

ChangeWell Training Academy (changewell.com)

My pleasure. It’s great to be here with you. And just my dog Siena, who is this is like her 1500 podcast.

So she has FOMO. She’ll basically be pretty good in the back. But but she does like you. So she might make herself known.

Stewart Gandolf (Healthcare Success)

I’m glad she does. My dog, Pirata is somewhere else. And we’ll see. I’ve shut the door so he won’t walk in.

But he does like to make appearances as well. So Mark, you know, talking about, you know, I’ve always been fascinated by Oh, I forgot your other credential.

Awesome acoustic rhythm guitar player.

ChangeWell Training Academy (changewell.com)

That’s the new criteria to get on to get on your podcast.

Stewart Gandolf (Healthcare Success)

Yeah, well, the like there. Yeah, my little electric Les Paul’s become kind of part of our brand these days.

Anyway, so the Mark, we have with our audience today, I would like to start off a bigger picture. We’re going to talk about your book and nutrition and all kinds of really cool things in a minute.

But as I mentioned two a moment ago, you know, at first I met you when you were having the aesthetic market.

I spoke at the aesthetic show when you were involved with that multiple times as well as Kathy, my colleague.

So very familiar with that. And then over time, you know, you became more, you know, sort of anti-aging and very involved like A4M.

And today, you know, I think you would define this as functional medicine. So I’d like you to define, you know, it’s funny, I took a moment here just to kind of review allopathic versus integrative versus functional medicine.

But I don’t have your input on, you know, how do you think these things are and maybe just a quick sort of, I don’t know, continuum of how these things are evolving over time?

Because you’re not have to think it forward and like to step, take a step back just for a moment.

ChangeWell Training Academy (changewell.com)

We met in 2000.

Stewart Gandolf (Healthcare Success)

Wow.

ChangeWell Training Academy (changewell.com)

The chief marketing officer for the Fraxel laser bringing that technology to practitioners around the world. But for the first half of my career, I actually was involved in integrative functional preventive medicine.

I started out in the Pacific Northwest, and I set up the first wellness prevention center in the Northwest. I saw patients for an hour at a time and other practitioners.

We had classes and workshops. I taught Monday night yoga. And all of that, that was the first part of my career.

So I like to describe myself essentially as a recovering family practitioner, who is essentially has a split personality disorder.

So half of my life has been an integrative functional medicine, and half of it has been in aesthetics. And when I went to work for Kaiser Permanente, I directed health promotion for them in the Northwest region.

I had the best boss in the world.

Mark Goldberg.

I said, what’s my job? He said, Mark, it’s very simple. Anyone in the Pacific Northwest says the word wellness.

The next words out of their mouth have to be, oh, you mean Kaiser Permanente. So you’ve essentially sort of brought up some terms and we’ve got integrative, whole person, holistic, functional, anti-aging, longevity, you know, there’s a, they each are flavors in a stew and they differ somewhat.

So I personally like the terms integrative and functional medicine. Functional medicine is driven by the Institute for Functional Medicine.

It has a really well-defined process and curriculum of identifying root cause, emphasizing lifestyle, looking at some of the newer tests that are available.

So that’s one paradigm of functional medicine is also integrative health, which is very similar. It tends to lean a little bit more to body mind, body, mindm spirit.

There’s whole person care, whole person health. My very first book in 1979 was called Whole Person Healthcare. So that’s an emerging term and you’re seeing that champion these days by a company called Fullscript.

So this is terminology. And you know, I think when I think a little bit about aesthetics, and again, this is my split personality, aesthetics is something that you do to a patient.

A colonoscopy is something you do to a patient. Integrative wellness, functional health is something you do with a patient. And if you’re going to do it with a patient, the rules are different.

The milieu is different.

Stewart Gandolf (Healthcare Success)

Wow, that’s a, I never thought of that. That’s really interesting. And it’s funny, Mark, I remember now when we were talking, it’s been a while since we talked about your earlier career.

And that’s right, you did do a lot in this category. I just happened to me enter into your life right around that time.

ChangeWell Training Academy (changewell.com)

Yes, about halfway at the mid, at the midpoint.

Stewart Gandolf (Healthcare Success)

Yeah, yeah, yeah. So, and by the way, I think the fact that where you live in Southern California is such a great place to sort of have that functional, integrative appeal, like your house is just like a little paradise.

ChangeWell Training Academy (changewell.com)

I am geographically desirable. And the best thing that happened was COVID. My dog, who I normally travel 150,000 miles a year, she said, Wow, you’re staying home for two years.

And I got way into gardening.

I’m great. I mean, I’ve got growing everything in my backyard. And it’s been wonderful.

And I just, you know, when you when your mind is full of a lot of ideas and things, there’s nothing better than your feet and your hands in the dirt and that’s kind of the, I mean, that’s an integrative perspective. That’s what integrative medicine is and that sense of you know getting that grounding getting that balance.

So You know that that’s oriental in feel to

Stewart Gandolf (Healthcare Success)

Yeah, so it’s so interesting yesterday my wife and I spent the day because I’m always working work these days It’s running our company agency and so yesterday We there are some big wins that took down our patio lights and our backyard was full of pollen It just needs some love and I spent four hours out there and it was even though it was you know task-y and not very fun It was like it was a little I really enjoyed it like I have to do something besides you know being in front of the computer.

ChangeWell Training Academy (changewell.com)

No, I get it. I spent the day in my garden yesterday, and you know if you think about it What is meditation? Meditation is when you and the act that you are doing the one. Time flies you are totally present.

You are right there with that activity. So I think that those of us with creative fertile minds really need that outlet, that grounding, that’s so important.

And it’s very meditative, you know, the day went by, and I mean, six hours of gardening and working in the yard, it was lovely.

Stewart Gandolf (Healthcare Success)

That’s awesome. So let’s talk about, and it’s really interesting your comments on or integrative versus functional. before the meeting, or before our podcast today, I did take a quick look at the platform at CDC, because they are very similar to the functional integrative.

And that voice out of integrative is more sort of combination of, because my experience with it when I was first introduced to it a couple decades ago, was sort of, you know, traditional medicine combined with some oriental medicine, right, and different herbs and acupuncture and all those things.

I think that emphasis in the mind-body connection was functional is more about disease prevention. If you look at the perplexity comments on allopathic, it talks about treat symptoms and diseases using scientifically proven methods.

Methods include pharmaceutical surgery, radiation. So it’s like it’s so different.

ChangeWell Training Academy (changewell.com)

It’s an incredible spectrum.

You know, I hate the word alternative medicine, and I would never describe myself at low end up, I’m retired from practice now, as an alternative practitioner.

But I do like the concept of complementary, complementary medicine that we need the best of what Western medicine can provide for us.

And we need to own up and each person to work on lifestyle. And then when you move beyond that, then there are these other things where you have herbs and you have mind-body techniques.

But you know, if you think about where the market is going right now, it is going much more towards the incorporation of personalization through advanced testing that we’re able to bring into our practices in order to really highlight why you need something different from me and why I need something different from the next person based upon my diet, my lifestyle, my medical history, true.

But what about my genetics? What about my microbiome? What about the functioning of my mitochondria and how they’re doing?

What about how I’m breaking down compounds and the metabolomics that are so critical? So there’s a whole body of really neat, exciting science that we’re layering on to basic lifestyle change, which is a given, and that’s the base.

But we have this ability to personalize care now and to be called precision medicine called personalized medicine call it precision or personalized nutrition that’s just part of it you know that’s where the real advances are and what if you think about it you’ll always have to be in a position of eye to eye with your patient helping them identify their motivations they’re WHY to look for that teachable wonderful moment but what happens now with this personalization is you have a powerful tool to get attention and people say whoa that’s that’s just not everybody’s guidelines that’s MY guideline because I have a snip a single nucleotide polymorphism a genetic variant that says wow I need more vitamin D or I need more zinc so or my microbiome needs to be shifted in a certain direction. So all of this is exciting and that’s where the personalization comes in. So you’re seeing that across the board but you’re seeing it skewed more towards the functional medicine side of things where I think they really do a great job in looking at these LDTs (lab developed tests) that you know very often you have to pay for them but this is where we’re another example a great example is the coronary CT angiograms.

So and what they’re doing now is they’re doing those angiograms and they’re putting them through AI through things called Clearly or Heart Flow and you’re able to see exactly where there’s an allusion that could be breaking off and it’s soft plaque because today we we

for a kid ourselves. mean, we kid ourselves with, let’s say, coronary calcium screening, scoring screen. You know, you can have a zero coronary calcium, which means you don’t have that calcified plaque.

And you can still die of heart attack tomorrow because it’s not the calcified plaque that’s a problem. It’s that soft, friable plaque that that’s the problem.

And it just doesn’t assess that. So you can see that there’s a level of personalization for bringing to bear.

Stewart Gandolf (Healthcare Success)

Okay, well, Mark, that’s fascinating. I feel like, you know, again, this idea of treating people, you know, before there’s a problem, and I, you know, I’m full disclosure, one of my wife was get failed.

Well, first of all, I want to make sure on the clear, I completely believe in allopathic medicine, right? And so, and I know you do too, we’re not saying just abandon, you know, things like vaccinations or abandoned, you know, pre screenings or chemo immunity or whatever.

What we are saying is that’s there’s more, there’s a lot more out there. And the fact my wife when she was you know, kind of run around by the traditional medicine system, I should say not so much the doctor with the system, I call you and I said, Hey, do you know what tell me about who’s functional medicine to take care of my wife, by the way,

She loves her and she sees her once a year we pay cash and it’s worth it to us to have you know that help and then what she needs when her functional medicine doctor orders up test those that we can get done by insurance we do those that we don’t we just pay out of pocket but it’s worth it and by the way she’s doing great she’s like exchange for going to a functional medicine doctor so this isn’t really a commercial for functional medicine today but you know I do believe in that and I see the place for that and also you know I’ve very very recently had a friend of mine I go through a major heart issue and you know so I can see the need for that too I was like you know there’s just a lot on ongoing issues we have to work ourselves through so let’s talk about the nutrition aspect we can talk about exercise another day which by the way I’m much better a probably exercise spectrum than personalized nutrition but let’s talk about you know personalized nutrition program how does that differ from traditional dietary advice

ChangeWell Training Academy (changewell.com)

yeah Traditional dietary advice is traditional dietary advice it’s assuming that everyone needs the same bit of advice the same guidance the same direction and I like to apply to skin because I think that skin is a very big motivator for people.

And if you think about it, there’s no two people on the planet with the exact same skin with the exact same combination of genetics and medical history and things they put on their face and allergies and food sensitivities.

So it makes sense that if we can learn more about what makes an individual unique, we can then tailor treatment more specifically for that individual.

Now, this might be tailoring as to what to eat, when to eat, what supplements are necessary in, you know what?

I’ve fought the supplement battle now for about 30 years or so, and I’ll never forget, I was at Cleveland Clinic once and hearing a doctor talk, he said, well, Americans just have the most expensive urine in the world. We don’t, we don’t need supplements.

And, you know, I will agree that the B vitamins do get peed out. mean, they are water soluble, and you will see bright yellow urine if you’re taking, you know, fair amounts of the B vitamins.

But, you know, I think this is, this totally regards the sad, the standard American diet, and how atrocious most people’s eating habits are.

mean, the vast majority of people, probably not in my close circle, or maybe in your close circle, but I’m not sure.

But, yeah,

Stewart Gandolf (Healthcare Success)

We’re pretty good.

ChangeWell Training Academy (changewell.com)

You’re pretty good. I’m sure, you know, you are pretty good. And, you know, not that, not that it’s got to be hard and fast.

mean, I like to, Think that I eat really well 90% of the time and then the other 10% of the time I you know, I I eat for other reasons So, um, you know this we’re learning so much more that we can apply in terms of specifics so let’s go back to supplements because if you think about it.

is a supplement? It is a conditionally essential nutrient That’s a really important concept conditionally essential nutrient if you buy that definition Then what are some of the conditions?

Well, how about pregnancy, lactation, Aging, concomitant disease. How about drug nutrient depletions the 26 million Americans who take statins that deplete coq10 or they’re on birth control and that depletes minerals and vitamins Have the same medical histories

of aging, have chronic diseases. Now if you list all of those conditionally specific conditions, almost everyone fits into one of them.

So now we’re learning that we can do intelligent supplementation. Now that’s the term that I like to use. And intelligent supplementation means that you understand why there’s a reason for taking supplement.

And then the other biggest piece is making sure I’m a firm believer in professional grade supplements. I’ve spent the last few months visiting some of the supplement companies and watching how the professional supplements are manufactured and the testing that goes into every step along the way.

So it says 100 milligrams. There’s 100 milligrams. If you are getting a fish oil in the summer time. It has not set in a hot warehouse and our vitamin E and turned rancid.

So That’s another piece of it as well that you know, we need to begin to steer our patients towards professionally professional grade supplements.

Stewart Gandolf (Healthcare Success)

So going back to your “expensive urine”, I’ve heard that since the 80s ever And I’m just curious, you know, we talked a little bit offline about the Business terms is called the diffusions of innovations and the idea here is a bell curve. There’s early adopters. There’s innovators There’s early majority, late majority, laggards. Do you feel, where do you think health care is on that scale broadly or is this still pretty much? Are you do you feel like we’re still singing to people that aren’t familiar with this?

ChangeWell Training Academy (changewell.com)

No, I here’s what I mean What we are seeing is this Incredible speed up in the rate of change and if you think that what quality is in healthcare is meeting and exceeding the needs and the expectations of clients and customers and patients, then these patients now are much more savvy and much more in tune with nutrition and supplements. So, we are starting to see that this is almost like a religion to some people. You know, 70, 75% of Americans take a vitamin supplement vitamin, mineral supplement every day. Half folks are taking a fish, oil or something else a specialty, a supplement.

So, the rapidity, the speed with which we’ve gotten this information into general public and the extent to which we’re seeing the general public moving towards wellness

longevity, hormone balance, skin health and beauty, vitality. This is the new language that that we’re starting to see. Now, we had early adopters, but what’s happening now is that we’re starting see this real ground swell.

And we’re seeing it in the practitioner space. I mean, this year, last year, the A4M, their annual meeting, they had 7,500 physicians and practitioners.

we’re seeing great uptick now. And now with this also comes the issues of Dr. Google and influencers who think, oh, you just need this fad diet or you need this one supplement that’s going to do everything for you.

need your olethinaia, need NAD or you need glutathione, it’s going to cure everything. Well, that’s not really the case.

You know, we need to going back to intelligent supplementation, we have to understand the WHY.

Stewart Gandolf (Healthcare Success)

Mark, there’s so much to unpack here. think one is, first of all, going back to your comment about, you know, with the patient versus to the patient.

I love that. That’s my favorite quote of the day. Number two, here’s the thing, you know, because, you know, as you know, I’ve worked with healthcare professionals for decades now, and so I’ve worked with them one on one, not just, you know, some marketing guys that actually talked with the doctor, right?

I used to lead seminars around the nation, like you’ve done tons of speaking, and so I’ve talked to thousands and thousands of doctors over the years.

But one of the things I think to attitudinally, I think there’s more of an openness today, clearly. But one thing that I first knew what you just said is, like, look, if you believe in this philosophically, great, you embrace it, but if you don’t, the patient will find somebody else.

Like, if you’re not leading them, they’re going to listen to that influencer. if If you don’t think it’s a good job, that’s a little scary too, right?

So especially in primary care, which by the way, I feel for primary care, it’s an impossible job right today, in today’s marketplace.

It’s just an impossible job. However, like I said, if there’s a void, it’ll, if someone else will feel it.

And that’s not necessarily like what you’re hoping for.

I’m not giving any comments on that, but that’s a, a real issue to me.

@30:19 – ChangeWell Training Academy (changewell.com)

Yeah, you know, the challenge with allopathic medicine, the traditional health care is you really just don’t have time and you don’t have, and you’re essentially limited pretty much to one symptom, and you get your one symptom.

If you’ve got something else, we send you to another specialist. And that is, in fact, the challenge is we’ve got these silos of care.

And what both, what functional medicine does and integrated medicine is, is look across the silos for essentially the root cause for ways in which we

we might have one root cause causing multiple issues for a person. So it’s just a different philosophy. I think people are starting to be willing to pay for this now, because at least those who can, will.

you know, a lot of this is is really based upon the establishment of a great patient, doctor, patient practitioner relationship.

And there’s that component of the great consult and empathy and listening. You know, I love there’s a study by Ted Kaptchik at Harvard.

And he did this wonderful, wonderful study on the placebo effect. And he just did random sham acupuncture on three groups of people with IBS.

Yes, a third never got to see anyone. A third got the regular kind of care. I got the regular 15 minute visit, and the third group got the enhanced visit with more time questioning, tell me, you know, how has this impacted your life?

What does this mean for you? You know, this has probably been really difficult for you. Talk to me a little bit about, you know, how, what this has meant to you.

So empathy, questioning. And remember, they’re putting acupuncture needles at random places. So this is a pure placebo test. And it’s also, by the way, the practitioner, my favorite part of the enhanced one is a practitioner saying to the patient, you know, I’ve had a lot of success with IBS with acupuncture for my patients.

What do you think happened? And all the indices, quality of life, global improvement, the enhanced group did so much better than the regular visit and the regular visit did better than just waiting for an appointment so it does show that there is this powerful bond powerful link on between the connection actually between the patient and the practitioner and the best docs you know let patients finish their talk.

They demonstrate empathy they ask questions they probe for deeper meaning I think a lot of that can be done in the traditional aliphatic viewpoint.

I mean I had a great alipathic doctor they made him retire it and it was an interesting thing because I’m the week that he retired I said what are you going to do.

Said Mark you know the issue that I have this I’ve got to figure out some ways to stay relevant and that’s that that was an interesting take for me to swear I’m actually older than he is.

So it was you know staying relevant staying vibrant keep engaged keeping your mind working I retired once. It was the worst year of my life.

I sat out on non-compete and it was horrible, because at least I needed that stimulation. I’ll tell you, one of my favorite quotes is Han Selyate, who’s a father of stress.

You know, did all that work. He said, there’s two kind of people. There’s race horses and turtles. If you’re a turtle, get out of the way, if you’re a race horse, realize that you got to run.

So I think that there’s a certain sort of vibrancy to keeping the mind alive as you age.

So you’re a race horse.

I’m a race horse.

He’s a turtle right there, just laying around.

Stewart Gandolf (Healthcare Success)

It’s so funny. Being a CEO of an agency, I just don’t know what I would do if I retired.

I’m just, you know, I couldn’t see doing something else, but just sitting around and doing nothing. And my wife said, no way, you just cannot do that.

Let’s pivot a little bit over to the testing and let’s talk about, you know, the testing and like, How do you do this? Well on the nutrition side.

ChangeWell Training Academy (changewell.com)

Yeah. So, you know, it starts with diet, diet, diet, diet, diet, diet. There is a little mantra that goes, I cannot out supplement your crappy diet.

Stewart Gandolf (Healthcare Success)

Oh my gosh, I love that. Another good quote for the diet.

ChangeWell Training Academy (changewell.com)

So there’s no way that I can just, you know, give you supplements to take. So at some point, you’ve got to work with the patient with their diet.

Now, before you even get there, there’s a level of introspection that needs to happen. And this is in fact something you can do in a short visit.

Tell me, you know, a lot of my patients have noticed that their skin improves when their diet improves. Have you seen anything like that?

Very often when there’s, when people are under a lot of stress, they overeat, has that ever happened to you?

What, what is a typical day look like for you? That’s better yet. Let’s, let’s go back 24 hours. What do you have for breakfast, lunch, dinner?

Great, do you ever overeat when you’re under a lot of stress, you eat too much, drink too much, etc. I think there’s a way to, and in the book Feed Your Skin Right, I do talk about how we make these connections to get introspection, because we want to be able to, if we think about population health, if we can move awareness and use the power, that practitioner-patient moment, which hopefully can be a transformative moment, that can be really, really beneficial for everyone.

So there’s introspection, there’s dietary analysis. Then there are basic labs that you can look at, look at CBC, minerals, minerals for zinc or magnesium.

You can look at it in both serum, better yet, in red blood cells. You can learn a lot from just a traditional CBC and CMP.

So you look for that. And then there are specialty tests you layer on top of that. Now, a lot of people will do an IgG test for food allergies.

So there’s IgE, which is the immediate peanut allergy. You know, that’s pretty well easily diagnosed early in childhood. But then there’s IgG, which is much more subtle.

It’s not immediate. It causes more subtle kinds of symptoms. So there are IgG tests for these antibodies. And that can be helpful.

Of course, the best thing is an elimination diet for people. Now, very often you will see people who are allergic to everything.

You do this IgG test. Oh, my goodness. They can’t eat anything.

And then, you know, you really have a case of leaky gut. I mean a bad case of leaky gut.

which is, if you think about it, you know, until the mid-seventies we were taught that the linings of the gut, you know, just one cell separates you from, not you, that the entire gut lining is just one cell. So if you think about it.

We used to think that these cells were glued together. That’s what I learned when I was in medical school and then in the late seventies, the Japanese noticed. No, there’s things that can get in between the cells, and that was the concept of intestinal permeability.

Now, if you’ve got a lot of that, what happens is things that shouldn’t be in the bloodstream get into the bloodstream, like, for example, the Endotoxins, the outer parts of these gram negative bacteria, but other things as well.

And they travel to places in the body, and they do something called molecular mimicry. So, what happens is that there’s a molecule that sort of looks like to the body that it should be in a knee cartilage, but it’s not a good fit, and we get inflammation that way.

We are, in fact, so leaky. Gut is one piece. Let’s continue down the road of the testing. A microbiome analysis is really critical. The microbiome speaks to the brain, it speaks to the skin with 80% of the neurotransmitters in the body are made in the gut, serotonin, dopamine, norepinephrine.

By the way, those molecules do not cross the blood brain barrier directly. They work by the vagus nerve to impact the brain, and we will see them go into the circulation, but we will also see the short chain fatty acids, bacteria.

Take fiber and they love fiber and they make butyrate appropriate acetate and that heals the gut lining and travels to other organs acetate is particularly important for the skin So that’s a really good handle most of the time you’re looking at diversity The more diverse microbiome the healthier an individual is and you’re looking for dysbiosis You know the ratio of good bugs to bad bugs and finally you won’t look and see what are these bacteria making?

What are their metabolites? That opens up the whole area of metabolomics, which is the metabolites sometimes we call those post-biotics But where the shift now is moving towards these metabolic tests.

There’s a new test called me-screen For mitochondria. We can finally begin to see if in fact id your mitochondria are working well and what kind of things that they need.

There’s um yeah so there’s just a host of really good lab tests that we can begin to bring in and help us personalize our treatment.

Stewart Gandolf (Healthcare Success)

So the that’s fantastic and um I love the got this to say I love that you cannot supplement yourself out of a bad diet.

ChangeWell Training Academy (changewell.com)

True story. I can’t out-supplement your crappy diet.

Stewart Gandolf (Healthcare Success)

Okay, that’s absolutely right

ChangeWell Training Academy (changewell.com)

You come to see me, I can’t out supplement it.

Look, basics are still the basics. I mean you want to keep away from the algebra process for the 120 pounds of refined sugar that people have.

You know if every practitioner visit if there was three minutes spent on learning to read a food label for hidden sugars you know you think you’re doing a really great job with your

with your yogurt because you’re getting that, know, all those good bacteria and you’re getting 17 grams of sugar, you know, in that.

So if all we did was teach label reading, I think that could be pretty helpful. So you’re going to try to move to more fiber, more on processed foods, cut back on meat, saturated fats, switch to more lean sources of protein, you know, these are the basics.

But then the fine-tuning is the personalized nutrition part.

Stewart Gandolf (Healthcare Success)

So I can’t let this go without conforming a friend of mine is in the and protege from years ago is in the supplement business or was.

And I had lunch with him other day and he had rice and fish and no vegetables.

I said, where’s your vegetables? Oh, I take supplements. I thought, Oh, no.

My wife and I both joke about this, like very smart guy, I don’t think, I think you kind of still need them.

ChangeWell Training Academy (changewell.com)

I mean the way you have to here’s the way I frame that up. I would ask someone and I’m not gonna ask you because I would embarrass you but I will ask an audience how much does your brain weigh and you know I get 10 pounds one pound 15 pounds you know all over the map well it weighs about three and a half to four pounds essentially the human brain and as I’m fond of saying men have slightly larger brain but it doesn’t mean it works as well so I get some points with the audience that way but the point is that the bacteria in your gut it weighs about three and a half to four pounds as well so if you’re thinking about it it is an organ that you have to take care of just like you take care of your heart or your brain for your muscles for your skin and those bacteria love to eat fiber. That’s their preferred food. When they get fiber and phytonutrients and the phytonutrients and the ruffage, essentially they make good metabolites that are good for lots of things in your body.

And that’s why I sort of position it with, you know, with a patient. They can just start sliding more fiber into their diet. I mean, that becomes very important.

Stewart Gandolf (Healthcare Success)

That’s great. Let’s talk a little bit about scaling all this. We talked earlier about the challenge of, you know, being in primary care if you’re in a traditional model.

And, you know, from an individual standpoint, I like everybody decides to become a concierge, practice, which kind of not so good for the populace as a whole.

So if you’re in, you know, you’re in primary care, you’re committed to being in primary care, but you want to help your patients.

Like, what are some of the things that you think are the hope of the future here?

ChangeWell Training Academy (changewell.com)

Yeah. So we talked about it.

cure them. is having some displays, tools, things you can put into the patient encounter to promote awareness. I mean, even something like, you know, label reading.

I mean, if you spent, you know, 90-seconds, you know, get off the keyboard for a minute, you know, and move on over and do that.

You want to bring up diet and exercise. I, years ago, one of the very first part of my career I was involved with smoking cessation programs.

And the patients who smoke didn’t want to go to see their doctor or chose a doctor that wouldn’t tell them to stop smoking.

This is a long time ago. And you know, if you think about it, you know, this is a powerful encounter that you have the opportunity to imprint on your patient and the importance of the

diet and exercise. So I think that these little messages do matter. I mean, if you put them out, you also have to walk the walk.

I mean, you know, you can’t be an overweight practitioner and tell people to exercise and eat less. And so the other thing is that we’re starting to see these, what I’d like to see is more systems of referral.

Now, the problem that occurs when you have a functional medicine or integrative medicine center within a traditional health care setting, yes, the patients love it.

But if it gets measured against the same metrics of what is our revenue per square foot per people’s time in this location, then it will never match the new MRI you’re going to get.

Okay. It’s just not going to have to return. So you have to be able to have a vision of a functional medicine department that is more philanthropic.

And usually what I’ve seen, the ones that are doing well, have gotten funding, they’ve gotten funding from OSHA, they’ve gotten funding that whole hospital here, we have a wonderful functional medicine group, and it’s because the donors, the people who believe in this, have contributed money for it, and see this as part and parcel of the identity.

So we’re trying to make a brand linkage here as well. Now what could you do as a practitioner? You should know some quality supplements, you should be able to recommend them, perhaps you can get a discount code for your patient, you can have your own, you have to check with how you’re employed.

But you might have this in your pharmacy and you’re recommending certain supplements, key supplements in your pharmacy. You may just recommend it and ask the patient to go online, maybe you’ve given them a code, so they get a discount on that.

Or you can actually profit if your contracts allow you to do that. But what I do like is I like to see specialty practices, pain management, cardiovascular, orthopedics, having a small formulary that they have right there with the patient, can buy it right there, or can get those supplements online and that practice gets the revenue from it.

So there’s, for example, with full script, you can do that or some of the companies like Designs for Health that I work closely with, you can set up a practitioner account and you don’t need a lot of inventory.

So that you have just enough because people who believe in this, they want to walk out with that supplement, but they don’t want to come back to you every month to buy more.

They like the convenience of getting that online and you can profit from that.

Stewart Gandolf (Healthcare Success)

You can be a marketing person for sure. I’m thinking about this a couple of thoughts I’d love to get you to respond to.

One is, one of the things I talk about a lot with clients or when I’m doing speaking to audiences, you know, marketing as a reminder, was the first one in the four piece, Product Place, Price of Promotion and later on I learned, okay, seven piece, you add into that positioning as a people and whatever the other one is, I’ll bet.

But the uh, look at packaging. So what, when we think about the idea of marketing, this particular service, we talked about, well, is the revenue match or not.

But, you know, you mentioned Hogue. I, I’ve happened to belong to Hogue Medical Group. Hogue is our hospital here and where I’m close by.

And I actually, I actually left my primary care doctor because Hogue was so much better in every other way.

And it stinks because I still like him, but it’s like Hogue has just got it down, everything, and they just got it down.

And the, so, but that’s part of the brand of Hogue is that they do have it down, right? So it’s not just ads, right?

But the fact that they’re offering this, well, of course, Hogue would do that. mean, I’ve learned that some institutions view themselves as forward thinking and innovative and like we have to have the best of the best and others just kind of go through the day and just it’s factual, right?

So, you know, where are the marketing opportunities? Because to me, branding, if you think about an institution on offering functional medicine, offering wellness of, and of course, Kaiser’s famous for that with their Thrive campaign, talking about wellness versus sick.

So you have that on the branding standpoint, but even, you know, on the smaller scale, which we don’t work between individual doctors, but you know, they can still talk on social media and still do offer these things to their patients.

Like, give me some marketing. Do you agree? Like, is this? Yeah, so you know what?

ChangeWell Training Academy (changewell.com)

I, so often, I go ahead and do Google, Google blank near me, or I take a city, I’ll take Kansas City, for example, or Indianapolis or Atlanta.

And I will go ahead and pull up integrative medicine, functional medicine, wellness medicine near me. And I will start looking at the verbiage and the positioning.

Now, I just recently did that for aesthetics. And it’s It is moving. There’s going to be a tsunami there and if you read through this integrating inside out from outside in, beauty from within, building a stronger, more vital view, living, all of this, there’s an enormous amount of very rich verbiage that you can see on these sites with them saying, okay, we’ve got all of these offerings.

And now these are wellness offerings. So it’s a both and it’s not an either or it’s a both and for many practices, at least it is an aesthetics, aesthetics, less integrated functional medicine, or the PEDIX plus regenerative medicine.

So you’re looking for these synergies and then that determines what the verbiage is and how it resonates with your patients.

So this is uh you’re you’re looking and you’re one of the best in the world with this. I mean this is what you do.

I know just enough about this but you know this is in your in your sweet spot which is what are you going to say?

How do you say it? What do you show? How do you train your people to sell this and talk about it?

That is the magic of the work that you do and I’ve always admired.

Stewart Gandolf (Healthcare Success)

Yeah thank you. It’s funny because I see opportunities everywhere and the you know I’ve worked on trying to be healthy and you know diet and nutrition and been certainly working out my whole life and there’s benefits that I get now as a result of that right that not everybody has. So the I think that when we look at going forward with the audience out there like how do we get that word out?

Like I you know I look at myself as you know part of the health care team. How do we get people to take care of themselves better?

How do we get them to you know eat better? How to get them to exercise. And you met, you kind of alluded to something I thought was really interesting, the aesthetic side.

I remember a doctor telling me, this is years ago in the Midwest, he convinced his patients to stop smoking by, not because it was going to kill them, not because of cancer, but he’s like, you’re getting wrinkles around your lips. I was like, wait, are you serious?

Yeah, so that was how he convinced people to stop smoking.

So yeah, the marketing side of this and the communication side is amazing. where I was going moment ago is, you know, like I fell, was out running on a trail, I run a mountains mark and I was, I found this stupid flat horse choke because there was a little piece of concrete I didn’t see.

I had to ground hard, but no broken bones right. Because I’ve been working out my whole life. the fact I was running me up that I was more likely to fall, I think, but those benefits are everywhere.

And I think about, for example, you know, urgent cares can incorporate this or orthopedic surgeon like you mentioned.

or cardiovascular like or even mental health like there’s if you’re interested in this topic and you know again we work with lots of multi-location bigger businesses these days or smaller individual practices there’s ways of doing this if you’re interested and it can help build help you first of all I think most doctors I would say that I know I would say it makes me feel better about what I do not just treating the the cause you know the results of that things are trying to help them prevent it so I think they can integrate and you’re nodding your head I think you’re agreeing

ChangeWell Training Academy (changewell.com)

Yeah I’m in I’m in violent agreement with you you know it’s interesting because a lot of the younger aesthetic doctors that I work with they totally get this you know but you know those the older plastic surgeons who are doing fine that don’t want to make any changes that are not particularly hungry but you know don’t really buy into this but the younger docs now coming coming out are they’re very attuned to this right now. I’m seeing that shift taking place. The other eye down the road from you is Felice Skersch. Felice Skersch is a highly regarded, functional OBGYN.

She’s one of the world’s experts in PCOS. And we had lunch not terribly long ago. And we talked about dinosaurs. Now, when I dinosaurs, what do I mean? We were both taught when we were in our training that if you asked a dermatologist and you said, does diet have anything to do with acne? They said, no, it doesn’t have a thing to do with acne. Now, there are and I can give you the research that shows that that’s absolutely positively wrong.

You know, acne is that perfect storm of hormones and low zinc meeting, high sugar and high fat and a lot of dairy.

I mean, it’s a perfect storm. And there are still some of those dinosaurs, but fortunately they’re dying off. And we’re beginning to see this paradigm shift, particularly on some of the younger, healthy, fit, vibrant practitioners who go into practice, who want to make a difference, who, know, who believe in this, personally

Stewart Gandolf (Healthcare Success)

So last question.

Your new book is Feed Your Skin, right? And I’m assuming it’s more written for the consumer, but like, how can we integrate this as a practitioner?

ChangeWell Training Academy (changewell.com)

Well, I get two things. This is my…

Stewart Gandolf (Healthcare Success)

Also, I need to copy of that! You haven’t sent one to me.

ChangeWell Training Academy (changewell.com)

Actually, I have a new book coming out, actually. In June, I’ve got a book called Integrative Esthetics. And that’s the how to do it part. And I steal very liberally from our work together, because it was so formative.

And I’d quote you, and you’re in there. I mean, every book I write has a little homage to Stewart.
But no, this is actually this is this is the book that’s written for the smart consumer. And you know the relatively smart practitioner, I mean so. And it’s a good book. It covers the waterfront of what you need to know. But increasingly, we’re starting to look at how you do it. So I’ve got a 10 hour Course I produce called Inside Skin Beauty.

And that’s you know, everybody gets everybody in the practice on the same same page. I think that’s really important. I mean, it’s one thing for the practitioner, but it’s got to be the front desk and the PA and the RN. And the MA. They’ve all got to get behind this. So I think that that’s pretty important as well.

So there’s training available. The beauty of the pandemic is that we are now in a world where you know, online training is is really good.

Stewart Gandolf (Healthcare Success)

Yeah, for sure. So Mark, it’s a pleasure as always. And we have to do a new book together someday.

ChangeWell Training Academy (changewell.com)

And I think we need to crank up. I’ve got an idea for us. always have another idea.

Stewart Gandolf (Healthcare Success)

Yeah. So the anyway, Mark, I know you’re super busy and you don’t have time for everybody in the planet to call you.

But if they do want to reach out to you, how’s the best?

ChangeWell Training Academy (changewell.com)

Yeah, the easy best way to get is [email protected], [email protected]. That gets me, gets to me and lets me answer questions and things like that.

Stewart Gandolf (Healthcare Success)

All right. Mark fantastic talking to you again.

ChangeWell Training Academy (changewell.com)

I knew this would be fun. Thank you so much. Always fun. Thanks. Take care.