Today we’re talking about an evolution in medicine.
You’ve heard me talk about naturopathic and functional medicine and getting to the root cause of your skin and other health issues, and my guest today shares how you may be able to have greater access to this kind of medicine now and even in the future.
My guest today is James Maskell. James has spent the past decade sparking debate and encouraging a shift toward a wellness-centered, functional medicine model. To that end, he created Functional Forum, the world’s largest integrative medicine conference with record-setting participation online and growing physician communities around the world. He’s also the founder of the Evolution of Medicine, a community e-commerce platform which provides resources, tools, and services, making it easier and more affordable for conventional doctors to embark on a new way of managing healthcare.
James Maskell has been featured on TEDMED, Huffpost Live, TEDx and more, and is a contributor to Huffington Post, KevinMD, thedoctorblog and MindBodyGreen. He serves on the faculty of George Washington University’s Metabolic Medicine Institute, and speaks regularly on the integrative medicine conference circuit. He lives in Venice Beach, California with his wife and daughter. On today’s podcast James talks about the evolution of medicine and what is happening to the shift medicine in the U.S. to a more integrative and community-based approach.
Many of you ask me if I see medicine in our country changing so I’m exciting to share this interview with you today.
I hope you enjoyed this interview today with James Maskell.
To learn more about James’ new book The Evolution of Medicine, go to Amazon
Also, I invite you to join the The Spa Dr. community on my website or subscribe to the podcast on iTunes so you don’t miss our upcoming shows. My skin quiz is new and revised! Go here. It’s free and only takes a couple of minutes to find out your unique skin type and ways to address your root causes. Also don’t miss out on all of the latest tips to get glowing skin.
Thank you and we’ll see you next time.
TRANSCRIPTION
| Trevor: | Hi there. I’m Dr. Trevor Cates. Welcome to the Spa Dr. Podcast. Today, we’re talking about an evolution in medicine. You’ve heard me talk about naturopathic and functional medicine and getting to the root cause of your skin and other health issues. My guest today shares how you may be able to have even greater access to this kind of medicine now and even more in the future. |
| My guest today is James Maskell. James has spent the past decade sparking debate and encouraging a shift toward a wellness-centered functional medicine model. To that end, he created Functional Medicine Forum, the world’s largest integrative medicine conference. He’s also the founder of Evolution of Medicine, a community eCommerce platform, which provides resources, tools, and services making it easier and more affordable for conventional doctors to embark on a new way of managing healthcare. James has been featured on TEDMED, HuffPost Live, TEDx, and more. He is a contributor to Huffington Post, KevinMD, The Doctor Blog, and MindBodyGreen. He serves on the faculty of George Washington University’s Metabolic Medicine Institute and speaks regularly on the integrative medicine conference circuit. He also lives in Venice Beach, California with his wife and child. | |
| On today’s podcast, James shares with us about the evolution of medicine and what is happening to shift medicine in the United States to a more integrative and community-based approach. Many of you have asked me if I see medicine in our country changing, so I’m so excited to share this interview with you today. James, it’s great to have you on my podcast. | |
| James: | Such a pleasure to be here with you, doc. |
| Trevor: | Yeah, absolutely. James, I know that one of your big goals is to empower and build a community of 100,000 integrative physicians and practitioners to become leaders and change agents in the movement of Evolution of Medicine. I love this goal because as a naturopathic physician, I know how great this medicine and I know I can’t see everybody out there. We need more practitioners. We need more awareness so that we can help people get to the root cause of their health concerns, address those root causes using a more natural, integrative approach to medicine, so I love your big goal. I’m here to help support you with that and see how we can help spread the word about functional and naturopathic medicine. Thank you so much for everything that you’re doing. |
| James: | Absolutely. Trevor, it’s been a journey to go through it and we just really early this year, I had the opportunity to attend a conference in Germany which was about medical systems around the world shifting from disease treatment to health creation. What became really clear at that conference is that the future of noncommunicable disease is integrative medicine. We’ve had a system that’s really been built for acute disease, for trauma, and for surgery and for the diseases of the 19th Century and the 20th Century. The whole point of the Evolution of Medicine is how do we help medical systems adapt to this new environment, which is a lot of noncommunicable, chronic disease, lifestyle-driven disease. That really needs a different system and so our plan of 100,000 micropractices is really what we feel medicine adapting to its environment in the most efficient way. |
| Trevor: | Yeah, absolutely. That’s fantastic. I love to hear that. James, let’s back up for a moment and talk about you and what made you decide to want to do this. |
| James: | First off, I was definitely the weird kid at school that did natural medicine. Seeing as I’m talking to a naturopath, I can tell you that I was a pulsatilla kid, so weepy, whiny, as you would know. I grew out of it, a little bit, anyway. Look, I grew up. I had a chiropractor. I had a homeopath. That was the way that I was brought up. My parents were very much involved in that. There were certain things about that that were sort of weird, but certain things about that that were sort of ahead of its time, like how does my mom, with no medical expertise at all, was telling the nurse at school that I was only to have antibiotics after they agreed with her. This is 30 years ago and now she’s like visionary of understanding antibiotic resistance 30 years before it was a thing. That set me up to, I guess, thinking this way. |
| I had a bit of a rebellious phase where I thought I needed to be an investment banker. I went to school. I did economics. I did health economics, actually, at university and that’s when I really started to see, particularly America, this crazy situation America with massive cost increases, but no increases in outcomes. I had a moment of clarity that something that I’d learned about in my childhood was going to be useful to addressing that problem and so 11 years ago, I moved to America. I had the opportunity to work in a clinic. The first job that I had was working in a clinic that was really designed to be a vision for the future of primary care, so was a naturopath working inside kind of like a day spa environment. | |
| Then I was starting to serve doctors like naturopaths. I was selling to them and I got to really understand what made them tick, what was easy for them, what was difficult for them. It really started me on this journey of discovery to really understand how I could be most useful in helping the profession thrive. One, helping more patients to understand the value of it and two, really help make it easy for practitioners to actually deliver this care because what I saw is that as I started getting out into the world and then teaching practice management, I found that there was a lot of naturopathic doctors and physicians who felt really called to practice this type of medicine, but also had to become an entrepreneur. That was sometimes a tricky transition for someone who just was passionate about helping people. | |
| Trevor: | I really appreciate you saying that because I know in naturopathic medical school, we go there because we want to help people and we want to be doctors. We’re not trained to be business people, but yet, after we graduate, we’re expected to just go out there and figure it out on our own. Sometimes, it can feel really a daunting task because we have to educate people about what we’re doing, so we need to get out and we speak. We need to do media and we need to run our own business and we need to see, help patients. It’s so much work to have to do all of that, so I understand that you’re helping practitioners with being able to find a way to really do this and in a way that works. |
| James: | Yeah. Look, the good news is I think we’ve finished this first phase of integrative medicine, what I call Functional Medicine 1.0. In Functional Medicine 1.0, the only people attracted to do it were the people who felt like a moral obligation to practice this type of medicine. They’d had some experience in their lives that showed them that this is what they need to do. Then they had to go to school and it wasn’t that easy. Still, naturopathic medicine only licensed in, what, 19 states now. I think Pennsylvania just dropped the other day, so still it’s not official and it’s tricky to do it. |
| We’ve just moved into this new era, which is where I think for the first time, if people are listen to this in five years, there will be jobs for naturopathic doctors and for functional doctors doing this because more and more health systems are starting to take this medicine on as they realize that this is a more efficient way of dealing with chronic disease. More and more practices have grown to a point where they can hire other doctors into it. In this first era, the only way to do it was to become an entrepreneur and that led to a lot of practice wreckage, right, people just wanting to do it, trying to do it, not sure how to do it, and going out of business. What we see right now is that for the first time in history, there’s an opportunity to build a practice with a lot less overhead. There’s technologies that are arriving to make the delivery of this kind of care easier. Throughout the last three years, we’ve been building the biggest community of these types of doctors. | |
| What we wanted to do, it started in New York, Trevor, where what we saw is that there was a lot of practitioners doing similar types of medicine. If you look at functional medicine, integrative medicine, naturopathic medicine, lifestyle medicine there’s probably a core 90% that’s the same, right? We’re all trying to empower the patient to be a participant in their car. We’re all looking for the root causes of health where doctor is teacher. All of these things are naturopathic principles, but are also principles of these other forms of medicine. | |
| What we wanted to do is first of all just to help practitioners realize that they were the same and that they could work synergistically together. I think naturopathic doctors and functional doctors sometimes feel like they’re an island unto themselves, like they’re the only weird one in their community that’s doing things differently and so through the Functional Forum, we’ve done 32 episodes now of the show. It comes out monthly. It started out with building a community in New York, getting all these providers together once a month into a room and seeing what kind of synergy we could unleash from getting them together. Then it started to build into meetup groups all over the world. We’ve got 200 meetup groups now of practitioners getting together not only all across America, but all across the world as practitioners realize that there’s value in getting together regularly. | |
| Then, as we built this massive community, earlier this year, some data came out that just reaffirmed what we had seen is that any practitioner providing this kind of care loved doing it. They loved their job. They were so satisfied by being able to deliver this kind of care, which is in stark contrast to most doctors who either want to quit their job or, in more and more cases, kill themselves. Doctor suicide in America is out of control. The numbers are scary. There’s a real problem with physician dissatisfaction, but here’s a group of practitioners that love their work. In the same way, patients love the care of the naturopathic profession, the functional medicine profession. | |
| The elephant in the room was that functional or naturopathic medicine was neither efficient enough, nor, in some cases, affordable enough for the majority of people to use it. There is an opportunity. Right now, we see the most innovative practices having a low enough overhead and are interesting new business models where we could close that gap. What we’ve been doing on the Functional Forum is sharing these ideas in between the clinical content and so this year, we just made it part of our plan to actively speak to our community and say look, here are the best practices that we’re seeing that have emerged in the last two years. Here are things that you can do today that you couldn’t do two years ago because of now technologists in Silicon Valley coming to support our community and so here’s a way that you can run a practice a lot more efficiently and with a lower overhead so we can make this affordable for more people. | |
| That’s the mission that we’re on right now, but it’s all really the same mission. We’re kind of a media channel. We’re kind of a practice management company. In a movement creation, it’s going to look a bit different as you seek to serve the needs of the people of your community. We have such a great relationship with our community. We always asking them what do you need. How can we help? The call came loud and clear to us earlier this year, like teach us how to operationalize the kind of things that you’re talking about. How do you a group visit? How do you build a provider team with a naturopath and a health coach? How do you use these technologies to reduce the overhead of having supplements and phlebotomy in house, these kind of things. | |
| We just set up a course to operationalize that, but because I wanted to make it free for everyone, I put all the best ideas in my book. I made my book free for everyone, so it was just like let’s just make this available to everyone, empower the whole community. If you can do it just from reading the book for free, go do it. If you need the help of our team to help operationalize it step by step, then we can help you with that, too. | |
| Trevor: | Yeah, great. Tell us about your book and is it still available for free? |
| James: | I got one right here, Trevor. Amazon lets you have it free for five days on Kindle, so I think it’s still 99 cents on Kindle, although the hard copy you can order. We will be having hard copies for free plus shipping and handling I think from the 1st of December. My goal is to send one of these books to every physician in America. I’m going to start with primary care and family medicine because those are the doctors that are the most burnt out and are the most ready to practice this type of care because I think they all have this knowing that they’re not helping patients who have these lifestyle diseases in the way that they could be helping them. |
| That’s the first step is we really want to get this in those doctors’ hands and then over time maybe to some of the specialists that are starting to see, for instance, we’re getting a flood of psychiatrists now who realize that hey, if inflammation affects mental health, maybe I should be learning how to reduce inflammation or I should have a partnership with a naturopathic doctor who has a lot of skills and tool sets to be able to deal with inflammation. We’re going to go step by step through all the specialties, but we’re going to start with the primary care and family medicine. | |
| Trevor: | Let’s talk about community solutions for health. How do you feel that could improve? What do you think are the opportunities there? |
| James: | We started off this movement by building a community in New York, so this was a community of naturopathic doctors, functional doctors, integrative doctors, and there was a value in community. Then we started looking is there other examples of community providing real solutions to care. There are solutions everywhere, from the very micro, where there’s this new science of human social genomics, where for the first time in history, genomic testing, like gene testing, is cheap enough that you can measure what actually affects gene expression. What they’ve started to find for the UCLA Stress Lab is that our human social relationships actually have a much bigger effect on our gene expression than smoking or diet or exercise. This is absolutely crucial, so that was amazing for this science to come out even after we started our movement to show the power of community on health is incredible. |
| Then on the macro level, we have the blue zones where you have just the best examples of people living to 100 consistently. They don’t have a big hospital down the road. They just have amazing sense of community, right? On the macro level and the micro level or the cellular level and at the population level, you see the community is playing a huge role in health. Then if you echo that with something like the Daniel Plan, Dr. Hyman’s plan, where he got Rick Warren, Saddleback Church participants on their Bible study night to learn about health. There was huge results. I think the population of 15,000 people who go to the church lost 250,000 pounds by working together in community, at no cost, by the way. This is not like there was a lot of insulin being delivered to everyone, not a lot of metformin or a lot of Humira, nothing like that. This is just people supporting each other through dietary changes and the core foundations of naturopathic medicine. | |
| I see okay, here’s a real opportunity, so what we’ve been trying to communicate is what are the clinical models that will allow us to access this kind of value because peer-to-peer community support is really the only medical resource that there’s an unlimited supply of. There’s not unlimited numbers of functional doctors or naturopaths or otherwise. Part of our big plan, if we look at creating a medical system with those kind of providers at the front end at primary care, the elephant in the room is that there’s not enough of them. There’s not enough to go around, so part of our goal has been to usher more doctors and show them this is a safe space for them to come and to learn to practice like this. That’s the first thing that we’ve been looking to do to try and get more of them. | |
| If we see how can we expand the reach of each of these providers, there are emerging best practices for engaging the community into care. As an example, group visits. We had Dr. Terry Wahls on our Functional Forum in September, amazing woman, reversed her own MS by her dietary protocols and now is proving that it’s reproducible with her research in the VA. Now, the way that she’s delivering the care is through these group visits because there’s not unlimited resources for her to do it, so she has to get everyone in groups. | |
| Now, when I interviewed her, she said even if she was given unlimited resources, if the VA said, “Here’s as many doctors and health coaches and naturopaths as you can use. Go get them,” she would still do it in groups. The reason is because she feels that there’s so much value delivered in the group setting, whereas now, she can share information into a group and now the group provides accountability, support when people are vulnerable in front of a group. There seems to be some sort of healing mechanism that’s kicked in. Now, when people become accountability buddies and will support each other, “What have you eaten today? Did you exercise today?” This is valuable to both participants and there’s value being created by the person who organizes the group, but no, it doesn’t cost anyone anything and so here are the real solutions. That’s just one example of building a community around your practice. | |
| That’s different from practice marketing because in practice marketing, you’re just trying to get an interaction with a new person. In community building, you’re trying to get new people into your community and then you’re introducing themselves to each other. That’s the future and so our training is all about spreading the practices on using community, maybe using a community of providers, like Dr. Scott Shannon, who’s this amazing psychiatrist. He has two psychiatrists, three naturopaths, health coaches, and biofeedback all on the same team working with patients as a community and in that way, is able to extend the role of the naturopath and see way more patients with way fewer providers because they’re working together as a team. The naturopath’s not doing everything. They’re just doing the clinical work, reducing inflammation, all of that stuff. The health coach is the one that’s now helping them implement these behaviors into their daily lives. You’re really getting efficiency into care and so that’s what we’re on a mission to do is how do you bring the power of community into medicine in a way that makes this kind of care available to everyone. | |
| Trevor: | I love that. I truly see the power in the community of helping. I’ve seen that as I’ve run group programs. When I was at Waldorf Astoria, we did a lot of those. I just could see people really flourish in those kinds of communities and then also, what you’re talking about with practitioner communities being able to bounce ideas off of other practitioners and because you, as a sole practitioner in a practice, I know I can’t do everything. I can’t provide everything. If you’re in a practice where you have other practitioners, it’s so nice to focus on what you’re really good at and then refer to the other people in the practice that can provide what they’re good at and especially if you set it up in a way where you complement each other, that there’s so much power in that. There’s so much power for the patient and their healing journey. |
| One question people often ask me about naturopathic medicine, functional medicine is about insurance. Are you finding with health insurance that people are getting reimbursement for this kind of practice? | |
| James: | I got good news and bad news, Trevor. Let’s start with the bad news. I’m not seeing a lot of insurance reimbursement at this present moment because of a number of factors. One of the things I think we all think is that insurance companies have a incentive to reduce costs. That’s just intuitive thing. You think if these companies, we’re paying them a certain amount of money and we spend less, then isn’t that good for the insurance companies? |
| The dirty little secret of insurance is that insurance works on a cost plus structure, so it’s kind of like the Army. When we go to Iraq, how do you end up in Iraq with a $20,000 toilet? It’s because the Army, everyone’s on a percentage of cost, so the costs just keep going up. That’s why you see insane cost levels in America. Everyone thinks that insurance should … You have the three biggest players, insurance, hospitalists, and pharma all with incentives to increase costs. That’s why your health insurance premiums are going up on average 25% this year because it’s just ratcheted up there. | |
| We do see some innovation in insurance where there are organizations that are using the power of community, like health cost sharing, which are a lot more amenable to these kind of things because ultimately, they do have the incentive to cut costs because it’s essentially a group of 35,000 healthy people splitting their costs and so there’s some innovation there. | |
| The good news is is that things are going to move in our direction and let me tell you why. One of the mandates of Obamacare that’s coming into play over the next four years is that we’re going to start to see insurance companies paying not for the delivery of services, like not paying for every extra stent in the heart, which is now the way it’s paid. That’s why naturopaths don’t make as much as cardiologists because naturopaths are mainly just spending time with people and cardiologists are doing stents. You get 1500 bucks for a stent and you only get $100 for spending an hour with people really helping them. That’s one of the problems with the old system is that it incentivizes too many surgeries and things that are expensive to be done. | |
| In the new era of health insurance, where we’re moving towards is outcomes-based payments. This would be something along the ways of okay, Dr. Cates, this is a patient under your care. I’m going to give you $10,000 from the insurance company, but that’s all you’re going to get and you have to take care of this person for the next three years or something along those lines. Now, there’s an incentive not to do as much stuff, but to actually keep these people well because if you can reduce their costs internally of what it costs you to keep them well, the more profit you make because 10,000 minus whatever it costs you to keep them well is how much money you make. As we move to outcomes-based payments, I think there’s a lot of excitement in our community. | |
| What I would just say, if I look into my crystal ball, I would say that in about three years, you’re going to see this amazing convergence, Trevor, where on one hand, you’re going to see all of these insurance companies starting to shift completely to outcomes-based payments over here. Then on this side, you’re going to start to see functional medicine proving itself to have better outcomes at lower cost. | |
| That’s what happening at the Cleveland Clinic right now. I was just at a conference last weekend and every time I see a presentation about what’s happening at the Functional Medicine Center at the Cleveland Clinic, it becomes more and more clear to me that in a few years’ time, when these studies are complete, we’re going to see that for the majority of chronic diseases that have a lifestyle component, from asthma to type two diabetes to heart disease to some autoimmune diseases, you’re going to start to see that you can get better outcomes at lower cost by really identifying, by really working with the patients’ lifestyle factors. That’s pretty exciting and so I would say it’s good news and bad news. Bad news in the short term, good news in the long term. | |
| I would say to anyone you may be having to pay out of pocket right now and actually, the other piece of good news is that most … This is not really good news either, but most people’s deductibles are flying out of control, as well. It’s not just the premiums that are going up with Obamacare. It’s the deductibles. When you have a $10,000 deductible, seeing a naturopath or seeing your primary care doctor are really kind of in competition and it’s like a direct competition for cash. | |
| The good news is that I think most consumers out there know how to find value. They’re doing it all the time. They know. They’re spending dollars and looking for value in every other service and I think that if you’ve been under the care of a naturopathic doctor or functional doctor and they’re helping to keep you well and you feel that and you understand that and you’re participating in your care, then I think if you have a understanding that they’re providing more value than a 10-minute visit with a cardiologist where they look at your labs and say everything’s fine. I feel like that’s working in our favor now, too. | |
| Trevor: | Yeah, and there are also health savings accounts that people can use. I think more people are starting to use those, as well, right? |
| James: | Totally. Yeah, that’s starting to happen. It’s not like that much incentivized in the new health system. I wish it were more part of the Obamacare strategy because I feel that again, anything that puts us on a level playing field ends up working out well for our community because it’s been such an unlevel playing field for so long. As the playing field becomes more level, I feel like it really helps naturopaths to thrive, patients under their care to thrive, so we are seeing a leveling out. It’s just maybe taking a little longer than we’d hope. |
| Trevor: | For people that are watching, listening, and are not familiar with health savings accounts, it’s something to look into because you have a lot more flexibility in that spending. Anything else you want to say about health savings accounts? |
| James: | Yeah. I think most people don’t realize what they can spend it on. I think if you don’t have one, ask about it with your health insurance carrier and if you do have one, really ask some questions on what you can use it for because most people don’t understand that it’s pretty much like a credit card and you can pretty much spend it on whatever you want. There’s a lot that you can spend it on, especially if you’re under the care of a naturopathic or functional physician. |
| Trevor: | Yeah. I’ve seen that with my patients that have them that they will oftentimes they can pay for their supplements and their visits and a lot of different things, so I think it’s a great option, too, until things change. We have to work with what we have, so a question for you. How do you feel the conventional medical doctors are taking this kind of movement, this kind of change? The people, the doctors that you’re talking to, how do they feel about it? |
| James: | It’s a great question. The proudest thing about my book, the thing that I feel better about than anything is hearing doctors who have previously been very skeptical about this movement to embrace it. One of the things that I talk about in my book in the second chapter is if you wanted to get laughed out of any medical convention over the last 30 years, probably the two biggest things that you could talk about were toxins or leaky gut, right? These were two things that if you just said those words, everyone could have a laugh at your expense. These were things that naturopaths have been talking about for 100 years and they were just the kind of topics that you could bring up that would make you seem like a joke. |
| Then, guess what? Now, in the end of 2015, the biggest medical organizations, the Endocrine Society, the OB/GYN Society say, “Yeah, we were wrong. Toxins do cause disease and not just in the people who were exposed, but in the children of those, transgenerational epigenetics.” That’s a huge moment, right? That’s a huge moment for physicians to be like oh, not everything that I was told was right. Most physicians are told at their very first training at medical school that 50% of what you’re going to learn in medical school is wrong. We don’t know what 50% it is, but you better keep vigilant because you don’t know. Look, you were wrong on toxins and if we’re wrong on toxins, that is a slice of humble pie that one has to eat. When one’s eaten that slice of humble pie, then maybe one is more receptive to be like okay, if toxins are a problem, what out of this detox fad is real because the thing is, patients are getting this earlier than doctors. | |
| That’s the other thing that I talk about is if you’ve been to a naturopath 10 years ago and you’ve been on the process of building a strong detoxification system because now you’ve been seeing it coming up in the literature because everyone has access to PubMed now and you’ve seen it in studies and your naturopath has been feeding you the science that shows that they’re right, on average, it takes 17 years for science to come into mainstream medical practice. What’s actually been happening, Trevor, is that the consumers have been pushing for this faster than the doctors. They’ve been getting it quicker than the doctors. That’s why we have this consumer health revolution. I think in a certain way, doctors, mainstream doctors, have been losing the trust of their patients by not being up to date with this and sort of relegating this information to something that’s not real. I see that with that push and with this new science emerging, it’s helped doctors to realize okay, this is a thing. I should know about this. | |
| Then it’s like what I’ve tried to portray in my book is that the movement from being a regular primary care or a family physician or even a specialist to building what I call a functional micropractice, a low-overhead practice where you charge the patient directly and make it affordable using things like episodes of care packages or direct primary care is a big new trend where you pay a low monthly rate to have access to a doctor and you don’t participate with insurance that they could actually have not only practice a type of medicine that’s really fulfilling for them, but actually really fall back in love with medicine and to be able to really help people in a way that they haven’t been able to help people stuck in the system. | |
| To go back to the original question, the best part of this whole process is to hear from physicians who read the book and go, “You’re right and I’m ready to do this. Show me how to do it.” That’s been amazing. I can’t even explain how satisfying that’s been particularly for doctors who I know, who have told me to my face in the past that they don’t agree with what I’m doing and this is BS or otherwise and then have come back and said, “I read the book. It really dealt with some of the skepticism.” | |
| Really for the first time in the book, Trevor, I was able to make my arguments, I feel like, in a cohesive manner where we went from this is what we can all agree on and just went through okay, if we agree on this, then look at the new science and say we can agree on this. If we agree on this and go through in that way and a lot of times in this debate, you hear one thing or you read it. You don’t have the context for where it’s coming from and so you just don’t agree with it. I think when I was able to make that series of arguments in that order, that was a big, big moment for me. | |
| For your community, I would say for any practitioners, go and grab the book. There’s tons of value in there as far as running an efficient practice. You’ll get a lot of ideas from it that will save you tons of money, help you build a more successful practice. For any patients who are out there who’ve been dealing with doctors that don’t get it, we’re going to have a way very soon for you to tell us which doctor we should send a copy to and then we’ll send them a copy and follow up with them because I feel like maybe what I’ve created is like a conversion engine for allopaths that has never really been created before. | |
| Trevor: | Thank you for saying that. That was actually going to be my next question is how can we all support you and what you’re doing and this movement and so I really appreciate you giving us something that we can all do and whether people are practitioners or they’re just interested in helping spread the word and have more access to it because we’re all going to be better off if we have more access to this kind of medicine. Then, if it’s more of that community approach that you’re talking about, then it’s going to reduce the cost and it’s also going to increase access because that’s one of the biggest things that I hear is I don’t have a naturopathic in my town or a functional medicine doctor that I can see or they don’t know how to find that person or they just don’t have that part of their healthcare team yet. |
| I think that’s great and I also really appreciate what you’re trying to do to help other doctors, too. I know that what you’re saying is conventional doctors and friends of mine that I know, they do feel stuck in their practices. It’s not like they’re bad people and they’re practicing bad medicine. They’re just stuck in the system and don’t know another way until they find another option like you’re providing. Having these seven or 10-minute appointments is what they have to do in order to get insurance reimbursement at this time, so looking at other solutions, helping people see that there are other options, I think all this is fantastic, so thank you. | |
| James: | No, no worries. Look, what I tried to do in the book was to tell the story of everyman doctors. I think up until now, there’s been a real focus on, I would guess, the celebrities in functional medicine, these amazing stories, like someone like Mark Hyman. It takes an incredible man to go and change the Cleveland Clinic and all respect to him and everything that he’s done. I don’t think the regular doctor can identify with Mark Hyman because he’s just an incredible human that’s done a hell of a lot. |
| What I tried to do in the book was to give examples of doctors who have made the switch, that doctors could say, “I could do that. That could be me.” Like Jeff Gladd, who’s one of the heroes of my book, he went through the whole shift from being sick and tired himself, unhealthy, sneaking SSRIs out of the cabinet, to getting himself healthy, realized he didn’t have the skills to help his patients get healthy, learning those skills, trying to do it inside a hospital, the hospital kicking him out because it wasn’t efficient enough, it wasn’t making enough money, and then starting his own micropractice and doing this all in Fort Wayne, Indiana, which, by his own admission, is like the least likely place in the country. | |
| Here’s a guy that I think most doctors can say, “Hey, I can empathize with that. I haven’t always been the most healthy and I don’t really know how to get myself well and when I go to try and look for ways to do that, it’s not really in my medical training to understand nutrition or sleep or exercise unless I’m a sleep doctor or I’m a physiatrist or whatever.” It’s been very compartmentalized. I think by making the stories like that accessible, people, doctors, I want doctors to say, “I could do that. That’s what I want to do.” That’s been really cool. | |
| Yeah, we’ll have some solutions. We’re working on this from a number of angles, Trevor. This moment, our focus is all on how do we get more functional medicine doctors because as much as I love the naturopathic profession, the truth is, there’s just not enough naturopaths to go around. There’s just not enough to serve everyone. Even if we started 100,000 people in naturopathic medicine school today, it’s going to be like four, six years until we have enough providers. The quickest way that we can get to where we need to go, the quickest way that medicine can adapt to its new environment, is to convince primary care, family medicine, and the range of health specialties that aren’t in love with their job to come and do this because you can learn this very quickly. | |
| In my book, one of the reasons why I pick out the word functional as my rallying cry rather than naturopathic or integrative is that functional has a reproducible operating system, that you could train 100,000 doctors quickly. That’s really, again, one of the things about naturopathic medicine is you’re a naturopath and there’s a naturopath down the road, but if I was a doctor and I came to shadow both of you, you’d probably do things differently. That’s good because it’s an art and a science, but it’s not good if you’re trying to scale. | |
| The thing I like about functional medicine is that there’s a system that you can teach people to do because I think doctors, when they come into this, they’re looking like just tell me what to do. Teach me what shall I do in what order. That’s why I like functional medicine because there is that operating system and also with the momentum that is has with the Cleveland Clinic and that credibility, I think, is a big force now. | |
| At the moment, we’re really focusing on how do we get more of these doctors, but in the big picture, Trevor, you’ll be glad to know what we’re really trying to work on is an access point for patients to be able to access those doctors in the most efficient way because the truth is, if you have a mild digestive disorder and you’ve never changed your diet, you’ve never done an elimination diet or anything like that, I’m not sure if you need a $400 an hour doctor to solve that problem for you. Maybe just working with a health coach initially to change the diet a little bit and to see what happens, that first journey of exploration. We don’t need all of those doctors straightaway to be able to deliver this care. | |
| In the meantime, while more and more of those doctors are training, I think we could use the resources that we have, these provider teams, groups, technologies, and so we’re working on it on both ends. At this moment, the best thing that your community can do to help is to get that book into as hands of as many physicians as possible to start their journey through the process. Next year, I hope to be back and we can talk again with some solutions to really connect your community to this network of providers in a way that expands the reach of every physician by taking best use of the whole community of providers that we have. | |
| Trevor: | Right. Yeah, that’s great. I just want to clarify with the functional medicine versus naturopathic medicine, if someone is watching or listening to this and they’re actually thinking about going into training, I really think that the naturopathic medicine program is a four-year program. It’s very comprehensive. You learn functional medicine, naturopathic medicine within the four years, so I think it is the ultimate training for naturopathic, functional, and integrative kinds of practice. |
| Like you said, it does take four years to do it, so someone’s already a practitioner, if they’re already a doctor and they’ve gone through medical school and they want to add in the functional medicine component, that’s going to be the fastest way to do it is to do a functional medicine training. I still think that the naturopathic medical training is the most comprehensive and creates a solid foundation for people to move from. If there’s the time for it, I think it’s the ultimate way to go, but if there’s not the time or the access, I know not everybody can get up and move and to one of the states that have naturopathic medical schools, too, so I think that helps people differentiate where to go. | |
| James: | I completely agree with that. I agree with that. I think if you’re premed or you’re a student maybe … I know you have a lot of people that are working with their skin and so maybe you’re speaking to a lot of people in that prime age who are deciding what they want to do with their life, I completely agree that naturopathic medical school is the best, the easiest journey to get to a point where you can be this kind of provider. As I said, the Evolution of Medicine is helping medicine to adapt to its new environment in the quickest way possible. We need to bring more people through naturopathic medical school and get them ready for that next era because this is not going away. |
| In fact, I just heard yesterday that for the first time, I know you know lifespan in America has been going up and up and up and then it was tailing off and it was flattening out. Just yesterday, you start to see data that it’s going down, which is really scary. We need people. We’re going to need people in seven years, too, so if you want to do this for the rest of your life and you’re in the age group now where you’re deciding on your career, naturopathic medicine because there’s not going to be a lack of people in seven years for you to deal with. | |
| Our goal right now with the book and otherwise is how do we convert enough doctors and practitioners across to operate in this paradigm, that we can really build a new medical system with these providers at the front because at the end of the day, if you really want to cut costs, the most costly medicine happens after the referral. The primary care is the front, so the naturopath, the primary care doctors, and then when they refer down to the cardiologist, the rheumatologist, that’s where you get the expensive drugs and the expensive surgeries. My vision, and I’m sure you share this, Trevor, is that if we can stop, we can go upstream and stop the majority of these chronic diseases at primary care, that’s the proper medical system. I think we all intuit that and that’s what we’re aiming for. | |
| Trevor: | Yeah, absolutely. Thank you, James, for everything that you’re doing. Thank you for your interview today and I am so excited about this, the Evolution of Medicine and this movement that you’ve got going. I think it’s really going to help get more people that have that access that they need to this kind of care and what they can afford, as well. |
| James: | Absolutely. Yeah, thank you so much for having me on here. I have to say this whole thing, it would not be possible for this to have the kind of momentum that it has now without the dedication of all the practitioners who did this. Every practitioner that signed up for naturopathic medical school in the last 25 years or any practitioner that’s been practicing functional medicine before today, the only reason why they did it is because of a moral obligation in their heart to practice this type of medicine. The only reason why things can move as fast as they are today is because there’s such a weight of good feeling about this community in the population due to the work of yourself and all of your colleagues over the last three decades. |
| This is not just James shaking things up. This is James just hopefully organizing something that already existed a bit better so that it can take its rightful place. I have to say thank you to you and all of your colleagues. It’s funny. When doctors get it, they often realize that they’re sort of like naturopaths all along and so it’s very exciting to see the sort of ancient wisdom infused with the modern science in a beautiful way. I think that’s the true potential of naturopathic medicine showing itself in the new environment, so thank you. | |
| Trevor: | Thank you. Awesome. Appreciate it. I hope you enjoyed this interview today with James Maskell. To learn more about James and his book, you can visit my website, thespadr.com. Go to the podcast page with this interview and you’ll find all the information and links there. Also, I know some of you ask me saying that you’re looking for a naturopathic physician and want to know where to find one in your area. You can go to naturopathic.org to find an ND in your area. I’ll also provide that link on my website, as well. |
| While you’re on my website, I invite you to join the Spa Dr. community there or subscribe to the podcast on iTunes so you don’t miss any of our upcoming shows. If you haven’t done so already, I highly recommend you go to theskinquiz.com and get your customized skin report. It’s free and just takes a few minutes to answer a few questions and you’ll get your own customized skin profile at theskinquiz.com. Also, don’t miss out on the latest tips to get glowing, healthy skin and vibrant health. Join me on Facebook, Pinterest, Twitter, Instagram, and YouTube and join the conversation. Thank you and I’ll see you next time on the Spa Dr. Podcast. |
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