Join us as we embark on a real-time series following long-time business partners—functional medicine doctor Nathan Morris, MD, and Kara Ware, NBCHWC—learn with them as they explore relevant topics for every functional medicine practitioner such as integrating genetics into your practice, marketing to your ideal patient and how to integrate a health coach to increase efficiency for a more dynamic practice.
It’s time to fundamentally change our treatment model for anorexia nervosa. Check out Dr. Greenblatt, MD's new book, Answers to Anorexia at https://www.jamesgreenblattmd.com/answers-to-anorexia/ The recovery, relapse, and mortality rates for anorexia are simply staggering. We can’t afford to wait. Roughly 3 million people in the US over 15 years old have anorexia. The death rate of anorexia nervosa is 12x higher than the annual death rate from all other causes combined for young women between ages 15-24 years. Over the last decade, treatment centers are reporting an admission increase of 400% among women over 40yrs. Traditional psychotherapy is associated with a relapse rate of 50% and a fatality rate higher than any other mental health disorder.
27 min 37 sec
Nutrigenomic testing allows practitioners to identify their patients’ unique genetic differences. These differences can impact nutrient requirements, susceptibility to environmental factors, or predispositions to chronic conditions. Combining nutrigenomic testing with organic acids testing (OAT) provides practitioners with key biomarkers that can be matched to certain genes and allow for the development of personalized nutrition and lifestyle advice. Join us on Monday, October 11th from 6:30-7:15 EST pm when Dr. Denise Furness unpacks a 32-year old female with consistently high B12serum levels, chronic fatigue, and fluctuating thyroid levels case study. Dr. Furness lends her expertise to this infertility, preconception, topic and takes your questions. Dr. Denise Furness will be using a PureGenomics® and a Great Plains Laboratories® OATS test. PureGenomics® was developed by Pure Encapsulations to harness the science of nutrigenomics to empower individuals to uncover the relationship between their genes, nutrition, and wellness.
23 min 20 sec
A 35-year old woman, grew up in a rural Pennsylvania farming community. 4 neighborhoods in total and acres and acres of rural farmland. The water source is owned by a private company; the owner is a local farmer. Evidently, the water has been leaking up to 70%. Breast cancer, celiac, asthma are on the rise in the community. One girl died of an asthma attack. Symptoms She feels misdiagnosed as a young girl. She feels they are POTS attacks, not anxiety attacks. She would often faint while working at McDonald's. She also has Ellers Danslos Dx, chronic fatigue, and high levels of Epstein bar virus. She constantly has bruises on her legs, and trouble with tendons and ligaments, as well as being super bendy- she has tight muscles and loose joints. She is constantly in PT. Her sister has mast cell activation and asthma. Otherwise nothing else in her family history. SNPs mentioned in this episode for the top objective of addiction Vitamins/Minerals/Omega 3s Category Vit D: GC, DHCR7, CYP2R1 Cognitive and Mental Health Category COMT met/met AA (Executive Function) TPH2 (Serotonin Production) BDNF (Brain-Derived Neurotrophic Factor) Energy and Fitness Category COL1A1 (Tendon or Ligament Injury) COL5A1 (Tendon or Ligament Injury) Detoxification Category SOD2 (Antioxidant Enzymes) GSTP1 (Environmental Toxins) Immune Category TNF-alpha (TNFalpha activation) Resources Nutrigenomics Case Study Events 2021 GMOTG Events Line-up PureGenomics PureGenomics Trait Tutorials Schedule a complimentary 1:1 Welcome to PureGenomics coaching session Do you have a reputable water testing company? Let us know! Have questions about how cannabis fits into your toolbox? Email: firstname.lastname@example.org
24 min 6 sec
A 29-year old man struggling with addiction. When he was younger, he was diagnosed with ADHD/ADD, struggled with focus, parents didn't want to place the patient on medications and didn't know about addressing root causes manifesting these symptoms. He began using drugs in high school and eventually fell into heroin and Alcohol. SNPs mentioned in this episode for the top objective of addiction Vitamins/Minerals/Omega 3s Category Vit A: BCMO1 genes Omega 3: FADS1 genes Vit D: GC, DHCR7, CYP2R1 Riboflavin and Folate: MTHFR c677T and 1298c Cognitive and Mental Health Category COMT val/val GG (Executive Function) DRD2s (Dopamine Receptors) Metabolic and Weight Management Category FTO (Protein Intake. FTO draws upon the dopaminergic pathway) Resources Nutrigenomics Case Study Events 2021 GMOTG Events Line-up PureGenomics PureGenomics Trait Tutorials Schedule a complimentary 1:1 Welcome to PureGenomics coaching session Have questions about how cannabis fits into your toolbox? Email: email@example.com
17 min 40 sec
A 55-year-old female who has been living with IBS since her early twenties. She had possible food poisoning around 7-years ago. She is eating a whole foods diet yet still has regular exposure to gluten and dairy. The patient adores running, however, is experiencing frequent injuries. Patient's top objectives 1. IBS 2. Mood 3. Energy 4. Weight 5.) Recurring Injuries Vitamins/Minerals/Omega 3s: · PEMT (rs7946) (Choline) · BCMO1(rs12934922) (Vit A) · BCMO1(rs7501331 (Vit A) · CYP2R1(rs10741657) (Vit D) · GC(rs2282679) (Vit D) · DHCR7(rs12785878) (Vit D) Gastrointestinal Category: · FUT2 (rs601338) (Microbial Diversity in Small Intestine) · MCM6(rs4988235 (Lactose Intolerance) Cognitive and Mental Health Category: · COMT (rs4680) (Executive Function) · TPH2 (Serotonin) Exercise and Fitness Category: · COL1A1(rs1800012) (Tendon and Ligament Injury) · COL5A1(rs12722) (Tendon and Ligament Injury) Resources Nutrigenomics Case Study Events 2021 GMOTG Events Line-up PureGenomics PureGenomics Trait Tutorials Schedule a complimentary 1:1 Welcome to PureGenomics coaching session
19 min 55 sec
A 45-year-old female who is inquiring about bio-identical hormones for depression, anxiety, and weight gain. Patient's top objectives 1. Hormones 2. Mood 3. Weight COMT Val/Val (wild type) COMT met/met (homozygous) SNPs (genetic variants) mentioned in this minisode: Vitamins/Minerals/Omega 3s category: · PEMT (rs7946) (Choline) Cognitive Health and Memory category: · COMT (rs4680) Detoxification category: · COMT (rs4680) (Estrogen Metabolism) · GSTP1 (rs1695) (Glutathione Peroxidase) · SOD2 (rs4880) (Antioxidant Enzymes) Resources Nutrigenomics Case Study Events 2021 GMOTG Events Line-up PureGenomics PureGenomics Trait Tutorials Schedule a complimentary 1:1 Welcome to PureGenomics coaching session
16 min 49 sec
A 57-year-old male CEO, with problems with memory. Pt has borderline blood pressure. Problems with memory started with taking a statin. Pt also has issues with borderline blood sugar HGA1C is 5.8 and bloating. Loses weight by avoiding fats and carbs Patient's top objectives: 1. Memory 2. Borderline blood sugar 3. Borderline blood pressure SNPs (genetic variants) mentioned in this minisode: Cardiovascular category: · SLCO1B1(rs4149056) · ACE (rs4343) · AGT (rs699) · CYP1A2 (rs762551) · LIPC (rs1800588) · PPARD(rs2016520) Metabolic Weight-Management category: · MC4R(rs17782313) · FTO (rs9939609) Resources Nutrigenomics Case Study Events 2021 GMOTG Events Line-up PureGenomics PureGenomics Trait Tutorials Schedule a complimentary 1:1 Welcome to PureGenomics coaching session
15 min 29 sec
31-year old male, placed on Ritalin in the second grade, whose top objectives are anxiety and depression, especially in the winter months, food aversions, year-round allergies SNPs (genetic variants) mentioned in this minisode: Vit/Min/Omega 3s category: BCMO1 (rs12934922, rsrs7501331) (Vit A) GC (rsrs2282679), (Vit D) CYP2R1(rs10741657) (Vit D) DHCR7(rs12785878) (Vit D) FADS1 (rs174537, rs174546, rs174547) (Omega 3s) MTHFD1 (rs2236225) (Choline) PEMT (rs7946) (Choline) Cognitive Health and Memory category: COMT (rs4680) (Executive Functioning) ANKK1/ DRD2 (rs1800497) (Dopamine Receptors) DRD2 (rs2283265) (Dopamine Receptors) DRD2 (rs1076560) (Dopamine Receptors) Resources Nutrigenomics Case Study Events 2021 GMOTG Events Line-up PureGenomics PureGenomics Trait Tutorials Schedule a complimentary 1:1 Welcome to PureGenomics coaching session Methylation Genetics: Why Choline is Often the Missing Link Email me for a summary of our Good Medicine On the Go (GMOTG) May case study event! You can read how these events can assist you with the interpretation and application of patients' genetic profiles to steer your clinical decision-making.
A 57-year old female patient, Dx with Hashimotos, has felt/been sick for 12+ years. Hx of mold illness, heavy metal toxicity, extreme fatigue, anxiety, vision problems, difficulty thinking, can’t lose weight. The patient has a clean DF/GF diet; has done AIP in past. No alcohol, limited caffeine. Eats very clean diet, loads of vegetables and plant matter. Beverages mostly water. Limited red meat. Snacks on nuts. Top objectives: “Can’t lose weight” /cellulite High cholesterol/triglycerides. AnxietyFatigue Vision problems Difficulty thinking SNPs (genetic variants) mentioned in this minisode: vit/Min/Omega 3s category: BCMO1 (rs12934922, rsrs7501331) (Vit A) GC (rsrs2282679) (Vit D) CYP2R1(rs10741657) (Vit D) DHCR7(rs12785878) (Vit D) FADS1 (rs174537, rs174546, rs174547) (Omega 3s) Immune Health category: IL-6 (rs1800795) Resources: Nutrigenomics Case Study Events 2021 GMOTG Events Line-up PureGenomics PureGenomics Trait Tutorials Schedule a complimentary 1:1 Welcome to PureGenomics coaching session Email me for a summary of our Good Medicine On the Go (GMOTG) May case study event! You can read how these events can assist you with the interpretation and application of patients' genetic profiles to steer your clinical decision-making.
17 min 36 sec
A35-year old working mom of 3. The patient says “I am young but I feel so old.” It is hard for her to enjoy life and time with her kids when she is always feeling tired, foggy-headed, and achy all over. Top objectives: Brain fog fatigue- exhaustion Headaches that have recently turned even more extreme Achy all over SNPs (genetic variants) mentioned in this minisode: Vit/Min/Omega 3s category: FADS1 (rs174537, rs174546, rs174547) Immune Health category: IL-6 (rs1800795) TNF-alpha (rs1800629) Gastrointestinal Health category: FUT2 (rs601338) Nutrigenomics Case Study Events 2021 GMOTG Events Line-up PureGenomics PureGenomics Trait Tutorials Schedule a complimentary 1:1 Welcome to PureGenomics coaching call here Email me for a summary of our Good Medicine On the Go (GMOTG) May case study event! You can read how these events can assist you with the interpretation and application of patients' genetic profiles to steer your clinical decision-making.
18 min 51 sec
A 56-year old woman who is dealing with significant weight gain, binge eating when stressed, and persistent knee pain? Top objectives: Weight Stress Injuries SNPs (genetic variants) mentioned in this minisode: Weight-Management category: APOA2 (rs5082) (Response to saturated fats) FTO (rs9939609) (Protein Intake) PPARG (rs1801282) (Monosaturated fat response) Exercise & Fitness category: COL1A1 (rs1800012) (Tendon and ligament injury) COL5A1 (rs12722) (Tendon and ligament injury) MMP3 (rs679620) (Achilles tendon injury) Immune Health category: IL-6 (rs1800795) (IL-6 activation) Resources: Nutrigenomics Case Study Events 2021 GMOTG Event Line-up PureGenomics PureGenomics Trait Tutorials Schedule a complimentary 1:1 Welcome to PureGenomics coaching call Email me for a summary of our Good Medicine On the Go (GMOTG) May case study event! You can read how these events can assist you with the interpretation and application of patients' genetic profiles to steer your clinical decision-making.
9 min 46 sec
A 32-year old female living with PCOS for the past 12-years. Asthma is in her health history. PCOS began when the patient went to college. Up until then, she was extremely motivated, hard-working, and accepted into an Ivy League school. Top objectives PCOS Weight gain Fatigue SNPs (genetic variants) mentioned in this minisode: Immune category: Il-6 (rs1800795), TNF-alpha (rs1800629) Vit/Min/Omega 3 category: SLC30A8 (rs11558471) Glucose Metabolism category: TCF7L2 (rs7903146) Resources: Nutrigenomics Case Study Events 2021 GMOTG event line-up PureGenomics PureGenomics Trait Tutorials Schedule a complimentary Welcome to PureGenomics coaching call Questions? Email firstname.lastname@example.org Email me for a summary of our Good Medicine On the Go (GMOTG) May case study event! You can read how these events can assist you with the interpretation and application of patients' genetic profiles to steer your clinical decision-making.
13 min 17 sec
In the marketing campaign we described this season, we’ve harnessed the power of simplicity to turn prospects into patients. But with these new patients in our practice, how do we continue to build upon our relationship and transform these new patients into raving fans? Get GMOTG episodes, blog posts, resources right to your inbox GMOTG Nutrigenomics Case Study Virtual Events with Dr. Nathan Morris have started, however, register at any time and receive past recordings and resources. The Kalish Institute Telehealth Business Essentials Bootcamp The 1-page Marketing Plan by Allan Dib Tell us what you want to hear on GMOTG
33 min 10 sec
Like in any good relationship, communication is king. Learn from experts on how to structure a communication campaign for your prospective patient, and how to make this process simple and streamlined. For resource mentioned in this episode, visit karawarecoaching.com The Kalish Institute Telehealth Business Essentials Bootcamp Get GMOTG episodes, blog posts, resources right to your inbox GMOTG Nutrigenomics Case Study Virtual Events with Dr. Nathan Morris Tell us what you would like to hear on GMOTG
26 min 41 sec
When your prospective patient says ‘yes’ and engages with your ad, where do they land after that? We’re going to explore how to continue their customized experience and why it is important to hold back on pushing the sale...for now. For resource mentioned in this episode, visit karawarecoaching.com The Kalish Institute Telehealth Business Essentials Bootcamp Get GMOTG episodes, blog posts, resources right to your inbox GMOTG Nutrigenomics Case Study Virtual Events with Dr. Nathan Morris Tell us what you would like to hear on GMOTG
17 min 36 sec
In order to make our marketing efficient, we need to meet our prospective avatars where they are: mentally, and physically. This episode dives into the importance of true market research, the role social media can play in your practice, and offers some tips and tricks to make this step easy and effective. Resources For the resources mentioned in this episode, visit karawarecoaching.com Kalish Institute Telehealth Business Essentials Bootcamp Get GMOTG episodes, blog posts, resources right to your inbox GMOTG Nutrigenomics Case Study Virtual Events with Dr. Nathan Morris Tell us what you would like to hear on GMOTG
27 min 56 sec
This season breaks down the myths of marketing and equips you with powerful tools to build better relationships with prospective patients An object at rest will want to stay at rest, that is why the first step of the marketing yes ladder is breaking inertia. Learn how to encourage your prospect to say yes to small steps, rather than asking them to take a huge (and expensive) leap of faith into your practice. For resources mentioned in this episode visit karawarecoaching.com Get GMOTG episodes, blog posts, resources right to your inbox GMOTG Nutrigenomics Case Study Virtual Events with Dr. Nathan Morris Tell us what you would like to hear on GMOTG
16 min 15 sec
This season breaks down the myths of marketing and equips you with powerful tools to change your practice for the better. In episode two, we identify two common marketing mistakes and hear renowned marketing expert Allan Dib, explain the importance of defining an avatar and joining the conversation that is in their mind for our marketing materials. Resources: For resources mentioned in this episode, visit karawarecoaching.com Let's continue our conversation! Join our newsletter Register for GMOTG Nutrigenomics Case Study Virtual Events with Dr. Nathan Morris Tell us what you want to hear on GMOTG
22 min 10 sec
Welcome to Season 3 of Good Medicine On the Go! This season breaks down the myths of marketing and equips you with powerful tools to change your practice for the better. In episode one, we hear renowned marketing expert Allan Dib, explain the importance of a niche, and how to choose one for your next marketing campaign. Resources: For resources mentioned in this episode, visit karawarecoaching.com Get GMOTG episodes, blog posts, resources right to your inbox The 2 Major Types of Marketing-And Which One is Better for Functional Medicine Providers? GMOTG Nutrigenomics Case Study Virtual Events with Dr. Nathan Morris Tell us what you want to hear on GMOTG
17 min 33 sec
We are excited to be back with you for Season 3, where we will be discussing marketing for your functional medicine practice. You are a great doctor, but maybe you’ve seen a low conversion rate or a dip in new patients since the pandemic forced many practices to go virtual. Marketing is the key to getting you back where you want to be, helping patients, and providing care. We know marketing can be intimidating, so this season, we will be breaking down what exactly marketing is, how to navigate it regardless of your business structure, and why it is applicable to every medical practice on the market – both new and old. Our goal is to show you how easy marketing can be, so you can get back to treating patients and not worry about your business. Get GMOTG episodes, blog posts, resources right to your inbox 1-page Marketing Plan by Allan Dib
10 min 10 sec
In our last episode of the season, we bring together key learnings and expert voices from the past 6 episodes. We summarize how to optimize entry points and utilize a health coach to improve your practice and make functional medicine more approachable, affordable, and sustainable. Learn about board-certified health coaches, where to find them, and how to integrate them into your practice. How to build a practice centered around patient readiness. Discover a first-of-its-kind resource that we’ve built to help you streamline the process of integrating a health coach in your practice and much more. Ready to learn more? Dive deeper, access resources, and connect with us by visiting https://karawarecoaching.com/season-2-episode-7/ Good Medicine On The Go is sponsored by Atrium Innovations Professional Brands.
38 min 32 sec
Learn how to discuss finances with your patients, and why this conversation is critical to a sustainable functional medicine lifestyle. What can the practice do to make functional medicine more affordable? Discover why working within a patient's financial threshold can actually benefit the therapeutic partnership. Functional Medicine Care Planner A patient autonomy tool for organizing, documenting, tracking, and budgeting their personalized plan. Ready to learn more? Dive deeper, access resources, and connect with us by visiting www.karawarecoaching.com/podcast/episode-6/ Good Medicine On The Go is sponsored by Atrium Innovations Professional Brands.
31 min 36 sec
Discover the business benefits of overhauling your Welcome Call and positioning a health coach as this most important first encounter Prioritize your patient by assessing their needs and readiness from the first encounter, and gauge preparedness for the long journey of Functional Medicine Optimize conversion rates by onboarding the right patients, and keep them engaged/activated Discover a tried and true method that drives conversion rates by focusing on onboarding the right patients who will stay with you for the long journey. Ready to learn more? Dive deeper, access resources, and connect with us by visiting https://karawarecoaching.com/season-2-episode-5/ Good Medicine On The Go is sponsored by Atrium Innovations Professional Brands.
34 min 39 sec
Interested in using a health coach? We answer the questions: how does a coach fit into a Functional Medicine practice, what does collaboration look like, and how does the health coach get paid? Episode #4 highlights a medical provider contracting a 1099 Independent Contractor for health coaching and possibly additional skills above and beyond health coaching. Learn ways to reduce provider stress, lower the risk of burnout, optimize communication, and bolster patient readiness There is a lot of pressure for Functional Medicine practitioners to ‘do it all’. We are joined by two phenomenal health coaches in this two-part series that show you there is a better solution through two highly effective, albeit exact opposite, infrastructures. Learn about how these clinical practices found their health coaches to be so impactful, the coaches are now called the “secret sauce” to the practices’ success. Ready to learn more? Dive deeper, access resources, and connect with us by visiting https://karawarecoaching.com/season-2-episode-4/ Good Medicine On The Go is sponsored by Atrium Innovations Professional Brands.
41 min 17 sec
In Part 1 Meet Ashely Howell, National Board, Functional Medicine Certified Health Coach Interested in using a health coach? We answer the questions: how does a coach fit into a Functional Medicine practice, what does collaboration look like, and how does the health coach get paid? Compare and contrast different health coach integration workflows from experts in the field Learn ways to reducing provider stress, lower the risk of burnout, optimize communication and bolster patient readiness There is a lot of pressure for Functional Medicine practitioners to ‘do it all’. We are joined by two phenomenal health coaches in this two-part series that show you there is a better solution through two highly effective, albeit exact opposite, infrastructures. Learn about how these clinical practices found their health coaches to be so impactful, the coaches are now called the “secret sauce” to the practices’ success. Ready to learn more? Dive deeper, access resources, and connect with us by visiting www.karawarecoaching.com/podcast Good Medicine On The Go is sponsored by Atrium Innovations Professional Brands.
28 min 24 sec
We are joined by Margaret Moore (aka Coach Meg) to discuss how health coaching is the #1 missing intervention in healthcare. We learn about the science of sustainable behavior change, the unique and powerful skillset of health coaches, and how integrating a coach into your practice can bring on game-changing results. Ready to learn more? Dive deeper into the research, access resources, and connect with us by visiting www.karawarecoaching.com/podcast Good Medicine On The Go is sponsored by Atrium Innovations Professional Brands; PureEncapsulations, Douglas Laboratories, Genestra Brands, and LivingMatrix.
39 min 26 sec
Creating entry points based on patient readiness Breaking down Functional Medicine Journey into incremental steps Here’s how we’re going to use a health coach to make Functional Medicine more approachable, affordable, and sustainable Ever struggled with patient retention? Are you wondering how to open up your Functional Medicine practice to a broader audience? In our new season, we are talking about re-imagining entry points to make functional medicine more approachable, affordable, and sustainable. In this episode, we share our own journey in building a dynamic, successful practice and offer guidance and actionable insights on how to develop a robust practice based on patient readiness. Ready to learn more? Dive deeper, access resources, and connect with us by visiting www.karawarecoaching.com/podcast Good Medicine On The Go is sponsored by Atrium Innovations Professional Brands: PureEncapsulations, Douglas Laboratories, Genestra Brands, and LivingMatrix
40 min 17 sec
As we wrap up Season 1 of our show and prepare for a great Season 2, we wanted to take this episode to highlight and recap Episodes 1-7 and give you an inside look at what is on the horizon. In season one, we created an entry point for practitioners new to Nutritional Genomics, from understanding how our genetics influence our mood, immune resilience, and our weight, to exploring what it really means to “eat right and exercise”. In our first season, we also talked about the four models of pricing and provided a detailed list of pros and cons for each payment model. Thank you so much to our listeners! We can’t wait to see you again in Season 2 and continue the work together to reimagine the functional medicine journey. For other show notes and transcripts, visit us here. Key Takeaways: [1:13] There are a lot of “aha” moments when a patient understands that they feel a certain way not because of a character flaw or weakness, but because of a genetic variance or vulnerability. The more they are on board with the process, the more the patient can strengthen their twin engines of change, self-motivation (I want to change) and self-efficacy (I believe I can change), When a patient believes getting better is possible they are truly empowered. [3:18] When a patient starts supporting their genetics, they can have more dopamine and serotonin bio-availability, making it easier to take action on the things that really matter for their health. [4:33] To recap Episodes 1-7, we covered over 22 SNP’s and how they relate to the common top objectives of our patients: mood, immune resilience, weight-management, and exercise. [5:18] In Episode 1, we introduce ourselves and the concept of using a 30-minute Nutritional Genomics consult to meet the patient, build rapport, and trust, and create validity to order more diagnostic labs to investigate further the phenotypic expression of their genome to better understand why are they reacting to their environment or tipping into unhealthy coping strategies. Episode 2, Dr. James Greenblatt, a pioneer in the field of integrative medicine, joins us to discuss MTHFR and COMT genetic influence on neurotransmitters, and how it may influence our behaviors. Episode 3, Dr. Sam Yanuck discusses with us ways that genetic testing can give us insight into chronic inflammation. [6:18] Episode 5 is the first of a two-part series where we explore how environmental and emotional factors such as stress and fear have an impact on our eating patterns. We welcome Morgan Knull who talks about how she customizes eating plans for her clients through her company Feed your Genes. Episode 6, we dive into the common saying “eat right and exercise” and how that’s not a one size fits all approach to health and a healthy weight. Dr. Penny Kendall-Reed joins us to talk mood and food, and take a further look at a few key metabolic hormones that drive appetite and satiety. [7:09] Episode 7 continues the “eat right and exercise” conversation by looking at how our genetics can help make sense of what exercise is right for us, the risks to be extra careful of, and the timing of when to include exercise into a personalized, therapeutic plan. [8:52] We like to approach nutritional genomics with the idea that it isn’t everything or a magic pill, but a powerful tool. [9:48] In Episode 4, a business application episode, we covered the four models of pricing and gave the pros and cons, starting from the insurance model and working our way into transitioning to the cash model. Just like working with clients in functional medicine, the name of the game here is starting slow and building on success. [12:07] The recommendation of having nutritional genomics as a 30-minute entry point to your practice is to build trust and rapport with your patients, and not to overwhelm them with so many diet, lifestyle, and medical recommendations that they feel overwhelmed and never come back. [15:52] In Season 2, we will extend and expand the conversation of creating an entry point for prospective clients beyond the complex patient. We will talk about setting up welcome calls, integrating health coaches, functional finances, and share a program we are designing to attract a new audience to functional medicine in 2021, [24:47] Good Medicine On the Go is our real-time series where we evolve Dr. Nathan Morris’s dynamic practice openly for all to see, so you will see the trial and errors and can follow along if you too would like to create a new entry point to service the masses right when they need Functional Medicine the most. Mentioned: Good Medicine Pure Encapsulations PureGenomics Free PureGenomics Business Integration 30-minute consult, schedule yours here Listen to Episodes 1-7 Quotes Worth Sharing: “If you can empower a patient, you really put in place the twin engines of change, self-motivation and self-efficacy.” [1:44] — Dr. Nathan Morris “We believe we need to create a solid foundation to then build on slowly for long term success. Functional medicine is not about the short term wins, but rather the changes that will last a lifetime.” [10:44] — Kara Ware “Lack of simplicity inadvertently stifles enthusiasm. And then we can't make that conversion to endurance for the long journey. This is true for both provider and the patient.” Kara Ware
24 min 8 sec
We’ve all heard the advice, ‘eat right and exercise’, but it’s often not clear cut what exercise is best for each individual needs, how long we should exercise, and the timing of exercise. In this week’s episode, we discuss practical ways to keep patients exercising safely and effectively. We talk about things to look at on genetic reports, such as inflammatory markers and polymorphisms that can serve as a predetermination for a higher chance of response and injury. We correspond examples of exercise with certain genetic findings and give our own personal examples of how our lives changed for the better once we applied them to our daily routines. Key Takeaways: [3:32] When we get the right kind and amount of exercise, we get a huge bump in dopamine that can boost our mood and help with attention and focus. However, if we exercise too much or in the wrong way, that can cause stress, trauma, and inflammation to the body. [7:42] Recovery and timing are so important in exercise, as we can become even more inflamed when we push the body after it is already deficient in sleep or healthy cortisol levels. [9:15] Practitioners should speak with their patients about what type of exercise they already enjoy and are called to do because they are more likely to stick with it long term then an exercise they don’t find pleasure in doing. [12:28] Genetic variance may affect someone’s risk for exercise, but should not preclude anyone from doing what they enjoy. [13:10] The top thing we look at with genetics when it relates to exercise is the response to inflammation. When a patient has a risk variant for Interleukin 6 and does intense exercise for around an hour, they really do not do well and could actually feel more tired during the day. Patients with this risk variant may do better walking for an hour or experience better results with a 20-30 minute work out rather than trying to do more intense exercise for a longer duration. Switching to low-moderate intensity workouts, they can recover and possibly reduce the chance of harm from an increased inflammation cascade. [15:06] ACTN3 is a muscle structure gene that tells us about your fast-twitch versus your slow-twitch. If you are a variant for the ACTN3 gene, you may be a better fit for endurance since you are able to get more blood flow to the muscles, and this may explain not feeling your best after interval type exercise. However, if you are practicing HIIT style and loving it, then go on enjoying it. This does not mean the average person has to stop this exercise. Again, referencing the IL-6 genetic variant is important. [16:53] ACE is really about how our muscles respond and how we recover. We tend to find that ACE can tell us if we have more vasoconstriction, where our arteries contract. And that's going to be more for your sprinters and more for the people that need that quick blood flow. These are the patients who are genetically advantaged to go long distances like riding bikes and marathons. [17:51] PPARGCA1A -this how well we're going to do with aerobic exercise. And so this could be a leverage point and say, "You know what, aerobic exercise is going to be just fine for you. However, you will also want to cross-reference the SNPs to prevent injury associated with aerobic training. [20:11] Exercise done correctly in the right amounts actually lowers our IL6 through the vagal nerve and that dopamine. So we really want them to hit that right amount of exercise, which decreases inflammation and does not increase inflammation. [21:18] The beautiful feature about Pure Genomics is as more polymorphisms are scientifically validated and added to the program, they automatically appear on patients' reports; one test equals a lifetime of information. It’s also easy to correlate genetic information with exercise recommendations. [23:13] LPL is what Dr. Morris calls a ‘leverage points’; they highlight response to glucose metabolism. If somebody is struggling with keeping their blood sugar down with diet alone, knowing their LPL and LIPC variants help show the patient that doing some exercise, 20, 30 minutes each day, can really help with your glucose. [23:53] LPL and ADRB2 are two more leverage points. These variants are related to fat burning as a result of exercise. For these patients, exercise a great way to lose this fat as they have beneficial biology for it. We call these “enhanced benefit SNPs”. [23:13] Not all variants are risk-inducing, which is why the term “risk variant” as applied to genomic testing can be misleading. In PureGenomics, SNPs are now reported as “No Action”, “Enhanced Benefit”, or “Consider Action”. SNPs like LPL, LIPC, and ADRB2 are some of the variants that have an enhanced benefit to the patient. [27:29] COL1A1 & COL5A1 are variants associated with ligament injury susceptibility and MMP3 for Achilles tendon injury susceptibility. And what all these SNPs show really is that you have problems with collagen and collagen deposition and strength. And so, Dr. Morris says before started an exercise program, you want to reference IL-6 and the injury prevention SNPs, COL1A1, COL5A1, AND MMP3 [33:28] We need to remember that polymorphisms are associated with a risk or a benefit. So even though it says risk variant, there's actually an advantage to having the variant as in the case of the LPL, LIPC, MMP3. This is why PureGenomics moved away from the misleading color coding and clearly marks when there is an advantage to having the ‘risk variant’. Mentioned: Good Medicine Pure Encapsulations PureGenomics Free PureGenomics Business Integration 30-minute consult, schedule yours here Why is the generic advice ‘eat right and exercise’ bad advice? With Dr. Penny Kendall-Reed First things first, Mental Health Feeding on Fear with Morgan Knull of Feed Your Genes Quotes Worth Sharing: “The timing and telling patients they are off the hook is as important as it is for us to help them add movement into their life.” - Kara Ware[7:29] “Exercise is just like diet - if we don’t give people the right type and the right time, we can cause more inflammation and injury.” -Dr. Nathan Morris [8:30] “We all know, in functional medicine, you always go to the gut, and inflammation starts there.” Dr. Nathan Morris[29:22] “We need to remember that polymorphisms are associated with a risk or a benefit. So even though it says risk variant, there may actually be an advantage to having the variant. Therefore, genes are not good or bad”. Kara Ware [33.28]
35 min 27 sec
This episode featuring Dr. Penny Kendall-Reed explores how clinicians can use genetics to inform patients in their weight management journey. We discuss how certain hormones and SNPs can determine the best diet and what “eating healthy” really means for each individual. We share practical advice for providers to identify which variants to reference that play a role in regulating the metabolic hormones that influence hunger and satiety. Key Takeaways: [0:51] We get a much better result of managing mood and weight when we first determine the underlying genetic drivers that influence appetite and satiety. [3:08] Dr. Nathan Morris shares a story that shows the importance of understanding the relationship between dopamine and serotonin with mood and food. He highlights the connection between our genetic variations and how they affect our eating behaviors weight. [12:39] Ghrelin is a hormone that increases appetite and also plays a role in our weight. Leptin decreases our appetite and lets us know when we are full and satiated. [INSERT] FTO plays a role in the production of these and has a big impact on our metabolism. FTO does not like simple sugar or saturated fats, and when you are variant with FTO you are likely to burn fat slower and not feel full. It is especially important to look for FTO before recommending the ketogenic or paleo diet. [15:48] With MC4R gene variant, there is a 43% increased chance of obesity. Patients with variant MC4R have often struggled with weight management, and despite trying different diets, they have a hard time with finding long term success. [17:45] FTO and MC4R are both influenced by the dopaminergic pathways. Their activity influences ghrelin, which can cause patients to become constant snackers seeking a dopamine hit. This relationship with dopamine means it is important to also look at the DRD2 (dopamine receptor) of patients to make sure their dopamine uptake is working properly. [18:53] FTO will also dictate how much protein we need per meal, the A/A risk variant, with the slowest metabolic position typically needs the highest amount of protein. [20:20] Those with the MC4R gene variant may have dealt with childhood obesity and struggled just trying to find balance most of their life. Dr. Penny suggests diet and exercise alone won’t always work, and we can benefit from treating this using a supplemental protocol including a combination of Piper betle, Dolichos biflorus, and acetyl-L-carnitine. [21:58] Leptin is our metabolic hormone which signals when we have had enough to eat. When we are constantly snacking, leptin may build resistance and prevent us from feeling full. Intermittent fasting may work well for patients as a way to help combat leptin resistance. [23:03] The APOA2 gene variant also affects these metabolic hormones and when Dr. Penny sees this she recommends the patient eats under 22 grams of saturated fat a day. [26:02] Understanding how genetic variations play a role in our mood and weight management takes away the guilt people feel and realize they have control over it. When they feel better and have a road map of what eating right really looks like for them personally, they are more likely to see good results and stick to their plan. This transforms food from a burden to a gift and pleasure. Mentioned: Good Medicine Pure Encapsulations PureGenomics Free PureGenomics Business Integration 30-minute consult. Schedule Here Ep 2 - First Things First, Mental Health Ep 5 - Feeding on Fear with Morgan Knull of Feed Your Genes Dr. Penny Kendall-Reed PKR Health Quotes: “Eat right really is generic advice that gives no clue to the patient of what that means.” - Dr. Nathan Morris “We are in some way enslaved to these hormones. It’s almost irrational what they make you want to do.” - Dr. Nathan Morris “We have our DNA which is our nature, but we can nurture it to be able to express optimal function.” - Dr. Kara Ware
29 min 49 sec
In the first of this two-part series, we explore how environmental and emotional factors such as stress and fear can highlight and exacerbate unhealthy eating patterns. We discuss the connection between neurotransmitter production and function and mood, sleep, weight management, and cravings. We look at two of the most important neurotransmitters, serotonin and dopamine, and what role each one plays on our behaviors that drive our habits. Then, we welcome certified nutritionist, Morgan Knull of Feed Your Genes, to talk about how she works with the genetic variations of her clients to empower them through custom supplementation and meal plans. Key Takeaways: [2:42] There are two main neurotransmitters that can play a big role in our mood. Serotonin helps regulate sleep, appetite, mood, while dopamine is our “feel-good” neurotransmitter and acts as the pleasure and reward-seeking hormone. [5:43] Single nucleotide polymorphisms (SNPs) can determine how we react to our environment and can give us some real insight on how to leverage these variations to support our health. [9:29] Good Medicine uses Pure Genomics 2.0 for many reasons, one being that it is a well-organized way for providers to see different SNPs in a simplified way, which will assist us in this rapidly evolving field. With so many different SNPs it can get confusing, or seem like “alphabet soup”, but Pure Genomics provides a user-friendly system. [11:10] Morgan herself spent decades trying different diets, and feeling frustrated when they wouldn’t work. She decided to get her own genetic testing done, and it changed the game, both how she ate, and how she looked at her own cravings. At her company Feed Your Genes, Morgan offers nutritional genomic consultations, which then can help her create customized meal plans based on the specific genetic needs of each individual. [16:01] When we are under a lot of stress, the demand for these neurotransmitters can be kicked into high gear which can deplete us and lead into the habit of self-medicating. When we are depleted of serotonin our cravings can be towards chocolates and sugary foods, while dopamine causes us to seek out salty foods such as chips and cheese. [21:22] The SNPs talked about in this episode include COMT, TPH2, FTO, and DRD2. [24:34] The FTO SNP is known as the obesity gene and one of the most well-researched genes, connecting appetite and satiety. There is a connection between FTO and the need to snack constantly because one never feels full. Morgan explains that when she sees the FTO gene, she can help create meal plans using protein to give her clients more satiety. COMT can help us see how we can clear out dopamine, and TPH2 is the precursor to serotonin which helps us with mood and appetite. [27:04] Morgan works with her clients to uncover reasons for eating patterns and behaviors that they may have beat themselves up for decades. When they have the tools and knowledge of knowing why something is happening, they change the narrative about who they are and success seems more possible. Quotes: “When we say sugar is an addiction and we laugh it off, it really is.” “The heart of functional medicine is discovering the why to the symptoms of our illness.” “This is why you are, this isn’t who you are.” Mentioned: Good Medicine Pure Encapsulations PureGenomics Free 30-minute consult. Schedule Here 23andMe Ancestry.com Kara Ware, LLC LivingMatrix Color Coded Cheat Sheet Feed Your Genes Dr. Penny Kendall Reed First Things First, Mental Health
35 min 34 sec
In this episode, we address pricing and how to create a reasonable pricing model for long term viability. We discuss four models of pricing and give the pros and cons for each, along with tips for transitioning and growing your functional medicine practice. This topic is a passion of ours because we often see doctors with an immense amount of knowledge, and skills who are unsure of which pricing model is right for them. This decision will shape their practice, and help them understand how to transition into private practice, create a business model that allows them to fulfill their calling, and finally translate the calling to making a quality living. Key Takeaways: [1:25] Functional medicine requires more time spent understanding the root cause of our patient’s symptoms and creating a space for them to tell their story. Finding a business model that allows this is crucial, but so is creating a price structure where doctors can make a living. [4:13] Insurance Model: Pros — It is often what we know best and what both the practitioner and patient are most familiar with, and can keep costs generally lower for your patient... Cons — Not a lot of time with patients; doctors must hit a higher quantity of patients when using the insurance model, which means they are unable to spend time deeply understanding each patient. This often leads to practitioner burnout. [5:50] Hybrid Model: Dr. Morris would have been really nervous to move from an insurance model direct to cash, so he elected to use a Hybrid Model. The Hybrid Model provides a stepping stone for doctors transitioning from insurance to cash models in functional medicine. Pros — a great option to include insurance and create membership models to grow your patient base. This model may give doctors more time with their patients, and provides a stepping stone towards a full cash practice. Cons - Each doctor must delineate the benefits of the extra costs of membership, because patients are unlikely to pay the fee if [8:30] Dr. Morris explains how the transition to functional medicine can often make doctors feel like they have to charge what the industry leaders are charging, even if it is a huge leap for them personally. When starting out, Dr. Morris kept his overhead low so he didn't have to charge as much and he could pass those savings on to his patients. As Dr. Morris’s reputation was growing and word of mouth referrals kept increasing he then felt ready to move to the cash model. [9:10] Cash Model: Doctors may benefit from crawling, walking, and then running, or in pricing model terms - insurance, hybrid, then cash.. Pros — Cash practice can be a little scary but it allows a doctor to spend as much time with the patient as needed. Cons — It can also be difficult to know what to charge, and to find the sweet spot where you can make a living, but your patients can also afford the extra costs that come with paying for their own supplements and labs. New functional medicine doctors could benefit from offering a discount to their industry-standard rate as they grow their patient base. [13:55] Direct to Primary Care / DPC Model: Pro — This model makes a lot of sense when you are transitioning to functional medicine. It creates a more affordable way to build your reputation and patient base. You can charge a set fee where people can manage their own appointments and Dr. Morris believes patients really do respect communication boundaries. Cons - ? [15:35] Contracted Position: When contracted with a hospital, it is still possible to also transition into functional medicine. Pros - you already have a full patient population that you can say, hey, I would love to discuss this with you, but I don't have the allowance to do that during this visit. If you would like to see me in my functional medicine setting, you can see me there, Cons - contract positions often limit a practitioner, especially when it comes to pricing, patients, and practice decisions. To overcome this, Dr. Morris suggests creating a separate LLC or corporation that you can direct patients to, and work with a lawyer and/or accountant to make sure it’s done correctly. [20:54] Overall, Dr. Morris likes about the hybrid and cash models because they create a space where people don’t have to wait months to see you, and the people that really need your care are able to get it in a timely manner. Quotes: “At first, there will not be a lot of patients banging down your door until you establish that reputation.” Dr. Nathan Morris “The more time you spend, the better you are at functional medicine, the more your patients will refer their family and friends.” Dr. Nathan Morris It’s important to understand what your needs are in creating a pricing structure, while also leaving room for the patient to meet their needs." Dr. Nathan Morris “ It is truly a calling to be a doctor.” Dr. Nathan Morris Mentioned: Good Medicine Pure Encapsulations PureGenomics Free 30-minute consult. Schedule Here 23andMe Ancestry.com Kara Ware, LLCLivingMatrix Membership Paperwork
22 min 48 sec
This week, a renowned expert in functional immunology, Dr. Sam Yanuck joins us to share a variety of ways that genetic testing can give us insight into chronic inflammation and better understand how to control the drivers of susceptibility to COVID-19. We discuss lifestyle changes and supplementation that may help lessen chronic inflammation, how genetics can serve as an indicator for a predisposition towards cytokine storm, and more about Dr. Yanuck’s online functional immunology course for clinicians, Cogence Immunology. Key Takeaways: [1:43] Chronic inflammation is the largest driver of susceptibility in COVID-19, and we think of it as the windmill of functional medicine. In hospital admissions, 88% have a preexisting condition related to a disease of chronic inflammation, such as obesity, diabetes or hypertension. [3:32] In a cytokine storm, we lose control of the brakes for runaway inflammation. Our Th1 cells help us kill bacteria and viruses, and we function best when our Th1 and Th2 are in balance. We can look at genetics to tell us who may be predisposed to cytokine storm and use that insight in combination with the Living Matrix Report that identifies higher risks and allows us to be proactive with our plan of action. [9:34] Even though COVID-19 is a new virus, a fair amount of research exists on other Coronaviruses and how the immune system works overall, along with immunological functions that are crucial and known to be central during COVID-19. [10:13] There are gene defects that we can test for that relate to inadequate zinc status and excessive Interleukin 6 cytokine. [12:17] We don’t want to think of the immune system as just one thing that goes up and down. [13:35] It is clear that zinc is central to immune function, and that Interleukin 6 is a big driver of the cytokine storm in COVID-19. [16:47] Each of us has a mosaic of advantages and disadvantages in our genetics and immunity. Figuring out what parts are overemphasized will help you figure out how to quiet those parts down, and bring up other areas that may be under-functioning. [17:53] Dr. Yanuck works with his patients to combine the results from lab testing, Pure Genomics tests, and 23andMe. [22:36] High histamine levels can often co-exist both with acid reflux and cognitive deficits. We can work with patients to take measures to support histamine and DAO SNP. [25:34] Genetics gives us insight into the upregulation of cytokines IL-6 and TNF-alpha which, if left unchecked, can lead to chronic inflammation and cytokine storm. Th1 and Th2 responses are neither good or bad, but long term imbalance is. This is where lifestyle choices come in. [27:13] This is a great time to engage previous patients and give them a reason to come in and get on a health plan of action that is proactive rather than reactive. Quotes: “It’s going to be a long journey. Let’s not just sit back and wait on people to get sick. Let’s go ahead and be proactive and empower them.” “Lifestyle changes, which is what we are after as functional medicine practitioners, are the most important things before we ever start going after genetics.” “We shouldn’t feel powerless in any way in balancing the immune system.” Mentioned: Good Medicine Pure Encapsulations PureGenomics Free 30-minute consult. Schedule Here 23andMe Ancestry.com Kara Ware, LLCLivingMatrix Paper on COVID Frontiers in Psychiatry Dr. Sam Yanuck Cogence Immunology Thought Leaders Guide to Immune Health
32 min 31 sec
This week, we are thrilled to be joined by Dr. James Greenblatt, a pioneer in the field of integrative medicine for over 30 years. Dr. Greenblatt discusses why it’s critical to use genetic testing in the field of mental health and shares how understanding neurotransmitters and our genetic polymorphisms provides a path to help patients understand that their mental health struggle is not a character flaw, but possibly genetic vulnerabilities that can be supported with targeted nutrients and lifestyle changes. We also talk with Dr. Greenblatt about his Psychiatry Redefined educational program and give an update on the new Good Medicine practice development Key Takeaways: [1:32] The more we can understand ways to support our body, the more compassion and less shame we can have towards ourselves and others. Kara reflects upon her own journey of understanding that the effects of stress and depression she felt years ago had less to do with a flaw in her character, and more about her genetic vulnerabilities. [5:38] Dr. Greenblatt is a pioneer in the field of integrative medicine and has been in practice for over 30 years. He uses genetics to make decisions around what supplements may work best, and even what medications would be helpful. [6:22] Dr. Greenblatt has said that 44% of adults and less than 2% of kids are actually getting the mental health treatment they need. With this time of pervasive stress and a loss of structure, it is more critical than ever to help patients feel comfortable to explore mental health options through Functional Medicine and Nutritional Genomics. [7:12] The Functional Medicine community has a profound responsibility to provide education about biological vulnerabilities, and how mental illness is related to the genetic environment. [8:36] Even if we have a family history of depression, addiction, or suicide, it doesn’t mean that it’s our destiny. [9:40] Dr. Greenblatt discusses 4 important polymorphisms that practitioners should be looking at with their patients: SLC6A4, MTHFR (A1298C and C677T), TPH2, and COMT. [10:35] MTHFR SNPs are the simplest to understand and probably have the most profound implications in traditional psychiatry and functional medicine. The SLC6A4 serotonin transporter gene helps practitioners understand how the patient will respond to SSI treatment. [15:29] Dr. Greenblatt developed Psychiatry Redefined, which is an educational platform that provides clinicians with a new evidence-based treatment model for mental illness. He recommends beginning with the Depression course which includes guidance on using labs and Nutritional Genomics together. [19:37] The twin engines of change are self-motivation and self-efficacy, and when we optimize their biological access to dopamine and serotonin patients can feel like they want to change ‘self-motivation”, and equally as important feel like they can change ‘self-efficacy’. [24:04] We discuss the patient flow in the new Good Medicine model. It is our mission to structure our business so our entire system is truly in partnership with patients, and the process feels welcoming, manageable, and sustainable. Quotes: “An important place for us to begin in a functional medicine practice is to first help people feel well and prepared for the process.” Kara Ware “The earlier we can understand these genetic vulnerabilities, the concept of prevention really screams out and its profound implications.” Dr. Greenblatt “If we utilize this genetic foundation and integrate it into our treatment plan, particularly in mental health, it has really significant implications for recovery and remission.” Dr. Greenblatt Mentioned: Good Medicine Pure Encapsulations PureGenomics Free 30-minute consult. Schedule Here 23andMe Ancestry.com Kara Ware, LLC Psychiatry Refined - Depression Course
25 min 44 sec
Welcome to Good Medicine On the Go. We are your hosts, Dr. Nathan Morris and Kara Ware, Clinical Coordinator. In this week’s episode, we introduce ourselves and do a deeper dive into how we are reimagining the functional medicine journey. We discuss why Nutritional Genomics is more relevant in our society now than ever before, and why it’s important to make Functional Medicine more accessible and affordable to both bring in a new audience and reactivate former patients. Key Takeaways: [0:57] We (Dr. Nathan Morris and Kara Ware) have been long time business partners, and we are now reimagining Nathan’s practice from brick to click. [2:07] When we see a long journey ahead of us we can feel overwhelmed and paralyzed. Functional medicine focuses on the approach of “What is our first step?” [3:31] Our philosophy calls for creating a solid foundation to build on slowly, for long term success with our patients. When we follow the principles of the Transtheoretical Model of Behavior Change, we can prepare the patient for a deeper commitment both with their time and expenses. [4:11] Using tests such as 23andMe and Ancestry can help clinicians make a huge difference with their patients and pinpoint how their genetics have an impact on their health. [5:04] Nutritional Genomics is so relevant right now with the current environmental factors, stress, loss of structure, and rise of unemployment which may make us more vulnerable. [6:36] I think that's the big epiphany I had early on in my functional medicine practice, that I had to first make my visit affordable, secondly, make sure I didn't overwhelm patients with supplements, and most of all, I didn't want to overburden them with tests. [11:30] One of the most important things about Nutritional Genomics is working directly with your patient on what their key issues are, and how you can best help them with a few objectives and tangible steps. TeleMed appointments are perfect for this, as they can provide a short connection time to pinpoint what is needed. Quotes: “The curveballs are sometimes the best things that ever happen to you.” “Fear is not a great driver.” “Nutritional Genomics is preparing the patient for a deeper commitment to Functional Medicine’s process and partnership.” Mentioned: Good Medicine Pure Encapsulations PureGenomics Free 30-minute consult. Schedule Here 23andMe Ancestry.com Kara Ware, LLC
16 min 58 sec