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    Health & Fitness

    Good Medicine On The Go

    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.

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    Copyright: © Good Medicine On The Go

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    Latest Episodes:
    S2 Ep7 - Interviewing, Hiring, Training, Optimizing the Integration Structure of a Health Coach Dec 18, 2020
    Show notes

    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.


    S2 Ep6 - The New Modifiable Lifestyle Factor (Finances) Dec 04, 2020
    Show notes
    • 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.


    S2 Ep5 - The 15-minute Entrance to Your Practice Nov 27, 2020
    Show notes
    • 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.


    S2 Ep4 - Health Coach Workflow Models in Clinical Practice: Part 2 Nov 20, 2020
    Show notes
    • 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.


    S2 Ep3 - Health Coach Workflow Models in Clinical Practice: Part I Nov 06, 2020
    Show notes

    Ready to integrate a health coach? You need well-designed operational and communication systems to create continuity of care. Take a look at Kara's proven proactive strategy model course, Therapeutic Partnerships Roadmap.

      • 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 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’. Two phenomenal health coaches join us in this two-part series that shows 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.

    Good Medicine On The Go is sponsored by Atrium Innovations Professional Brands.


    S2 Ep2 - The Missing Intervention in Healthcare - The Science of Health Coaching Oct 30, 2020
    Show notes

    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 open or restructure your private practice based on a proactive strategy model that better prepares your patients on how to co-create their treatment plan so they feel empowered, confident, and competent to implement changes and see results? Check out Kara's Therapeutic Partnerships Roadmap course.

    Good Medicine On The Go is sponsored by Atrium Innovations Professional Brands; PureEncapsulations, Douglas Laboratories, Genestra Brands, and LivingMatrix.


    S2 Ep1 - Building a robust practice based on patient readiness Oct 23, 2020
    Show notes
    • 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 create your version of my proactive strategy model?

    The Therapeutic Partnerships Roadmap Course allows you to reduce stress and take back your time and energy by showing you how to effectively design and streamline your operations systems to create strong relationships, optimize outcomes and boost word-of-mouth referrals.

    Good Medicine On The Go is sponsored by Atrium Innovations Professional Brands: PureEncapsulations, Douglas Laboratories, Genestra Brands, and LivingMatrix


    S1 Summary- Highlights and A Sneak Peek a Season 2 Aug 07, 2020
    Show notes

    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


    S1 Ep7- Exercise is as Unique as Your Patient Jul 24, 2020
    Show notes

    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]


    S1 Ep6- Why is the Generic Advice "Eat Right and Exercise" Bad Advice? Jul 03, 2020
    Show notes

    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


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