Listen: The Community Cure: Transforming Health Outcomes Together
"Topic for today is called the Community Cure. He is in demand speaker. An IMPRESARIO IMPRESARIO featured on Ted Huff Post live and text as well as lecturing internationally he lives in Sacramento California with his wife and daughter order. James Let's get right to the nitty gritty. Why this book in why now? Well I've been on a fifteen year plan to try and transform healthcare. You know the first fifteen first few years I was really learning about what was going on and ultimately I come from this position of a health economist semester. I was trained in health economics. I saw that both in America where we have this kind of like health insurance kind of system with employers and people and then in the UK. Where I grew up where we have a single payer system in both systems? The same problem is we're completely running out of money not enough money to pay for care and you know the world is having to adjust to that reality and a big part of it. When I came to learn over time is that this is sort of like the overall thesis? This is that a pharmaceutical I approach to life style driven chronic disease is a failure is failing and has failed and it's failing in both America and in the US and the UK and so ultimately you know we need to find a operating system of care where the goal is everyone's just well and independent of the medical system and so that led me to functional medicine and that led me in two thousand fourteen to stop the functional. Oh Forum to really grow the number of practitioners that were capable of getting people off medication and getting to a point where they were independent of the healthcare system Kim and living without medication to into the ninth and tenth decade but ultimately that plan is worked and we've grown the number of doctors. There's a now. There's one functional medicine doctor in every town but ultimately what I realized is a couple of things. One functional medicine is all about the root cause but the biggest root cause in chronic disease and death was not being dealt with effectively. And that's loneliness. So loneliness is a bigger driver of all cause mortality not like social stress with loneliness and social isolation as a key driver is the biggest dry is the biggest driver of all cause mortality and death more than smoking. Smoking more than alcohol Morvan nutrition and just think about how many causes fat on nutrition says the biggest issue. And we're not dealing with it at all right and then the second thing is that functional medicine has not made it to poor people. Let's be real about it like it's made it to some of the middle classes in the last few years. By some new remodels that we've been teaching like direct primary care and and that kind of stuff but ultimately hasn't made it to poor people like the bottom fifty percent of America that can't afford a health deductible adoptable and over the last year like I took a road trip around the country for four months. We put on twenty six events in the summer two thousand eighteen and over over the last few years I've borne witness to a really elegant solution to all of those issues a solution by which everyone could have access to functional medicine. Listen that would solve so many problems. simaltaneously loneliness chronic disease physician shortage physician. Burn out like thank all of the big big things that could be solved can be solved with one super simple solution. Once I tell you it a month. Your listeners here. I don't I think you're going to be able to shake you out of your head because in a certain way it's obvious you know. Think about it before I tell you what it is. Just think about how we treat alcoholism in America Noah right alcoholism alcoholism since the nineteen thirties. We put people in groups and we have people share with each other because what the alcoholics need. They need accountability support support education. They don't need drugs and they don't need doctors and so that's why the AA has a group that's being created around that what. I'm here's what I talk about in my book is that it is clear to me. Not just through my own ideas but through what I've seen on the ground what I born witness to that lifestyle driven in chronic disease must be treated in groups. And it's as simple as that. You know you've talked about this for a long time In our other podcast cast. You've talked about socio economics. Correct me if I'm wrong. James you know in all of the blue zones where they these people live the longest. They have enormous enormous sense of community. And my correct on that. Yeah absolutely you know the community does two things one it. You're not having loneliness and social stress as a driver for of disease but also in the blue zones the community access sort of like the vehicle for doing healthy behaviors. They eat together do they. Exercise together they move together they they you know they deal with stress and community like all of these. Things is a compound effect. Because it's not just the the the the the the loneliness but it's like the healthy behaviors are done in groups and that's that's the key factor and so what I see. Is that like group. Medical visits have been around for a while in America. It's not a new idea to do group. Medical visits the new thing is what are we gonNA do with people when we get them in these groups and and ultimately what we've seen in the last five years and particularly in the last year and I can give you some amazing. Examples is functional medicine delivered in groups. Wha- hat let's get a group of people together and let's teach them self efficacy. Let's teach them how to eat. Let's teach them how to relax and not let let's not just teach them. Let's actually do it. Let's practice it in these groups and the results when you see when you actually execute that at any sort of scale the results Are So transformational that you know even big health systems and hospitals and whatever it will not be able to ignore this data. Jane does this. Is this being done in person or online or is it a little bit of both or what have you seen. Online is super bleeding edge right. I think it's I think one of the things that we have to acknowledge is that online has actually you know the Internet has actually increased loneliness and isolation Gen Z.. And millennials are the loneliest and most chronically ill generation in history. You know I sort of stopped the other day in the UK. One in full millennials has no friends so we've created a situation where the traditional ways that community has come together. The church local groups have have dissipated and and certainly in the UK more than in the US but ultimately online has taken over as being very difficult for people to actually have the quality of relationships by online my medium so while I think there's a lot of potential in online groups. I think that you know the real results that we're seeing the most effective results that we're seeing are in person and I just WanNa give you an example now because this this example I think we'll contextualized everything about what I'm saying. So one of the reasons why my show the functional forum took off and I think he might have even been in the room. That night was when Mark Hyman announced the Cleveland Clinic Center for Functional Medicine. This was like March two two thousand two thousand fourteen and he announced that night that we were going to have a the you know. The Cleveland Clinic was gonNA start a sense of functional medicine so fast forward four years or three three and a half years. And what situation do we have. It's working it's up and running. People are getting better. But they've got a two thousand person backlog right they got two thousand patients who want to be seen by the functional medicine. Doctors they got five doctors going and Tony Jones. WHO's the head administrators? Just like this is would never going to be able to catch up. We can't recruit Dr Fast Enough and it's not efficient enough and you know honestly it's not even profitable enough because we got to spend all his time with patients and we WANNA take insurance so she comes up with a ten week. Two hour a week group visit modeled functioning for life. Well basically people have to go through this ten week process in order to qualify to see one of their doctors so they put people in groups of six ten twelve sixteen and they group them by sort of like the disease type and these groups are being run not by doctors but by physicians. Assistance Health coaches and Dietitians so the preliminary data of these results salts where a thousand people have now gone through this show that half the people in those groups get so much better in that ten weeks that they don't have to see the doctor at all that completely better and that on average that that going up five pro-moscow points which probably doesn't mean anything to to most people but it just means that people are like basically completely reverse chronic disease in ten weeks because by week to some people have found new friends by week. Five people are being super vulnerable with each other and bye week nine. This is a new community eighty percent of people show up to every meeting. That's a really high number anyone who's ever tried to run any sort of group you know that people don't show what they life gets in the way you know those kind of things. So when I saw and heard I went last Last October two thousand eighteen and I saw that I was like this. Is it like this is happening. And so I spent the last year interviewing everyone who's run groups in functional medicine. I did a whole podcast series and when I recorded the very first podcast outcast with Dr Jeffrey Gala. WHO's been running groups in the poorest areas of Boston for twenty years? After I did that interview I was just like this has to be a book because in that what you see is that by treating loneliness specifically the results of treating loneliness by creating new groups is transformational if you then and teach those people how to take care of themselves with functional medicine principles we have now the Bass Rock for the future of medicine."