Broken Healthcare
|
February 4, 2020 - Episode #5 - Why can't I get the help I need from my doctor? Finding hope outside of traditional healthcare with Dr. Villanueva
Sick and tired of being sick and tired? Done with a doctor dismissing your symptoms away after not even giving you the time of day? Our health care system is broken. It is a system based solely on sick care; not health care. Doctors are forced to treat parts and pieces of the body without looking at the entire system. Care is focused on addressing the symptom without investigating the root cause of WHY the symptom is happening. Treatment options focus on expensive medications and surgeries. Little thought is given to disease prevention and lifestyle medicine. The current sick care system benefits when you stay sick! Does this resonate with you? Do you find yourself frustrated because you can't get the help you need from your doctor? There is hope! Listen to a doctor's perspective on what is wrong with our health care system and learn about a positive solution found in Functional Medicine. Join me as I have a candid conversation with Dr. Carol Villanueva, a board-certified Internal Medicine physician who has a passion for using functional and lifestyle medicine to address the root cause of chronic disease. Remember, if you are looking for support and you need a health coach to help you tackle the obstacles that you keep running into time and time again...I've got your back! A client recently referred to our coaching sessions as "a breath of fresh air!" Consider a virtual, one hour session for a health strategy personalized just for you. Check availability at https://www.inspirehealthyharmony.com/coaching.html#/ and I'm looking forward to meeting with you soon! _______________________________________ Today’s Guest: Dr. Carol Villanueva Dr. Carol Villanueva is a board certified internist with a passion for using functional and lifestyle medicine to address the root cause of chronic disease. She has a practice along with Dr. Corey Rice in North Texas. This functional medicine practice brings a more lifestyle based approach to traditional care. You can connect with Dr. V at https://mymodernmedicine.com/ Read Full Transcript below Where else to listen: (note: Google is only available on android devices)
FULL TRANSCRIPT February 4, 2020 - Episode #5 - Why can't I get the help I need from my doctor? Finding hope outside of traditional healthcare with Dr. Villanueva - Is our healthcare system broken? Is a system that is supposed to restore health doing anything but? We are addressing this controversial topic today on Healthy Harmony. Welcome to Healthy Harmony, where we help you clarify and discuss health tactics to harmonize your life. I am your host and health coach, Jennifer Pickett, and today my guest is Dr. Carol Villanueva. Dr. V is a board-certified internist. She completed her bachelor of arts in psychology from Boston College. She spent an entire year doing volunteer social service in the Portland, Oregon area, helping people with HIV and AIDS. She attended medical school at Nova Southeastern University and got a Doctor of Osteopathic Medicine in addition to a master's degree in public health. After graduation, she did both her internship and residency in internal medicine at Methodist Dallas Medical Center. If you ask her about her passion, she will quickly tell you she has a passion for using functional and lifestyle medicine to address the root cause of chronic disease. Am so excited to have Dr. V on our podcast today. Welcome, Dr. V, how are you? - Good, thank you, Jennifer, for having me. - I'm so glad you're here. I will tell you we're gonna discuss some tough topics today. I'm very curious. What do you think is wrong with healthcare today? - Well, boy, that's a loaded question. - It is, isn't it? - Our healthcare system, I think that from most angles, most users and providers would both tell you that it's a broken system. I think our healthcare is very good at acute care and hospital medicine, but where our system has fallen short, which is really no surprise to patients or to providers, is in chronic disease management. That's where functional medicine comes in and provides a very unique and personalized approach to achieve better results. - You mentioned it's a broken system. I think that's a very powerful word. Let me ask you. Do you think the traditional healthcare model thrives when people are increasingly becoming more ill and staying sick? - Yes. I think that the way that our healthcare in the United States is set up is based on sick care, and that's what the healthcare is good at taking care of, is sick patients and sick in a very acute way. So that's what I mean by it's good for hospital medicine and good for infectious disease, but not good for chronic disease management or not necessarily good for looking at a whole systems approach to underlying root cause of disease or disruption. So, when we talk about functional medicine and why and how the approach is different, it's really and truly an entire philosophy shift where you are not just looking at a symptom and how do we address that symptom alone. I mean our healthcare system is also very parted in terms of you have specialists for different organs and for different systems. The goal of traditional primary care is to put all those together and have them work together. It doesn't always pan out like that. So, when we're talking about chronic diseases that have a systemic backing or maybe affecting multiple different organ systems, it can be difficult to really improve and/or often times we talk about restoring health, which when you talk about a traditional system that... For example, you are diagnosed with diabetes or blood sugar problems. Putting you on medication that improves your blood sugar or is just for blood sugar control is not really improving the root cause, or say you're even just a step further. Maybe you have neuropathy because of uncontrolled blood sugars and you have a neurologists just looking at the neuropathy or retinopathy where you're kind of have all these different specialists that are working, but nothing is doing anything. We're maybe looking to give you a medication to manage a symptom. It's not doing anything to restore health and/or to reverse the disease process of diabetes which we have seen time and time again with the functional medicine approach or lifestyle medicine approach. This disease can be completely reversed. Now there's different types of diabetes and those kinds of things that may make things different, but the idea and our goal from a functional medicine perspective is really truly personalizing the approach to the individual in front of you. So it's necessarily the same course of action for every individual that you see. - We see this so much. We see all the different specialists and they're treating one particular body part or body piece. Why can't, in traditional healthcare, why are they not putting that all together? Because it seems like that is one of the most common things that is falling through the cracks. In modern healthcare, why aren't we putting that together? - I think that is multifactorial as well, and I think a lot of it has to do with what has traditionally been for training and how we go through training and the medical system from medical school and on. So even for postgraduate training, and internships, and residency, and specialists are highly specialized in their unique specialty to offer this specialized care, but I think this kind of standard of the way that we're taught from the very beginning and how as you advance through training, it becomes less of a big picture and much more of a fine tuned, let me hone in on this area, this is what my kind gig is. And then while intentional primary care specialties are meant to kind of help facilitate and govern the blending of kind of all these specialties, it doesn't actually happen that way in real life most of the time. Again, in the hospital system, I think this is done much better where specialists are communicating directly with each other on a team approach in the hospital. But for chronic disease management and the outside and long-term care of this is where, and I don't think it's a surprise to anyone that you pass. When you talk to patients, most are very unhappy in the traditional system. They feel like their doctor is always rushed, can only-- - They really are, they really are. - Yeah, most of the time, there's only 15 minutes at most for an appointment. It's hard to address when patients have a lot of complicated issues, and the providers are just as burned out. They're frustrated that they can't spend more time with patients. It's kinda like a rat race. You're stuck in it and you don't feel like it's easy to have much of an impact. They're trained to say pick your two biggest symptoms that you want me to discuss and address today. So they're never even capturing a full picture of what is going on in this patient's life. - So I find it really interesting that so much of this really goes back to your training. That's where we really see that specialist mentality evolve, and it kinda expands from there. So, I hear your frustrations that you reference patients really not getting adequate time and doctors feeling very, very rushed. So tell me what are some of your biggest frustrations that you had as an internal medicine doctor when you were practicing in this traditional healthcare model. - Yeah. I mean I feel very comfortable speaking about this and coming from a very traditionally trained background and feeling the same experience from both a patient perspective and a provider perspective and feeling, and hearing my patient's say, "I do not want you to tell me to take another pill. "I don't want to do that. "Is there something else that I can do for this?" - Patients are looking for other ways, aren't they? - Absolutely. And we credit our patients to getting us into functional medicine. And everything that we have explored from a postgraduate perspective has been all credit to my patients in saying, "You know, Dr. V, I hear you "and I get that most people do that, "but that's not what I want. "Is there anything else that I can do?" As part of our approach, we have always promised to listen to our patients and look and research to see if there's something else that we can do. And a lot of our patients have said, "Listen, I read about this. "Can you tell me your opinion and how you feel." And that's honestly how we found out about functional medicine. - That is so interesting. So tell me, when you are in the traditional healthcare model, what was the breaking point for you that made you make a decision to move towards functional medicine? What was that breaking point? - I would say it was patients saying, "No, I'm not gonna take another medicine, "so you're gonna have to tell me something else "or I'm gonna find a new doctor." And also, feeling the frustrations of feeling rushed and like I couldn't do more for my patients, I felt like I was not doing much and not helping them by kind of following a standard of care medicine packet, like, "Well, you have a label of diabetes "or high blood sugar, "we need to start you on, you know, "an aspirin, statin, ACE inhibitor." All this, this whole cocktail of medicines, and these are patients that are saying, "Nope, nope, nope, I'm not gonna do it. "Help me figure out what else I can do "to change this course of disease for me." - So what makes us rely so heavily on medications? Where is this coming from? Because I think this is such an underlying theme, and the healthcare model is we're relying very heavily on medications, and I hear you reference that several times and how patient said, "Hey, I don't wanna go that route." Why are we relying so heavily on medications? - Yeah, again, I think there's a few things that I have alluded to, but not directly mention, and that is both a lot of our research in medicine comes from big pharma. Much of funding and those kind of things come from the companies that are making these medications. And then from appointment times and physicians feeling rushed, much of our healthcare systems is governed by health insurance companies that really and truly want to just put things in a simple box and protocol, and say this is what you should do, and this is how it's done, and this is how many patients you have to see in a day for reimbursement rates to meet standards. Even outpatient clinics and facilities are run by big healthcare systems that are fighting to kinda keep up with and operate under the main sources of funding being the pharmaceutical companies and health insurance companies. - So how much pressure was on you where you were in the traditional healthcare model? How much pressure was on you to get these patients seen, and get them in, and get them out? - Oh yeah, that's just the way that it is. I mean that's like the way that you're trained and this is what you have to do, and I mean to the point that you'll get letters and notes if you even applied independent thought believing that this case is different, then often times you'll have to explain yourself to an insurance company and why you're not going with this, for whatever they feel like is written in the protocol as their first line of therapy. That's why a lot of offices, you kinda talk about keep the doors open and a lot of the offices have to meet these numbers and this criteria because you have to kinda keep. And we saw this first hand in our own practice too, is adding more and more staff just to be able to keep up with trying to get what is owed to you even for reimbursement from insurance companies, because they want to kinda figure out why you have maybe not gone with the first line therapy, so then it becomes a lot of administrative work to explain why you're choosing different. - It's amazing to me how it's become so very different and has become more about the paperwork and meeting certain deadlines and goals for getting patients in and getting them out. It sounds like it's taken a lot of the freedom away from the doctor. It's no longer about patient care, but meeting certain margins if you will. - Correct. - would you agree with statement? - Yes, I would, and I think that's a huge reason why physician burnout is so high. Most physicians go into medicine with a passion for helping people and wanting to make a difference. When you feel like you're kind of confined to minimal decision-making so to speak, then that's not really fulfilling your intellectual and educational goals either. - So tell me bout that burnout. How did you experience that burnout, and then what prompted you to take that next step towards functional medicine? - Yeah, I feel very fortunate that I was able to see and find this approach much earlier in my career than I think a lot of people do. And again, I credit that to patients and credit that to nutritionists that we work with who let us towards the institute of functional medicine which is how I got my additional training and understood how to apply functional medicine to clinical practice. Much of this or all of this is all postgraduate training, so it's not something I felt like I had a good understanding of through my traditional medical training. It wasn't easy. It was easy, excuse me, to realize that, wow, this is amazing. I can help people so much more with this type of approach and I can really make a difference in a way that I didn't feel like was possible under the traditional system, and being able to truly, confidently tell people, no, we can help you reverse this disease process. No, you do not have to be on medication for he rest of your life. We can change-- - So there's another question. I certainly want us to unpack your training in functional medicine. But before we do that, your traditional training, as you were being trained to be a physician in internal medicine, did that training involve any kind of education on lifestyle, nutrition, et cetera? - Very, very, very minimal. I kinda laugh because when I think back on the way that I thought about things even in residency, it was like you would kind of allude to this, oh, lifestyle modifications, and we would say, okay, try lifestyle modifications. What that actually meant, I had no understanding of. - Oh that's so interesting. - Yeah. And in terms of nutrition and the impact of nutrition on overall health, I mean, really truly, I think lifestyle factors, when you're going through medical training, are not good. Most of the time we're not eating well. We're not sleeping well. We're not exercising the way that we should be. We're under intense amount of stress. So, you know, when we kinda talk about lifestyle modifications, and that was a lot of what, certainly from a provider perspective, it's easy to relate to, because it's like, golly. Yeah, we say, everybody knows the first line of therapy is lifestyle modifications, but it's really kind of an academic exercise to write that in a chart, but you don't really anticipate that anybody will actually do that, nor are we as providers from a traditional perspective educated on how to truly coach people to do that, and that's where, yeah, that's where the additional postgraduate training in functional or lifestyle medicine can bridge that gap. - It's so interesting to me. Being a dietician and going through that training and having been taught many years ago that physicians really did not receive that training, that it was a little more disease-focused. And then if I compare that, which there is no comparison, your schooling is so much more intense, but just looking back at my training as a dietician, it was very much disease-focused as well. It was not prevention-focused. It was much more disease management focus. And I'm hearing some of the same themes with you. I think it's one of the reasons that patients walk away from the doctors office so very frustrated. They're sick and tired of being sick and tired. They go for answers and the only answers they hear are here are some medications you need to take. And yeah, you need to lose weight. We need to get those cholesterol numbers down. Hey, your blood sugar is not going too good, but there's no real education. There's really no empowerment for that patient, and I think they feel just frustrated. I love how you really spoke about how your patients were really your driving force to go into functional medicine. So, how did you make that jump? Obviously you said that you went to the institute of functional medicine to receive that additional training. Is there anything else that you want people to know that kind of constituted that decision to make a jump from traditional medicine to functional medicine? - Yeah. To me, it was not hard to believe and/or understand that what you put in your body is going to have an impact in how you do or feel. So, when we met with a clinical nutritionist who said, "Oh gosh." And I think she had been exposed to several traditional providers. I say that we were in the, oh yeah, I believe that, but I have no idea how that's done, or how food impacts, or where you begin, and she said okay. But I promised this patient of mine that I was gonna look for another option for her. This patient was telling me she was extremely frustrated. She had also asked about bioidentical hormones, which is something that, a phrase I had literally never heard of. Unfortunately, within the traditional training, it's easy because you feel like you have studied. You have studied so much and you have worked so hard to learn what you have that the kind of knee jerk reaction when it's something that you have heard of is, oh gosh, what is this garbage. Because, you know, there's a lot to sift through out there. I complete understand and respect that, that it can be really difficult to kinda know what to listen to and what not to listen to. But at least from my perspective, when I met with this clinical nutritionist and she said, "No, there actually is another approach, "and there actually is a whole lot of education "that you can get on this." It is very much so evidence-based because again that's kind of your perspective when you come out of traditional medical training is what's the evidence, what's the evidence, what's the evidence. - Evidence-based medicine. - Evidence-based medicine, exactly. And it's not hard to believe. Oh my gosh, it doesn't take a rocket scientist to understand that a bowl of broccoli is going to do something different in your body than a bowl of ice cream, and kinda to understand the impacts of nutritional deficiencies and how that is played out from a clinical perspective in how you do or how you feel. It's also one thing that was easy for me to feel very impacted by was in my training hearing, you know, there's no such thing as a Prozac deficiency. You don't mean-- - Interesting, yes. - You're not having a Prozac, but what are you deficient in that is exhibiting these symptoms of depression for you? Is there some deficiency that is making you feel depressed and manifesting this way? And to me, that hit me hard. - It just makes sense. - It does, it just makes sense. - Yes. Okay, so we keep using this phrase, functional medicine, and I realize that there's some people out there who may not have heard that phrase before. So give me your absolute best definition of functional medicine. - Sure, yeah. Functional medicine is really a systems based approach that looks at underlying or root cause of disease and is truly this whole philosophy that I've been talking about from a different perspective when you look at an approach to disease process within the body. - It's so fascinating to me, and I love hearing that it is that deeper dive. Instead of just throwing a medication that it is truly asking. Like you said before, if someone is struggling with depression, why are they struggling with depression? If someone cannot loose weight, why can they not loose weight? And taking a much deeper look, a closer look and getting to the root of the issue. So, very briefly, we use that term as well, root issues. What are some of the most common root issues that are driving disease today? - Yeah, that's a great point. And also to back up a little, I think functional, kinda describing what functional medicine is is when you kinda put it into this concise statement, it I think sounds somewhat vague or can be somewhat vague. And part of that reason is that it is so personalized to each individual. So when we're kind of talking about this approach to diving deeper, there are so many different systems, right, organ systems, body systems that go into a total body health and wellness. And when you're kinda talking about common root causes, we may... Often times you can't mention functional medicine without addressing gut health or overall GI tract health, and that's because this is such a huge physical barrier, but then also the component and the link of overall gut health with immune health and with brain health. That's what I'm kind of referring to when I'm saying a systems-based approach where they are somewhat all linked. Hormones. Hormones are a huge piece and-- - And that's a whole nother topic, right? That's a whole nother huge, huge topic, but I love just that systems approach. I hear someone say that the functional medicine is more about the why. Why is this happening? Traditional medicine is a little bit more about the what. What is it? Let's stick a label on it? And I think that this is an approach that really empowers the patient to take control of their own health. What have you seen? What has been the biggest thing that you have learned as a functional medicine doctor? And taking this very unique approach where you're using that holistic approach, you're using lifestyle medicine, you're digging deeper and looking for the why, looking at those root issues, what has been maybe an aha moment, or what have you learned over these years of being a functional medicine doctor? - Wow. I would say I'm still constantly learning. It's an amazing field. I think that there is, because every patient is different and because the approach is so individualized, there's always things to learn. I mean we look at genetics, toxicity, gut health, hormones, all these different components. There's always potential for different things and no two people are biochemically exactly the same either. So while, yes, we see trends and patterns and things that work in terms of an approach, for many, there's always outliers. And that's why it's exciting, because it's never a dull moment so to speak, which most physicians lIke that there's ongoing learning. You don't wanna feel like what you're doing is exactly the same and-- - Certainly, certainly. And I think people walk away. So, I have come to see you, so I have a personal connection. I searched online, found a functional medicine doctor. I also received some recommendations and I think that's make a big difference. And what really stood out at me when I came into your office is how much time we spent together. I was absolutely floored. I was shocked. I felt very heard. And I think patients walk away feeling heard. They feel validated, and I think they kinda feel like, "Hey, somebody's in my corner." And then the other component to that is that someone feels empowered, like here's what I can do to take control of my own health. I've got somebody in my corner fighting for me and they're not just taking a cursory glance and walking away, but they're also empowering me to be the best me that I can be, to really take control of my health. So I love that component of functional medicine and how much time is being spent with the patient. - Yeah, without a doubt, it is a partnership. And it's no set course like I keep kind of mentioning. What's important from my perspective is often time, okay, what are your main goals. What is that you want? Because that's gonna be the driver. That's gonna be the motivation. And it's important that your provider knows and understands that, because I may put a completely different thing as the highest priority. But if that's not where you go and because this type of approach puts a lot of work, so to speak, back on you as the patient, it is extremely important for you to feel empowered, heard, that we are your advocate and your partner and want nothing more than your success, and we are there to help guide you to it. Often time I tell people. I can know what's right, what will work, and what will help. But if you're not ready wanting and willing to commit to the work, it won't help. - So right, so right. - So much of the process relies on, you know, what you as the patient want and your role. It's very much so a partnership and a working together. - Most definitely. I love how you put that it is a partnership. So as we kinda wrap up our time together, how would you advise someone, someone who is just sick and tired of being sick and tired, someone who is frustrated with traditional healthcare, they've heard this concept called functional medicine, they're certainly curious about what it can offer them? How would you advise somebody to move forward and find a functional medicine doctor. - Typically recommend people look at the institute of functional medicine, and you can search. There's a link on that website that says find a provider, and that is a very, very academic-based institution that provides excellent training to physicians and is a great place to kinda start. Now because there's different components of what you can get into or even somewhat specialize in from a perspective of functional medicine. The way this is practically being carried out in healthcare in different clinics is somewhat unique, so sometimes it's just a matter of finding the right fit for you as an individual too. Like with anything, you kinda have to find your perfect fit as well. - And certainly considering that this is a partnership, you wanna find a place, a doctor that is a good fit for you. I think that's such a great way to put it. But I love how you really opened up our eyes today to what's frustrating in healthcare, but also this hope that we have in functional medicine, this new approach of lifestyle medicine, that there is certainly hope on the horizon for those who are just very, very much frustrated with their health journey. So I just wanna thank you for spending time with me today. I think this has just been fantastic. Please tell us where can people learn more about you and your practice. Where can they find you? - Absolutely. Thank you so much for having me, and really this is just the type of the iceberg and I would love to reiterate that there is hope. A lot of people do find functional medicine out of that desperation feeling and feeling failed by the traditional system. That's how a lot of people find it. So, yes, there is... Feel empowered, know that you can be helped, and there are lots of folks out there that can help. Our website is called mymodernmedicine.com and has a lot of information on there for you to look up. And our office phone number, we have two offices, one in Forney and one in Addison, and you can access those phone numbers on the website as well. There's a bunch of information and videos and things like that that you can find as well that can be helpful for background knowledge. - Fantastic. Thank you so very much. Guys, also remember to subscribe to us on your favorite platform of choice. Like us on Facebook, on Instagram, @inspirehealthyharmony. And hey, why don't you join in the discussion on our Facebook group as we talk about functional medicine versus traditional medicine and the frustrations that people are feeling. You can also check us out on inspirehealthyharmony.com. So until we meet again. I hope you have a fantastic day. Bye y'all. Remember, if you are looking for support and you need a health coach to help you tackle the obstacles that you keep running into time and time again...I've got your back! A client recently referred to our coaching sessions as "a breath of fresh air!" Consider a virtual, one hour session for a health strategy personalized just for you. Check availability at https://www.inspirehealthyharmony.com/coaching.html#/ and I'm looking forward to meeting with you soon! |
