how to transition from allopathic to integrated practice - imm brazil 2015

Transition from Allopathic to Integrated Practice of Medicine

Louis Cady, MDCEO, Founder – Cady Wellness Institute

Newburgh, Indiana (US)Indiana School of Medicine,

Dept. of Psychiatry

Brazil, 2015

Ethics and financial/logistical practicalities of these lectures

• Nothing is more important than taking care of the patient.

• “The needs of the patient come first.” (Dr. Will Mayo, MD)

• The current “medical model” is at variance with what is ethical, moral, and factual.

• If the physician is not stable and financially secure, the system implodes.– “No margin, no mission.” - Steven R. Covey

• If the system implodes, the patient suffers.

Background

Deat

hOptimal HealthTraditionalMedicine

Hormone Modulation

No

Dis

ease

= H

ealth

Diet, ExerciseNutritional Supplementation

“Wellness [integrated] Medicine”

Diagnose andTreat Disease

New DrugsNew Drugs New Surgical New Surgical TechniquesTechniques

Forestall and PREVENT Disease – Optimize Function

Health is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.  -  World Health Organization

American Journal of Health Promotion; November/December, 2002

19% of those surveyed

were completely healthy with high levels of both physical

and mental health and a low level of

illness.

18.8% completely unhealthy, defined as having low

levels of health with high levels of illness.

Two-thirds of the adults reported some degree

of mental or physical illness that kept them from

being completely healthy.

“Incompletely healthy.”

HEALTH continuum

DEA

D

OPT

IMA

L

66%“Incompletely healthy”

The “Survival Curve” – Where Are You?

Outline

• Overview of concepts• My bias – a practice model• Current state of allopathic medicine• Microchip as disruptor and disintermediator

– (“Change or die”)• Current state of patients and society• What’s your model? Chloraseptic or PCN?• How to start changing….

The evolution of my practice• Sidetracked in high school, two degrees in music (’77 and ’79)

and learned piano tuning• 1976 – 1989 – piano tuning (through pre-med and med

school). “fee for service”(Med School finished 1989)• 1989-1993 – conventional allopathic psychiatry residency at

Mayo Clinic• 1993 – start practice. 1995 – l-tyrosine and EFA’s• 2002 – first IFM conference• 2003 – Cenegenics training• 2005 – founded Cady Wellness Institute• 2010 – 2011 – Neil Rouzier, MD & WorldLink• 2012 – rTMS (Transcranial Magnetic Stimulation)

May 2002: 9th Annual IFM Conference

The Functional Medicine component

Dead Doctors Don’t Lie - Joel Wallach, DVM, ND

Current socioeconomic state and allopathic (“conventional”) medicine –

DISRUPTIVE NOTIONS• CONVENTIONAL Allopathic medicine = symptom

focused, reactive, “taught,” unthinking, uncreative, PRACTICALLY non-informed by peer-reviewed medical literature. – Commoditized. No variability. “Providers.”

• Integrated medicine: individualized. Can’t get it elsewhere. Not a commodity. Scientific. Informed by peer-reviewed literature.– Concept of “information brokering” (example: THYROID)

Medicare–Workers per Beneficiary

http://facts.kff.org/chart.aspx?ch=383. Accessed April 3, 2010.

Year

Millions

SOURCE: Kaiser Family Foundation based on the 2009 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds.

Slide courtesy of John Adams, MBA – CEO, Cenegenics

The Future of Medicare

“Medicare is going bankrupt. The Medicare Trustees estimate that the program will run short of money starting in 2017.”

•Rep. Bobby Scott, Senators Jim Webb and Mark Warner

http://www.congress.org/congressorg/bio/userletter/?id=3181&letter_id=4747883751. Accessed April 3, 2010.

Slide courtesy of John Adams, MBA – CEO, Cenegenics

Healthcare Reform–Physicians Perception of Medicine Over the Next Few Years

http://www.athenahealth.com/index.php?open=26. Accessed April 3, 2010. Slide courtesy of John Adams, MBA – CEO, Cenegenics

Are the Best and Brightest Staying in Medicine?

“60% of physicians would not recommend medicine as a career to their children.”

• – The Physicians’ Foundation

http://www.mayorswellnesscampaign.org/wp-content/uploads/2009/05/merritt-hawkins-survey.pdf. Accessed April 3, 2010.

Slide courtesy of John Adams, MBA – CEO, Cenegenics

Is there hope for medicine?

“The Great Crossover” – the microchipcf: Dan Sullivan www.strategiccoach.com

Accessed August 30, 2015

A change from the allopathic model?

Socioeconomic/disruptive forces with two models

Allopathic• Disease and sickness

focused• Short appointments• Commoditized• Compartmentalized• Doctor as priest• Uninformed patient• Sicker patients• Either practice

ignorantly or with guilty conscience

• Worry/poor satisfaction

Wellness/ fxnl med• Integrated and whole

person model• Bill for time• Non-commoditized• Collaborative• Informed patients willing

to “pay for expertise”• Practice per peer-

reviewed literature; No crises (pl) of conscience

• INTENSE satisfaction

CHANGE AGENTS

• Microchip/internet

• Increase in chronic disease

• “boomers”• Job/socio-economic pressures

Divergence of focus of two models

Allopathic• Relief of symptoms • Organ specific• Aggressive. “magic bullet”• Rules, practice guidelines• Patient as uninformed

protoplasm.

• Tied to medico-pharmaco-industrial complex

• Use of synthetic, patented, not-from-nature substances

Wellness/ fxnl med; “complementary/alternative”• CAUSE of symptoms, prevention• SYSTEMS focused• Gentle, methodical.• Creative. What works?• Patient as integral part of team.

Questions/participation encouraged. • Focused on health and optimization

with natural, bio-identical methods• Use of PROVEN botanicals and

natural hormones (as well as conventional RX).

Adatped from “Alternative Medicine: Why so popular? By Hans R. Larsen, MSc ChE. International Health News, Sept 1999, issue 93 http://www.yourhealthbase.com/alternative_medicine.htm accessed 1 21 2012

Some interesting thoughts:

•“A naïve analysis of stability is derived from the absence of past variations” (or “The Turkey Problem”)

– Nicholas Taleb, author of The Black Swan

What does integrated, holistic medicine “look like?”

A quick dip in the literature

% U.S. Women with inadequate quantities of nutrients

Arab L, Carriquiry A, Steck-Scott S, Gaudet MM. Ethnic differences in the nutrient intake adequacy of premenopausal US women: results from the Third National Health Examination Survey. J Am Diet Assoc 2003; 103:1008-14.

= 2 apples (fruits) & 3 - 4 vegetables – per CDC

4 – 13 servings of fruits and vegetables per day, depending on energy needs

Cf: http://www.veganforum.com/forums/showthread.php?t=3532

North America 85%South America 76%Asia 76%Africa 74%Europe 72%Australia 55%

% Mineral depletion from the soil during the past 100 years, by continent

Source: UN Earth Summit Report 1992

If we know all of this stuff….

Why don’t we DO anything about it (with our careers, or practices,

and our patients lives)?

Factors trapping physicians & HCP’s• “Doing it, doing it, doing it.” (Michael Gerber, The E-

Myth)• Already time-pressured –

– Minimal time to think or plan– PROBABLY ADRENALLY DEPLETED ALREADY, perhaps

with suboptimal thyroid and sex hormones• Tip – GET YOUR LABS CHECKED!!

• Must “make overhead.” • Can’t “take chances.”• Trapped by “provider panel” arrangements, including cut

rate fees

Beating the FUDD Factor ™

• F ear (medo)• U ncertainty (incerteza)• D oubt (duvida)• D ESPAIR: (despair)

– Don’t know where to start, don’t know how to test, don’t know how to interpret the labs, afraid of “hurting” the patient.

MAKING THE TRANSITION• Must DECIDE

– Must have INFO (e.g., this weekend)– Must INTROSPECT

• Must have something LEGITIMATE to offer• Start SMALL – both with interventions and testing

– E.g, ¼ grain Armour, or Cytomel 5 MICROgrams, or Cortef 5 mg twice daily, or FDA approved testosterone for guys

– E.g., OAT and IgG testing

• Get EDUCATION– IMMH Conferences – AAMG – American Age Management Medicine Group; Institute for

Functional Medicine. For hormones – Neal Rouzier & World Link Medical

• Find a mentor (s) – start here

Marketing & Practice Development• Maintain excellence in allopathy, osteopathy,

chiropractic or naturopathic medicine)– (knowledge base, prescribing, surgery)– (“Be able to debate the great issues.” – Jim Rohn)

• Know your [new] stuff!• Do not badmouth the competition. • Give CME talks and paper over their objecting

mouths with references. • Spiritual and ethical clarity.

“You can have everything in life you want, if you just help

enough other people get what they want.” - Zig Ziglar

What do patients want?•To be treated with respect•To not have to wait!•To FEEL BETTER•To HAVE HOPE.•To not be doped up.•To NOT have their money wasted.

$5,000 worth of wisdom on one page – from Jay Abraham

• Risk reversal• “USP” – unique selling

proposition• Defining the buying

criteria• Three ways for more

profit:– Higher price– More frequency– Additional services

Focus: “Be able to treat your clients (or patients) as dear and valued friends.” - Jay Abraham

Jay Abraham References (recommended)

www.amazon.com

Evansville Courier & Press: May 29, 2006

References: www.pharmanexmd.com ; www.slideshare.net/lcadymd;Dr. Oz show on YouTube: http://www.youtube.com/watch?v=rX4oxxGWi_8

Building CWI - what has worked• Being nice to patients

– (on time, polite, compliment on questions, don’t be a jerk or abrasive, put yourself into their shoes, etc.)

• Be good and get results. BE THE BEST!• Be TRANSPARENT – give’em their labs.

– Write on them. Draw pictures. Take time (and BILL FOR IT).

– Cenegenics model• Be appropriately self-protective of your time and

talents. “If they show up, bill’em.” – Dan Kennedy.

Be Awesome!

NEW reference. Grab it.

MARKETING – what has and hasn’t worked

Worked• Word of mouth• Public seminars• Web site• Going to MD’s/DO’s

offices PERSONALLY• Free stuff – PR

opportunities• Going to places and

NETWORKING

Hasn’t worked• Paid advertising (TV,

print, magazines)

• What I HAVEN’T tried:– Marketing consultants– Radio ads

New initiatives:•Proprietary, paid websites•“SEO” – search engine optimization (Willie Sutton principle)

Additional resources – handouts available at end of lecture

• “The 10 Commandments of Marketing a Medical Practice” – Cady (handout, free)

From Chet Holmes - Grow Your Business 10X web presentation

Success and Failure (Jim Rohn) What about you? You’ve only got one body.

• “Errors in judgement” - High glycemic eating, no exercise, poor nutrition, no labs and “flying blind”, lousy/no supplementation, high stress practice.

- “Good disciplines” – appropriate diet, labs, supplementation, exercise, hormones. Stress management. Decent practice and lifestyle.

"If you have knowledge, let others light their candles in it." - Margaret Fuller (May 23, 1810 - July 19, 1850)(American journalist, critic, and women’s rights advocate.)

I wish you all the best! Good luck!

Contact information:Louis B. Cady, M.D.

www.cadywellness.comwww.Facebook/cadywellness

www.TMS-relief.com

Escritório: 812-429-0772E-mail: lcady@cadywellness.com

4727 Rosebud Lane – Suite FInterstate Office Park

Newburgh, IN 47630 (USA)

Download fromiTunes or Android App

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“slides”

A few extra references follow