Changing the Perception of Wellness
Hi Elise Lunen here co host with Gwyneth of the podcast. Today's guest is Dr Robin Burden Person. She is our next guest and our special eight episodes series that we are hosting in partnership with Banana Republic called Women on top. I'll tell you a little more about that before we get to our conversation some of the most interesting businesses or maybe all of the most interesting businesses is were born out of curiosity desire to explore to ask questions and Sherry answers. This is the space that Gwyneth was in when she started goop. It's also the space from which Banana Republic was founded back in nineteen seventy eight when to California creatives with adventurous spirits began up cycling military surplus clothing and the rest history when we talked to the team at Banana Republic about partnering up on a special podcast series their vision revolved around the idea of living a life with no boundaries. This is the inspiration behind their clothing. Today it drives how they source premium materials from around the world the ways they choose to innovate with their designs and how they think about abusing style with substance this is all in display in their fall collection which combines iconic banana republic styles with a modern twist to see it all and to shop Banana Republics Ball collection had banana republic dot com slash goop. Don't hold anything too tightly. Just wish for it want it. Let it come from the intention of real truth for you and then let it go. The amihai soul is like it's unbound. It's limitless but we will use words to limit ourselves when people stop believing that somebody's got your back or Superman's coming we turn to ourselves and that's where you become empowered courageous participation attracts. It's positive things I'm GONNA paltrow. This is the Goop podcast bringing together thought leaders culture changes creatives founders founders CEOS scientists doctors healers and seekers here to start conversations because simply asking questions and listening has the power got to change the way we see the world today is no exception a letter lease fill you in on her extraordinary guest all right over to Elise Dr Robertson is a practicing physician and the founder and CEO a parsley health an amazing program that combines primary care with a functional approach to Madison Robin Designed Parsley because she wanted to help people get to the root cause of disease rather than only treating their symptoms during her residency she realized just how little time doctors get to spend with their patients and how our healthcare system continually sacrifices quality for quantity. She felt compelled to change the game. Parsley health is an APP designed to increase the time spent between doctors and patients which allows doctors to deep dive into the roots of Disease Robin believes in being the architect of your own health and she and her team at Parsley or there to help guide you you download the APP and pay for a membership and then you can see their doctors throughout the country have locations in New York and a second location in Los Angeles coming in West Hollywood this ball get your mind on board with your body like you can't fix your your bod without looking at mental emotional spiritual and whether you have a meditation practice or an exercise the practice or something that allows you to self soothe be present kind of get into your physicality and calm that that is when your body's in a para sympathetic state which is your arrest digest relax and he'll state and when the bodies there and then the body can start fixing things but if you never let it go oh there then you don't get to fix anything okay. Let's get to my chat with Dr Robin Burson. I obviously have known own of Parsley and your work and we've met before and I've been able to interview before but never like this ever like this. That was a very fun panel though it it was fun yeah you held a down. That was good. Those panels are always the highest ranking events too. I mean people are just desperate as as you know in your own experience I guess for clear concise insight into how to navigate their wellness really yep. So how did you get here. How how did you land up functional medicine. Did you have a healing crisis. You know I'm it's interesting story because didn't have a personal healing crisis if I like. I've had to dig way back because sometimes I'm like. Where did this come from. Why am I doing all of this but when I did way back and I think back to college where I was not premed did not think I was is going to be a doctor but ended up in the middle of college at some point taking this course on cancer and the sociology biology epidemiology of cancer and it was topped by Eh this incredible geneticist at my university one of the top four most researchers are researchers and cancer and at the time I think what inspired me to take the course looking back is that my grandmother was dying of colon cancer and she had smoked cigarettes her entire life and that's one of the number one causes of colon cancer answer and as I started digging and researching I ended up writing this paper on alternative therapies for cancer and cancer prevention and kind of getting into the medical research. Which is a world? I'd never touched before and if I think back it was really that moment that helped me think I'm kind of really interested in this stuff and so I went to medical local school Columbia knowing that I was interested in public health chronic disease primary care prevention holistic forms of medicine by that time I'd become a yoga the teacher at a meditation teacher that was like my side Hustle in med school and those things really stuck with me as my interest areas and through that discovery discovered functional medicine got it and so were you practicing for a period of time before you started parsley or did you just go right to it relatively soon so along along the way also co-founded a healthcare technology company enterprise offer for hospital systems with a buddy from med school and that kind of got bit by the Tech Bug and then after training in med school residency. I was in this kind of crosshairs where I was consulting and health tech but also practicing medicine and a really amazing integrative the greatest functional medicine clinic in New York City and I think I had this moment of these two worlds Soda Line. I'm really passionate about both of these things. I see how technology is going to transform healthcare care. I see how the functional approach transform healthcare but like how does that match up for me in any way and those experiences has crystallized in this idea wow I can actually bring them together and can we almost create a new healthcare system that brings the best of primary care the best of functional medicine and the best of new technology in a model that makes this form of medicine accessible and so that was kind of the German nation and I saw how powerful powerful the functional approach was to help people heal and I saw how important it was to bridge the gap between healthcare and medicine as we think of it and wellness in a world where ninety percent of our disease costs are due to chronic lifestyle driven diseases where we're living ourselves sick but I also observed how the functional and integrative space had had become extremely inaccessible from a price point standpoint from the way that it was operated and I don't know crazy ideas. He is were were born and this is where we are no. It's so interesting because I feel like functional. Medicine is often at its own thing. I think some people who don't know what it is are often like that makes so much sense right. This idea of understanding root causes rather other than treating symptoms and also this what has become very modern mashups of technology. Is You mentioned and lab testing and really understanding or baseline like your data and then care because too often when you're when you're theoretically a healthier while person you go go through your you know you get your pap smear. You have a quick conversation you don't. There's no other real at least for women. There doesn't seem to be any other other baseline. Check and what's happening. It's kind of wild like you're. You're hoping for the best and I remember when I came to open. The first time I started are working with functional doctors and having that moment of like de feel joy in your life. I know some of those things are creeping into Western medicine as well but that that sort of those stop you in your stops questions about how you're living your life my no. That's not a question but like it's M- it's missing right. I mean we've we've lost some fundamentally important things. We've lost the long-term relationship. The research shows that when you have a doctor who knows knows you who knows who you are costs are lower. Outcomes are better patient. Satisfaction is higher but we've made medicine really transactional and we've made it really inaccessible like one of the crazy things about parsley. Is that three hundred sixty five days a year. You can write in and ask a question or get a refill. You have this constant. Communication and health is happening in your life. He knew ninety ninety. percent of your health is having your life. It's not happening in a doctor's office and yet our medical system is pushed us into this place where we have these very transactional transactional often desperate moments in those are only interactions with the medical system and so in this way having this relationship. Where are you going through a divorce or break up. Are you in a new job and you're really stressed out. What's happening with your family your health and happened today. It's an amalgamation with everything that's happened to you in your life that got you here and so you have to get to know someone as a whole person you have to look at someone over time because what happened in two years ago or twenty years ago matters and then you have to look at all of these things that get sort of pushed aside in medical culture as soft and yet they they drive the majority of health outcomes which are the social determinants of health. What you eat how you move your environment how you manage stress Your Relationships. These these things are driving most of your health and doctors drugs procedures interactions with the medical system only actually account for a small percentage of it but medicine sort of ignores an entire really the rich data set and then you have all the cool diagnostic testing it takes new information seventeen years on average to get into medical school education and so we have the microbiome and genomics and hormones and toxins and so what I love about functional medicine is that it's bringing together the best of modern medicine and the breast of primary care but with this holistic view which is what we need for today's world. The old system doesn't work anymore and to your point about women you know the research shows that women and minorities minorities don't get heard by doctors in the medical system as much our pain gets ignored or symptoms get dismissed but that's it's crazy when you think about it because women are medicine. More than fifty percent of doctors are now women. The majority of primary care doctors are now women women. Dr Eighty percent of healthcare spending in this country and only like something like thirteen percent of healthcare CEO's or women and so we have this entire service layer. That's like fundamental to the functioning of our lives that's been designed for and by men over time and where women haven't had this voice and then subsequently aren't heard in the same way and so it's just a space that's so ripe for so much change and parsley as part of that. There's there's lots of folks who are part of that. I think what you're seeing right now. Is this kind of ground. Swell of saying wellness is amazing now. There's a kind of force function or an energy energy pushing to say this has to come to medicine to exactly because I think too you know the wellness movement is trivialized or mocked you know as is this trait undertaking people who have too much time and too many resources and I know we started on that line now. It's it's very dangerous because it's as you mentioned it's primarily led by women who have been overlooked who know we know our bodies. We know when things aren't right and like being well is obviously both an essential part of longevity and being there for your family but also also infinitely less expensive but I do want to get you going. Where do you think that that comes from the fact that the healthcare system was designed by man Dan or where does this. I mean I know it's like hysteria and the uterus and wandering uterus and yeah I mean I think it comes from so many places I mean I I think it comes from the medical system and in its history of of being somewhat reduct reductionist and thinking and sort of you have this symptom take this drug rate and that was important in a world where infectious disease was like the number one thing we were dealing with and in a world where we have chronic lifestyle driven diseases heart disease diabetes depression gastrointestinal issues infertility autoimmune these things that are a slow lober and that we live our way into that kind of whack-a-mole approach doesn't work anymore and I think it comes from that. I think you know women. Dr Eighty percent of healthcare spending and there are also the early adopters of all health tack of all healthcare a wellness of yoga of all of these things the research shows that at least historically men only engage age in their health once they're already in crisis true and so women are been the ones listening to their bodies and our bodies are awesome rate the only vehicle you're going to Hafer life. You'll have for life and they have so much information to share with us and we're you know for whatever reason I don't know why maybe a little bit more tuned in but women are listening to that that and I think the wellness movement comes from that and when I said don't get me started. It's it's the dismissal of wellness by medicine that makes no sense when we know that again nutrition mental health environment relationships movement these things drive so many of your health outcomes we'd rather spend hundreds of thousands of dollars ripping out of your leg and tied around your heart when you have heart disease than spending a a couple of thousand bucks up front to help empower you to understand your health into live differently and that that is an economic value system right and so oh you know a lot of my work is around. How do we bridge that gap between medicine and wellness because they're they're part and parcel of a continuous same thing and we don't want to throw the baby out with the bathwater. Pharmaceutical drugs are awesome really important tools. All of the modern testing guide nerd out on that stuff all the time. That's what we do but it's awesome but it's not enough yeah I think too. It's important to understand where the resistance is coming from. Anything change in general is hard and I think we're also living in a world. Obviously that's becoming much more bottoms up where people have access to information and validation Chan they don't necessarily have to go to their teacher their doctor their priests whoever it may be like the Patriarchy is crumbling right but I also feel to like there is this it's not a war but it's unclear who it's unclear where the resistance is actually really coming from because I feel like I meet so many a conventional doctors and so many researchers at university who are completely on the side of lifestyle medicine and absolutely think it's important like that's the first thing they want to understand is what people are eating also. I'm curious where you think it's coming from this because it feels like it's kind end of ally. This created that there's this tension establish that when you actually start poking holes in it you it's hard to to find people who aren't who are on different sides. Oh I I think they're they're oh yeah yeah. Yeah I mean coming from you know the proverbial ivory every tower of medicine in my training. I definitely know it's there. you know even my dad just retired as chairman of medicine at a Community Hospital for after thirty years of of practice to seeing you know. It took him quite a while to kind of get it. I think it's generational. I think it's our research paradigm you know the randomized controlled trial. L. which is the gold standard his pretty old research paradigm and it's pretty clunky like it's somewhat narrow and its focus and so it's great for showing if a drug is better than another drug or drug will kill you or not but it's not great at looking for these multifamily to`real overtime factors jurors like what are you eating and how does that impact you and then. I think it's also our healthcare system is a is a big well intentioned and awesome beast right. That is an anything like that. You know turning a speedboat is much easier than turning the titanic and I think think that just by the nature of it takes time. I had this incredible experience this week. One of my professors at Columbia Med who's just just to renowned doctor. They're probably in her eighties at this point and she sends me this email hi Robin. I don't know if this is still your email address but I had to tell you patient of mine her daughter was stealing with kidney failure and no one could figure it out and she ended up seeing one of your pediatricians and being diagnosed missile toxic mold and she's better and I wanted to commend you for seeing a future as it didn't yet exist even even when you were here because she knew me and I like cried when I got that email because yeah that validation matters to me from these incredible institutions Susan's where I train but where most people were not necessarily on the same wavelength than I think. Sometimes you can think how does not everybody dot just see not this right yeah and yet I think to your point is changing yeah. No I think that there's mold is an interesting example too of this. This idea like US imagining some sort of crisis but to your point like toxic mold is deadly and there are so how many things in the environment and in that are already circulating within our bodies that are problematic and yet that that concern is often also invalidated elevated by your body can detox itself and the idea of trying to sweat more or being careful about what you can see him or put on on your body is not essential like your body can handle it which I think. We also know that sort of a fallacy. Do you imagine a time. When will that will look back and be like that was so crazy. Oh Yeah I mean. I think that we'll see that because what we're talking about here is just thinking outside the box thinking more broadly right. I always describe the toolbox that you learn in medicine as being really fantastic but being primarily composed of certain tests certain drugs certain procedures and when you start to think of nutrition and sleep and meditation and supplements and this wider and more more modern array of diagnostic testing is adding to your toolbox. It's not an or it's an and suddenly your ability to help someone heal which is what doctors are here to do. Teach and heal and guide is just so much broader and I think I do absolutely think that we'll get there and I think that and I mean you guys like Goop is a huge part of this rate. It's we've seen in the past five to ten years. Especially five years assist ground swell on the consumer side on the the individual side saying we wanna feel well being alive and existing isn't good enough right and we want to feel well and we WANNA listen to ourselves when we don't and we want to pay attention to the signs in our body when we don't feel that way and medicine is great for keeping you alive but it's not going to necessarily help you thrive in those those are two different things and I think what were talking about. At least partially is like how do we expand the mandate of medicine and make it bigger. Yeah I think to you know so much of it is if you remove the problematic factors right the body will heal itself. Do you think that will come to a time when and it seems like this will happen and it can't be that far away when we'll each have sort of a blueprint to our solves like our genetic potential failed points and the ways in which we can steer ourselves that we'll have ultimate autonomy not that we won't obviously need doctors and nutritionists and need guidance but that will be so dialed child and to how we individually need to live that will have most of the power. I think we'll be much more more empowered than we are now and I think that medicine is moving towards personalization. We'll absolutely like as we understand. I mean we're at like the what I call the snowflake on the tip of the Iceberg Connecticut understanding rate. We're just like fairly scrapping scratching the surface in terms of what we know about how our genes impact our health although we know and that snowflakes pretty bad right we know a lot and we partially we use that information all the time but to your point. I think it's just about personalizing treatment rather than saying one-size-fits-all size fits all and the research was done on the smog of people and we're going to ignore that maybe those people aren't like you or whatever all man yeah exactly exactly and we're going to begin tailoring things to you and using your personal data that includes everything from your genetics epigenetics which are the genes jeans that are turning on and off in real time your gut microbiome your skin microbiome to your mental state and your spiritual state and your emotional state. Which are we know huge drivers of the neural hormonal cascade happening in your body every day if you are stressed and living in fight or flight? Ah Sympathetic overdrive he proverbially running from the lion all day. Your Body can't heal. It's immune system. Your Cortisol goes up your blood. Sugar goes up your metabolic bollock disarray you crave sugar all of these things happen and they're coming from from the mind right and knowing that to we sort of separated mental health and physical health yeah in our current medical system and that's another thing. I love about how how how to work as a doctor or is that I recognize that those things are not separate and how could we possibly consider one without the other yeah and even the idea of the placebo effect which is and how how it's perceived as like if you get a placebo and you get better your dupe right like you you're so gullible along among the mind is incredibly powerful and the placebo effect is incredibly high bar for these studies to beat and and the fact that we have continued to downplay the power of our own minds that that these outcomes are imagined right is also really frustrating that whole thing needs to be rebranded yet. I mean our minds are incredibly powerful tools vice versa. We have so much power over our our mind state through our bodies. You know the ability the way that sugared creates inflammation in the brain the way that simply exercising exercise goes head to head with a a lot of antidepressants if you're not moving than you are probably not sleeping and probably not pooping and lots of things should be happening in your body are not and if you sit in front of a desk all day and you kind of calm the jitters with the wine at the end of the night and then you don't sleep well in your honor. Rinse and repeat cycle you are on a crash course for things things like depression and anxiety and so one of the things in that's been really cool and gratifying to see how many mental health providers whether they're psychiatrists psychologists or therapists are healers referred to us at Parsley because they love to see like what else is going on in the body. That could be driving this one donate women in her lifetime will be diagnosed with thyroid condition. If you are constipated have dry skin gaining weight and depressed you could have low thyroid word function but so often women get told oh you're just depressed. Take this medication. You need to work out more. It gets dismissed right back to the not listening when you're just getting old yeah. It's just aging yeah. You're thirty four in the valley flat. Yeah and you're like no what what's going on here. In the new test for it's there and we're you know a little bit too too much like zero to ambient in this culture yeah and not asking why not looking under the hood. We've had some incredible success helping women get pregnant within avoid. IVF simply because we helped balanced blood sugar balance hormones John's lower inflammation understand the underlying triggers of some issues that were then identify thyroid problems and these things all when unsolved resolved resulted in healthy pregnancies and women who were told that they would never get pregnant without Ibn often these things. Are you know. The power is there. We'll get back to Dr Burleson in just a second I mentioned a few weeks ago on the PODCAST. Curiosity is my favorite state of being. I try to carry the attitude with me every day. It's certainly easier to do it at a place like goop that places such a premium value on being curious and feeling empowered to explore and ask questions. Banana Republic DOC is another company that values curiosity their founding story starts with a California couple. WHO's looking for an adventure fun fact Banana Republic began as Safari Safari inspired clothing company and today the inspiration for their clothing designing for life and motion or as they put it living a life of possibilities with no boundaries raise their fall collection is iconic banana republic styled for now so they're utility inspired styles made from premium materials think your favorite dresses and pants updated an animal prints and menswear patterns and quintessential Suede jackets and cashmere sweater the aware for many seasons to come and now Banana Republic is celebrating some some true modern icons with goop through our special podcast series women on top? I hope you'll listen to every episode. These are the women who lead with power grace and curiosity who I think define what it means to break boundaries and maybe most importantly poor working hard so that others to can live a life of possibilities so keep listening and keep shopping with our friends at Banana Republic to get their fall collection had two banana republic dot com slash goop. There's a workout then there's goop workout and then there's goop leak coop. League is our first major fitness focused experience. We're launching this new event the weekend end of October twelfth to Thirteenth in the city that we love and that's become something of a second home to us. That's Austin Texas guys and we'll be at our favorite the Line Hotel aw downtown Austin right on the river. What in the world can you expect from the team this time group. Lee is all about tapping into the incredible potential of the body. We were bringing together some of the most talented and cutting edge instructors and experts from the world of fitness. These are the people who are redefining physical wellness and shaping the way hey we think about an approach the mind body soul connection as a guest that group. League you'll get to take three classes with these top practitioners in several different studio spaces ground lift pulse burn and Relief and some of my very favorite teachers will be there like an array a former dancer from la who has developed a wholly holy unique compelling and fund. We've method that revolves around reconditioning your fashion. It's extraordinary I promise in call at Dong from the nest in New York City will also be there. The executive team cube recently did the nests new bounce and sculpting classes together. When we were out on the east coast it was hard knocking ally but it was kind of hilarious and very cool and of course you'll get to see and do a lot more if you come to keep league there will be our pop shop food drinks and a bunch of power stations shins where it will have tools for soothing our muscles relaxing and just finding a little thin so to join the group League? You can get a pass for the event on Saturday October twelve or Sunday October thirteenth just head to Goop DOT com slash goop league back to my chat with Dr Robin Burson so in terms of the breakdown of who uses parsley what percentage of it as people who are just WANNA maintain or improve their overall wellness or maybe rebuild their immunity and and how how many people come to you because they are out of options nita to help detective cannot figure out what's going on across the board so we have three core user groups there folks who are optimizing ising. They don't have a diagnosis. They don't have symptoms oftentimes. There's a personal trigger. Maybe a family member diagnosed with Alzheimer's disease. Maybe they had kids hits and they kind of want to clean up their act. Maybe they've been reading Tim Ferriss all day and are really just ready for that. Genetic tests I know and we love working with those folks because everybody gets sick sometimes and the data that we have available to help people optimize awesome and then we're there for them. When I have one patient in New York he's like a thirty year old guy looks like the healthiest person on earth and he is and he's one of those people he knows he has two copies of Asia four so he wants to reduce his Alzheimer's risk. This can optimize heart health but along the way he got ticked by the lime disease side effect reaction to a drug and other doctor prescribed him like stuff happens happens right. We're human no matter health how healthy we are so that's one crew. The next crew is symptomatic but doesn't have a diagnosis so that's folks who are trying to figure it out. They're not feeling well. They're bloated. They're breaking out. They're exhausted. They're anxious. They're digestion zoff. They don't have a disease. They're not looking you you know for the last ditch detective but they want somebody to put the pieces together and then the last group is folks who do have a diagnosis. Maybe maybe they have heart disease or a mass or infertility or depression or whatever the case may be and they're frustrated. They're the ones who say I'm frustrated frustrated with not having time with my doctor. I'm frustrated with asking for these tests and having them look at me like I have three heads. I'm looking for a quarterback for my health. I'm looking for somebody to managers and figure it out and so as really across the board in New York which is our originals center. You know we started seeing kids too and we're going going to extend that across the country but now we see families and that's really cool and so it's kind of everyone it's men and we work with men and women were slightly slightly more heavily female population because again women are the early adopters. They're the ones that jump on board which is awesome but it's kind of our oldest patients eighty nine and wow yeah. I know it's been. It's really hard to get men engaged in health. I know this from my personal experience where my husband is literally like pre-diabetic. I mean his his his his blood. Sugar is out of control but that I can't I'm working him into. You know getting some testing but he's going to resist yeah well. Sometimes they see the numbers though Oh yeah for that type of of perspectives sometimes these see the the data and they get a little bit competitive calls which is a lever you can pull. It's also ironic because I feel like most men I know are the hypochondriacs and our diagnosing every single thing on the Internet. Hey where women are like. I'm sick and I'm still going to go to work. So what's your so for the people who are generally well wanting to to maintain their wellness. Like what do you recommend like. How do you like people to eat. How do you like people to supplement. Let's assume it's a thirty five year old. Women are thirty five to forty five year old woman so we developed something called the symptom tracker at Parsley and it's forty five questions look at nine body domains and I have rarely seen the person who takes this two minute quiz who says that they're perfectly healthy. That has a score zero never happened so we all have something right and I think I think that's the starting place the other starting places just hearing your history your story. Do you have a family history what I might recommend for that thirty five forty five year old woman with a strong family history of breast cancer or heart disease might be a different set of tests and a different diet or different things than somebody who doesn't right so you need to look look back in time as well as right now but then from there it's often about on the nutrition side taking out the crap so refined sugar a fine flour processed foods all the things that come in a rapper bag that you pop open something that didn't grow out of the ground. Those foods are poisonous. They're filled with pesticides and dyes and preservatives and things that our bodies were never meant to work doc with right and so and then just the sugar and refined carbohydrate factor when you spike your blood sugar and Spike your insulin and you do that on a repeated basis you create this massive downstream fact that affects your hormones your brain your gut and then from there your immune system and everything else and so a lot of it's it's not about you know eat. Paleo Kito Vegan like those specifics might be right for a given person in a given context and we will recommend a very personalized nutrition plan in that way and at times we may recommend intermittent fasting or a ketogenic diet and those things have their place but the number one thing that we have everyone do is get got all of that stuff out and eat real food which takes more time and a little bit of Huntin and a little bit of sort of wherewithal as I discovered covered in the airport in in Boise Idaho this weekend coming back from a wedding amino. You have to kind of say this is what I care about in this one. I'm going to do and to not beat this thing and find something that that fits here but that's number one and then supplements. I noticed like such an annoying answer but it's so highly personalized personalized. Some people don't need any supplements and some people really benefit from I benefit from these glaciated helps me sleep at night. I benefit for methylated deleted b-vitamins because I have certain genetic so they boost my mood for shore. If you're pregnant or thinking about getting pregnant you need a certain type of prenatal but you don't need that leader. probiotics can be really really helpful but aren't necessarily needed all the time so it really comes down to those things and then the last thing is get your mind on board with your body like you can't fix your your bod without looking at mental emotional spiritual all and whether you have a meditation practice or an exercise practice or something that allows you to self soothe be present kind of get into your physicality and calm that is when your body's in a Paris empathetic state which is your rest digest relax and he'll state and when the bodies these there than the body can start fixing things right but if you never let it go there then you don't get to fix anything. Are there supplements since obviously not all are created equal all from claims on the bottle and not being matched by what's inside or the amount to issues like it's an unfortunate pro. It gives supplements a bad name because there are some bad players. Are there any brands that you particularly like so you know you you say it like there's some bad players and then on the consumer market. It's just like impossible to know what the good ones are a shelf it here pharmacy or your local grocery store and it's like my is cross in there right so for us because we're doctors we only work with supplement companies that only work through physicians and and so they don't sell direct to consumer so there are made in what's called. GNP certified facilities which are pharmaceutical grade facilities that are vetted they have third party data meaning a third party hardy analyzes what's in them and says yes this thing actually contains what it says it does and isn't contaminated with scary things and so forth and so anything with like our label on it as made by one of those companies anything that are we carry in. Our office is made by one of those companies and there's a bunch of them. There's ten the fifteen of them that I could rattle off. The mostly aren't selling direct to consumer aren't all but that way physicians because to your point supplements can be really powerful and supplements can be powerful tools and they can be really helpful and they can be much more of a side effect and better long-term game plan some MHM case than a drug or they can just be supportive in a certain period of time whether it's magnesium or adopted Jin. I know you guys have an amazing line and so it's about without knowing where they're coming from a knowing that whoever's representing them some something that someone that you trust yeah now for sure. I mean that's been our experiences in gem be certified and all you have to do ingredient testing and you have to do ingredient testing lab testing like sourcing horsing. It's a mess and you have to know right and I think the biggest problem with them. A lot of what's on the market is that it's not that it's going to hurt you some of it well but most of commits won't but it's that most of it is so little of the active ingredient that it's like taking a quarter of an antibiotic and wondering why your sinus infection doesn't go away like it's just not useful and so. I think that's where the professional grade stuff and you guys are using professional facilities to manufacture. You're getting different potency and quality of ingredients. That thing's going to like work yeah if you're going to bother to take it right and so that's for us what we what we stand behind yeah is there when you sort of look ahead both tactically and otherwise like what are you excited about. Are there certain things that are mainstreaming. Now are becoming available that you think will be transformational. I'm really excited about all of the diagnostic testing that's kind of getting into our hands and empowering us with information so I'm a big fan fan of all of that home diagnostics a lot of doctors like hate them because you know people say oh people don't know what to do with this information. They don't know what it means. There is a risk of some of these struck consumer tess not being you know medically accurate so obviously we have to regulate that but I think it's great because I think why should we not want people to be more curious and interested in what's going on in their bodies like that's a good thing. I do see people left a lot of time sort of unmortgaged with that information it could be something so simple as a vitamin D and they bring it to us and they're like what do I do and how much to take and how often what should my levels be. When do I retest and that's one point. The re-testing is really important. Don't test once like test taking action test again. I'm just excited about how accessible all of this information is becoming becoming and how much people are excited to like learn about their health and wellness into you know I saw a long time ago like a some article in the newspaper about like it's so bad that all these people are obsessed with wellness and WanNa know all these things and they wanted to like the author was a physician and I wanted to like shake that person and say this country's problem if you just WanNa focus on the US for a second this country's problem is not people will be too interested in their health and wellness. Yeah sure there are some people who might take that too far but the vast majority of people need education and motivation and inspiration Beret Shen to get excited about their health and to learn more and start doing something about it because that's the cool part we actually can transform totally and the and having the transparency into what's actually going on and having access and an understanding of what those levels mean also breeds accountability and I think we aw want that for ourselves right. It's very disempowering. Feel like you have no control over your health. When in fact I think we know we can fact dramatically are their baseline task for people who can't get parsley doctor you and what what age for women do you think that they need to establish. I like a hormone baseline or baseline in general I mean as young as possible like when you graduate from here European attrition and whenever that happens for you for some later than others earlier than others but you are I think in a great moment and even as early as your early twenties to understand we are heart health. Your hormones learned some things about your genetics and become empowered with that information and and then to retest it periods in the future right and to see where you're landing. I think there's no like time. That's too early we sort of have said in culture culture well like with any of that raid and why are we waiting until it's too late to test for things. Most of these tests are most of the things you can do. Blood work in their are relatively cheap or inexpensive covered by health insurance if you have it they're not you know we have. We certainly offer at Parsley lots of what I call fancy pants tests but not everybody everybody needs those and that's certainly not necessarily where we start. We start with in-depth blood work and these are things that lots of doctors are doctor owner looking at your thyroid looking at your female hormones looking at your nutrient levels looking at inflammation markers looking at what's called an M. R. Profile of your heart health so the shapes and sizes of cholesterol particles not just the total number which is not super helpful kind of getting those deep dive looks or as early as possible because then you have a baseline you know where you were yeah no it's interesting and even thinking about something like cholesterol and our understanding of it and how that's evolved and how I mean as a child I have. I have high cholesterol total number and I was a skinny little kid Kim but I was put on a very restrictive diet with this idea of forcing that total cholesterol down and then I was sort of let off seemingly seemingly let off the hook until recently when I don't know if you know Dr Echoes but he was looking at some of my genetic factors and he essentially was like you are not someone you can ever do bulletproof or eat high fat and high fat with the Bandon because of your genetic attic predisposition toward high cholesterol which I thought was fascinating to sort of in a way Yup come back to it and that's a great point like we see people doing a lot of these this diets and there are people who really need to be on a plant based high fiber diet and cannot get away with these high fat diets and so people are doing them without out the diagnostic testing not knowing that you know it's a smaller percentage of people that that happens too but I I we see it all the time where yeah you gotta get that. MCAT DT oil and you know high fat dairy like out because it's not it's not working for you and so that's what I'm like excited about all seen seen more of just as everything kind of shifts do you. How do you feel like this. Whole world becomes more accessible muscle for people I think as we see more and more medical grade but consumer available diagnostic testing and will put pressure assure on the system to take the veil off of what are somewhat false prices I think that as you get more education per providers here's out there. One of the things we've done is we've built in house fellowship that trains doctors in the functional approach and just we need more providers to understand this but I think that well because I think is you have greater availability right. It's kind of like basic economy demand supplies you increase supply of people with this knowledge base who are on the provider side prices will come down and I think that you're seeing it just across the space of everything happening and consumer health right wait. There's just more and more and more of it because people want to feel good and that's a good thing this not might not be an appropriate question but do you collect elect and I. This is like a potentially triggering. I'm I've been watching the facebook documentary but do you think you'll have a data set at some point that you can extract bigger vaguer learnings bigger cultural learnings that are applicable to a wider swath of people. Yes absolutely that's one of the sort of driving missions Shin's of Parsley. We you know it's all anonymous we don't. We're not selling our data but we are tracking outcomes. We've actually shown that we reduce chronic prescription drugs by. I seventy seven percent. I mean we have real data already in cohorts around gastrointestinal disease blood sugar autoimmune conditions Hormone Moan imbalances already showing that we're helping people immensely improve more even resolve these conditions and so as that data is set gets larger sure one of the things that I've always had as North Star for Parsley as we started out at a very relatively affordable price point at about five bucks a day. Eh for the membership and we don't bill insurance directly because insurance hasn't quite caught up to the model that we have but it's getting there her and one of the things that were one of the reasons we're collecting outcomes data has to be able to work with the insurance companies and say look at the how we move the needle look at how this approach approach to care moves the needle and look at how people investing in their health in this way are changing their own health outcomes and how could you not pay. Hey for this right. How could you not reimburse this. Do not reimburse it not at the peanut like primary care rates that has forced primary care doctors to see forty patients a day at fifteen minutes each not getting anybody anywhere. How can you reimburse it at rates that are commensurate with the value. That's being created and that's one one of the things that's a hopeful in the American healthcare system is that there is this underlying movement towards value base care. We need to get away from volume pain pain for volume and pay for value because if you think about pain fee for service or pain for volume the system is incentivized for you to stay sick because it gets paid every time you come back and in a value based model which is what Parsley is where it's a membership and there's many other examples of that or a health oak. There's lots happening that sounds centers for Medicare and Medicaid. Services is really prioritizing this. You're seeing this movement towards understanding and always be a blend. I think of value based in fee for service. It's hard to do just one or the other but a move towards recognizing. How do we create more value for people now and so that's another way I think prices we'll come down and yes the the onus of Parsley at looking at our own outcomes? De Data is to be able to affect that kind of change. Thanks for listening to my conversation with Dr Robin Burzan. You can learn more about her at Robertson. MD DOT COM that's B. E. ARE Z. I N. and check out parsley health a parsley health dot com. That's P. A. R. S. L. E. Y. That's it for today's episode. If you have a chance please rate and review hit subscribe to keep up with new episodes and pass it along to a friend. Thanks again for joining. I hope you'll come back this Thursday for more four and in the meantime you can check out dot com slash podcast uh.