Transcript: #117 Hot Topics in Functional Medicine with James Maskell

Listen

Listen to this podcast or watch the video. CLICK HERE

Transcript

• 01:18 About James Maskell
• 03:06 What is Functional Medicine?
• 05:31 Why Our Current Health System is not working
• 08:31 Integrating Functional Medical Care with Insurance
• 13:16 Similarities Between Functional Medicine, Holistic and Integrative Care
• 15:02 Where to Find a Functional Medicine Doctor
• 19:14 Bringing Community into the Medical System
• 25:29 Other Ways to Revolutionize Primary Medical Care
• 29:01 Government and Pharma Profiting from Sickness
• 33:18 The Evolution of Medicine Summit
• 50:30 The Most Pressing Health Issue in the World Today: Chronic Disease
• 52:08 Where to Find James Maskell

Wendy Myers: Hello and welcome to the Live to 110 podcast. My name is Wendy Myers and you can find me on myersdetox.com. You can find this video podcast on my YouTube channel, WendyLiveto110.
Today we have James Maskell on the podcast today. His websites are RevivePrimaryCare.com and FunctionalForum.com. He’s going to be talking today about some critical hot topics on functional medical care and we’re going to be talking about how you can really get to the root cause of your health issues using functional medicine.

Please be advised that this podcast is not intended to diagnose or treat any disease or health condition and is not a substitute for professional medical advice. This podcast is for entertainment purposes only. So please consult your healthcare practitioner before engaging on any treatment that we suggest today on the show.

James, thank you so much for coming on the show.

James Maskell: Great to be here with you. Such a pleasure, what a beautiful place.

Wendy Myers: Thank you. Thank you very much. We’re at my home in Malibu.

Wendy Myers: So why don’t you tell us a little bit about how you got into functional medicine.

James Maskell: Well, I was the weird kid at school that did natural medicine. I had a chiropractor and a homeopath. I didn’t really realize that was abnormal until I got to school and no one knew what a chiropractor was. That was my world until basically the whole world kicked in and you think your parents are insane and you rebel.

My rebellious phase took me to being an investment banker. I’m straight out of the university. I did economics. I was on the trading floor of one of the biggest banks in the world and just had a moment of clarity that I was playing for the wrong team and that some of what I had learned growing up, part of my life might be part of the solution to what is essentially the biggest problem in the world. If you take a step back and say what severely has the potential to hold mankind back and chronic illnesses is really that.

And through my economics training, I just saw that America was spending so much money, so much more than anywhere else and not getting any increases in longevity and actually moving down the scale and things like infant mortality. So I thought, “Well, if I’m going to do something with my life, let’s tackle something that’s important or valuable.” That was 10 years ago.

I put myself right in the trenches of health creation, working with doctors and working in practices. Over the last 10 years and particularly over the last five years, I really started to try and think. So, so many great results and so many patients being empowered and inspired and I saw the ripple effect outwards of really great medicine and just thought, “How can we bring this to more people?” And in the last five years, our focus has really been on scale.

Wendy Myers: Why don’t you tell us a little bit about what exactly is functional medicine for any of the listeners who don’t know what that is.

James Maskell: So functional medicine is an operating system of medicine. It’s very different from regular medicine. It’s really designed on a few different principles.

One is that systems biology. The way that I like to think about it, Wendy, is that our medical system was really designed for acute disease. So it made a lot of sense in acute disease to categorize the body into geography. That’s why you have an endocrinologist and a gastroenterologist and rheumatologist.

But what functional medicine focuses on is the interaction between systems. It’s got a basis in systems biology, it’s got a basis in ‘food as medicine’ and understanding how lifestyle factors affect health. Instead of necessary just treating the symptom as the core thing to get rid of, doctors who do functional medicine will look at a pattern of symptoms overtime to determine what the root cause is.

So when people ask me about functional medicine, I really think the best way to think about it is root cause resolution, looking to understand what the root cause. Now, in acute disease, it made a lot more sense to create a reactive system around one particular course, whereas functional medicine is more of a proactive system built around potential causes, potential triggers in the environment that I’m sure your audience has become well aware of through your work.

It’s sort of like a formalization of that. There’s a lot of new science and exciting understanding of epigenetics and so forth to back up this type of strategy. But it’s proving itself to be a really effective way to dealing with chronic disease.

And that’s why last year, you saw the Cleveland Clinic, which is traditionally one of the most conservative –maybe not the most conservative, but certainly most innovative health organization out there build a new sense of full functional medicine because they saw the power of it to reverse chronic disease in a way that’s really not possible through biochemistry drugs.

Wendy Myers: Yeah, because so many people today, they go to their primary care physician, which is the only care typically covered by insurance, and they receive medications or surgeries. It’s the only resolution to essentially cover up their symptoms.

Wendy Myers: Can you talk a little bit about how our current health courses or knowledge is not working?

James Maskell: Yeah, I think this system was designed for acute disease. And that’s just obvious because that’s what we had to deal with in the 20th century. What gets most people frustrated, I think, is that the system is not evolving quickly enough to deal with these modern epidemics. We’re still taking an acute disease approach to chronic disease.

I think the straw is going to break the camel’s back and all of these is autoimmune disease where you see that we really understand now the causes of autoimmune disease. It happens over a period of time and it has a lot to do with genetic susceptibility, meeting environmental triggers, meeting leaky gut. So, you have these three things happening together. And yet if you go see a regular doctor for the symptoms of your autoimmune disease, you really can’t reverse it without understanding the core root cause of it.

And so, we’re seeing people getting better from autoimmune diseases – clearing up their lab work, reducing their symptoms, the underlying function of their body coming back into play. So that’s where we see it. So I think functional medicine is the operating system of a medical system that is designed to prevent and reverse chronic disease.

Wendy Myers: I completely agree with you. I’ve had my own personal clients reverse autoimmune disease, Hashimoto’s thyroiditis simply by healing and sealing their guts, taking care of gut dysbiosis and improving their overall health in their body, improving their body’s systemic functioning. It’s just that you’re not going to find the answers in the traditional model of care. It’s just not going to happen.

James Maskell: Yeah, exactly. And people are becoming frustrated with it and are seeing it. But the good news is there’s an emerging class of physician and providers that are really getting this and understanding it. And what my role has become and what we’ve been doing with the Functional Forum and otherwise is really to accelerate this evolution of medicine.

Find those providers that are ready to do this and give them instruction whereby which they can do it and deliver really high quality root cause resolution medicine to a local community and take advantage of some of the community and technological advantages that allow this to scale out. So that everyone could afford it.

I mean, if it’s only for the richest one percent, it’s not going to be good as well. That’s one of the things that functional medicine has to overcome and that’s part of what we’re trying to do. How do we scale this out and systematize it so that it can be really available to every American? And I hope, beyond.

Wendy Myers: Yeah, that’s the problem. Many people that will go to a functional medical care specialist, a lot of the testing that they do, et cetera are not covered by insurance because they’re not deemed medically necessary if a drug does not resolve the symptom et cetera.

Wendy Myers: Can you talk a little bit about what you’re doing to try integrate this functional medical care, perhaps get it covered by insurance, so that more people can enjoy that?

James Maskell: Yeah. Look, there’s different ways that you take it. There’s a lot of people who have been working for quite a long time to put functional medicine as part of the system. My own feeling about it is a little bit more Bucky Fuller where I think you got to create a new system that makes the old system obsolete.

If you look right now in publishing – I saw this thing the other day. I’m sure your audiences have seen it – the biggest provider of accommodation in the world, Airbnb, all of those properties, the biggest star taxi company in the world, Huber, has no cars.

So you’re reaching another phase where whole industries are just being changed overnight – the publishing industry, books and movies and all of the media industries. I think that’s the model for health.
I think what we should be really looking at is to say, “Look, no one else has the answers to chronic disease management.”

I grew up in the UK and people in America think, “Wow! If we only any had a single payer system where they just pay for everything, we’ll be fine.” Well, you won’t be fine because in the UK, it’s the same cost. Same people are getting sick with the same chronic diseases. And instead of you, your business and your government splitting the bill, which is what happens here, the government just pays for everything. But the government can’t afford everyone’s Hashimoto’s thyroiditis. It doesn’t matter who’s paying the bill, it’s not going to be solved.

So, what I’m interested in saying is, “Hey, look, we’ve got answers here.” We’ve been at this for a while and medicine has made fun of this profession a lot. We’re not going to integrate with you. We’re going to build our own system.”

I think the quality of the medicine plus the feeling of the medicine – one of the big things about functional medicine is that it’s an interactive, it’s a participatory partnership between patient and practitioner, which is completely new.

And if you think about the cost of retooling a whole medical system from a doctor-centric system to a patient-centric system, there are so many skills that have to be learned and so forth. I am thinking, this is what we’ve been looking at, really thinking about, “How do we build this new model without having to take all of the cost and all of the structure across because it’s so slow?”.

And the rate that chronic disease is increasing, there’s going to be tipping point where we can’t afford it anymore. And so, my goal is really to try and help to bring some structure to a core medical value proposition that is proving itself successful in the small test cases that’s it’s having up until this point.

Wendy Myers: I really like what you said about it’s more patient-centric, that functional medicine is more of involved with the patients, that they have to take a much more participatory effort in their care. I’m finding that as well.

With my own client base, they have to take a lot of personal responsibility in their own care. It’s not just them taking advice from a doctor and taking a medication. They have to take an effort, a big effort on their part to improve their own health.

I think that’s where we’re going. I think patients have to take much more responsibility for their health learning about their health conditions and taking supplements and more natural means to improve their health.

James Maskell: Yeah, if you want a patient-centric medical system, the patient better do something because that’s the [inaudible 00:12:05].

Look, what we’re fundamentally changing is who’s the hero of the story. The old medicine, acute, it made total sense for the doctor to be the hero because they knew everything, they could be objective. And if you have an infection or if you got hit by a bus or otherwise, you don’t want to be in-charge. You don’t want a patient-centric system in that system.

However, when you’re dealing with chronic diseases that are majorly driven by the patient in terms of the lifestyle that got them there or the underlined dysfunction that’s at their control, you have to involve the patient.

So the future of medicine in chronic disease management, I feel, Is not something that’s going to be done to you. It’s going to be something that you participate in.

But people like that. People like that a lot more. They like being empowered. They like to be part of it. Initially, it’s been a bit of a shock because we’ve been pretty lazy as far as what we had to do. But now, once you get over that, it’s actually really empowering proposition because if you really, really, really, really want to live to a 110, you probably could. You just have to do something.

Wendy Myers: Yes you do. Knowledge is power. That’s why I created Live to 110, so that people can get all the information they need to heal their health conditions naturally through functional medicine.

James Maskell: You have to start now.

Wendy Myers: Yeah, can you talk a little bit about some of these similarities between functional medicine, holistic and integrative care?

James Maskell: Yeah. I mean, that’s a tricky thing. It’s had different words over different times. Words are being bastardized as well. I love holism. The word ‘holism’ to me, that just perfectly explains this, but if you use the word ‘holistic’ in the wrong way, people have all kinds of ideas of what that means. To me, holism is just understanding the synergy between systems. It’s what I was saying before where you’re looking at how different systems interact and looking at the whole picture, the whole person. And so I think it’s a good terminology, but I think it has its own baggage to deal with as far as what the name meant.

‘Integrative’ just means integrating different modalities. So you can have western psychiatrist with a meditation teacher and that would be integrative whether or not that’ll be holistic or functional medicine. Functional medicine is more of a brand in a certain way where those are just words. And functional medicine refers to a very specific way of taking patients through a system.

So I think functional medicine in its own way has brought a legitimacy and a scientific understanding or scientific basis by which to actually deliver. It’s the kind of medicine that I don’t think holistic had before. That’s why we called our thing the ‘Functional Forum’ and not the ‘Integrative Forum’, really because we just see how much momentum this functional medicine movement has right now and how well positioned it is to continue implementing.

Wendy Myers: Where can people find a functional medicine doctor like this?

James Maskell: So if you’re really interested in functional medicine, you can go to the Institute for Functional Medicine. That’s where they train doctors. That’s at FunctionalMedicine.org. At the moment, our focus with our business is really looking to work with those doctors and make it easy for doctors to switch across and do functional medicine. You can go to my site RevivePrimaryCare.com. We have a practitioner finder on there. But there’s quite a few different ways to do it.

I think different naturopaths, naturopathic doctors actually deliver medicine very differently, some do a lot more scientific functional medicine, some do a little less. There’s a bandwidth there. But I know a ton of very, very conscientious, very, very successful naturopathic doctors will get right results as well.

And if you ask a naturopath, they also will tell you that functional medicine is sort of just their medicine, just sift off a bit. So I think at Naturopathic.org, you can find a naturopathic provider.
But I think in all of those cases, the things that they can have in common are looking for the root cause, engagement with the patient, food as medicine, really going aggressively after lifestyle and looking to work at the root cause level.

Wendy Myers: Yeah, I was actually amused when I first went to a naturopathic doctor and received supplements instead of medication. I was very, very happy about that. I actually didn’t know the doctor I was going to was a naturopath at that time. I was very, very thrilled.

James Maskell: Yeah. Well, you’re certainly seeing that starting to happen as well. I think in the next few years, what you’ll start to see is that it will actually be more part of medicine. What’s really exciting about this, and what’s happening in the grandeur pictures as well as a lot of things that I feel I saw happening to propel this thing forward, one of the things is this value-based payments with Obamacare. So they’re moving into a system. They say by 2018, 90% plus of payments would be based on value.

And so if you do want to stay inside the insurance model, I think that most providers who are delivering this kind of care, the value proposition is actually very, very strong and the results are very strong. I think by combination of tracking outcomes and systematizing what’s really working, again, we’ll be in a really, really strong position.

That’s why I don’t want to spend my time trying to get functional medicine into a system that is really not designed for. I mean, even the fee for service model, fee for service doesn’t really – it’s not an environment where patients do their best work because everyone knows how to interact with a lawyer. You only use a lawyer for as little amount of time as you can because you know that you’re on the clock.

If you have that relationship with the doctor, are you fostering the best type of relationship where you know, “God! If I have to go in, it’s going to be another couple of a hundred bucks and then this on top.” You’re potentially just putting money in your health at odds with each other.

And so that’s why we’re being really keen to communicate other business models for doctors where they could have a membership or other types of ways in which, “Okay, I’m a member now. I know where I get my value from and I don’t think about money anymore. Now let’s really just get focused on keeping me healthy.” So that’s some of the underlying structure that I think needs to change.

But I think there’s ton of things that are happening in the digital health evolution, which, by the way, by the time everyone’s got an Apple watch, they’re going to want functional medicine because that’s the only medicine that improves the numbers on the watch. Everything else, the doctors – doctors are trained putting out fires. I would hope that we would get to a point where before the fire, the watch, and then you’re dealing with things up the stream.

There are a lot of things that I feel playing towards this becoming the standard of care for primary care. I hope that I’ll be able to make some serious impact on this in the next 20 years.

Wendy Myers: So with all that you know, how is community being brought into the medical system? How can that be done?

James Maskell: Yeah, so this has really got me thinking recently when I have an opportunity to TedTalk. I was thinking about the potential for – what I felt was like the core of all of this work and I really felt like if you look at what makes –

First of all, you’ve got to start with where’s the healthiest place in the world? Where do people live consistently to a hundred or 110 without the same incidence of chronic disease that we have here? What do they have in common?

And so that took me to work at the Blue Zones, Dan Buten’s work. It’s really amazing! He identified a number of places in the world where people consistently live to a hundred. And there’s actually one here in Loma Linda, California and then in Costa Rica and different areas around the world – Okinawa, Japan. There are a lot of things that we have in common. They do eat a lot of plants and they have a healthy diet and we could talk about some other things. But the really most powerful things that I thought was community.

If you think about medicine in the way that it is right now, there’s no community, really. You see a doctor one-on-one, you don’t share your medical information with everyone, it’s completely private. And that’s, again, probably the way that you wanted it in an acute system, but the power of community is really, really valuable in keeping people well. And particularly, what I would say is this peer-to-peer support. And so, that’s one of the things that we’ve been trying to think about, what’s the best way to do it?

But you can see it. Even brands are doing it. Just down here Santa Monica, I was walking past Lululemon and they have a running club that meets a couple of times a week. And I saw a study recently that said groups of low income people walking together in community, 45 to 90 minutes, three times a week, their health results were so spectacular that if it was a drug, it will be a blockbuster drug. There was a reduction in blood glucose and waste and all these different factors as a result of doing it. And it was one, because they were doing the exercise, but two, because they were doing it together in community.

So we’ve been thinking a lot about how can we actually get community into medicine. I think that’s going to be one of the biggest task and something that’s going to be really, really powerful.

So some of the ways that we see it right now, some of our doctors are doing functional medicine group visits where essentially, instead of seeing one patient at a time and going from room-to-room, you might see 16 people with Hashimoto’s thyroiditis together.

Think about it like this. One of those people could be a patient that’s come all the way through your program and can sing its praises because they come out the other side and then you have a social proof.
Two, people want to hear from how people are dealing with these symptoms. These symptoms obviously have an impact on your life and part of your quality of life is trying to work out, “How do I deal with this every day?” So you have that support and people talking about how they eat, sleeping tips, habits, other things that have helped them for other people to try. People like to hear from other people with the same issues as them. But then you also have group accountability and support.

My mother-in-law recently lost a hundred pounds. And really, the only difference that she had was she had to call someone every day and tell them what she ate. She had to be accountable to someone else. And this was, again, a peer-to-peer relationship. It wasn’t paid, it wasn’t a coach. It was just they were accountable to each other.

So I thought, there’s so much power in that. There’s really a lot of value in that and so we’ve been looking at ways to do that.

Maybe the most classic example is the Daniel Plan, which was Mark Hyman and a couple of other functional doctors working with Rick Warren at the Saddleback Church. And what Mark Hyman saw is he saw what looked like 15,000 people going to the same church or it actually was groups of five to 10 people meeting, all those 15,000 split up in groups of five to 10 doing bible study couple of times a week independently. So he’s like, “Let’s see if we could use that community to empower behavior change. And if 15,000 people lost a combined 250,000 pounds and reap all kinds of amazing gains with that…”

So again, it was free, it was valuable to everyone that the person who knew more, the person who knew less, you always want to say if you want to learn something quickly, teach it. So they had this structure that really did it. And then the accountability and support was really powerful.

So, I feel like community is going to be the most important tool.

And I would just say one other thing that functional medicine does really well and that’s coming into its own, understanding the microbiome. That’s our internal community. That’s a community too. If you look at it through the community eyes, these germs inside that help you so much with digestion, metabolism, immunity, we have this amazing internal relationship with them. And as soon as that community goes out of whack, your health goes down the drain.

And so there are learning lessons in our internal community that I think we should be applying to the external community. It’s quite an elegant form of medicine. I think it’s time is arriving virtually.

Wendy Myers: Yeah, I love how you’re talking about that we need group support. And that’s why on Facebook, all these groups dedicated to different health conditions are so successful, so that people can get support from each other and get tips and tricks.

And that’s also why I started my Mineral Power support group that’s open to anyone that wants to join, so they get all kinds of tips on their health and how do improve their health conditions.

James Maskell: Well, think about that Facebook group for a minute. You’ve got people on there who are new, so they’re getting value at no cost from all the people there. You’ve got the people who have been there for a while who know a lot and want to share. They’re getting value from the fact that they feel like validated and they’re sharing and they’re adding value.

Then you’ve got someone like you who’s just the person who put it together who is probably participating in any of those two roles, but is also just facilitating it. And then you got Facebook, then it’s just like their structure [inaudible 00:25:37].

So here is something that’s valuable to everyone. Everyone is getting value from it. Facebook, you, the junior and the newbie, are all getting value from it. It’s all free. And I think that’s just the way of the future. And so how do we set up those structures that empower that kind of behavior change.

Wendy Myers: Is there any other way that you conceived of how we can revolutionize primary medical care?

James Maskell: I think community is a big part. I think functional medicine is the operating system. Those two things go hand in hand. But the revolution I think is one other string to the bow. One other big part of it is this technological revolution. I think that it’s going to happen anyway.
I’ll just give you examples. I spoke to this lady the other day and she put something in my mind that I think when I said it to you, you’ll realize it the same ways. The companies that now run on healthcare (Atma and Oxford and Blue Cross), everyone hates them. They literally have a 5% to 10%. They are the only company or the only organizations that have worst rates in congress, the insurance companies. But that’s because we don’t have a choice. There’s nothing else there.

So I’ll tell you right now. Amazon and Google, all these big companies are working on a health product and it hasn’t arrived yet. So you think when Amazon brings out a health insurance and they know from your purchasing or otherwise that you live healthy otherwise and so your insurance is now like $200 a month as opposed to thousand, you’re going to see big companies that are going to come in, companies that we already trust and like develop into the health field and I think a lot of all these old companies is just going to go away, which none too soon in my thought.

So I think technology is going to play a huge role. I need to tell that story just because it’s an interesting glimpse into the future to a point where a lot of businesses have made their way by having no real competition because no one can really create the structure and systems that they have. But the digital revolution is allowing that in a really new and innovative way.

So that’s just one example. But I said before, the digital health revolution, quantified self I think will be a big driver of it. It may not look like a revolution. It may just look like, “Wow! I just have this much better care.” Just like Uber, sometimes, it looks like I’ve got this way better taxi. You don’t think this is a revolution in car sharing, you just think, “Wow! This is a lot better than it used to be.” I hope it will be a bit more like that.

Wendy Myers: I’m really stunned to hear that Amazon’s going to be getting into the health field. I’m actually really, really excited because I love Amazon. They do everything so efficiently and deliver everything so flawlessly that it’s just so natural that they were going to healthcare.

James Maskell: I mean, I can’t say it for sure, but I was speaking on a panel with people who know a lot more than I do about it. And when they said that, I was just – I warped time thinking about it, just thinking, “Wow! We haven’t even seen the beginning of this transformation.”
The good news is that until it happens, you can take control of your own health and play whatever role you want to do in that. But just know that some disruption is coming and generally, those kinds of things work out really well for the consumer.

Wendy Myers: Can you talk a little bit about a subject that’s a little bit controversial. What is your opinion about the government and big pharma being in bed together to profit on our sickness?

James Maskell: Yeah, it’s a tricky topic. I would say five years ago, I was mad and I really wanted to rebel and do that kind of thing. But then I caught this. I got that book that Bucky Fuller wrote where he said, “You never change anything by fighting the resisting reality. To change something, you have to build a new model that makes the old model obsolete.”

I just thought to myself I could probably be really angry about this for a long time, but all of these things, for whatever reason and however I managed to put myself in this situation, I can see that this is an operating system that solves a lot of these problem. And by being in the middle of this and making this grow, we could probably solve that problem again.

I think it’s ugly. I mean, it’s definitely clear. I’ve seen films like Trace Amounts. I just saw it last week. It really looks at how so much mercury got into our environment and what it causes for health. It’s shocking and the cover-up of it is even more shocking.

So I think, yeah, it’s definitely an unholy alliance. There’s definitely examples of regulatory capture where the regulators that are meant to be regulating the companies get captured by the company and do the companies’ bidding, which is a really terrible situation.

But again, I feel life’s a pleasantly optimistic about one, the truth will out. People are really learning about this in a way through the internet or otherwise. There’s not just one mouthpiece. The media has been really complicit in it as well. And so the media’s complicit. You see who owns what and how the information gets out.

So it’s really exciting that you can control your immediate. I mean, here we are. You have your own podcast, I have my own podcast, you have your own thing and it has the potential to scale to infinity. You’ve seen people, activist out there like Food Babe who are causing a real stir because they’re talking about things that no one should be really talking about and people are starting to take notice.

You can look at everything that happens day-to-day as either positive or negative. About five years ago, I just decided I was going to be positive about it and that there were enough people who had a lot of the pieces and could see it and we could work together. Just seeing what’s happening in Silicon Valley where smart people are not afraid to disrupt big industries, that has me very, very excited! That’s the power of the human spirit will overcome what’s been holding us back.

But look, to answer your original question, the incentives work in a really horrible way. If people stay just sick enough to take medication, but not dead, if they stay in that position, they’re extremely profitable. And I think, at the end of the day, if you have a profit-driven system, with that system set up, there’s always going to be people who take advantage of it. And I think it’s time to change.

Wendy Myers: Yeah, I agree. I absolutely agree.

James Maskell: You vote with your dollars too. Every time you vote to get your media from different sources. You’re seeing right now, HBO, it’s suddenly available on Apple TV and you don’t need to have cable anymore. I got rid of TV six years ago and I see that, “Okay, enough people do it” and they realize, “Okay, there’s a market here.” If you vote for a party in an election, maybe your vote doesn’t mean anything that day, but it’s a signal to other people that, “Hey, look how many people did it last time.”

It takes a long time, sometimes, for these things do work out, but anything you buy, anything you do is a signal for the rest of the system, the market system. And so by living your truth and making the decisions that you want to make based on what you really think as you’d like to see in the world, it does create change to whatever degree you do it.

Wendy Myers: Let’s talk a little bit about how your personally creating change with the Evolution of Medicine Summit. You held that last year and you’re holding it again in September, correct? Can you tell us a little bit about that?

James Maskell: Yes. Our first year, it was really just to set a foundation of the ways in which we saw that medicine was evolving, however slowly or fast. So, the movement from doctor to patient-centric, the movement towards food as medicine, for food as fuel, technology coming into medicine, the understanding of the microbiome, the understanding of the mind-body connection, that’s what we focused on the first year. It was really laying out the foundation of this shift.

So we had a patient track and we had a doctor track. So our patients, it’s all free and available online. Patients can listen to the things that were really designed for them on how to keep themselves and their family healthy and what were some structures that really created change like the power of family, the power of community and that kind of thing.

And then, we had training for doctors who’ll be like, “Okay, this is a day we chose to focus on the brain-gut connection.” The week that we were doing our event was when the first journal of that came out as a medical journal. And then also, we’re speaking to doctors about the practical aspects of delivering this kind of care.

So it really set a solid footprint for who we are and what we do. I was really glad for it. We had an amazing response. It was great to get so much feedback from all across the world. We got on to the Hufftington Post for five days. We did a whole five days of segments with them. That was really fun too. So it was a lot of fun to do and I’m really proud of the people we had to come to speak.

This year, we’re doing it again in September. And the focus this year’s going to be on healthcare from scratch. When I did my TedTalk back in April (that was actually March), I did it in this little island called Guernsey. Guernsey is a tiny island between England and France. It’s got this smallest amount of bureaucracy of any – it’s not in the EU, it’s not in the UK.

The guy who organized it was like, “You know what? If ever there was going to be a petri dish where you could do something completely new with 65,000 people, which is the size of a small town. And here you have an island where you could maybe get venture capital to pay for a new medical system to be built without asking for permission, what would you do? What would be the building blocks of a new medical system?”

That’s really what I would’ve focused on for this year, what are the building blocks. And I think that we’re going to focus on people that have one, a really strong message as far as what the building blocks of the new medical system would look like, but also, those who’ve been able to scale up their message to a lot of people because there’s a lot of doctors that have a crazy amount of information. I’ve met so many brilliant doctors. But there’s a real art to communicating that in a way that really scales out to a lot of people.

And so, that’s where we really focused on for this year and who knows next year. But I really think that it’s an interesting conversation to have, what would you do if you could start from scratch because most of us are really just stuck in the mindset of, “How do we evolve this behemoth that is really not designed for what we need? How do we chip away at the edges to try and make it a little bit better?”

But the truth is that as technology just increases, the distance between what we’re doing what we’re capable of just keeps growing. So what I’d like to do is like how can we just get over that and start over there rather than having to just move this thing across. That’s the conversation I wanted to engage this year because I think there’s a lot of people who are interested in it, ready for it and want to be part of it as well.

That’s the cool thing. This medicine is participatory. By anyone watching this, making better decisions in the supermarket or otherwise, you’re participating.

The first time I moved when I went to America was Georgia – not even Atlanta, rural Georgia. So there was a supermarket. And the food there was, there was no natural food. It was no good. Now, 10 years later, I go back and the place is completely different. There’s a huge organic section. There’s all kinds of healthy recipes, half the store basically. And I was like, “Wow! In 10 years, that just happened because people are making different choices. Imagine the impact as this accelerates forward.” That’s what I’m excited to see.

Wendy Myers: I’m really excited to see the doctors changing from providing traditional medical care and moving towards functional medicine because we need so many more functional medicine doctors and integrated practitioners.

Wendy Myers: Can you talk a little bit about how can a physician transition from primary traditional medical care to functional medicine?

James Maskell: Absolutely! Well, we’re looking to be that transition agent. So if you come to Functional Forum and you sign up, we have an Evolution of Medicine concierges. They can help to really understand your unique position to put you in touch with some tools.

Obviously, there are a couple of things. One is the clinical side of things. So you have to learn a new operating system. In a certain way, it’s a tricky proposition because you have to unload quite a little bit to be able to do this and you have to unlearn a little bit. Those doctors that had done it, they had to unlearn quite a lot. But you can also see that those practitioners, naturopathic doctors, physician’s assistants, osteopaths, certain chiropractors, these, in certain cases, have to unlearn a little bit less. Nurses, there’s a lot of nurse practitioners that’s stepping up to deliver it as well.

So the clinical part is one part and there are organizations already that do that really well – the IFM, the Functional Nutrition 101. There are other organizations that are really designed to make it easy for doctors to understand functional medicine for that point of view. I think iFamily is certainly the leader. There are other groups coming along there.

Wendy Myers: And that goes back to Mark Hyman’s…

James Maskell: Yeah, he’s the chairman of it, but it’s been around since 1991. It’s got a real foolproof system for giving people the structure of how to understand it.

But there are a lot of doctors that have taken that training and still aren’t doing functional medicine because it’s difficult to do it in private practice. What you’ve actually seen in medicine the last few years is an opposite movement where people who are moving into working in the hospitals because it’s really hard to make it in private practice.

So what we’re focused on in the Evolution of Medicine is the non-clinical aspects of how to run a successful, what we call, ‘micropractice’. The reason why we’d say ‘micropractice’ is it’s low overhead. And one of the things that I hear from doctors is they feel like there’s no way they can quit their job because they have a life and a family and everything, quit their job at x hundred thousand dollars per year that they get in the hospital system and then just switch over and have this micropractice, waiting for people to come in.

But with the micropractice, that’s often the transition from most practitioners. You just don’t see that. You see the big functional medicine practice and you say, “Wow! I couldn’t have this. Look at the overhead, look at how many people are working here.” But what you didn’t see is five years ago, they just have one office in another office in another practice’s office and they’re just doing their thing there and they built up patients and then a team. It was just this build that came to that.

So what we want to do is really make it easy to build that micropractice because one, this medicine is not technologically advanced. It’s really a lot of just me and you talking. And so you don’t need a lot of structure for that. I mean, even telemedicine is stepping up where you can see a doctor on your phone. I think that’s really exciting too because, again, think of all the structure.

When I say that the infrastructure that needs to be evolved, think of hospitals and buildings and all of these things that you’re going to have to re-tool for chronic disease management. You don’t need as much stuff.

You don’t need as many things for this. You just need human connection and you need empathy, you need an understanding of the different role, the patient understands their role, the doctor has a slightly different role because they need to be empowering people, which is not a skill set for doctors, but coaching is something that’s come from business that really fits nicely into that and really creates behavior change in a way that the medical professions has never really had to do.

So what we’re focused on is really helping doctors understand that non-clinical transition. One of the technologies, one of the structures that really would make it easy for you to start this is one Saturday a month. Get a few patients, get some experience, then go to two days a week, then move into that. Eventually, you can have that practice that you want where you’re not have the same –

That’s what the other thing is. I speak to so many doctors, they’re so stressed. They can’t live, they’re telling their patients, “You got to reduce your stress,” meanwhile they’ve still got 15 more patients and it’s four o’clock and they still haven’t done their charts and their kids are on school and now, all of these. The most horrific example of that is the level of physician suicides which is terrible. It’s a real travesty. You’re seeing it now younger and younger with students.

So what we want to do is really create a structure – not a franchise because you can’t really do that in medicine, but a structure whereby which a doctor would be able to come in, do this type of medicine, have a healthy relationship with their life and their family. That’s what I hope that we can do.

Wendy Myers: Yeah, I think that’s so valuable because I think a lot of doctors go through medical training and they’re not taught how to create a practice, how to run a business. That’s very much a part of being a practitioner, to be a successful practitioner.

I think that many functional medicine doctors and even people like myself who is an FDN, a Functional Diagnostic Nutritionist are becoming the Netflix of film where they put blockbuster out of business. It’s bricks and mortars way of doing things and into the digital era where you can see someone. I have clients all over the world and there isn’t any need to see someone face-to-face. I can see them over Skype or what have you are, even on my phone. You can treat them and give them advice that way.

I think this is such a better model because people have much more power in who they chose as their heath practitioner. They don’t have to be in their small town in Georgia and pick the one doctor in that town. I think it’s so empowering for patients and so far reaching for health practitioners and physicians to be able to practice in medicine in that way.

James Maskell: Absolutely! And I think that’s part of the exciting part of it. There is that potential.

Think about the words (what really got into my mind), the two words, ‘primary’ and ‘care’. What has that come to mean? It’s come to mean like a seven minute visit with a doctor. It literally has two tool at its disposal or three. Surgery is not going to do it, primary care is going to refer (so referral into a specialist) or some sort of drug therapy there. That’s literally the only two options they have.

And I’d like to tell you a list. This is something that I didn’t really plan on telling everyone until down the road, but I’ll give you a preview. When your doctor, when your primary care doctor makes a referral to a specialist, you have no idea why they’re making that referral.

What is happening now is more and more doctors, as they form part of their hospital system, they then get talked, “Okay. Now, you’re an employee, you need to send more people to the rheumatologist. You need to send more people to the psychiatrist. You need to send more people there.” So then, the doctors, under pressure, say, “Look, I only sent five people to the psychiatrist this month. This person’s coming in with some anxiety, it’s probably a good idea for you to send them on.”

That is happening. I’ve spoken to doctors, I know that’s happening and It’s disgusting. If patients knew that that was happening, they would lose all faith in the primary care system, which I hope will happen, but only once we have enough practitioners like yourself who can provide real primary care. Primary, what’s primary?

What comes first. Primary prevention, it starts with the patients. It’s not involved with the doctor at all. I hope that what we see as medicine now will be this acute care system that hopefully, we never have to engage with. And if you get hit by a truck or otherwise, you need that system. It’s really good at doing what it does. But in context, it shouldn’t be part of primary prevention, it shouldn’t be part of chronic disease management really generally.

So I think that should be more primary, having a relationship with someone on your phone or otherwise where you can get them right now and they know who you are and you have a good relationship. I think that’s good.

And then care, the care of someone else, the empathy to ask the right questions to really uncover the triggers or the environmental issues that may be driving your health condition right now or the relationships or whatever that might be.

But then also care, primary care, taking care of yourself to a certain degree like what you’re saying earlier, really taking responsibility, that that care can’t fall on anyone else. It really has to fall on you. Unless you have three [inaudible 00:47:03] who are feeding you and exercising you and otherwise, which is insane, it’s never going to happen, you need to take that primary care yourself.

I think reclaiming primary care is big part. That’s why I call our initial business ‘Revive Primary Care’ because I was like, “That needs reviving” and maybe we’ll come back to that part. But at the moment, we’re just hyper focused on making sure that the doctors can deliver this kind of medicine because you have to make sure that the demand and supply doesn’t get too out of whack, so it’s sustainable.

Wendy Myers: The same thing that you talked about with doctors sending out referrals because they’re under pressure too, the same thing is happening with big pharma as well where doctors earn rewards for writing a certain number of prescriptions. Can you talk a little bit about that, about how doctors won trips for writing x number of prescriptions, et cetera?

James Maskell: I mean, it’s been so obvious. John Oliver did an awesome expose of it a few weeks ago on his show. That was amazing and it just really got to the heart of it. You don’t know, you don’t know what those incentives are behind it. You can be sure that the pharmaceutical companies have all the data, so they can know where to massage or where the leverage is.

Now, some of the most ridiculously obvious things are being taken away. So you can’t give doctors money in the way that you hope you’ve been able to do in the past. Now, it has to be a little bit different. But yeah, it’s an ugly business.

And so I would just say, the thing that I would say is that the majority of people like yourself who’s delivering this kind of care, they’re doing it because they see that they wanted to help people. I feel that what this industry has at this very moment that it may not have forever as it becomes bigger is that the vast majority of the people that I’ve met who are in it really care and really want to do the right thing and have got into doing this because they love what they do and they want to help people.

And so I think that finding the provider with the right intentions is probably you best bet. That could be a functional M.D. It could be a regular M.D. There’s a lot of regular M.D.s who aren’t doing functional medicine who really care and do deliver great care. But I also feel like the other providers that deliver this type of medicine is a better choice.

For my daughter’s health too, we have a chiropractor that we really like and she’s very well versed in functional medicine. Now, if there’s an emergency, I know where to go for emergency medicine, but I don’t interact my child with emergency medicine unless it’s an emergency.

Wendy Myers: Yeah, yeah. I agree, absolutely. I’m very lucky that I’m able to take care for my daughter for the most part because I don’t want to lend out for a care to anyone else and I’m definitely not going to give her medication or anything like that. So, it’s wonderful to have a functional medicine practitioner like a chiropractor on your side, on your team.

James Maskell: Let’s be building trust every period of time. I know her, I trust her, I’ve seen, I’ve spent time with her and there’s just a really good solid foundation of that relationship. So that’s really important to me.

Wendy Myers: Well, I have a question that I like to ask all of my guest on the podcast.

James Maskell: Okay.