Full Transcript Defining Whole Health 0:00 I think full health to me really means being able to look at the whole picture and hold the complexity of somebody and being to integrate not only like 0:10 a conventional approach but also bringing in integrative and functional principles and looking at what are all the possible interventions that I could 0:20 use for many different disciplines and how do I put together a very collaborative team to care for a patient. 0:26 So it's this ability to hold the wholeness and get complexity and then make it very practical into a plan that somebody can actually take. 0:35 Hello and welcome back to the Evolution of Medicine podcast. 0:39 We are coming to you live from the Institute for Functional Medicine's annual international conference. 0:44 we are speaking to leaders and innovators, speakers, people who are taking functional medicine into places that has never been. 0:51 And I'm super excited today to connect in person with people I've spent a little bit of time on Zoom with over the years. 0:59 We have Laura Sandquist and Kate Atremba, leaders in the implementation of bringing functional medicine into the whole health system. 1:08 So let's talk a bit about your journey to get here and how you ended up speaking here, and sort of what started this all. 1:16 Yeah, well, what started this whole thing is that Kay and I have been working together for the past six years to develop a really large integrative and 1:25 functional medicine program within a conventional health system in Minnesota. 1:29 And throughout doing that work, we've learned a lot of lessons of what works, and what doesn't work. 1:35 We wanted to present to really help other people know how they can implement this into systems because it can be a challenge. 1:43 Yeah. 1:43 Different challenges than before. 1:45 And this year I hear that 40% of the attendees work inside health systems, which is a new sort of growth area for IFM. 1:52 So it's probably good timing for you to be here. 1:55 What were some of key lessons that you shared in your talk and what has been the response from the community here?
Building Functional Medicine in a Health System 2:00 Yeah, the main areas we focused on sharing with people attending here were how to build an infrastructure so that you can thrive within the conventional 2:10 system because the Conventional System does have some constraints like you have to meet certain RV requirements to be sustainable. 2:15 You need to chart in a particular way to able to bill through insurance. 2:19 And you want to make sure you don't burn out your practitioners because of those constraints. 2:24 And sometimes, too, you have a limit on how much time you had with patients versus a private practice where you can call your own shots on the time. 2:31 So within those constraint, what we're trying to show people is kind of what is the infrastructure you need to build. 2:37 Some of it is clinical tools that clinicians can use right at their fingertips as soon as they get into practice for translating what they learned in the 2:45 Institute of Functional Medicine into the day-to-day. 2:48 So we developed smart phrases, practice guidelines, and other templated things within their day to day practices that really helped it work. 2:59 And then we also found that it was so popular within the system that we needed to deal with that access issue. 3:07 So we started group medical visits as well, which is something you had supported us in doing, learning that whole process. 3:13 And so we have also successfully launched two different types of group, medical visit, some that are nutritionists only led, 3:20 and then some of our practitioner nutritionist co-led. 3:24 So those have been kind of the main infrastructure we've built to make this possible. 3:30 And I don't know if you want to talk about how we also kind made ourselves known within the system, too, with the training. 3:36 Yeah, you know, because when you're in a system too you need to really develop trust with a primary care provider and specialist, 3:43 and that can be one of biggest barriers. 3:45 We created a two-day CME for primary care providers and specialists, physicians, MCEs, PAs, and we offered that six times over two years. 3:54 Two-Day Conference, that just gives them the basics of taking an integrative and functional medicine-informed approach. 4:00 And that was really effective to gain trust and just help to spread that across the system. 4:06 What was unique about Alina Health that made it a good fit for this to sort of flourish within it? 4:11 Yeah, Alaina House actually has had an integrative institute since 2003. So they're pretty early adopters. 4:19 And so when I came to the system in 2016, there was a really nice stage set to be able to do this work. 4:27 I can take what had been built and then you continue to move that forward. 4:32 But I would say even after all those years, for people to understand what is an integrated and functional medicine. 4:40 So those doctors take that training that you did and then you find them more likely to refer across or to actually run their own group visits. 4:46 How did that work? 4:47 Yeah, mostly we saw an increase in referrals and collaboration, reaching out and saying, I have some tough cases and I'm kind of stalled on where to go, 4:55 what might you guys have to offer? 4:57 How could we partner? 4:58 We also saw them doing more integrative things in their practice, so starting to think about magnesium for constipation or breath work exercises for their patients, 5:08 not just an SSRI. 5:10 So we also felt like it shifted how they were thinking more holistically and from that whole person lens as well. 5:18 Yeah, that's super cool. 5:23 I'm glad to reconnect because in the process that I got very excited about the potential for group visits, I convinced myself with a book and I just want 5:31 to say from my perspective is just how wonderful it was for me to feel like validated that you guys were excited about doing it and that we got a chance to, 5:42 you know, start the journey together. 5:43 You know I think I can say learned a lot, like I never really integrated with the health system in any way and didn't really understand what I was getting into, 5:50 right? 5:52 And it's a lots different than, than organizations where practitioners just make their own choices and do it. 5:58 Um, but I, I hope that the time that we spent together, you know, maybe accelerated some things, may be supported some and that,
Infrastructure, Group Visits, and CME Training 6:06 when I saw you guys on the list saying that hey, we've been successful and we're going to show you how to see us. 6:10 I was like, yes. 6:13 Yeah, it was a great experience to go through that process and understand. 6:18 And it would get me excited all the time because I just felt like we were breaking new ground and bringing something in that could solve the equation that 6:28 everyone wants to solve, which is like, how do you do this on insurance? 6:31 How do actually move the needle? 6:33 And so, yeah, I'd love to understand some of the some of the things that are resonating since you've been here. 6:41 We had a guest who I just interviewed who said that that was their favorite talk of their whole time. 6:46 She wasn't there, so she's probably biased. 6:48 But yeah, what has been the resonance here and what do you think is possible moving forward? 6:54 Yeah, well, I think, you know, one of the best things about being on the conference is just connecting with other people doing the same work and just learning 7:02 from them what's working and what not working. 7:05 And so that's what I find, most valuable. 7:10 Yeah. 7:11 And we've also had a lot of people approach us on these billing questions. 7:14 So it's been really nice to be here and be able to say, yes, this is doable. 7:17 This is how you do it. 7:19 It's definitely inspired us to think about maybe a course that would teach people on how to do that as well. 7:24 I think another thing we have noticed is a hey, I understand functional medicine, but how do I translate it into practice? 7:33 And that was something we saw when we built our very large team is we had to kind of give people some support with bridging that gap. 7:40 And so that's why we launched our new company was to just help teach people how to start to apply functional in practice. 7:47 That's something that we've been hearing here at the conference too. 7:49 So we're excited to build that network and share what we have learned about how translate this all into practices as well. 7:56 Yeah, share a little bit more about that. 7:57 Because I think that when you start doing this, you started to realize, oh, there's a missing piece here. 8:01 You know, people who are going through different trainings are missing this key part that we've learned from being in tension with the problem for a while. 8:08 What was the starting point where you looked at each other and said, we got to do this? 8:14 Yeah, well, I think, you know, after we've trained, about 24 people in on how do you do this, we just saw the need and kind of the desperation of someone 8:24 who has the training, but then someone's in front of you and you think how can I piece this all together? 8:29 And really needing that additional mentorship and support. 8:33 And so we knew it was a need, and we'd done it a lot the last several years. 8:39 We just thought we have to do that for more people. 8:42 we can teach this on a broader perspective and just help make that transition easier. 8:48 Also, I think not only though is functional medicine trained, but we get a lot of requests of people who say, you know, i'm really interested in taking 8:56 an integrated as functional informed approach or a whole health approach. 9:00 But they feel that doing an entire training in functional medicine might be too overwhelming. 9:06 And so what are the basics that you could do in a primary care setting or specialty setting, especially with illness system? 9:13 How do you do that practically? 9:15 And we've figured that out over the years. 9:18 So that's what we want to be able to share. 9:20 Cool. 9:21 I know it's called Whole Health NP. 9:23 Why NP? 9:24 What is special about the NP and what is especially about NP, what they can bring to this transformation of medicine. 9:30 So I just want to take a minute to talk about incredible mission partners that we have here at the Evolution of Medicine that have made this possible. 9:37 First and foremost, I want thank. 9:40 So Fullscript has been an amazing partner for 10 years. 9:43 We only pick partners that can help us achieve our vision and help you achieve your practice vision. 9:49 FullScript have been incredible partners for a decade, but their new offering journeys, this is why we called it the Evolution of Madison Journeys, 9:56 is allowing practitioners to combine the relationships that they have with the newest technology to sell direct-to-consumer lab testing and use it as a
Launching Whole Health NP 10:06 funnel to bring into your practice and it's a game changer for the whole industry. 10:09 So go to goevomed.com slash journeys and you can get started on building the journeys for your practices an optimal way into practice. 10:17 We're going to have some conversations about it. 10:19 This is a Game Changer. 10:20 Next, Jenova. 10:21 Janova have been fans of the Evolution of Medicine for a long time. 10:25 We're big fans with them and they now have a lot more specialty testing. 10:29 They have lot of more tools and it's a key part of understanding the body ecologically. 10:35 So go to goyomed.com slash Jonova to find out more. 10:38 Come on over here. 10:39 I want to show you about the other mission partners. 10:42 If you've been following us for a while, you know that these are organizations that we trust, that add a lot of value. 10:47 Freedom Practice Coaching, I have been supported by them since the beginning. 10:53 And so many of the issues that practitioners face in building a successful practice, scaling a success practice come down to having the right support with 11:02 people who have being there and done that. 11:04 Go to goevomed.com slash FPC. 11:08 Big boost marketing. 11:10 Uli and his team are the best in the business when it comes to really understanding how to market your functional medicine practice. 11:15 Go to goevomed.com slash big boost and see how they can help you. 11:21 And then what you're going to be hearing a lot about is the formation of clinical networks. 11:26 Ultimately, True Neura is our first effort at that, which is to build an integrated clinical network combining independent practices from across the country 11:35 into a network that can reverse cognitive decline. 11:38 And if you go to goevomed.com slash Trinura, you can get a demo. 11:43 You can see what it means to be part of an integrative clinical networks. 11:47 That's mentorship, that's software, and that is making it easier for you to get incredible outcomes in a disease state where there are no other options. 11:55 So thanks to our mission partners. 11:57 Let's get back to the content. 12:02 I'll let you add to this, but essentially because a lot of our lens is from the nursing lens and we think it lends very well to what functional medicine 12:11 also has to offer. 12:12 So we're essentially blending the two, so that's why we wanted the NP for nurse practitioner. 12:16 Just to essentially signal that there is a bit of the Nursing wisdom that is also infused in the way we teach people how to be in front of a patient and 12:27 where to start applying the functional Medicine principles. 12:30 also supported by the principles of nursing, and I don't know if you'd say any more. 12:33 Yeah, we're both trained in integrative nursing which is a specific type of Nursing and that aligns really well with functional medicine's philosophies. 12:43 They found combining that is really great synergy and so many nurse practitioners and nurses kind of just get this way of thinking. 12:51 And so we wanted to really just like highlight that this is the skill that nurses and MPs have. 12:58 And it can be kind of unique, you know, to our profession. 13:01 A lot of other people can do it as well, but nurses are fabulous. 13:04 Well, I didn't tell you I was going to do this, But I'm going put you guys on the spot right now. 13:08 If I just interview Tracy Gordet, and we have a great relationship, And one of the things that she's worried about is that the use of The word whole health 13:16 will not represent what whole Health really is. 13:19 So it's a test that you have to answer is what does whole-health mean to you? 13:22 Yeah. 13:23 Good question. 13:25 I can start and then go for it. 13:26 Yeah, I mean, full health to me really means being able to look up a whole picture and hold the complexity of somebody and being to integrate not only 13:37 a conventional approach but also bringing in integrative and functional principles and looking at What are all the possible interventions that I could 13:47 use for many different disciplines? 13:49 And how do I put together a very collaborative team to care for a patient? 13:54 So it's this ability to hold the wholeness and that complexity and then make it very practical into a plan that somebody can actually do.
What Whole Health Means 14:04 Yeah, and specifically looking at the person is not just a bunch of body systems that may or may not be dysfunctioning, but also someone in a context, 14:12 right? 14:13 So relationships, environment, all of their spiritual connection, their sense of purpose, All of those things potentially impacting their health on all levels, 14:23 you know, spiritually, psychologically and physically. 14:25 Good news. 14:26 You passed the test. 14:27 That is whole health. 14:28 And, you know, we were joking about the idea of being, that we're talking about things being dressed up as whole-health that aren't because it's sort of 14:37 out of the now and it is a new word in that. 14:41 I think we, in the same way that functional medicine is having to now set standards for what functional is and the certification, 14:48 because You know, there has been the use of the word functional medicine in many different ways, which I think is healthy for this emergent movement that 14:55 we're part of. 14:56 But now it's sort of like trying to, you know give people confidence that when this word, functional, medicine is used or functional medical certification 15:04 is that there's some sort like foundational standard. 15:06 And, in the same way we were talking about that is like, what is whole health? 15:10 And whole-health is really about the rehumanization of medicine. 15:14 So I'm really glad that you came together with that answer because I feel that Especially if you have the background in integrated nursing, 15:22 that's really where this all came from and that the foundational elements for it. 15:27 So I'm excited to see that moving forward. 15:32 Who are the kinds of groups that you'd like to work with? 15:35 If you could wave your magic wand, who would sign up that would be like, this is the dream? 15:40 Well, as far as practitioners that we want to train, even though we're coming from an integrative nursing perspective, we really think any practitioner 15:49 could use the knowledge of how to take a whole health approach. 15:53 And if everybody on the team has that perspective then things tend to flow and work better together. 15:58 So it's really anyone, physical therapists, occupational therapists acupuncturists, speech pathologists. 16:04 And we can go on and on. 16:06 Even psychologists, like we've had a lot of conversations even with a local clinic that is a psychology clinic and they were saying, 16:13 gosh, we really want our clinicians trained in this model because sometimes you're sitting with someone and you know you are at the end of what you can 16:22 offer from your skill sets. 16:24 But if I had a bigger sense of all the picture and the connections, I might know who I need to refer them to and really keep them on their path towards 16:33 healing versus stalling with me. 16:35 And so we see it valuable to anybody who's working with people in the healing realm. 16:39 I can really see the need for that in mental health, but guys, you know, if you are a talk therapist, there's only so much talk therapy you can do. 16:46 But if have a range of physiological factors driving on mental conditions, and you need that support and that might be. 16:56 There's so many obvious examples, but let's say something like pans in a kid, right? 17:01 Precisely. 17:02 It goes off the reservation and you don't know why it happened rapidly and find out why that happened. 17:08 That could be a lot of pain and suffering for something there's quite an elegant solution for, and it could also be what's happening at home and trauma. 17:16 There are so may ranges of things that it can be and when you find it and deal with it because you've got the right team together. 17:21 Exactly. 17:25 you know, whole health solution, while you can only do talk therapy, you sometimes realize, and I've spoken to a number of people who are psychologists 17:34 and doing mental health, where it's just taking one patient for them to send someone to more of a whole-health approach, 17:40 come back and see, they say, now you see it in every patient. 17:43 Exactly. 17:46 So now with the new organization, does that mean that Alaina is fending for herself now without you, or are you still in there part-time? 17:57 Laura's gone, so I am fening for myself without Laura.
Scaling Whole Health and System Change 18:01 I'm still the clinic lead as of right now. 18:05 And yeah, they're kind of looking at the next steps for the Clinic and where we move into the future and focusing a little bit more on prevention. 18:12 Okay. 18:13 So if you come back in a couple of years back to IFM and we do this again, tell me where things are at at that moment. 18:19 Yeah, I mean I'm hoping that more people are able to access some of the things we're teaching and that we are seeing more functional medicine in the conventional 18:28 system successfully and insurance-based access for sure. 18:32 Anything else you'd add? 18:33 Yeah. 18:34 Yeah, my dream is just to see everybody in healthcare taking this whole health-informed approach. 18:41 You know, it doesn't necessarily have to be in-depth functional medicine, but I think if we think of everybody coming at care with that perspective, 18:49 we will see transformation in the healthcare system. 18:52 I mean, I guess maybe just a word on that, because the real transformation that I think that you understand and that your facilitating is not easy, 19:03 right? 19:03 There's a lot of mindset shifts that have to happen. 19:05 There are systems that has to change. 19:07 You know, there's whole sort of ecosystem of changes that that had to occur. 19:11 Is there anything that would like to share on some of the things that might be helpful for other people who are considering this shift? 19:22 I find that, at least from our experience doing the education series at Alaina, was that when practitioners could experience this type of care themselves, 19:31 that was really transformative into their buy-in. 19:34 And so, I mean, definitely something I'm hoping to see more of is people seeking this out for themselves who are already clinicians and understanding the value. 19:43 Yeah, and I would like to see the incentives change for insurance. 19:47 You know, we're still stuck in a fee-for-service model. 19:51 And really, the system probably won't change much until the incentive change is really what I learned. 19:58 So if we can see a shift somehow there, that would be really meaningful. 20:03 Can organizations that profitably sell tertiary care get behind prevention in a meaningful way? 20:11 Or is that just too big of a structural incentive to overcome? 20:19 I think they can. 20:20 They just have to want it. 20:23 And I mean, we've proven with our clinic that it can actually be profitable. 20:27 So it's just a matter of having the people with the training, the right philosophy of care in there and given the opportunity. 20:36 Well, look, thank you so much for your leadership. 20:39 I'm really grateful to get to meet you in person and to be able to thank actually for the time that we spent working together. 20:46 All of these lessons inform where I am going. 20:52 The functional medicine whole health revolution hasn't really happened yet. 20:56 We're still right at the beginning of it. 20:57 But I see that all of the battle scars along the way inform what has to happen next. 21:05 You know, as much as I hope that at this moment, you know we would have found a way to help a hundred health systems deliver, 21:12 to deliver group visits at scale, I can tell you that the problems of loneliness are not getting any better, right? 21:17 The problems with disconnection are getting better. 21:20 The problem of implementation into systems are better but the problem still remains and it's like a huge population that needs help. 21:28 And so I'm grateful to be on your team. 21:32 Likewise, great to see you. 21:33 Wonderful. 21:34 All right, well this has been the Evolution of Medicine podcast. 21:37 We've been here live from the Institute for Functional Medicine and these two have been educating this community about what it takes to build successful 21:46 practices and to deliver whole health in a large health system environment. 21:51 Check out Whole Health NP and if you're interested in finding out more, we'll have all the details in the show notes for you to get in touch. 22:00 Thanks so much for tuning in and we'll see you next time. 22:03 So we are here asking practitioners about their practitioner journeys and the reason why is because journeys is a new product from Fullscript. 22:12 Journeys allows you to set up your own lab offerings as the top of the funnel, give the patients what they want, they wanna know about themselves and it's 22:21 the easiest way to bring them into your practice. 22:23 We have all types of practices from across the country that are building their own unique lab panels for their unique practices, 22:30 selling them to their community and acting as a great funnel into their practice. 22:34 This is a massive innovation. 22:36 I think this will accelerate the evolution of medicine. 22:38 You can go to goevomed.com slash journeys to find out more. 22:42 Set up your own journeys in half an hour and transform the health of your community. 22:47 Go get them. 22:48 So that was the podcast. 22:50 What an epic session. 22:51 Thank you so much for tuning in to the Evolution of Medicine podcast, we'll be back again next week. 22:57 And thanks so
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