Integrative Approach to Pain with Dr. Touchinsky

Intro and guest introduction 0:00

All right, so when I see it live there, I'll screen it. Okay, all right. It should be popping up any second now. Oh, my camera is very high. Hey guys, we're gonna give it a few seconds and let people hop on. We have Dr. Tichinsky here. Did I say your name right? That's very good. Yes, I did. Yay! I was caught you by your first name, so what was it? I'm like, wait a minute. I should probably ask if I am saying it right for his last attempt. Yeah, absolutely. Good. Awesome. So we're going to be talking to him about his functional medicine practice.

He is in Pennsylvania and he's got lots of really great stuff going on there. And I wanted to highlight him and bring some attention to what he is doing because I think it's phenomenal. It really is a wonderful approach to health and wellness and being able to manage your health. in a different way, in an effective way that can be out of the box for some of us because it's not something maybe that we're familiar with. So, or maybe we are familiar it, but maybe were a little intimidated by, you know, whatever the case may be.

I thought it was a great opportunity to have him on. And I'm going to tell you a bit more about him in second here. It looks like we have some viewers. popping on now, which is great. Let me make sure I can see the chat in case people have questions. Yeah, I got mine pulled up here too, in the case anyone has any questions, so if you guys have any question at all, go ahead and type those in and we'll try to get those answered for you live. If it happens after the fact, then I'll see that alert and I'm trying to answer them as well, if I could.

Absolutely. Okay, cool. So let's see here. and while you're working on that, hello to my audience. I was able to share it to peak integrative medicine. So I just posted something saying we're not going to have a Wednesday night live tonight for peak integrated medicines page, but I figured out a way to, to shared Jen's feed to our page. We're having it tonight. And the technology all worked. It's great. They did oddly enough. There's always good days when that happens. Well, we've got great weather here today, so that's helpful.

made it all fall in line perfectly. So a little bit more about Dr. Tuchinsky. He's a chiropractor and a functional medicine practitioner, and his focus is on creative solutions and innovative methods to help people solve their problems and maximize their health. It was in his chiropractic practice that he started to find the missing links when it came to health, the health of an individual, and it really became apparent through that. And that led him to study and become certified in functional medicine and to develop a team, as a whole team of like-minded practitioners and open an integrative medical center in Pennsylvania.

So I know a lot of our followers are South Jersey area, Pennsylvania, some even Western PA. So this is a great resource for you guys. I hope you stay and listen to Dr. Chachinsky. Thank you for being here. That's a pleasure to be here, thanks for having me on. And you were a guest on my program a couple of weeks ago. Hope everyone went back and watched that. No, I'm real happy to here and to relinquish the host's duties for an evening. Yeah, to be on the other side for a change, right? So tell us about, like I said, some people are somewhat familiar with an integrative approach, what do you mean exactly by that?

I guess the best way to illustrate that is to share my story as a newbie practitioner back in the day, 2005. I came out of school, I played college ball and I've had some injuries and had experience with chiropractor helping me for that.

Why integrative medicine matters 4:20

Like in school we learn, we get a pretty good background in nutrition and some herbal therapeutics and a little taste here and there of functional medicine. And I'm like I don't want to do any of that stuff. I just want to treat injuries. I want a crack backs. And I'm not worried about kind of that other kind weird stuff that's out there that some people are doing. But pretty quickly like within a year I would say I working on these people and they just heard all over. And it's not because they just like bent over and tweaked their back, lifting something, or it was not, because if they fell on the ice and had an injury or a car accident, I'd say nine out of 10 people, and still to this day, nine of the 10 that come in, it is not from a single injury.

It's from just slowly getting worse over the years. Their muscles are in poor condition. They have just this inflammation all over their body, which causes them to really easily trigger muscle pain and muscle inflammation. and just working on their backing and their joints moving better as a chiropractor, stretches or exercises wasn't doing the trick. And then on top of that, these people with chronic pain and chronic injuries, recurring injuries also had almost, almost nine times out of 10 as well, gut problems and they had digestive issues and had a poor diet.

So I'm like, all right, I built, again, like resisted that. I was like I'll just send them to someone. and I am up here about an hour and a half northwest of Philly, kind of in the foothills of the Appalachians here. And a real small town, 4,000 people at Worksburg and lots of small towns like that around me. We don't have like a lot of integrated practitioners like you might have in a more urban area. So I looked around long enough and I'm like, all right, no one else is going to do it. I think I better study up and start to offer that.

And I did, and kind of fell in love with it, so that's why I am here today. Yeah. And then when it comes to chiropractic, you know, this is a chirapractor, but people don't realize that, they complain about having to keep going so often to a car factor. Well, your general overall health has a lot to do with how well you hold those adjustments, which then dictates how often you have to go. Right. Yeah, yeah, it all works together because even if your body's ability to even fire the nerves that control your muscles and then for the muscles to fire themselves properly.

There's a lot that goes into that it's not just kind of a simple mechanical thing like a pulley or like There is a this whole chemical kind of cascade that happens every time your body does really anything from a thought to moving a muscle to digesting food. And that requires different nutrients different neurotransmitters and it involves a healthy functioning nervous system immune system brain and just really it's you can't separate them out and without going into too much of kind of a rant, that's kind the problem with healthcare these days.

You have the, this is the age of the super specialist. So it can be as kind splitting hairs as much as, all right, I think you have a throat problem, so the doctor sends you for a throatscope. And then they find something that down like an extra couple of centimeters. Well, like, no, it's the GI guy, So I can't, you end up splitting a person into so many different pieces. This doctor looking at that problem. Whereas I feel in functional medicine, and even with like health coaching and some of those other wellness related fields, that's looking at the whole person.

And we need to do some more of that. Now you need your specialist. If I have a certain type of tumor in my brain and there's a surgeon that only does those, I'm going to him. But when it comes to a lot of this other stuff, we needs someone. We need a super general, so to speak, to kind of put everything together for people. That's what we're lacking. Yeah, definitely. So you probably see a lotta people that struggle with inflammation too, right? Yeah, inflammation has been for all sorts of reasons from stress, poor diet, or gut health.

I mean, there's lots of different causes for that inflammation. And yeah, same thing there. You need to take like a holistic approach, meaning look at their, the totality of that person. So look their diet. Look at the exercise, look of their sleep. People aren't sleeping these days. Looking at, like I had a guest on last week that we talked about circadian rhythm and how screwing that up and not sleeping well can affect neurotransmitters, which can then kind of one thing leads to another, leads another.

And then there's the psychological factors too, right? So what do you, how do see that represented? Yeah, so we see. So I kind of had four broad categories here. I made notes because I'll go off on a tangent and talk about one thing way too much or kind get scattered here, So when we say integrative, like I like to look at the kind different categories of what causes pain. Let's we got we've got real broad there for a second. So let's talk specifically about pain, because that's what the title is.

And if people are coming for their chronic pain. Let us give them what they came for. I would say there's mainly four main broad categories of what can be triggering pain and it's usually not either or it is usually all of the above. But one is the physical or biomechanical triggers of pain so that is actual like you jam your joints. you fall and hit the ground. You twist an ankle, you twist the knee, poor posture from sitting at a desk all day long, or driving the car all the day, long lifting something too heavy.

So most people when they think about pain, they kind of get you with you would guess this is the reason why people are in pain. And the only reason people aren't in the pain really, it's because they've done something that physically looks like we lost him.

Four causes of pain and inflammation 10:20

All right, let's give him a minute to get back on here i'm not sure it looks, like it's still live streaming so that's good we'll give. A second to. get. Back on. Here and he was talking about. the different aspects of pain management and how an integrative approach can be very helpful in that area. We think of paying medication, we think shots, We've think about all of these other ways to manage it, but we don't often realize that there's so many aspects that feed into this. And so Can't wait for him to get back on and talk to us a little bit more about that.

Let's see. So while he's trying to get back in here, I'm gonna share with you guys his website. It's peak integrative med. And he also has a Facebook page that I would encourage all of you to join on there. So let's share this. I am here. Oh, you are here? Where are you? I don't see you. Here is his Facebook page. Ah, there he is. He's coming back in now. Here we go. There you are. You're muted. All right. We're back. The window disappeared and the internet cut out. So should I pick back up where I was?

Yeah, so the last thing you're talking about the physical and the biomechanical pieces. Yeah. So the fix for those things are things like chiropractic physical therapy massage therapy physically getting in there and Removing whatever is affecting that person we're fixing whatever's like physically fixing that so it's kind of like the pebble on the shoe theory where you get a pebbled in your shoe, and that's causing the pain that the main cause and cause for the paint. You don't take an aspirin or Tylenol or an NSAID or prednisone or anything like that to kill the inflammation you remove the damn stone.

So that's kind of like a physical or bio or biomechanical approach and and that I think we all inherently know that and what causes pain is like physical problems, but then we need to look at biochemical causes as well. So, and again, this is not either or it's usually a little bit of all the above. So we go from like the extreme end of physical only where that's like chiropractic, manual therapists, massage therapists PT stuff like that. And then you have the other side of things where you. A lot of the conventional medical doctors, orthopedists, family docs, pain management, stuff that where they address the bio biochemical part where.

They see inflammation and they just want to remove the inflammation. And here's where I think an integrated approach is good because yeah, you might have a stone in the shoe. It's irritated the foot. You remove the stone, but it's still really irritated and swollen, which is in itself causing some irritation and swelling. So you need to address the biochemical part of it as well. That's why medications could kind of overlap with doing some more quote unquote natural stuff or non-medication stuff.

Um, but then there's the, the other thing with biochemical causes is you might have some kind of underlying chronic bio chemical issues. So by that, I mean, what we talked about a little bit earlier in this broadcast is looking at things like inflammation. And, um, like you addressed this in your program with your people and, and a group program where we, we have something similar where We go through and we look at different lifestyle factors, foods that are common triggers of inflammation and We see this all the time we see people that Are just not following the right habits.

And it's not because they're not necessarily trying it because They just don't know like you're eating whole grains. because they feel like they're healthier than eating like refined grains. But for them, the grains are still triggering inflammation in their gut. And when someone comes to me and they have, all right, they've a rotator cuff issue. They have low back pain, They they a knee issue, planar fasciitis. I asked the person like, well, how's your gut feeling? Or how your got going? Oh, it's horrible.

Like constipated, like you only go once a week. Or it the opposite where they diarrhea all the time, where there's lots of gas and bloating. Then they are like why is it about my gut? So that's where we start looking at some other underlying costs. So now we know it's biochemical, you have an elevated inflammation, but why? And I'm sure you see this in a lot of your people as well, right? Yeah, definitely, for sure. And then when you work with these people and you remove these inflammatory triggers and allow their gut to heal, then they feel better overall.

The other reason too is if you're inflaming the gut by eating the wrong foods. Let's think about it a little differently. we know we have vitamin C from an orange. So if you eat that orange, you digest it, it goes into your gut and then it breaks it down and you extract the vitamin and it gets sent to every cell in the body because every single body needs to use that vitamin c. But what we don't think about is if our guts chronically inflamed all the time because of the foods we eat, sometimes what would seemingly be healthy foods like whole brains, Regardless of their inflaming the gut that inflammation is absorbed because inflammation, it's very nonspecific.

It's kind of like our first line of defense for our immune system. it affects all cells of the body different ways, but it effects most cells in the. So that just like the vitamin C when you absorb it in through. the digestive tract and into the bloodstream. Now that circulates everywhere, these inflammatory mediators and can signal other cells to become inflamed and cause like histamine. So you can create cascaded events that really cause inflammation all over the body. And I've seen this often in our reset program where people get rid of all those foods that are triggering those effects.

One, for instance, rheumatoid arthritis on meds, Now she's off meds, no off-meds and her rheumatoid arthritis is better than what it was when it on med. And it's like, am I crazy? How is this happening? Or why is it happening and it is because of that whole thing that we just talked about. Yeah. It's funny because when people come in, I'm sure you have this experience all the time too, and people say, you know, they come for one issue, right? And so, again, not understanding fully this integrated, this holistic, whole body approach, right?

And they come in for this one specific issue and the trigger, the impact of that starts changing all kinds of other things and they start seeing improvement in all these other areas and like, could this really have done this? Could that really matter over here? It's like yes, it all is combined. It all works together, Yeah. And that's the cool part because, um, I often say this when we get like a big group of people and then we usually, or we used to sell it as a weight loss program. and, uh, we, w we still have that program and we've mentioned the weight-loss benefit because that.

Brings people in. That's what gets their attention and it's something that already we're changing my diet. Then I know that will affect my weight in a good way and I'll lose weight and not feel better about that, but what they don't get is, and. Sometimes you can't even say. Because you. On substantiated claims. They're substantiated but you can't like make claims against certain medical conditions. So I guess I want to mention them here, even though our medical clinic now so I think we can mention those but just to keep Facebook happy and not get your video banned.

There are things that people suffer from like I can be more general I could say that so brain fog lack of focus. Like if I start saying like, oh, you joined this program and you're going to get more clarity and your going get rid of your blank brain fog. You're gonna be able to think more clearly throughout the day. Your not gonna need to pound cups and cups of coffee all day long in order to your work done. It's like yeah, how can I do that? It gets harder for people to make the connection or like sleep.

That's one of the things I notice most is when I'm eating on point and following the program myself, Yeah, my sleep is on point. I sleep really well. Um, usually I wake up multiple times throughout the night, like every couple hours. And when I'm doing everything just right, Like I'll hit the pillow at like 10 PM and I woke up and it's like five, it said, well, where, Where did I go? Cause usually, I am used to getting up frequently throughout night. So you start to see all of these other benefits and then people start coming to us and its like, Well, II know I wanted to lose weight and lost weight, but then I also my skin's better.

Like why is my, skin better? Why is, why's my hair better or why am I, and why my My thinking more clearly I don't get hungry anymore and on my cravings, it got rid of craving even though I'm eating less foods or less calories I should say it's more food more bulk but less less. calories. So that's my favorite part of the whole thing is that it really all starts working together so that why we kind of shifted towards. Um, moving into more of an integrated medical clinic where we want to work with people.

We don't want have to say like, Oh, coming to lose weight. And then we're going to fix all the other stuff. You want it straight up, say, like look, you're gonna come to our clinic.

Psychological factors in chronic pain 19:40

Do you want address everything you got going on with you? Let's hit it from every angle that we can with the tools that you have, and you'll feel better. That's going be better than maybe what you are doing elsewhere because you just addressing kind of bits and pieces one at a time. Mm hmm. Yeah, that's great. So I you told the story one time before and I want you to share with everybody about the psychological factor. and how that plays a role. So can you tell us that story again so we can share it with them?

Yeah that's something else that people don't think of like your pain, your chronic pain can be not psychological in the way it's made up and not going in that direction because it not pain is real even if it is only in your head let's say even it it only it still you're perceiving pain and it hurts. So psychological a kind of extreme aversion to that is if you ever heard of phantom limb pain so someone gets their hand crushed in an accident, they have pain for months and months of months eventually they haven't amputated, but for years afterwards, They will still feel that hand, even though it's been amputer so that's how powerful the brain and the nervous system is.

So in a way, I'm kind of talking about that, but to a lesser extent. So if you have pain in your, let's say your low back pain and you had it injured at work or a car accident and your pain for many, many months, your body's wiring will change so that it's easier to feel pain or trigger pain that area. Those pain pathways are really efficient at building up better and better. It's kind like if people that work out and they get big biceps working out a couple of times and without really killing themselves, So pain pain pathways are kind of like that so that's one respect of talking about that when it comes to psychological effects of or causes of pain and but then the other side of it we talked about it before the broadcast was story I share is I have an older gentleman who came in and initially pain in his back when he stands up straight, his backwards, so he was really really hunched over to the point where he's almost looking down at the floor when And after about four to six weeks of seeing him, um, he got to the point where he comes in and like, how do you feel?

It's like great. No pain. I haven't been backwards. Haven't bent sideways. Have him twist. Um, I stretch him on the table. He can move in every different direction. It doesn't trigger his pain and then as soon as he like goes to walk out the door, He gets back in that same hunk punch posture again. And I said, what are you doing? He's, like what do mean? I say, look, you look a little way you're standing. Does it hurt when you stand up straight? And he's No, I get I guess not. So sometimes we just get so used to compensating for pain that we kind of keep the same patterns, which then can lead to more pain because if he just goes back to hunting again.

Well, if I hunched like he did and walked around all the time, my back would start hurting again, so he's just kind like when I say psychological it's kind of like subconscious where we don't know we're doing these behaviors or holding these patterns but we are and it is leading to some of the other stuff that we talked about. Yeah. So tell everybody how your practice is different from most other practices that they'll experience and come across. Good question. In our practice we like to like we We have the standard family practice stuff.

So we have medical physicians with medical providers that will see you to help manage you for acute conditions. Cold, earache, flus, like all that stuff and so that's kind of standard stuff, but with that said, we're also going to look at it with a little bit different slant. If you're getting chronic recurrent sinusitis, it's not going pump you up with steroids. I started this conversation today with someone. We're asking to pump you up with steroids every six weeks, hoping to calm it down and then hammer it with antibiotics.

Now, in some cases that might be necessary, but in her case, it's going on like four months now where that's not working. So that's where we would say, so we know from our functional medicine perspective, like the microbiome is pretty important. So let's work on that and that person, because those good bacteria, the micro biome live in our gut and our stomach, our throats, or sinuses. Let's not just hit it with antibiotics all the time. What's that it was some beneficial probiotics and then we can use some different nasal sprays to help.

Like what if they're going after bacteria with some of those medications, but what, if it's fungus mold or something else, and we there are things that we something called biofilm disruptors, which we can have the person spray and help kind of break down that protective material that prevents the antibiotics from working or the other nasal sprays working as well as they could. Or maybe it's a histamine response because of something that they're eating on a regular basis. And that's just, so it just one thing after another after other.

So let's peel back some more of those layers. Now, if the first one came in, one round antibiotics are good. All right, maybe they just got something, some kind infection, we have to get rid of it. So from that perspective, I was going to say, like we're the same as other providers in that respect, but I don't think we are. But where we really shine and where it really makes a big difference is when we look at like more of the, we call it the wellness to illness continuum. So I feel like a lot of times in conventional medicine, and this is no fault of the providers, no, fault the people that are actually providing the care and giving the car, they're doing the best that they can in a somewhat broken system.

But the way insurance works is they are cutting payments to providers. They're paying lower and lower rates. So they have to make up for that with volume because they still have pay for these nice big buildings and hospitals and all the provides that fill those hospitals. So they need volume, they needed volume. So you end up seeing like three, four, five, six, eight, I don't know how many people they see an hour, but it's a lot of people. They have less time.

How the practice differs from conventional care 25:00

Now it is just putting out fires. What's the immediate problem? It's reactionary. It is reactive, where we need to take a little bit more of a proactive approach. In the reactive approach, you've got it broken or it isn't. You're sick or you're not. Your diseased or not, In reality, there's a lot of shades of gray in there. So when you look at that continuum from optimal health down to disease and death, that whole place in the middle, well, who's really looking at who is addressing that? So I like to share another story that kind of illustrates this point.

Someone comes in and let's say they have an A1C of, oh, I don't know, 5.8. Now that's not technically diabetic, but it's getting there. So why wait until it becomes a problem? Let's put that person on a diet plan. Let us look at their house, look their sleep, their lifestyle, because that affects your blood sugar every bit as much as food does. Also, there's circadian rhythms. How much sunlight are they getting? So let's look all of that stuff and get them on the plan to move that A1C into an optimal range, not just a quote unquote normal range because the normal ranges are pretty wide.

And you could be right on the edge. If that flag doesn't show up that it's abnormal, it often doesn t get looked at. And even worse is a lot of times those things are flagged as abnormal. But it s like, well, if not that abnormal or it is not bad. So when you ask like what s the difference, I think that illustrates a big difference is we're going to look at that stuff from a functional medicine perspective and you can call it whatever you want. There's different names, integrative medicine, different names for that over the years, but look at it through that lens and say, well, how can we be better?

And then the other thing I hear often is, I feel like crap, my brain fog, no energy. I go to the doctor, the blood work looks great. They say looks straight and then, all right, see you next year. But the person sitting there saying they still don't feel great, so then that's where you need to look. Okay, what else? There's something off here. The blood work that we ordered is quote unquote normal, but are we ordering the right blood worker? Or is there something, can you take it a couple of different layers and see if there's something underlying that might be wrong?

So that's the people that want to work with, people who want do the digging and figure out what's going on so they can feel better than they do now. And you have some great, you very affordable programs too, the way that you've structured all of this, right? Because you don't take health insurance, correct? There's, there's like I tell the story a lot throughout the day since I found this out and I have patients asking me about our new practice and i still see chiropractic patients one visit and they don't have to join our membership.

But we have what's called the DPC direct primary care so that means you pay your care provider directly. And then we provide services that are included kind of in our menu of services. So basically, everything you go to a family doctor for, a chiropractor for. And we take care of all that stuff, cough, colds, flus, acute cares, well visits, sports, physicals. We also add in the functional wellness stuff. Some diet plans. Once a couple of times a week, we do open office hours for people to pop in.

They can chat in a Zoom room just like this. But yeah, so when you start When you charge cash direct to people. Now you can directly negotiate with labs with vendors with other suppliers with Other clinics to get cash pricing. You can't do both. They can make some and then some cash on insurance. It's called a dual dual fee schedule. So for billing out X for blood work. We can then turn around and only charge why for a cash patient. not legal. So here's an example I use for that. We accidentally ordered the blood work the wrong way.

It was the average panel that we would order on an annual visit. And normally it comes out to $80, our cost, because we negotiate direct. That's included in our membership, by the way, we don't charge the patients extra. But we accidentally clicked the box that said, bill to insurance. The rates automatically went from 80 bucks to over $800, so 10 times the amount. Wow. That's just crazy. Sleep study. We get it for $2.75 if someone doesn't have insurance. If they have an insurance, it could be a lot less than that.

You go to a sleep clinic, an assurance-based clinic. $2000 to $3000 is what I'm told. Fired ultrasound, we sent a patient for a thyroid ultrasound to the hospital across the street. We said, they're coming over there paying cash. What's your fees? What will you provide for our member? 220 bucks. I had someone else go for the same thyroid, ultrasound. So same CPT code. They billed 2200, insurance paid some of it, knocked it down. But because of the deductibles, They ended up paying 1200 out of pocket.

People think they have insurance, like great insurance that's covering things. but they're paying their premiums, they super high deductible, and they are getting charged more when they do have to go for care. So I think it's a complete racket. Your approach is definitely a great one if you're in the area and you do virtual services too, right? Yeah. We like to say in a way, we're kind of the Netflix of healthcare too because we are a technology forward company. and practice but we still have that hand on stuff so for those of you that like the ability to have a visit like this now not going to work on it as a chiropractor over zoom.

But to how telemedicine visit to talk about your blood sugar management like there's really no physical exam that has to take place now there are certain times when yeah you're going blood pressure checked, and your heart listened to, your lung listened too. So you're definitely gonna have to have that. But if you wake up with an obvious issue that is, that can be diagnosed in this fashion, why say like, okay, I'm free at 3.30 this afternoon, you have wait till then, or you need to drive a half hour to see me just to a face-to-face talk when we could have had a Face-To-Face talk over Zoom like this.

We like to use technology in that way. reviewing blood work and tests and stuff like that. I know I've done this in the past where, all right, why bring you in for a visit for that? Or why just type it up and say, hey, everything looks great. Why not record screen share? Here's the bloodwork. Screen share me talking through it and here's what I'm seeing and sending it to the person. So now, instead of in a business, trying to listen to what i'm saying and then remember it after you leave, you can watch that video over and over again and pick up the information that you need from it.

So we like to include a lot of tech and online. That's huge because so many people come to us. I'm sure you too. And I got this blood work and they never called me back. They said that if they don't hear from him, everything's fine. But I don' know what any of it means. Right. It's like, that's a huge, huge thing right there. Just like in that, because ultimately it teaches you so much more when you have information like that. Like you're explaining, you know, and you go through in the video then they actually learn something about what's happening.

It's not just this imaginary thing that happened and I guess it's okay and i'm not really sure you know they're learning about how their body functions and what this all means and it gives it a different value. Absolutely. And the best part I almost left out, well, two best parts. One best is just having the group and the community. So with HIPAA, privacy laws and all this other stuff, we almost feel like as the patient, oh, I can't talk about what I have going on. Health information is private.

It needs to be a secret. You shouldn't tell anyone. Now, as a provider, a doctor, and I'm not going to talk your problem with anyone else. I mean, that's absolutely true. But when people start feeling like, Oh, like I could can talk So what we're going to have group visits we can have a group zoom calls like this when our new buildings right right through this wall here is going be the new building out there. We're gonna have nice nice area to meet people, so I have those group meetings and then we could have like.

to build that community and have like-minded people share their experiences. Like, oh, I'm working through, i'm pre-diabetic and iIm doing X, Y, and Z and I am really struggling with this. And you have another group member chime in. I know you do groups now as well and we were talking about it before that. So once you did group, it's really hard to go back to one-on-ones because the group makes it more affordable because you can see 10 people at once instead of having 10 hours of your day taken up.

You can work with 10 So that allows us to really make it much more affordable than we would have to charge otherwise.

Direct primary care, virtual visits, and affordability 33:00

But the the side effect of all that is you got people helping each other at that point and someone going through that problem or that had just gone through. That problem six months prior has much. More impact on someone that's just starting the journey versus us as the provider saying, oh, you need to eat this way or you. Need to do that. And like myself, I have my own journey where I did kind of fix that, but it's like 10 years ago now. So it is nice when you have someone there. It's just basically one step ahead of them saying, hey, i was where you're at, don't worry, stick with it and it'll get better and that's super powerful.

And then the last thing is that I mentioned how we can really reduce the price to offer all these things. three or four, well, it's probably five or six years ago now, time flies, but functional medicine programs where I work with people in this capacity when it was all one-on-one, when we didn't have like a team practice, the technology was kind of there, at least in my practice it wasn't. I had to charge between three and five thousand dollars to work for someone for a period of four to six months.

Now, we have a practice like this and we can build in primary care and attract and enroll members that that are interested in this stuff and want to have access to providers that do what we do we just we only have to charge 120 a month to make it work and in a practice like ours we're only gonna we'll only going to take like probably the first year maybe two three hundred members even after year two or three maybe 500 members so compare that to a standard family practice where each provider there they might carry a load of anywhere from 2000 to 3000 to 4000 patients so we're going to know our patients very well and we are going have the chance and the opportunity.

We're gonna be super accessible to have conversations that need to be have to help people work through their problems that they're coming to us for so I'm just I am talking a lot but I just like that about it. You're fine. This is what people need to hear. You need be talking a lot about this. They need know there are other options out there. And it's, you know, what we're being told that this is the only way or there's nothing that can be done or whatever. That's not the case. So keep talking. Awesome.

Yeah I see some of the comments here. Dawn says insurance is worthless. I'm a big advocate for health sharing plans and we partnered up with a company called Zion Health. i was able to take my family's health insurance from 1200 bucks a month with that $16,000 deductible down to $300 a months with about a $5, 000 deductable. Now their deductibles work differently but We're saving a ton of money. I had a family sign up last week. So they're paying for the health share and our practice membership for their families.

And now they are covered like all the way around. They're covered for that catastrophic stuff. Now they cover for all of the family practice stuff and those two together are $650.00. they were paying $2400 for insurance alone out the door like just gone. So we're saving them $20,000 a year, and they're getting a hell of a lot more than what they've gotten for that insurance, if they would have went to an insurance based practice. Yeah, because that, insurance costs still didn't factor in the deductibles and their co-pays and everything that it didn t cover.

Wow. And it was like $1,800 more per month. Well, I am very grateful that you're doing what you re doing. And hopefully we'll start to see more and more practices pop up like this or maybe you can start duplicating yourself. Yeah, once we prove it works here like I want to like the happiest thing for me would be if I can help save more conventional providers. And because I talked to several before this practice I interviewed three or four family physicians and um they were all just like not happy with life and then once someone straight up admitted it like it's just a tough system and it' s it s cracking at the seams and that was well that wasn't kind of in the middle of covid so uh there were problems before covid covid just kind like exposed a lot of the weaknesses and and really brought them to the forefront but they're overworked they they sign up for a nine to five shift they' re there till 11 o'clock at night doing pre-authorizations and completing insurance paperwork the one family doctor's wife basically crying because her husband who's almost ready to retire is at work at one in the morning trying to catch up on things.

So it's a rough system. That's why I place no blame or I cast no aspersion upon anyone that's working in that. They're just doing the best they can. The cards, they're handed. And there's providers that they are locked up with no compete clauses, so it was hard to really get them to jump over with us right now. But yeah, there is nothing I would like more than to prove that this model works. Whether it is our practice at a different location or or we make a kind of a franchise out of it, or it's just other practice other practitioner seeing like, oh, you can do that.

You mean you could charge cash direct the patients they pay and they're happier and and I'll make as much money as I make now with less headaches and. And that's the biggest thing, too. In this model, the medical provider sees about 10 patients a day, whereas in the insurance space, because of the volume, it might be, I don't even know, 25, 30, 40, patients today. So it's really nice for the provider as well, and the happy provider is going to work a whole lot better with you than, all right, well it looks good, on to the next one.

And yeah, it's a crappy system and hopefully like grassroots style we can prove that there's other ways of doing this, including the health share part of it, because that's really nice and people are so used to like needing insurance we're told we need insurance, something happened you need an insurance and these plans, you talk to someone with the healthcare plans are like, well that thought real insurance they don't have to pay it not like a guarantee. but they've been around long enough now. And I had a friend who had life flight surgery, some pretty major issues, almost died, six figures and a health share paid without blinking an eye.

So there is every bit as much legit, in my opinion, as health insurance, even better because they don't have all of these layers and layers of the books, the book's literally like a four page PDF instead of like 30 pages of exclusions and stipulations and copays, deductibles, different situations. Anyway, I'll step off the soap box. Well, we'll definitely be following your journey, guys. I hope that you follow him on Facebook. It's Peak Integrative Med is your Facebook page, right? And that's also the name of your website.

So check out his plans if you're in the area or, you know, for the virtual services that they offer and definitely follow them on facebook because hopefully we will see more of them popping up, all right. Thank you for being here, buddy, and spending this time with us, Dr. Chiginski, Awesome. Thanks for having me. Bye.