Charting Opportunities with Dr. Carlos Jorge and Nathalie Jorge

[00:00:00] We have been hosting this, uh, I guess I should start off and say thanks everybody for coming out, um, early January. Everybody loves to talk about health and wellness in January, and we, um, surprisingly, we actually have a, a number of folks dial in online as well, so we’ve got a YouTube channel and LinkedIn as well.

So to our international or global audience, how do you want to define it? Thank you for dialing in as well. Um, so, um, a, a quick couple notes before we get started. Um, first and foremost, I wanna say thanks to Triple C Brewery. Um, we’ve been using their event space since April of last year. This is an open event space.

It is a gorgeous event space. It is acoustically set up. The Charlotte Symphony plays here, um, several times a year [00:01:00] because the acoustics are so well, you can tell there’s no echo. Um, it is a fantastic place to host an event and I would encourage anyone and everybody to try to host an event here. So the event space is filled up because I’ve known Chris since we were in sixth grade.

Um, and I think the world of ’em. So anyways, fill up Chris’s event space because it’s a great space to be. Um, another thank you, um, to the team, um, uh, John Caitlin Sohi Bo. Um, it doesn’t happen without a whole bunch of people making these things happen that I don’t know how they happen anymore. So thanks everybody for doing that.

Um, and then before we get started further, there’s a QR code up behind me. We’ll leave the screen on for a little while. The QR code is, um, a link to Companion Health’s website. Um, so if you like what you hear today and you want to learn more, then the QR code is the way for you to be able to learn more.

Um, and since we have [00:02:00] some new faces in the audience today, what are we doing here? This is an event series we call Charting Opportunities. Uh, Portus Wealth Advisors is a wealth management firm. We primarily serve business owners. We started serving business owners, um, as kind of our niche in 2023. Um, this is a speaker series.

As a result of the immersive financial planning process that we go through with our clients, we feel like we have a pretty good idea of the things that are important to them. So we bring in speakers once a month, uh, mostly local speakers to talk to business owners and others about those things that we think are important.

So. There’s no more important thing out there than health. Um, and January happens to be a time where health is on the top of a lot of our minds. So, um, this is an obvious one. Um, I’ve been fortunate enough to have been introduced to, uh, companion Health by a good friend of mine, Scott Pope, I believe in 2019.

Um, they’ve done a phenomenal job with me over the years. Um, and [00:03:00] so Dr. Jorge came in and spoke last year and did such a bang up job that we thought having him come back with a softened approach and, um, a better half approach added into the mix would be a nice way to start off 2026. Um, so before we dive into the interview, um, I’m gonna read off a quick disclaimer because we live in a legal world these days and we always have to check off those boxes.

So bear with me as I get through this for a second. This conversation is for general informational purpose only, and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice and no doctor patient relations, doctor patient relationship is formed.

The use of information of this conversation or materials linked from this conversation is that the user’s own risk. The content of this discussion is not intended to be a substitute for professional medical advice, diagnosis, or treatment. [00:04:00] Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their healthcare professionals for any such conditions.

How’d I do? Did I go do okay? Awesome. All right. So anyways, so let’s dive in. Let’s talk about health and wellness. Um, so any business owner, um, and a, um, companion health is a phenomenal business. Um, any business has an origin. Um, so. Um, as people that have been in and around medicine for a while, can you give us a background on how companion health came about?

Well, thanks for inviting us and thanks for all of you showing up tonight. I love that the front row is completely empty. I don’t know that we’re so scary, but, um, hopefully we’ll, uh, we’re not, uh, as far as getting started, I’d say our journey began far before we actually opened our [00:05:00] clinic doors in April of 2020, right in the midst of COVID.

It began when our oldest, who is now 24, was just six years old, and she was vomiting excessively and we could not figure out what was going on. I took her to the pediatrician and the pediatrician suggested it might be attention getting, and I just. I just knew this child was not trying to get my attention and left feeling deflated.

But very fortunately, I have this very, uh, in-house doctor to. Help troubleshoot what might be going on. And we, we took our daughter to a gastroenterologist and they did a full barium study. And again, they couldn’t find anything wrong. But what I know about Carlos and he does not often share with the general public, is that he’s as good of clinician as he is a research scientist.

And he figured out what was going on with her. And once we had a [00:06:00] diagnosis, um, our world changed in so many ways. I started as the mom reading everything that I could get my hands on. I learned about the exposure of, to toxic chemicals in our environment, the impact that nutrition could be having, sleep stress.

And not only as we started to chip away and make changes in her life addressing some of those key areas. What I found is that our whole family started getting healthier and healthier. And once you know what, you know, you can’t go back. And so that was what kicked off. The way we live our lives today and the way we practice medicine.

And I’ll let you sort of pick up with your simultaneous Yeah. Journey in medicine. Um, yes. And again, thank you William, and thanks everybody for coming. I know it’s, uh, uh. It rained earlier and it’s a little cold, but we appreciate it. Um, so as Natalie sort of alluded to, I think, you know, we spent a long time with [00:07:00] Leah and, and now ourselves sort of walking the, you know, the, the, the walk talking, the talk, and.

For me, it, um, after doing three iterations in of healthcare, so I’ve done, you know, I I say I’ve done time with the two big systems here, which is Atrium and Novant. Um, both were formative, both were really different experiences. One was, you know, doing uninsured care. The other one was doing, uh, the opposite building, um, executive health programs and corporate wellness programs and realizing that I don’t take orders very well from anybody.

So I bought half a practice in, um, 2008 and did really structured insurance-based healthcare. So, you know, you’re traditional seeing 30, 40 patients a day cranking, and I say cranking ’cause you’re really, you’re, you’re in and out. Um, and I think one of the things that, like over time I realized was that.

While you think you’re making a difference, you realize that you’re just sort of, kind of pushing [00:08:00] things very slowly and the changes you make are not really incremental, lifelong changes that people tend to really thrive and exceed on. And so, um, right around 2017, I, I started realizing like, this is not good.

Like, I’m not enjoying what I’m doing. I’m, I’m trying to find quick fix solutions for a larger healthcare problem, which is, you know, we introduce cosmetics and we introduce, you know, um, other programs, everything, trying to fix both dissatisfaction with what you’re doing, but also watching yourself work much harder.

And honestly, seeing your pay go down and down and look as a physician, we’re blessed. We do well and we work hard. Um, but that wasn’t the case and I was. Honestly just miserable. And so 2019 I left that practice and we said we would never work together. ’cause uh, you know, knowing each other for [00:09:00] as long as we’ve known each other.

Married, I mean, we started dating in college. It’s just like we were not going to do that. And then, um, I think we really spent time, we traveled, took some time off, and then really started to think conceptually about, you know, my background, having three board certifications. How could we do things differently?

What do we really believe in as far as what healthcare needs to be for people and how do we actually deliver it? Um, and that’s really what drove the creation. One thing I thought it would be a tragedy with. Carlos, if someone with as big of a brain and a heart with integrity would exit healthcare because of burnout.

And so part of the conversation we had was, yes, our marriage comes first and do we really wanna do this together? ’cause it’s a big undertaking, but is thinking about we’ve gotta keep you in the system. We mean need more doctors like Carlos. So how can we create something that could [00:10:00] change the needle and move things in the right direction?

So I did wanna add that was a big component of too many great doctors are leaving the system right now. They’re burnt out. And the joy of getting into medicine is about the art of medicine. And so really focusing on that, again, bringing that human back. Yeah, no, agreed. A hundred percent. Um, so 2019, um, you.

Walk out the door, um, and you decide to open up another door. Um, obviously everybody here now knows that’s a door called companion health. Um, that it’s, it’s a functional medicine practice. And I think a lot of people have heard the words concierge medicine. A lot of people have maybe have seen the phrase functional medicine.

Um, but what does, what does it mean? Um, what’s the difference between that and the traditional medicine, the way medicine’s been practiced for the last 80 years? And remember, you’ve got eight minutes on this question, not eight hours. [00:11:00] I, I mean, I used to talk about functional medicine is root cause medicine.

That’s what it’s traditionally described as. And the origins of functional medicine have to do with like Jeffrey Bland, um, other, um, providers like Mark Hyman. So there’s lots of folks who have come before who have done functional medicine and really helped put it on the map. Andrew Wheels and other one integrated medicine, I think.

The way we think about functional medicine is, is really, I think, the way medicine should be, which is it’s trying to understand the why of how someone who, for all intents and purposes, should be healthy or is healthy. All of a sudden their optimal health has fallen to the wayside. Right? What are the triggering factors that do that?

And so if you want to call it functional in the sense that we try to understand, um, at a deep, sort of root level, the function of each system that a person may be, you know, out of balance with, so [00:12:00] their gut, their hormones, their nutrition, their stress, et cetera. Those are all functional things that we measure and track.

However, we now talk about it more as this is how medicine should be. Like the idea that you go to a physician, nurse, practitioner, pa, whoever your provider is, and you’re walking out usually with two to three prescriptions after a five minute visit, is not medicine. Like that is not what, certainly not what I went to school for, not what I believe in and not what most people who have that calling to do medicine, be it a nurse, nurse practitioner, pa, et cetera.

And so functional medicine, I think at its kind of basic, is root cause medicine for us. It’s how medicine should be. We spend time with our clients, we take, you know, anywhere between, our first visits are usually an hour and a half to two hours. Um, and then follow-ups usually are 45 minutes, not, you know, sometimes 30, 45 minutes.

Um, but it’s really trying to [00:13:00] understand kind of that, um, that whole system. I often explain functional medicine from the client perspective or the patient perspective. And I give an example of, Hey, if I have high blood pressure and I come into the office, yes you can give me a medicine to lower my blood pressure, and you’re very much treating this symptom, but why do I have high blood pressure in the first place?

Is it because it’s a genetic predisposition? Is it because I’m not sleeping well? Is it because I’m not eating well? Is it ’cause I’m not moving? Am I high stress? There’s so many different things that could be contributing to me having high blood blood pressure. And in the conventional medicine model, you’re pretty much given a prescription and told, you know, take care of yourself and take this medicine.

But what Carlos really does is he understands what those underlying conditions are that might be contributing to you. You having high blood pressure in the first place. So. As a business. Um, how so? I mean, [00:14:00] y’all have a, a phenomenal staff that goes along with you, an office, um, a beautiful office building too.

But how do you build, I mean, at the end of the day, you have to build a business. How do you build a business around that, right? That’s and how do you grow it and expand it? Like, just talk about the business side of it, um, how it integrates with healthcare, right? What have you put around Dr. Jorge to make that work?

That’s a big question again. Um, eight minutes. Not eight minutes. Well, you know, one of the things that I was hoping we could talk a little bit about before we get into the business of is the complexity of talking about all this diff all these different names. So functional medicine, that’s a category of medicine.

And then you hear concierge medicine, that’s like a business model of medicine. And there, there are all these acronyms and it’s all very confusing to me. And so I wanted to hopefully set a little context around what is concierge medicine. And so I was thinking what is something [00:15:00] that most of you probably have had some experience with, which is either building a house, renovating a house, renovating an office.

Anybody have experience doing that? Okay. Well I’m guessing that the first thing you did was not call your subcontractors. You probably engaged. An architect, you may be hired an interior designer so that you could draw plans and start to know where and get everybody on the same page. And then you didn’t stop there.

If you didn’t serve as a general contractor yourself, you probably hired one of those two. So that individual would help coordinate. So the HVAC person didn’t show up when the electrician was supposed to be there before the drywall people, et cetera, et cetera. So when we’re thinking about healthcare, we very much have a mess of a system where there’s no lead architect, there’s no general contractor, there’s no designer, or we’re serving in that capacity ourselves.

We bounce around from [00:16:00] provider to provider. They’re not talking to each other. We’re googling. To figure out what our symptoms are. We’re consulting chat, GBT, we’re scanning social media. And so there’s this glut of information and yet no one’s really organizing all that information. So when we talk about the business that we created, we decided we need to be that person, um, for our clients.

And so what you see with concierge medicine out there is you do have a lot of general contractors. They’ll give you more access to care, they’ll help coordinate that care. A lot of that is more in the traditional space. It’s not in the functional space, which we have in the functional space. We didn’t touch upon this.

We have more advanced diagnostic testing and tools that we can use with our clients. So sometimes in the concierge space you get that and sometimes you don’t. But what we really do most uniquely in how we set up the business was we decided we wanted to be our client’s lead architect and their designers as well.

So we bring all that in-house so that not only are we delivering excellent [00:17:00] primary care, but we’re also taking it a step further and helping say, where have you been? Where are you now and where do you wanna go? And then we pair all our clients to support the providers and our clients with health coaches because they’re like the designer.

They help you like fi figure out what exactly your choices that you’re gonna make that best suit you, that are gonna help you advance your health. So it sort of answers your question and sort of doesn’t. A hundred percent does. Okay. Um, expand on the health coach, right? Like how does that pair with the doctor side, right?

Like how, how and why? Um, so when we came up with the concept and Natalie was our first health coach, um, on purpose, I mean, we did it to test it. Um, the idea is that a health coach allows. Us as providers to level up in a sense, right? So if I see a client and I say, Hey, you’ve gotta go gluten-free, we’ve gotta work on, you know, your gut [00:18:00] health, we’ve gotta work on stress management, et cetera, et cetera.

Our health coaches, then that implementer or the, as Natalie, using that analogy, the designer of that plan for them we’re supervising. And the difference has been that conceptually we, we did, that’s unique in the market’s. You know, it’s now being more recognized is that everything that the coach does with a client is treated as a medical legal document.

So it immediately gets put into their chart, um, and it’s reviewed by us, the provider, and our PA and nurse practitioner. And then we’re having kind of bidirectional conversations about what that program is going to be for the, for that client. Um, the, the, the key to coaching too is accountability. I think, you know, as Natalie kind of alluded to it, but I’ll, I’ll speak to it, is that a lot of the traditional practice is, as we talk about reactive care in the sense of, Hey, you come in, we give you a prescription, I’ll see you in three months.

Usually [00:19:00] a, that prescription is most of the time not filled. B, if it’s filled and their side effects, they’re usually stopping the medication probably within like six to eight weeks. And then there’s a drop off because maybe they don’t come in, um, maybe they forget about their appointment. And so what’s happening a lot is that a lot of the care that’s happening is not being reinforced.

And so what this allows us to do with coaching is that we have, we kind of call it like touch points with folks. It’s a constant sort of reminder. Um, a a a little bit of a sort of pat on the back and sometimes it, it’s a kick in the ass if somebody needs like, some motivation to get them going, right? So, but the key is that it’s, it’s, it’s a support structure that we’ve really, really, from the very beginning we launched, um, we’ve really sort of made it a priority for most of our clients from a limitations perspective of the current system is that, um, so proactive rather than reactive, um, ongoing versus.

Once a year. What are, I [00:20:00] mean, the current system, the system that you left behind, what are the limitations in that versus, and how has that led y’all to build the practice that you’ve built? Um, and then I wanna follow up on that for Natalie. Yeah, I, I mean, I think the limitations are, and again, this gets, it’s, it’s a much complicated conversation and Nellie and I can speak to it for a while, which is we’re in a very reactive billing driven system.

It’s a system that’s driven by insurance payments and, um, like, look, insurance is super important. However, the problem with it is that it’s driving a lot of decision making. And the decision making unfortunately, is having consequences in how people are able to navigate the healthcare system, as we sort of talked about earlier, but also how to actually get like healthy within that system.

And look, there’s a, there’s a reason and not to, to pick, but there’s a reason the CEOs of hospitals and, and, and insurance companies make. 20, $30 million a year. Like I’m all for them making a lot of money [00:21:00] as much as they want. But I would like to see it reflected by healthcare improving our chronic diseases improving and our outcomes improving.

And the reality is that’s not happening. And so when we’re spending 20% of our GDP on healthcare, but our outcomes are worsening, there’s something inherently flawed in that system. And so for us, we spend a lot of time, a lot of effort, and we’ve built a system that’s driven about how do we really start moving the needle on a person’s health and get them to what we call optimal health as opposed to, you know, just, Hey, here’s a medication.

We’ll see you like. I think sometimes even some of our clients probably are sick of us constantly. Like, Hey, you’re back in six weeks. Wait, I was just here. Well, no, no. You’re back in six weeks because we’re going to be revisiting what we’ve just talked about to make sure that you are actually implementing and doing the things that we’d like you to accomplish, which is, goes in, um, in hand with Natalie’s quote.

Um, I’ll read it so I make sure I don’t mess it up. If you [00:22:00] design healthcare around billing, you get billing. Um, so how do you design it differently? Um, and I guess that’s, well obviously we think we are designing it differently. Yeah. But it does feel like we’re going up a against a tidal wave. ’cause we are an anomaly in the marketplace in terms of how we focus on primary care and prevention.

And so just taking a step back, big picture of the insurance. Healthcare, medical complex, whatever we wanna call it. Um, if you think about what makes money for a large healthcare system, it is when you are really sick and you need expensive surgeries or you need cardiovascular care. And so primary care is not really anything but a cost center.

And so there’s, it’s more of a bring people in through the front door and then funnel them to the areas that make money for the, for the healthcare system. So when we say healthcare is built around billing, it really is driven by that supply that’s service that they wanna get us to. [00:23:00] Um, and I think there was a statistic at one point that Duke Hospital had more people in billing than they actually had hospital beds.

So. Just the whole system is a bit of a shell game and flipped from where the emphasis, emphasis should be, which is really on taking care of human beings. So when I also say that it’s built around billing, EHRs are not built with your experience with your healthcare provider in mind, nor are they built with the provider’s experience in mind.

Providers are essentially equipped with or expected to become billers through the EHRs. So the technology is very antiquated and it doesn’t do anything but help with operational workflows and billing. Yeah, that’s interesting. It’s almost like, uh, that’s, um, general practice is almost like a loss leader, right?

Where everything else is is there for the profit centers. I never thought about it that way, but it makes sense. [00:24:00] Unfortunately, unfortunately. Um, so let’s get away from building. Let’s talk about happy stuff, um, health, um, health span. Um, let’s spend some time diving into health span and, and what you mean when you say that, right?

The difference between healthspan lifespan, um, story to share, if it’s helpful from an audience perspective, how do you see it? Yeah. Um, I think everybody now is probably seeing every other, like I would say, LinkedIn ad, Instagram ad, et cetera. Everything’s about longevity right now. Everything’s about protein.

Everything’s about, so why the interest? Like, what’s, what’s really happening? So, you know, when we talk about lifespan, lifespan is how many days you have in this, in years you have on earth, right? So the average lifespan right now in the United States is about 77 years, 77.1. The health span is the time that you actually spend during that time, healthy.

Right. And healthy being without any chronic disease or illness. And the difference of that is that that average is about [00:25:00] 66 years of age now to all the women in the house. You guys are beating us as men. Okay? So those stats are better for women. Um, and what that tells us though is that most people in the United States are spending about 11 years in bad health.

And what does that do to a system that’s already, let’s just call it expensive and taxed, is that it just becomes more expensive and taxed. And so when we talk about longevity, um. There are 14 probably drivers of longevity, and I’m not gonna get into all of them, but everything from what we call oxidative stress, mitochondrial health, um, genetics, epigenetics, hormones, like there’s a lot of different drivers that will affect your longevity.

In our sort of world of longevity medicine that, that I also operate in is we talk a lot about something called inflammaging, right? So Inflammaging [00:26:00] is this concept that all of us, as we age from stress, from our nutrition, from our lack of exercise, lack of sleep, um, other medical con, you know, conditions we may have, some genetic issues that we may have, um, are constantly having this sort of chronic inflammatory response that’s going on in our system.

And what that does to our aging process and ourselves is that it accelerates that aging process. And so in our kind of world of longevity, we talk about in inflamm aging a lot. And so the beauty of it is that a lot of these things that we mention as aging factors are very modifiable, right? And that’s the, that’s where we spend a lot of our time trying to orient our clients to.

And notice we don’t call our clients. Patients, we call them clients. We are a service industry. And I think that’s the other thing that we approach this in a very different way. Like people are hiring me as their consultant to allow them to live longer and hiring our team [00:27:00] to help them live longer and healthier.

Okay. And so as far as you know, health span, what are the big drivers? And Natalie will speak to some of these from a coaching standpoint, but look, we start with the basics with our clients. We spend an inordinate amount of time talking to them about nutrition. We talk to them about sleep. We talk to them about stress and exercise and like we spend a lot, a lot of time on those things before we start talking to them about all the other fancy stuff that I can bring on stem cells and peptides and all.

You name it, we can do it, but there’s. If the foundational pieces aren’t there, longevity is not gonna happen for these folks. And so that’s kind of how we orient that conversation. And the whole theme of this conversation is building health wealth, right? So when we talk about health span, what is health wealth?

So I think a lot of us, and I like to use the [00:28:00] analogy from your world of thinking about retirement and a 401k, and we know there’s value in making regular contributions to our retirement counts, starting in as early in age as possible because those additions are gonna compound over time and result in this beautiful nest egg at the end.

But a lot of us do not think about our health in the same regard. We sort of kick the can, kick the can, kick the can, kick the can. All the while. What we’re really doing is debiting from our health. Wealth account and we’re sort of barring. And so over time those things can accumulate to a negative and then that’s when symptoms start to appear.

So decades, um, often go by and disease is, is is sort of creeping along. And then you get this symptom and you’re like, ah, I just, I wanna stop that symptom. The problem is it’s because of all those choices you’ve been making on a day-to-day basis that may have led us to [00:29:00] where we are right now. So we talk about, okay, well how do you wanna live when you’re 60, 70, 80 years old and you’ve made all the money and you’ve got this great retirement nest egg?

What happens if you’re not vibrant and able to really utilize all that wealth, that financial wealth, because your health is compromised? So when we talk about health span, it’s marrying the two. Yeah. Okay. Mm-hmm. And I’ll add too, uh, one of the interesting, surprising things, and I’ve talked to Natalie about this, is that we, ’cause there you, you serve as business owners and other people here, or business owners is often we get folks who have sold a business and they’re faced now with a sort of, what do I do?

Question. Um, and often they’re not prepared for the health question, right? They, when I tell them like, what do you think you’re gonna be doing in 20, 30 years? And they’re 60, they’re like, 20, 30 years. [00:30:00] I haven’t thought that way. Well, I’m like, why did you work so hard and sell a company for X millions of dollars if you’re not going to enjoy it?

Like, what’s the point? And so for us, like we really approach this as both a health. Kind of account, but also we really want to put it in a way that they can orient and understand it. ’cause they’ve worked so hard to accomplish what they’ve accomplished, but they’ve, like Natalie says, they’re kicking this other piece down the road.

And really, if we can catch folks earlier, like we get some folks who are in their early thirties, forties who are building this wealth and now we help them kind of build that health component of it as well. It, I think it’s gonna be a much better outcome for them in the long term. So this is for both of you.

Um, so this is a hypothetical. You ready? Um, so business owner, um, 20 employees, a hundred employees, 200 employees, um, building a business. Wakes up all the time at two o’clock in the morning, goes back to sleep at four o’clock in [00:31:00] the morning. Um, he’s checking emails. He’s wondering about finances. So he is worrying about billing.

He’s worrying about X, Y, Z. Um, he’s traveling nonstop. He’s eating fast food, he’s eating dinners out. He’s doing all of the things, entertaining clients, customers, um, going to, um, association events or whatever it ends up being. Um, emails are constantly coming in and they’re ping ping. Somebody’s not happy about this.

Somebody isn’t happy about this. Um, fires have to be put out. Uh, truck hit somebody and now they’ve gotta worry about to replace the truck lawsuits and everything. Like it’s a constant bombardment of stress, bad eating, poor sleep, and probably adding in a little alcohol to wash down the night. Right? So.

From a, from a health perspective, um, what moves the needle for that person? Well, first of all, it doesn’t sound very hypothetical because we meet a few of those folks and we, we have been those folks. I mean, let’s be honest, I [00:32:00] mean, all of us in this room are bombarded with stress, um, if not our personal lives, then the world around us.

So what moves the needle? Well, as Carlos alluded to, one of the things that you have to focus on is the foundation. And the foundation isn’t something that insurance can bill for. It’s not sexy. It is those things that you alluded to, William. It’s the basics. It’s nutrition, it’s sleep. It’s stress management, it is physical activity.

Let’s get moving and relationships, especially in today’s environment where more of us have moved online, even in a digital work environment, we need human relationships. So those, those things, focusing on those things and not all at once. So if your, you know, exemplary, uh, person is, uh, to be picked on, it’s figuring out, first of all, this person has to want it.

Like this person we work with, folks who want to have agency over, who feel a [00:33:00] sense of agency and want to be participatory in their care. Folks that are just wanna be fixed. Are not good folks to work with because there’s, this is a collaboration, a client relationship is a very different than a top-down doctor patient relationship.

So first and foremost is I have to want to participate in my own health journey. And it’s never too late to get started. It’s better, like Carlos and I alluded to that. You start early and you start making those contributions, but it’s never too late to get strategies may have to make more aggressive contributions to your health.

And I’ll let Carlos talk about, yeah, I, I think Natalie sums up kind of the coaching implementation that we would do with a client like that. I think where we’d start is certainly understanding, um, you know, where they are from a current health, um, or not health stand. Um, so that person, obviously, if they’re, you know, sleeping poorly, [00:34:00] um, drinking more than they should, weight’s probably off, they’re not exercising.

I can pretty much say a, their cortisol pathways are gonna be off. Their gut’s gonna be a mess. They’re gonna probably have high blood pressure, high cholesterol, they’re probably gonna be at a higher risk of cardiovascular disease and risk. And so as we go through those things, then we start saying, okay, well how do we test for all those things?

And start kind of chipping away at all those, um, different potential pathologies that they may be having. And once we have identified both the, let’s just call ’em cardiovascular risk markers, the gut risk markers, the neurologic risk markers, et cetera, then we say, okay, here’s, you know, here are the things that we can start.

Working on from the coaching side, um, the, again, the basics matter a lot. Um, and, and one of the things, and I, I’m sure Natalie probably would’ve picked up on it and said, it is often like the really small changes make a difference, right? So a client sort of, you know, dinner that you have to go to, well, let’s be smart about it.

Like, part [00:35:00] of what we try to teach our clients is, you know, look at the menu before you go. And our coaches, we have, we have our coaches actually research for our clients where they’re gonna be traveling, what restaurants they may be going to, and we have them look at those and say, Hey, the healthier options on that menu are X, Y, and Z.

If you’re gonna drink. Here are better options for you than you know, what you traditionally drank or, you know, stop at two drinks and really start, you know, thinking about how do you control for that? Do you need more help with that? Because there are options and other tools that we can give you for that type of alcohol use sleep.

Um, honestly sleep is one of the biggest like superpowers on, I, I mean, I’m, as Natalie sort of said, is like, we’ve been guilty. I mean, I, there are times when I’m sleeping three hours a night because I’m thinking of, you know, a problem that a client has and I can’t get it outta my head. So we recognize that, you know, both as a medical professional and as business owners, we stress [00:36:00] about, you know, whatever may be happening at the company, et cetera level.

Um, but we really try to talk and, and show our clients like what sleep can do and how to start working on those. Is it meditation? Is it breath work? Is it, you know, just learning how to breathe better? Is it doing some relaxing things at night that are different? The other thing too, from a business owner standpoint, honestly, is like at 12 o’clock at night, two o’clock in the morning, you’re not gonna be able to affect change at that moment.

And it’s real easy to say it’s much harder to do. Okay. But the, the more and more that mantra can be repeated to both business owners and to, like our cl you know, our clients or even personally to myself, like if I wake up in the middle of the night and I’m like, oh gosh, Mrs. Smith’s test is coming back tomorrow.

Well, it’s two o’clock in the mor morning. Yes it is tomorrow, but I’m not gonna be able to act on it today, uh, like at this moment. Right. So, you know, I think we, we really try to build a roadmap and then we [00:37:00] start reinforcing those things over time. And I can go into details of testing and stuff, but that would be a little bit longer conversation.

We will keep you here till nine tonight with the q and a afterwards. You can go into those details. Um, Natalie, you mentioned, um, something that I don’t think somebody else from a another doctor’s office, traditional doctor’s office would say relationships matter. Um, expand on that. Why? I mean, ’cause, uh, Dr.

Jre spoke about it last year. Why do relationships matter in our health? I mean, why else do we exist but to be in relationship with one another? Otherwise we’d just sort of be operating in our own little silos. Um, they matter so much. If you look at the longest lived people in the world, one of the core themes is that they have relationships and commu a sense of community.

Carlos likes sharing the statistic and it’s pretty staggering is that loneliness is the equivalent of, of smoking 14 cigarettes a [00:38:00] day. So it’s a very powerful. Um, impact. It has a very powerful impact on our health. We need each other. Yeah, I mean, from a, like, from a science standpoint, what the data shows is that when you’re doing, dealing with loneliness and social isolation and loneliness and, and social isolation are not the same thing.

Um, you know, social isolation is someone who’s completely sort of extracted from society, is not really engaging in, in any sort of relational, um, conversation. Loneliness is, you know, you just don’t have much like friendships or kin. I mean, it sounds similar, but they’re, they’re different. Problem is they both have the same effect and that same effect.

Is that what the data shows is that it increases stress significantly. It’s more common in the elderly minority populations, L-G-B-T-Q community, um, and sort of disabled community. Uh, additionally from a cardiovascular risk [00:39:00] standpoint. Uh, social isolation and loneliness. Loneliness increases cardiovascular risk by like 29%.

It increases dementia risk by 50%, and it increases your risk of having a stroke by like 24%. So it is not an innocuous thing to be alone. And again, not to get too into like the weeds of this, but we all have this massively powerful device. I have mine over there on the chair called a, a phone and an iPhone, and it’s a, an incredible gift that we have.

Um, at the same time, it’s one of the biggest drivers of isolation because we get completely pulled into, you know, Instagram, LinkedIn, whatever it may be. And the next thing you know, you’re spending an hour totally isolated from other people. And so it is a big deal. It’s not a minuscule thing. And so when we talk about chronic disease and risk.

Loneliness and social isolation is one of the things that sort I talk about a lot because it’s a huge driver of potential [00:40:00] risk for developing disease. You mentioned two things there. You mentioned, um, chronic diseases and cardiovascular, right? Um, it turns out that Americans are, are pretty bad, um, on both fronts I would think, right?

Like we probably have a higher rate of heart attack than other countries, and we probably have a higher rate of chronic diseases. Like how can we, um, how can we better manage it, right? Is can we manage it, can we reverse it? Um, or is it manage it? Like what can we do as we sit here today, um, consuming, um, potentially a beer or a glass of wine or something else, um, that, you know, um, how do we stay away from it?

So, okay, so it’s some numbers again. So, chronic diseases in the United States, the five biggest ones, as we mentioned, cardiovascular disease, neurodegenerative diseases, cancers, diabetes and loneliness, social isolation, cardiovascular disease, kills about 800,000 people a year. It’s still the number one killer in the United States.

Um, despite all the cath [00:41:00] labs on every corner, and despite all the cardiology groups, et cetera, et cetera, um, women have a much higher risk of cardiovascular disease than getting cancer of the uterus, breasts or, or uh, ovaries. Um, but we don’t hear a lot about cardiovascular disease in women. We, we wear pink ribbons and it’s super important.

I don’t minimize it, but it’s not what’s killing women. So neurodegenerative diseases, about 10% of the population down in the United States is, has Alzheimer’s or is in pre dementia and Alzheimer’s risk. That’s a huge number. Cancer killed about 620,000 people last year. That number dropped a little bit.

It probably has to do with some of the newer drugs and new identification and, and really sort of more active screening that’s happening. And then diabetes, we have a hundred million people who are pre-diabetic in the United States. It’s a huge, huge, huge issue. And that, um, diabetes and pre-diabetes are risk factors for cardiovascular disease.

Like if you’re pre-diabetic, you are already at risk with cardiovascular disease. Cardiovascular disease means [00:42:00] heart attack, stroke, peripheral vascular disease, kidney issues. So it, it’s a, it’s a massive, massive, massive problem. And what we’ve done is, and again, not to kind of go full circle, is a lot of this is reactive care.

It’s, you come in, you get a prescription, you come in, you get a prescription. We’re not really addressing at the root level the things that need to be addressed. And so for us, what we tend to sort of focus on is, again, the really good things that our coaches do, which is our nutrition, sleep, stress. And it sounds like a broken record ’cause it is a broken record and you’re gonna get sick of hearing it, but it is the most important and, and really just vital thing to your overall health.

And so we spend a lot of time on those things. Do we use a lot of medicines? Do we use a lot of supplements? Do we use a lot of testing? Yeah, we do. ’cause we wanna identify things earlier. So we’ll start looking at markers of cardiovascular risk and disease. In a 30-year-old, like most women who are 30, have never had their [00:43:00] advanced cholesterol panel done.

They’ve never had a carotid ultrasound done, they’ve never had a coronary calcium score done. And when we do it, we often will get, like the radiology group will be like, why are you ordering this? And we’re like, well, ’cause if it was your sister, you’d probably would want her to know, like so, you know. So we are way more aggressive on those parameters than most people are with diabetes and obesity.

We’ve, we’re going through an incredible revolution of drugs right now. The GLP ones, the gli and those sort of mix of drugs are incredibly powerful and they’re making huge differences in the risk. Four diabetes and pre-diabetes and we’re seeing an incredible movement on the needle. And so from a like outcome standpoint, like it’s gonna be really, really fascinating to see over the next five to 10 years what that does to diabetes risk.

Um, but there’s still a lot of other huge issues which are, are food. Our sort of environment that we exist in drives a lot of [00:44:00] these other variables. And so for things like neurodegenerative diseases, we really spend a lot of time also with our clients on more esoteric things, hormone therapy, which is now becoming more mainline, which is great.

Um, but things like, you know, heavy metals, mold, COVID, long COVID, we see, you know, a lot of folks with long COVID and the consequences of that. So it’s a complicated problem, but it is certainly, I would say most chronic diseases, if addressed the right way, are reversible. It’s, it’s interesting. We’ll go into rapid fire questions in just a second, but, um.

You almost kind of address that to the females in the audience. And whenever I think about the chronically ill cardiovascular issues in society today, I gravitate towards the men because we’re stressed, we drink too much, um, and we eat really poorly and always think about the women taking care of themselves.

Um, practice is made up of, of women just as much. Is it, is it almost 50 [00:45:00] 50? Yep, just about 50 50. And I think it’s really important to also address the women’s health piece of it, because what I find dumbfounding is that it wasn’t until 1993 that women were actually required to be included in clinical trials.

So a lot of the medicine that has been developed has not required women to be participants in said data sets. So a lot of the work we do is oriented towards women and we do do, like even I’m going in on Monday and getting my carotid ultrasound done, which is. It is a test I have to pay for. It’s $125. Um, I got referred by my provider.

And who would that be? That would be Anya Wallace, um, who’s also part of our practice, who I think the world of. Yeah. And she has been phenomenal with my care, but we as women do need to not sort of think that our hearts are as healthy as, you know, the, the, the other half. Um, and so [00:46:00] it is good to get that baseline and just know that, that it’s, it’s not an expensive test, relatively speaking.

It’s a good to get that baseline. So. Yeah. And as far as like cardiovascular risk, as Natalie’s saying, like, there are simple things that can be done, and if you want more information, we can give you. But like I always say, like knowing your numbers and knowing your numbers means knowing your cholesterol numbers, but your advanced cholesterol numbers, knowing your inflammatory markers, knowing your carotid, knowing your calcium score, knowing your family history is important.

Um, and then with women’s health, like it’s, we’re seeing now a complete reversal of what was women’s health in the past. Right? In the, for, for many years, women were on hormones, and then about 20 years ago, every woman was told, Nope, hormones are bad for you. Well, it turns out that’s not true, right? And then what happens is, in, in science when an, you know, a lot of research is done, sometimes the population that’s [00:47:00] studied, the timing of the population, the medications that are being used will skew that data.

And that’s really what happened for like the Women’s Health Initiative. Perimenopause and menopause. So, you know, even today I had a client who’s, you know, he’s 60 and he’s like, Hey, my wife, you know, doesn’t want me on hormones. ’cause her doctor tells her still she shouldn’t be on hormones. And that honestly, I, I told him today, I was like, I think in about three to five years that’s gonna be considered malpractice if, if a doctor says that to a woman.

So, you know, I think that is really, really changing. And if you think about what happened in the last 20 years to women is we saw their overall health worsen bone health, cardiovascular health, dementia, risk, health. I mean, it’s just, you can just check it off and it has to do with a lot of that hormone sort of deficiency that women have been dealing with for a long time.

Yeah, no, that’s interesting. Naturally, selfish male here, um, only thinks about the other male in the room, so [00:48:00] I’m glad you pointed that out. Um, so a couple rapid fire questions, then we’ll kind wrap up. Um, so the way we’ll do this, either one can answer, I’m good with it. Um, scale of one to 10, and then if you wanna add like a qualifier on there as well.

But in terms of, so it’ll be just a statement, um, or a word. Um, is it good for health or bad? Does it matter? Right? It’s a move in the needle. Um, so we’ll start off with like vitamins and supplements. Um, GNC out there in the world sells nothing but vitamins and supplements. Are they good for health or bad for health?

One to zero to 10. GNC in particular, not, not their supplements. Are they sponsoring this event? Just supplements in general. You have vitamin supplements. Um, supplements. I mean, I score. You wanna score? Score. I have to caveat this. Okay, that’s fine. I mean, supplements, there’s a time and place for supplementation, but it’s supplement means in addition to really great nutrition.

So you start with the basics of nutrition. I’m a big advocate of. [00:49:00] Highlighting fiber where everybody is, protein is very important. Most of us get enough protein. The quality of the protein is not maybe as good as it should be, but what we’re not getting enough of as a society is fiber. And that’s really important to our healthy gut bacteria.

So if you’re not taking a lot of fiber in and you’re taking supplements, you’re probably not getting the bang for your buck out of the supplements. Not all supplements are created equally as well. There’s a lot of marketing out there. Part of the thing, I know this isn’t rapid fire, but part of what we deal with is a lot of misinformation and disinformation and marketing companies that create supplements are very different than research labs that are creating supplements.

So buyer beware. Um, I didn’t give you a number. The answer’s five and a half. Five and five. Five. Five. We’ll be that I like it. No, it is fine. I mean, I want the explanation, right? I mean, you can’t just give a five and not give the explanation and you give a 10 and not give ’em an explanation, but you can’t give a five without an explanation.

Um, [00:50:00] popular one these days, um, sauna, um, I. Yeah. Um, so I’ll sauna. Um, okay, well let’s do sauna and cold plunge kind of the same time. That’s cool. It kind of goes, so not so much rapid fire. So there’s something called hormetic response, right? So hormetic response is a stress response that your system has. A cold plunge is a stress response.

Um, you don’t need to do long periods, 30 to 120 seconds of a cold plunge. Typically it’s like 40 to 45 degrees is gonna cause vasoconstriction is gonna cause reduction of inflammation. It’s gonna help with mitochondrial efficiency, and it’s gonna wake you up and give you some like neurologic kind of boost, right?

So that’s benefit of cold plunge. Now the problem with cold plunge is. People tend to overdo it. Either they’re staying in too long or they’re doing it at the wrong time. So if you’re doing it after a heavy strength training and you go cold plunge, you’re not good. It’s, it’s, it’s actually gonna cause kind of constriction.

And so you don’t want to do it then, um, [00:51:00] you want to alternate back and forth. With sauna, there’s different types of saunas. So there’s high heat sauna, which is usually dryer steam, and then there’s infrared saunas which operate on an infrared wavelength, not so much heat. Um, different benefits to each, but really out of the Nordic country, Sweden, Finland, Norway, um, wet saunas or, or sort of the, the humid sauna that you traditionally see are very effective for vasodilation.

They increase cardiovascular output, um, helps with reduction of stress and there’s data to support that. So it helps with blood pressure, helps with cardiovascular outcomes, and so alternating those. So typically what we would say, if you’re gonna start implementing something, if you can. If you can’t tolerate three seconds of a cold shower, you’re not gonna like cold plunge.

So just try not to like, push yourself. But regulating breath is real important when you start to try to do a cold plunge because the first thing somebody does when they get into a cold pool, cold water, is they go, that is not what you wanna be doing. You wanna regulate your breath first [00:52:00] and slowly ease yourself in five, 10 seconds and build up gradually to, you know, 30 to 120 seconds and then sauna 15 to 30 minutes.

Three to five times a week is typically what would be indicated. Um, infrared is different. It’s a lower heat, but you’re getting, theoretically the idea is that it’s penetrating to a deeper tissue level and getting at a mitochondrial level, more sort of efficiency going, um, at a shorter duration and, and shorter heat.

Exposure. I don’t know about y’all, but I, I heard 7.7. Did anybody else hear anything else? Can I say one thing? Of course. Every, everything that we’re sharing is we treat every client as an n of one. So I will not, I will tell you now, I will never cold plunge. I would die. So not everybody has to follow every trend that even if there is some evidence that it could be beneficial, you know, what you need to do for yourself and be part of that process, be the, be the ultimate decision maker.[00:53:00] 

So, yeah, no, sorry, I’m pulling all of these off Instagram, right? So then my, my, uh, my primary care physician is Instagram. Um, but no. Um, so lifting weights, um, lifting weights versus, I don’t know, um, lifting weights good, bad. Good, good all around. I mean, um, so, okay, I’m gonna be quick. I’d give it a nine. Right?

So strength training is super important, especially as we age, strength training and maintenance of muscle, both for bone health, um, for being able to get up off the ground as you get older, right? So one test for, for you to sort of think about, depending on what age you are, is can you get up off the ground from a seated position without using any sort of support?

Um, it’s very hard to do. Number two, can you get off the ground with just one piece of support, which is usually your arm? And if you can’t do that, then you have some work to do, right? So that’s where strength training comes in, and especially for women, um, strength training is super important for bone health and for men, but especially for women, small amounts matter.

Um, so it doesn’t mean, you know, you need to [00:54:00] spend an hour, but anywhere from, you know, just start at five, 10 minutes and build from there. Doesn’t take a lot. Um, low carb numbers.

Not all carbs are created equally, is where I’ll start. Um, that’s fair. Yeah. Uh, most of you’re probably familiar, they’re simple carbs that are very easily processed by your body, like white bread and white pasta and chips and candy. Very different than our complex carbs because I really like that fiber.

Remember I talked about most of us don’t get enough of it. Uh, broccoli’s a carb, uh, sweet potatoes, a carb. There are a lot of carbs that you need and that you should likely ingest. Now there are special cases that Carlos could probably talk about where doing a highly ketogenic diet is of medical, you know, benefit.

So I say it depends number wise, but complex [00:55:00] carbs I’m a big fan of, so I give ’em a seven. How about pasta? Um. Are you asking for a friend maybe? Um, I mean, pasta on occasion is a great thing. There are lots of varieties of pasta as well, so you could, you know, change up the pasta, maybe use a legume as a base from time to time.

My wife in the back of the room just celebrate it ’cause she’s gonna reintroduce pasta into my diet on a, on occasion now. Um, so Okay, glad to help. It hasn’t been in the house since 2015. Um, so intermittent fasting, um, depends on the person, I would say yes. Uh, overall I’d give it probably like an A seven to an eight.

Um, what is intermittent fasting? It’s usually just reduced caloric intake over a period of time. Um, most people will do a fast whether they want to or not when they’re sleeping, unless you’re eating and sleeping, which is not very [00:56:00] common. Uh, so you’re. Typically we would say an intermittent fast of 12 to 16 hours is reasonable.

Some people like to do liver fast. Um, there’s a five and two schedule. Some people do 24 hour on, 24 hour off. You can do intermittent fasting, uh, just on the weekends. I mean, so there’s lots of different, what the data would say that 12 to 16 hours is more than enough for most people. There is something called fasting mimicking diet, which was, uh, created by Dr.

Longo. He’s out at USC in California. Fasting mimicking takes your normal caloric intake, let’s just say 2,500 calories, drops it to 7 50, 800 to a thousand calories for about a period of five day, five days or so, and your body treats it and thinks it’s in a fast. The benefits of fasting, uh, it helps with regeneration of cells, helps the microbiome, um, helps with what we call kind of autophagy and getting rid of cells that are dying, uh, and helps with ketosis, which has some benefits for, uh, brain function as well.[00:57:00] 

And then, if I remember correctly, Natalie, you’ve written something about the, um, the fasting mimicking on the website as well, right? So there’s more information on that too. Yeah, so Natalie and Karen, one of our other coaches, um, they recreated some of the fasting mimicking using whole food as opposed to dry soups and stuff like that.

And that is low carb because you, we do fiddle with the, the macronutrients. And in that fasting mimicking state, you’re going higher fat and low protein and low carbs. So without pasta, no pasta is included. Okay. That’s fair. Um, peptides, um, big topic these days. Peptides, uh, zero to 10. I’m gonna say it depends.

So look, peptides just, y’all are hard here. You’re killing me. Well, I, it’s because peptides are just, again, by definition the FDA defines a peptide as a 50 amino acid molecule or less. It has a bioactive function. Okay, so a peptide is insulin, uh, wegovy, ozempic, [00:58:00] zeep. These are all peptides. So peptides are studied and there’s over 70,000 peptides that are anywhere for performance, brain health, cardiovascular health, gut health, healing, repair.

I mean, you name it, there’s a peptide that we can use for these things. So from a optionality standpoint, I’d say it’s an 11 from a problem that every Instagram influencer has a peptide that they’re promoting, and every corner has a peptide pharmacy that has opened. And so quality and what you’re getting is very concerning.

And most people who are prescribing peptides have not done a course. They don’t know what they’re doing, and it’s unfortunate. Um, I oversee several providers that do peptides. They have to, before I supervise ’em, they have to show me that they’ve done training and certification and those things. So they’re very potent.

We use peptides for, um, there’s some that are used for growth hormone performance enhancing for weightlifting, [00:59:00] for fat burning. We use a lot for healing. Gut health. We use, uh, in folks that have like Crohn’s disease, ulcerative colitis, et cetera. So very, very like important area of science. It’s the wild, wild west right now, and that is a bit concerning to us as folks who have done the certifications and what’s occurring.

Last one steps, 10,000 steps. 10,000 steps. That was just an invented pull outta the air. Had something to do with marketing. I think movement. It worked. It, it worked. Um, movement is really important. Obviously we need to move. I will give an example from an actual client with whom I worked and she was demoralized because she was never achieving her 10,000 step goal.

And I was so proud of her ’cause she realized, you know what? I’m gonna pick my own goal. I’m gonna do something that I can actually do in a day. And so she said it at 5,000. And just the simple act of her saying, [01:00:00] here’s what my step goal is. She has come so far. She’s now working out regularly at the gym.

Like her life has changed. So any steps are better than no steps. So end of rapid fire. Um, so I open it up for questions before I do the, um, on the kind of the wrap up piece, like I’m sure, um. People ask you questions all the time. And when you put those, those were 10 different rapid fire questions, right?

That was, um, but doing one of those doesn’t lead to wellness. Like it goes back to it’s treating the whole self, right? It designed to practice is to tackle all of those things and everything else that you talked about tonight, plus four, probably just not, you can’t just grab one of these things that expect to be with.

Yeah. There, there are no silver bullets. Yeah. Yeah it is. Again, no, there’s not a silver bullet. One thing is meaning new. [01:01:00] And I think what we tried to do is kind of the systems approach. Um, which is all of these systems influence each other. Any questions? So we had two online audience questions. Uh, the first one was somebody online really liked your boots once another.

These are, um, New York food companies, but these are all of ’em, not for. 15 years and I’ve had ’em resold and redone and re cobbled like three times. Nice. So the second question was, you mentioned importance of fiber, uh, and supplements. What are some natural foods that provide the best fiber to do with you coming?

It’s great. You don’t have to buy ’em in plastic. They come in the produce section. So definitely doing a lot of, I mean, if you like broccoli, great, but there are a lot of other foods that have high fiber. Any of your green vegetables, you have blueberries and blackberries and [01:02:00] raspberries. You can eat chickpeas, you can eat lentils, black beans, nuts.

I mean, these are all great sources of fiber. What’s amazing is these are the things that are also full of nutrients, so you don’t need as many supplements. They’re packed with phytochemicals. Think that these as many powerhouses, all these whole foods that you will eat, they’re doing so much for your body.

And if you’re eating the chickpeas and lentils and the nuts, all these things also contain protein. Even broccoli contains protein. You don’t have to go get a protein bar to get protein because often a protein bar is coming with a lot of things that you don’t want, including sugars and other gums and unnatural chemically ingredients.

You can get protein and fiber all into cold food.

Anybody here questions

I have, like, I have one question. How does pharma, the [01:03:00] pharmac, how does the pharmaceutical companies with their marketing affect medicine and the medical world? Um, so very complicated questions, but. It. Look, pharmaceuticals are important. Pharma companies are important. They fund a lot of research. Um, they certainly have helped create some of the most, you know, remarkable drugs that we have.

Um, both curative and sort of treating lots of, lots of different illnesses. And they, again, just the example of GV one medications and what that’s done for obesity and risk is, is incredible. Um, people who have rheumatoid arthritis and other sort of more complicated autoimmune disorders, some of these new drugs that are, um, Janus inhibitors and all these things, these are, I mean, it’s amazing.

It’s incredible. [01:04:00] And then the, the flip side of it is there is a lot of targeted marketing and there’s a lot of money spent, uh, to the population, right? Every other ad if you watch football this weekend, every other Adam was, were good up. Um, so a lot of other countries don’t allow it. In the United States, we’ve allowed that.

And so that certainly influences both what a person comes into a doctor expecting. And I think it also influences cost because the amount of marketing that is embedded in that is very expensive. Now, beyond that, the pharmaceutical com like conversation is more complicated because, and this take this much more complex problem, but, but every large system is touching by the, the, the insurance company touches the pharmaceutical company through their pharmacy benefit manager.

The hospital systems negotiate with the insurance companies and pharmacy benefit managers and sometimes directly with the pharmaceutical companies to get sort of pricing [01:05:00] of it. So it isn’t just one problem that needs to be solved, it’s a multilayered and multi tier problem that at the end of the day, though, at the end of the day.

It’s the patient and the human in this population that’s suffering because of it. Because it would be one thing if we were spending billions and billions of dollars and we were all getting healthier, but we’re not. And so that has to flip. And so when we talk about healthcare and now only I, we constantly hard on putting what we call a human back in healthcare.

And, and it’s, it’s a real big issue for us. And again, we’re real passionate about it. And the pharmaceutical company is just one of those pieces that we are gonna have to learn how to play with, but play with them in a way that they’re actually delivering what we want them to deliver to our clients.

Gotta listen. Anybody else? Chair? Uh, hi. [01:06:00] We recently, uh, Jane out Cock Fish was, or Trade New Food. And I just would wondered what your thoughts have had food charts forever. Um, and I don’t know all the details. I know that, uh, the agitated, maybe hope builds other things when get your feedback, you what you think are okay.

So high level I would say it’s, it’s a quasi improvement in the original food period. Um, on a more kind of deeper metal level of it, I, I don’t think everyone should be eating, you know, eight ounces of red meat every day. We’re ignoring, we’re ignoring what 50 years of science and data has shown, which is saturated fats matter.

Are they the only thing that mattered? No, not by any means, but they matter and they matter for cardiovascular risk and [01:07:00] cardiovascular disease. And I just said 20 minutes ago, that’s still the number one killer in cardiovascular disease in the United States. And what we’re saying now is, well, let’s improve nutrition by telling people to eat more saturated fats now.

So that’s one sort of concern I have. The second concern I, I would say, is at the top of the pyramid there’s are the base, really the most things that you should be eating are the things that Natalie mentioned, which is vegetables, high quality fruits, nuts, lean cuts of if you want meat, if you choose to eat animal protein.

That’s another sort of big ethical question that we could, we have way too much more time that we’d have to have a conversation about. But also learning how to eat vegetable proteins, right? Different, you know, beans and tofus and then from there going into complex carbohydrates and then from there going into other things.

So is it an improvement potentially? Potentially. I think it’s too early to tell. [01:08:00] I also, not everyone should be drinking milk. We talk a lot to our clients about how dairy and milk potentially is very inflammatory for some people. And so again, it goes back to yes, on a broad population, should you just eat certain things more of, yes, I think we have to nuance it and go back to again kind of that and one, if you’re sitting in front of me and I found something that says, Hey, for you dairy no good.

Like we need to not do that. So that’s part ’cause of your inflammatory or cascade or whatever it may be. Okay,

thank you. Said the, uh, phrase ended one a couple times and just talk more about the business side. What does capacity look like for a business like yours where there’s so much personal attention? And then kind of on the flip side, you know, I, if I like what I [01:09:00] hear, I’m interested in more about capacity.

What would that look like for you guys? I mean, we’re not a volume based practice, so, um, we currently have about 250 clients. We probably, you know, won’t go beyond for little bit. Um, that said, we are also building, um, a program and system for companies. Um, so part of what we’re our 20 26, 20 27 goals is we have a platform that we’ve built, a tech solution that we’ve built, a protocol solution that we’ve built to be able to lever up two companies.

And there are lots of comp, you know, there’s lots of companies out there doing sort of things that we do and touching on things that we do. And yet, most healthcare costs, both for self-insured companies, have for large companies that insure through, [01:10:00] you know, blue Cross, et cetera. Their healthcare costs are going wrong.

Again, it goes back to why aren’t they moving the needle if they’re bringing in so many quote unquote tools to help their employees? And so for us, we want to approach at a higher population level what we do, but on a larger scale and how you scale that is now, you know, there’s lots of tools that we have now available to allow us to do that.

The difference for us as a, you know, couple is that we don’t want to take financial investment from outside sources. And why is that? Because the minute we do that, we dilute what our vision is and we dilute like what we’re really sort of trying to accomplish. It’s not to say we won’t ever do that, but right now we have been self-funding purposefully.

I think it’s a really good question and we are very intentional in not taking on more than we can chew. [01:11:00] You know, what we’re trying to avoid is being a value-based business. That that’s what we currently have in our healthcare system. And so knowing that first and foremost is our client experience and never compromising our ability to fully care and advocate for them because so much of what we do that people don’t see is behind the scenes.

So if you need to go see a specialist, our folks are picking up the phone and trying to get you in as quickly as possible. If you need to use green shines outside of our walls, we don’t accept it for our purposes, but if you need to go see a cardiologist, we are picking up the phone also and trying to get that prior authorization done so that your in your insurance will pay for.

So we do not wanna be at a point where we’d ever not be able to do that for our clients. So we deliberately capped the votes that we are able to, um, take. We have added recently a June provider who is going to help with some of our less complex care patients. Um, [01:12:00] clients and so we do have the ability to expand our base some, but again, our ultimate goal is not just to serve the small population that we currently do today, but is to take the brains behind what we’ve built and enable more people to benefit and elevate the level of care.

Not only that more people can receive, but more more providers can deliver. And so really it’s looking at both sides of the equation. It’s building something for the providers as well, because the joy has been, has been removed from practicing primary care medicine. I’ll end on this one last note is that I had a conversation with a physician who’s involved with Wake Medical School and really helping with residents, and nobody wants to go into primary care anymore because there’s no money to be made.

And if they do. Their debt load from having gone through medical school is so extremely high that they are jumping ships soon after. And doing things like writing GV one [01:13:00] scripts online for a lot of these consumer or direct consumer oriented companies that have surface so in a one is really important to us.

And we think we can do that at a bigger scale by wanting the, the supply providers to do better by clients. Awesome. Thank y’all. Um, I mean, as you can tell, uh, different practice, right? Like, um, you care, you created a system to ab buy in to show that you care, um, and knowledgeable to right. A lot of people who care, but they don’t have the knowledge in order to, to affect change with the people that they work with.

So they’ve done a phenomenal job, um, with your, uh, clients. Um, and, and, and also job I, so I can’t thank you enough of now in sharing. Um, but the boat’s here, [01:14:00] so.