Barbell Shrugged - Building a Homestead Nursing Home and Finding the Right Primary Care Physician w/ Dr. Garrett Butler, Anders Varner, Doug Larson, and Travis Mash #787

Episode Date: February 26, 2025

Garrett Butler, MD, is a devoted family man and physician serving rural West Virginia as a husband, father, son, and friend. With a strong academic foundation, he earned undergraduate degrees in Physics from Johns Hopkins University and Molecular and Cell Biology from Towson University, followed by an MD and Family Medicine residency from West Virginia University School of Medicine. He’s a busy healthcare professional, working as a hospitalist at Vandalia Health Davis Medical Center and Broaddus Hospital, while also caring for patients as an outpatient family physician at Broaddus Family Care. On top of that, he serves as the medical director of Mansfield Place Nursing Home, showcasing his commitment to his community. Please check out the Mansfield Place nursing home YouTube page Work With Us: Arétē by RAPID Health Optimization Links: Anders Varner on Instagram Doug Larson on Instagram Coach Travis Mash on Instagram

Shrug family, this week on Barbell Shrug, Dr. Garrett Butler is coming in to the podcast and he has been a client of ours for over three years, like one of the very first people that trusted us with his health and performance and he is a doctor, medical director at a hospital in West Virginia and we dig into what you should be talking to your primary care doctor about, how you can have those conversations. Garrett actually is one of the most trusted sources that I have in my life because he is very well entrenched in the, call it the medical establishment and being a medical director. And at the same time, he's a client of ours, which means he's way outside the box when it

comes to looking at the functional side of health and performance, how all these things relate together, and just a wealth of knowledge. And he can kind of bring me many times back to what I should be doing when it comes to actually like the traditional side of healthcare. And there's very few people, in my opinion, that can offer such a well-rounded view as well as knowing what we do inside Rapid as in-depth as he does after three years of being with us. And as always, friends, if you love this show and you want to experience what Garrett has been doing with us for the last three years,

head over to aretelab.com, A-R-E-T-E-L-A-B.com. That is where you can learn about all of the labs, lifestyle, performance testing, analysis, and coaching that we are going to be doing with you. And you can schedule a call and get yourself rolling so that you can feel and perform better than you ever have in your entire life. Come and hang out with us and you can access all of that over at r-a-t-a-lab.com. Friends, let's get into the show. Welcome to Barbell Shrugged. I'm Anders Varner.

Doug Larson, Dr. Garrett Butler. Welcome to the show, man. This is your first podcast. You are the medical director of two hospitals in West Virginia. And when you came to us, one, it was two. Yeah, I'm just a minion at the other one. There you go. Well, when you came to us, you were about to take on the gnarliest schedule I have ever heard in my entire life. It was maybe getting some of the details wrong here, but seven days on 12 hour shifts in a row.

Yep. Switching to the night shift without a day off. So a 24 hour straight day and then seven nights and then repeating that for two years. Correct. Yeah. So when it, when it first came out, uh, the way it sort of worked was, uh, my weekend shifts, cause I'd always start like on a Saturday or Sunday weekend shifts are always shorter, especially rural, you know, West Virginia where I'm at. And it wasn't a full 12-hour shift. You know, you'd be up there for sometimes five hours, something like that. But it's about a 45-minute commute from my house to get to work and then 45 minutes back. And then what I would do is I'd work a full clinic on Friday. And then to make the flip to night shift easier, I just said, hey, you know what? I'll start my

night shifts on Friday, get done with clinic, bust butt 45 minutes back home to where the other primary hospital is in this area, work a full 12-hour night shift, and that'd be my kickover into night shifts. Come home, be completely exhausted and ready to start the next day, and then go straight into my 12s, and then come off Friday morning and be done, sleep a little bit through the day, get up, have dinner with the family, try to go back to bed, get up on Saturday, head back to work. Let's rewind a little bit. That's an insane schedule. It's an enormous amount of work. Your position, you're already working at one hospital, basically full-time, if not well over full-time. Why do you need a second hospital slash, is it a second job technically?

Or is it kind of the same thing? Like, why are you doing this in the first place? So it's all one health system. And so particularly the region that I'm in, we do have a hard time with physicians and keeping enough providers in the area to do what they need to have done. So from my respect, what I decided to do is I've actually been busting my butt ever since residency. You know, you go through residency and for me, a typical schedule is about 80 to 100 hours a week during residency. You don't get paid a whole lot to be a resident physician. And then you get out in the

big kid world and the big kid world. They're like, hey, we'll actually pay you big kid bucks to work those same schedules. And I'm like, dude, I'm already doing it. I mean, I'm not going to back off and like start slacking. I can pay off my student loans. I can start paying well off on my house. I love to work. I love what I do. And I mean, if you're going to pay me to do it, by all means, I will sometimes burn the candle at both ends and just get it done. Yeah, I mean, and you absolutely did.

You came to us because you wanted to survive the kind of the sleep recovery side of this thing. Yeah, I haven't really got like a got like a big report on how that's been going here, at least lately. How are you doing these days with all of that? Doing really well, actually. The first big thing, because prior to the shift, it's been two and a half years now that I've been with you guys. I'd been primarily doing day shift. And so my big concern was, you flip to do a night shift and shift work in general. We already know it's a carcinogen. We already know it increases your risk for diabetes, heart disease, everything else.

And I was like, man, I got to make sure that I head this off before I start doing it. So I was like, I'm going to jump on board with you guys. And at the time, rapid health performance and it was like a rapid health reset, I think was what the actual term was then. And I say, I got to do this because I need to stay on top of my own health or else I'm going to start getting sick. And that's the last thing I want to do is get sick, not be able to work, end up, you know, home laid up because I'm just not taking care of myself. Yeah. You've taken on a very cool, we're going to talk about homesteading for a little bit because your boy

just moved to a farm and you're doing the coolest project. You just bought a nursing home and you're renovating it and turning it into a homestead nursing home. Give me all the details because people need to go follow this. I'm watching you on YouTube. I'm seeing you put it all out. I'm going to give you a chance.

You can tell everybody where to follow you. Absolutely. It is such a cool project. We talked for about half an hour the other day and I was like, you know what? We're doing, we're doing podcasting things. Let's go. Um, but yeah, tell everybody about this project. Awesome. Yeah. So, um, I, uh, last summer decided to take a leap of faith and put a bid in on an online auction on a building I'd never walked through and a 50,000

square foot building on 15 acres. And, uh, it's it's an old, it originally started as an orphanage back in 1908, and then turned kind of into a convalescent type center, just old people home. And that actually ran all the way up till the first year of COVID. And they couldn't, basically, it's just costing too much to maintain it. And they just started auctioning it off bit by bit. I put in a bid and thought, hey, there's no way I'm going to be able to win this. And they call me one afternoon, don't recognize the phone number, send a voicemail. It's like, hey, is this Garrett Butler? You just won an auction. I was like, oh, shit.

You said you were good for it. Now you've got to pay the bill. So I go over there with my parents and we sign on the dotted line, do dotted line, do the pictures and everything and walk through this building that, you know, is 114 years old. And she needs a lot of work. You know, she's 50,000 square feet, like I said, built in 1908. It's all like plaster and good wood and the outside's all brick. Tons of land around it. Like I said, 15 acres with the potential to purchase

probably another 15 more. And the long-term goal, which it's probably going to be pretty long-term because it's going to take me some years to get this baby back up and running, but is actually to not only have it as more like assisted living, kind of that in-between, not quite the nursing home because there's a lot of restrictions on nursing homes, lots of things you got to do. But to be able to have it kind of that midway point for people that can still function, but aren't necessarily to that debilitated, like bed bound state and just really needing a hundred percent care. But then also having those farm grounds, having orchards, being able to raise all of our own

food, you know, actually having a gardener on staff, having the residents help out with it, you know, canning our food, even if we're having, you know, lamb, sheep, pigs, chickens, cattle, you know, whatever, just having everything there and try to see if we can make the entire thing fully self-sufficient, like not reliant on reaching out and getting this like this mainstream, just crap food that's out there. Have everything done right here locally. Anything else that we produce above and beyond what we need, sell back to the community, help support the project.

Yeah. Are you going to be doing, kind of like with the population there, I could see your brain going, I got a big idea here and I'm going to put my medical background to use along with this belief in kind of this holistic, functional side of things. And are you do you have the ability to kind of run your own kind of like experiments and like get papers written? Is that a part of it? Like running consistent, like blood work on people just to see how you're able to change their lives

essentially by what would normally be going on in a community like that versus, no, we're gonna get people outside and they're gonna be gardening and they're gonna be interacting with animals. There's, it's a, if you've ever been into one of those homes, which I'm sure you have, but it's like, every time you walk in one,

you're like, this is not a place for health. This looks, even in the nice ones, you're like, not for me. But if I was to walk in somewhere where everybody's outside gardening, hanging out, doing things together more than just sitting and playing bridge, that's like a place of health.

That's like the opposite end of the spectrum of most of those communities. I could probably do some observational type stuff, but I think when you really start getting into running true studies, and I mean, you guys know from having experience in college, especially Doug and everybody else, they have that experience actually.

Like you have to have your papers, you have to have your consents, you have to get the whole family on board. That part could be a pain in the butt, but certainly having that observation of this is people in almost like a simulated blue zone. Dr. Andy Galpin here. As a listener of the show, you've probably heard us talking about the RTA program, which we're all incredibly proud of. It's a culmination of everything Dan Garner and I have learned over more than two decades of working with some of the world's most elite performers, award-winning athletes, billionaires, musicians, executives, and frankly, anyone who

just wanted to be at their absolute best. Arte is not a normal coaching program. It's not just macros and a workout plan. It's not physique transformation and pre and post pictures. Arte is something completely different. RTA is incredibly comprehensive and designed to uncover your unique molecular signature, find your performance anchors, and solve them permanently. You'll be working with not one person, but rather a full team of elite professionals, each with their own special expertise to maximize precision, accuracy, and effectiveness of your analysis and optimization plan. Arate isn't about treating symptoms or quick fixes. It's about unlocking your full potential and looking, feeling, and performing at your absolute best physically and mentally when the

are the highest. To learn more, visit ArateLab.com. That's A-R-E-T-E lab.com. Now, back to the show. This is people in almost like a simulated blue zone. You have that, this is that longevity piece. And can we keep these people out of the nursing home? Can we keep these people here for the long term? Heck, what happens if these people just die here? And that's okay too. Yeah, for sure.

It sounds like it'll be a very active environment, which is, you know, movement wise is fantastic. But is there like a physical therapy slash strength and conditioning exercise component to that facility? That's the fun is basically I have to completely remodel the entire building. So idea wise, I can do anything from the ground up. I mean, there's plenty of space. I mean, the 50,000 square feet is the above ground. I mean, I have the entire floor space underground in basement space as well. That used to be back when it was an orphanage, like they still had the hookups for the speed

bags and the heavy bags downstairs in the basement and the locker rooms and the showers where the old, like where the kids used to shower after they busted their butts. So I mean, Grandma's down there. Yeah, exactly. You could have so, so much fun. Like to have like a, like a, like a real gym at a facility like that, where all these older people that they're not like,

they're not like so far down the road where they're debilitated, where they can't take part in some actual strength and conditioning. Like if you brought like a, you know, coach or a whole crew in there to help, you know, help grandma and grandpa stay fit and strong and healthy all the way to those later years, that'd be pretty, pretty rad. Yeah.

And we can also dive into some of the other fun stuff, having like sauna, doing like cold plunge. Imagine grandma jumping into an ice bath. Grandma jumping in an ice bath? We are warding off all dementia when your brain realizes there's survival happening right now. There is no chance you're getting any of those brain conditions. Like, I'm freezing every day. My body is fighting to stay alive. We need 100% brain capacity.

Absolutely. Oh, wow. I'm ready. That's where I'm going. West Virginia. Wonderful. As busy as you are with all the stuff we started the show with, like, how do you have time to renovate? Yeah, because the renovations are happening.

Tell the people about the YouTube channel because that's where all the renovation sides are going on. Yeah, yeah. So right now it's my family and myself basically doing most of the work. We got a couple of neighbors that help out with us. And the newer schedule that I've been working probably for the past six months gives me a few more weekends off. So I'm definitely I'm only doing one week of nights now and three weeks a day. So the schedule has gotten a lot better in the past six months. And so now it's primarily just on the weekends. And we started up a page on Instagram and on YouTube, The Odd Fellow Manor. And it's just a cool place where I'm just kind of putting the information out there,

letting people sort of follow along, drumming up that interest so people can see what it is that we're doing. And, you know, if people really like what it is, you know, if they want to help out, by all means, it's, hey, reach out to me, see what we can do to help. Because, I mean, we can use all the help we can get right now. I mean, I don't have any, you know, I'm a family doc. It's not like I'm making millions of dollars here. I'm just kind of like the extra money that I get that I have left over. We're putting towards the house, paying off the mortgage and just bit by bit working through it.

I love it. It's super cool, man. I, uh, when you, when you told me that I was like, that is, that is the jam one. It just aligns, it aligns everything, right? Like your, uh, your, your professional career, your profession or your personal interests. This journey you've been on with us for the last couple of years. And also, I'm on a farm now. So every time I hear people are doing those things, I'm like, yo, yo, you're doing this chicken thing. Sick. I got chickens at my house, too. It's worth it. Right.

Did you grow up in that kind of environment, like like rural setting? Yeah, I grew up in rural Nebraska. So right along the Wyoming border, Scotts Bluff, Nebraska. And so that that area is a little bit more sand dunes and and manmade farming area where they have to do like the center prop irrigation, where you have to drill down to get into the aquifer to be able to bring the water up to even use it in those areas. So, I mean, that's what I'm used to as a rural environment. Moved out to West Virginia in the late 90s. And, you know, at first being a kid in this area, you know, you're like, I don't necessarily know if I want to be here. So, I'm like, I'm going to go to the big city. I'm going to move to Baltimore. You know, lived in Baltimore for a while. And I was like, I'm done with the big city. I want to, I want to go back to rural. So, you know, found myself up in Morgantown where West Virginia university is.

And, uh, and then I loved it there. I did all my medical school there, did my residency there. And then, uh, even towards the end of residency, I was like, you know what? Like even Morgantown starting to get too big, you know, Morgantown has, you know, the Morgantown proper is like 30,000 people. You had the 30,000 of the college there and all of a sudden you got 60,000 people and not that big of an area. I was like, I want to go down smaller. And I stumbled across Elkins, West Virginia, and it's got, you know, 6,000 people in it. And you can have an acreage and you can get out and in nature and there's everything around us. It's such an awesome place to be. Awesome, man. Awesome. Well, the outside of all of this very cool stuff, what we kind of wanted to have you on here to talk about is actually how do you go about finding, since you would be an excellent person to ask this question, finding a family doc that essentially if you moved to

Lewisburg, North Carolina, you would be my family doc. So how do I find you where I live? Somebody that understands the kind of the healthy life, the physical activity, the desire to never be on medications or living because of medications or needing medications for the quality of life that I want to be living. But how do I, how do I go find Dr. Garrett Butler in wherever town people are going to be listening to this? Like where, what is, what is some of the like qualifications or conversations people should be having to, to be able to actually locate someone that's going to be aligned with kind

of the values that we find important. I think some of the big stuff is actually whenever you get to a new area, sometimes you have to do some trial and error. Sometimes you just have to do a meet and greet because there's something to be said about having that actual interaction with another human being and going into it. So, I mean, you get into the rural areas like where I'm at, your choices are not always going to be a family doc. You know, you're sometimes going to be seeing a nurse practitioner, sometimes a physician assistant, sometimes a DO. Remember that there is a little bit of a difference between an MD and a DO, allopathic medicine versus osteopathic medicine. We all

have our different ways of practicing. But when you go to the area, you sit down and you have that conversation and you find out their approach pretty quickly when they start talking with you. Because, I mean, when I meet my patient for that new patient visit, it's like, hey, tell me about yourself. What do you got going on? What are your goals? What do you want to do? If I discover that your cholesterol is 500, am I doing something about that or are you wanting to chase this down another route? And I think that's going to be the biggest thing that I would say, unfortunately, I do hear from a number of my

patients after they sit down and talk with me, that's like, Hey, you're the first doctor that's actually tried to explain this to me and talk through this stuff with me and what you want to do. So sometimes when you get to that area, it's a matter of just finding that person that meshes with you. Now I'll tell you, even when I first came here, with my love of doing as many things as I possibly can, I became CrossFit Level 1 certified, and I was coaching the 4 and 5 a.m. class at my local CrossFit gym. Why not add a third part-time job on? Of all the random stuff I love to do, I've got that mindset in that I love physical movement and I love just health and wellness.

And especially when you start going back to the roots of CrossFit and how it all works, it's not just sickness and health. It's like sickness, wellness, and then that optimal performance and chasing down that bigger and better. And some people want to have that. Yeah, how long have you been doing CrossFit?

CrossFit, I probably started filming my first workouts to submit on YouTube back, man, 20 or 2009, 2009, 2010, somewhere in that range. You're super OG. That was before I opened my gym. That was like right when you opened up, right, Doug? Yeah, 2009. right when you opened up right doug yeah 2009 29 yeah i was i opened in 2010 i started in 06 um yeah i love those days yeah i could i i still totally buy into most of greg glassman talking yep maybe not the craziness but a lot of what came out of his mouth, maybe not, maybe not all of it, but I find, I find that I align with the core message of that still very well.

Most and most of it being like, I want to play a lot of sports in my life. The sport of CrossFit for the rest of your life probably isn't the best thing. But I, I, and then when you start to look at the nutrition part of that it it's almost hard to like argue with it yep i totally uh i almost wish that it's like it's like kind of like saying i want to go back to the frat party and then you go no i don't but there was a lot of cool stuff that happened yeah exactly it was fun at the time but like on like a healthier one like there's there's many parts of that that radically changed the way that i thought about just because i didn't i never had like a strength and conditioning coach so glassman would have been like the first person that ever actually like explained fitness in a way like i there was no

chance like my my business partner when i opened the gyms was like do you remember Bally's Fitness? He was a personal trainer there. And every time I would like go to the gym and watch him working and I'd be like, dude, this job sucks. Like this is how you train people. This is awful. This isn't even close to what we do. Like nobody here is strong. Nobody here is trying. This is awful. He'd be like, dude, this is the worst summer job ever. I'd rather do anything else. And we were like, there's no way you can be good at fitness for the rest of your life and like make it a career.

And then Greg Glassman was showing up doing it in dingy gyms. And I went, dude, maybe there's a chance. Maybe, maybe there's a way we can do this. And it worked somehow, but those, the, the, the beginning mantra of all of that stuff, I feel like I could do that first hour of the seminar, maybe still, but what is CrossFit? I think I could do, I could give you most of that talk still. I watched it so many times. Are you still coaching? No, no. With the job change and with the schedule that I was running, I had to drop out from doing that. Yeah. So when people are kind of like having a conversation, this is like one of the biggest turnoffs of going to a medical doctor is the immediate desire to talk about medication. How do you not have that conversation

or find somebody that is looking to have a healthier conversation than I think this pill will help you? Absolutely. I think if you're going to chase that route with any provider, looking for that certification of functional medicine will definitely help functional nutrition. Lifestyle medicine in general, because that's actually a new certification that

physicians and anybody else can get. It's going to be that lifestyle approach. You can get certified in lifestyle health. It it is chasing down, you know, the concept of it's not always going to be medicine. I will say that some of your newer physicians, I know that especially my generation going through medical school, we were definitely taught that people are on too many medicines and you're going to start dealing with this pattern that you're going to catch up on an older physician who started a medicine which had a side effect that then started another medicine that then had a side effect that then started another medicine. And you have this pathway of all these medicines that are linked back to just starting this one.

And there was never that conversation of, hey, do you exercise? Do you eat fruits and vegetables? Do you drink enough water? And that has to be the start. I think too often, you know, the people in my field anyways, I try not to do it myself, but, you know, sometimes you get a little bit jaded and you get a little bit of that piece of, they've already failed lifestyle. I have to jump to medicine. But you didn't have the conversation yet.

You got to have the conversation. You have to have that little bit of curiosity where you're like, what have you been doing for this? And it's like, oh, yeah, you know, I'm drinking the 24-pack of Mountain Dew every day while I'm driving my truck because I'm on the truck for 18 hours a day. It's like, well, yeah, that's probably why your A1C is 14%, which, you know, shit A1C. Like, how about we pull back on our Mountain Dew a little bit, consider diet for a little while? I know you need the caffeine. Let's try something different.

Who invented Mountain Dew? What a guy. Who poured all that stuff into one bottle and was like, you know what? Let's get everyone addicted to this and it's going to taste delicious. The most sugar, the most caffeine

and it's green. It looks like slime. They'll remember Nickel. It's like they'll remember Nickelodeon slime and they'll love it. Um, yo, so, uh, every time I, not every time, but very often on podcasts and strength, conditioning, health, fitness, like there's always like this, like this view, um, spoken about of, of doctors where doctors only get five or 10 minutes at most with, with, with the client. And so it's like, someone comes in,

they have a problem. They're basically asking for medication. Hey, I have this thing. Can you give me this medicine? And the doctor doesn't want to say no, or just tell us that you don't, you don't need that.

And like, then you have like a dissatisfied client and you don't have time to like really explain the whole thing. Cause you got five or 10 minutes. And so it's not, it's not like doctors are like these, these people that want to push medication on people. Like people have this expectation and the doctors, the person that's supposed to give it to

them and they're trying to have happy clients and so they're kind of caught in this in this ordeal where they're it's like expected that they're supposed to give the people the medication because that's what they came there for and so and there's not enough time to educate them and following up with them to make it to make sure they're eating the healthy food and doing the workouts and whatever it's just like not practical. It's not their job. They're not a nutritionist. They're not a personal trainer, et cetera. And so if they just tell, you know, farmer Bob, like, hey, instead of giving you blood pressure medication, why don't you go why don't you go on more walks and eat more, eat more broccoli? Well,

I mean, how well is that really going to work? I probably just give them the pill and then tell them also, hey, make sure you eat well and whatever, whatever, whatever. And so it's not like really just the doctor's fault specifically. It's it's people's expectation. It's like the environment, the system, so to speak. Like, how do you work through all of that and and make any changes that actually move the needle? Yeah, so it really the health care system right now is it's broken.

I mean, honestly, just the approach to healthcare, and especially for a lot of clinics, and that's why some clinics will run these five or 10-minute visits, is that it's about numbers. How many people can you push through in a standard workday to maximize the number of people that you touch? So the start is actually fighting for your time. And that's one thing that I do for all my patients. My shortest visit's 15 minutes. All of my new patients and all of my

annual wellness visits are all 30 minutes. And that way I have that chance to sit down and discuss everything that I can. And sometimes if I can't discuss it all, sometimes I do. I point them towards videos on YouTube and you have those conversations. But I don't deny it does turn into a, I'm only here for my blood pressure. My blood pressure is 190 over 100. Give me a pill for this and I'm going to go away and I'll see you back in six months. And you do, you have patients like that, but you still try to educate. And, you know, I think that's actually what pulled me into medicine because the one sort of oddball thing that I have in my own history is that I didn't just go straight into medicine. Like I studied math and physics in undergrad and I became

a high school teacher and I was teaching high school and I was like, this is not the place where I need to be. I need to be teaching something else. And then I stumbled into biology, stumbled my way into medical school. I'm like, yeah, shit. Yeah, this is awesome. This is this is the stuff right here because I can still educate. And that's part of my own practice is having those conversations. You know, even when I prescribe a medicine, it's like, hey, this is how this medicine works. This is what we need to be thinking about. And some people, it's you start that medicine. It's like, but we're going to make these lifestyle changes. And as we follow up, your blood pressure is going to get better. And then we're going to be talking about pulling off of this medicine. My diabetics, hey, we might have to start this medicine, but you stop eating like an asshole and you start eating some better stuff. We're going to get you better. Your A1C is going to get under much better control. And if you hit it the way you need to, we will see you down the road and we're going to start peeling all this stuff back. Because my goal for the long run is not having you on as many medicines as I can prescribe for you. It's the least amount of medicine to give you the best

quality of life. So you can live a long and fruitful life doing all the stuff you want to do. It seems like both sides are kind of together coming to that conclusion. Like everyone realizes that that medication has its place. And if you need it, then it's great that we have it. But you really, as you just said, you want to be on the minimum amount to to do the job and no more absolutely yes i feel like now are people now coming to you less likely than in the past to just say hey like please give me this medication i need it or are they coming in there saying i have this problem like what are all the things i could do i'll take medication if i need it but only if i

need it i actually have a really good mix i mean's a, you have some of the people that are really just the wham, bam, thank you, ma'am. They just want to be in and out. They don't even want to be at your office. Like they don't care that I give them 30 minutes, they'll take 10 and, and they're just out because they do just want a medicine, but I'm having more and more people that are asking the right type of questions. And it's also with me kind of stimulating them. Cause I mean, I'm even surprised like some of my favorite patients, I had one little lady that was, you know, she said, Oh, I'm falling a lot. And I'm having this. And is there a medicine to make me have more balance? And I was like, No, medicine doesn't make you have more balance, you need to exercise. And she's like, What kind of exercise should I be

doing? It's like, Well, you know, I really like almost all of my patients to be able to do a push up and a squat. Because if you fall fat, flat on your face, what's your first movement? I have to push myself up off the floor, get my legs underneath me, and stand up out of a squat. And she's like, I can't do a push-up. I can't do a squat. And I was like, lean against that wall for me and push yourself away from the wall. And she pushed herself away from the wall. And she's like, oh, I can do that. And I was like, that's a push-up. That's your starting point. You know, you're 90 years old and you can do that. And she goes, well, I definitely can't do a squat. I was like, did you sit down in that chair?

Yeah. Stand up out of that chair for me. She stood up out of a chair and was like, see, you're doing pushups and squats. And so it is a matter, and that's that education point of finding that little in to be like, hey, you know, we don't necessarily have to use a medicine for this. We actually can chase this down with lifestyle changes, exercise. She comes back to me now and she's like, hey, look at this. And she'll do 10 pushups for me on the countertop in the office.

And I'm like, sweet. And I'm like, are you doing any more movement? She goes, oh, yeah. Well, I do 30 minutes every day on my trampoline because I got one of those little bouncer trampolines in the living room. My balance is great now. And I'm walking every day. I don't do upstairs really well, but I do seven flights of stairs down. I ride the elevator to the top of my building and then I do another flight down. I'm like, awesome, man. That's

stellar. And you're like, you're in your nineties and you're doing this. And all I did was have to tell you that you can walk, you can do a pushup and you can do a squat. And some people are really receptive about it. Yeah. I'm curious, kind of, you know, and Doug was talking about the trends of the profession. And I think West Virginia is beautiful. Also, not always known as the healthiest state in the union. Yeah. Typically somewhere near gold medal ranking of most unhealthy. Hey, we're at the bottom of the poll right now. The, but when you talk to other doctors in the area, what is the like consensus on how to improve something that is kind of been on such a bad track for,

for a long time. I would imagine you were kind of at the, maybe at the forefront of this conversation in your profession. Yeah. It's, it's tough. Cause it's like, I, I bothered looking up the statistics before he even coming for this. Cause I figured you guys might question it, especially not having a ton of experience with West Virginia. We are technically as far as health of the nation, the worst state, I figured you guys might question it, especially not having a ton of experience with West Virginia.

We are technically, as far as health of the nation, the worst state. 75% of our population is either overweight or obese. Yeah. The flip side of that, of course, is, you know, like think about like our median household income. You know, median household income in the state is $55,000. For my region right here, it's $40,000. The poverty line for a family of four is like twenty nine thousand yeah like yeah the people here don't have a lot and i think that's part of the reason why so many people in these rural areas feel like they've been kind of left out of the mainstream you know we're not the city area we're out there and so it's really just

starting one person at a time you You just do that education point. And a lot of the older physicians are jaded. They are, I'm done with it. I can't fix this. I'm just going to prescribe my medicines and go on. But we do. We have younger, not only physicians, we have younger nurse practitioners, physicians assistants. We've got naturopaths starting to come into the state. We've got other peopleropaths starting to come into the state. We've got other people that are just starting to come here to try and help out. And honestly, it's one person at a time. It's like that starfish story, right?

The kid walking down the beach grabbing starfish and throwing them back into the ocean. Old man looks at him. You can't help them all. It's like, yeah, but I helped this one, right? And you just do it one at a time. And it's going to take forever. It's going to take a long time. i honestly had never even thought about it there was a um there was a show of a chef that came in i want to say it was to morgantown okay um and came into the elementary school system

and tried to rebuild the school lunch system yep and i don't know what the long-term effects of it were, but it also along the way in telling the story of this town showed how hard it is to overcome all of these habits and systemic problems that have just been cultivated for decades and decades. And even when somebody comes in to try to overhaul something that is extremely important, obviously like a daily healthy meal versus pizza and fries, which also that's what I ate many times when I was a kid at public school. Like that's just the way they are.

But that, I wanna say that I was probably somewhere around, you know, 19, 20, 21 years old, something like that. And had never really thought about the overall like implications of what the government, what the systems in place, how they are in a way stacked against the average person to be able to go in that you talk about, you talk about the, uh, the income side of it. If your family is making somewhere between 40 and $50,000 a year, you don't really have the energy to go look on the internet to find out where to do this healthy thing. You're you got way like the, the, the Maslow's hierarchy of needs has a different level of survival for you than the person that's going, let me hop on the internet

and go over to this rapid place. What do they got going on? And you are very reliant on the system to, to help at least get nudge you in the right direction. Have you seen any improvements in that? I would say even in the last, call it 20 years, which I want to say is when that show went up, when I first started to pay attention to some of these macro factors that take place. Yeah, I think that was actually Jamie Oliver. Yeah, nailed it. There you go. He was British or something, right? Yeah.

Yeah. He came over and he actually had like really good input. I'm not sure how that school system, I don't think it was Morgantown. I think it was another even smaller, like one of the Coalfield regions that just doesn't have a ton of resources. And I'm not sure how the school system is doing. I know the rest of the state, the school system is still struggling hard. I mean, just for that kind of like food for thought, quite literally pun intended, is that we have such food insecurity in the state of West Virginia that students at school, when you get to school, actually have a breakfast available because so many students don't have access to breakfast at home. They have lunch and there's a lot of schools that will actually give their students meals for dinner because there's no guarantee that these kids are actually going to go home to a meal on the table. And so when you don't have that access to food, you grab whatever you can. And it is it's gas station food. It's it's crap food. And you're not learning good, healthy habits because what are you getting from school to?

Yeah. You know, I and just even bringing it to where I am now, when you get out more into the rural areas, it's really it was like the coolest thing ever. I have 83 trees on my, on my property that there's no way I'm eating 10,000 plus fruits this summer. And I went into the church cause they run a food bank out of there. And I went, Hey, I got all this fruit. Is there a way that I can just give it to the food bank? Is that something that you guys obviously be interested, but it's like, it's going to be like a lot. Yeah.

And they literally looked at me as if like that Sunday, the guy showed up and I was like, settle down people. It's just some apples. Right. But you, the lady looked at me and she goes, she's like,

I give away food, but everything comes in a package and none of it's healthy. The fact that you would be able to drop off like eggs and fruits and vegetables would be the most enormous help to these people, just because that's the part that nobody ever gets finding these processed packaged things. And, um, you know, you, you may have seen like a, one of those, like that you put the books, like, it's like a little library or something uh you put the book in you take a book i can't remember what they're actually the little food pantries the little yeah yeah they have those at some of the restaurants and stuff here and i look in them and i go oh that's all

packaged edible but not healthy food so if you are and like in the facebook groups and stuff there's lots of people like hey where can i get a and it tears me apart because i it's not for a lack of trying but there is a lack of education and there's a lack of system to be able to help people and when i went there, I just thought I was trying to get rid of some food. And then you can see these people's faces light up and they're like, oh my gosh, actual nutrition is going to show up. That's incredible. It was, it was, it was very interesting. Sometimes I'm not used to this rural life yet. So like these things happen and I go, oh wow, like this is a new thing to me.

Absolutely. And I don't know, you know, there's a part of me that thinks like, like in a situation like yours, not that you need to be doing this, but going to your, the community you're building and having a place where you're not completely reliant on a main food system or what is like the United Food or whatever to show up and drop off the giant canned peaches. You actually have the trees. And you talk about kind of like the little things that you can do. I think that's a massive thing that seems probably like a little thing of like, oh, I just want these people to eat real food. But it's actually this little thing that has such a massive impact. It might just be for the people in that community.

But if those skills could be taught or if people had just seeds and seed banks to go to, like, I didn't even know our library had seeds that they gave out. Like, I learned all this stuff. And it's like, how do you take that little piece of good and actually expand that into a population or a neighborhood or an entire town that would actually radically transform the health versus it having to come from a doctor. You've got to teach it to the kids. I mean, to be honest, I mean,

the kids are our future anyways. And I mean, the fact that you're going to be raising your kids in a farm type environment and doing that labor and trying, just start one garden bed. I mean, that's all you have to do. Garden bed does not take up much space. You can get clay pots for your back porch. You don't even have to dig in the ground if you don't want to. And you can grow some of your own stuff. And that's the start is you just have to peak that interest in kids and show them that, hey, this is interesting. This is cool. And that's the start is you just have to peak that interest in kids and show them that, hey, this is interesting. This is cool. And then when this crop finishes, you're going to eat some of this food. You're going to save some of the seeds so you can be ready to grow next year

and teach them that process. And you have to peak the interest of kids. And I think so many kids now, it's just like you go to school, you sit in a desk, you listen to a teacher drone on about subjects that a lot of the kids aren't really super interested in. They play on their phones all the rest of the time or sit in front of the screen and they're not getting their hands dirty. They're not out there doing it. You really just got to, if you

can drill in right there, get them interested, that's going to flow through to everybody else because then the parents are going to learn about it. Hey, let's try canning. Let's try growing our own peaches. Let's try growing green beans and corn. Yeah. Are your kids kind of integrated into everything that you're doing?

My daughter is a very typical 12-year-old, almost 13-year-old. So she thinks you're a dork. Dads are digging in the dirt. Look at them. I'm definitely the nerd of the dirt. Look at him. I'm definitely the nerd of the household. We've learned that from a few of our clients. They're like, Dad's doing that health thing again. Yo, circling back to how to pick a primary care physician or just like a family doctor,

do you take any online clients? Do you take any online clients? Like, do you have any virtual clients? So we have an online platform. It's kind of hit or miss. It's difficult to do practicing out of state because the way medical licenses work, you have to have a medical license for every state that you practice in. And so if your patient is currently like, say, if you're living in North Carolina, you live in Virginia, you live over in Washington or California, if I have a license to practice in that state, I could take you as an online client. But without that, I only have a practice, a license to practice in West Virginia because they don't have like a universal license for all states. So we do have some online, but for my patient population in particular, I'm still in a region that we don't have cellular everywhere. I still have patients that don't have Wi-Fi. They don't have internet at the I still have patients that don't have Wi-Fi.

They don't have internet at the home. I've got a couple of homes that they're just starting to get electricity in the home. I got some homesteads. Now, I do offer a little bit different because I am classically trained as family medicine. And not only do I do clinic work and hospital work, but I also do home visits. And especially for patients that can't make it out of their own home. And that's kind of a niche market too, because a lot of the bigger areas, not rural areas necessarily, but the bigger areas have concierge medicine where you can actually have a retainer fee,

and you can have a doctor on call 24-7. And, you know, you have your two to four visits a year that come to your home, or some of them will have a brick and mortar that you can go and see them. Some of them do it all online. And, you know, there's something to be said about that online interaction, but there's also something to be said about that just human connection of actually shaking hands with somebody, giving a good listen to your heart and lungs,

and, hey, show me that mold that you're concerned about. Right. Yeah, let's dig into that a little bit more. I've done the online concierge medicine thing and really enjoyed many aspects of it. What do you see as the pros and cons to online versus in person? So the online, I think, is just the ease of use. And as long as you have access to internet and you have the technology to be able to do it,

I think online can be absolutely fantastic. I think there's a certain level of human interaction that is not, you can't cross that barrier of being on a Zoom call. It's, you know, when you guys meet in person and you guys are lifting together or you're moving together or you're doing something together, that togetherness of actually being in contact with another human being, there's nothing that will replace that. And I think if you're going to have a really solid relationship with your provider, doesn't matter what their training is from there. I think some of the best interactions are actually like, I even have it in part of my notes. I've got some of my little old ladies that therapeutic hug administered in office today. And it's like a little bit of depression, a little bit of the blues.

And you know what? They're happy every three months when they come in to see me. I administer a hug and I enjoy it too it makes me feel good it makes them feel fantastic they walk out with a smile like this is damn good day and all i had to do is give somebody a hug and you know that that's the thing that can't be done through the online avenue like i said it's easy to be online but that that human connection is just so powerful yeah fully agree you missed you missed the uh the physical aspect of it granted not everyone wants to be like physical yeah not everyone wants to hug but i actually do like i'm like super i would hug you buddy you're my doc that's how we'd start

every session yeah that's like that's my preference like it like with basically anybody like like when covid happened and you couldn't shake hands or hug or doing any of that, I was like, oh man, like it's gonna be hard for me to feel like I could make a new friend. If I, if I just walk into in someone's house and I kind of just like wave at them from across the room, like, like emotionally, I feel like we're not friends. I'm just like, hello over there. This person that I will never be friendly with. Absolutely. Yeah. The power of a handshake. I mean, when you, when you see somebody, you know, and just that power of like, Hey, how's it going in a good firm handshake. I mean, when you, when you see somebody, you know, and just that power of like, Hey, how's it going in a good firm handshake? I mean, that's, you can't replace that in that, that lack of human connection. That's the one thing COVID certainly hit us for that.

And that's something that we're still trying to crawl out of. Yeah. How much, uh, I would say in, in your kind of medical, I don't think I've actually talked to a medical doctor since COVID. I know I haven't personally been in or had a relationship with one that I would even ask. What has kind of been the impact, like not the Twitter impact where I'm like looking at a bunch of numbers and like anger and yelling, but like boots on the ground, like the difference between three years ago and today of the general health kind of like as as that year and a half to two years has like compounded an additional. I mean, we're like three, four years out of it now, four years out of it. What what has been your just kind of your thoughts around that?

I COVID basically has just become the new flu. Um, it's, you know, it's just one of those diseases that people are going to get seasonally. Um, there really is no season though. Cause I mean, I get COVID people in the summer. I get COVID people in the winter. You just get used to it. Um, in general, what I've seen is I've seen a lot more people with what we call long COVID. And so having

kind of that brain fog, having that fatigue, having that shortness of breath. And, you know, I coach as many people through it. It's like, dude, got to eat right. You got to exercise. Nothing's going to fix this. You got to fix this with time and energy. And even then, there still might be some residual things. The flip side that has certainly hit the health system is that like in the state of West Virginia, you know, we had such a difficult time staffing that we were hiring travel nurses to do everything. And then we started paying out so much in travel nurses that these hospitals just don't have the budget to be able to maintain it. And we had, I think it was like, it was either last year

or the year before last, we had a third of all of the nurses in West Virginia decide not to renew their nursing license. People just vacating medicine because the environment and, you know, it's it's you don't want to get too political with it. But, you know, that polarizing effect that can happen from covid, from politics, from everything else really caused it that, you know, we have to have signs in my hospital now that states this is a peaceful environment. Violent actions will not be tolerated because we've had families get violent with us and getting angry about, you know, oh yeah, your relative has COVID. Oh, COVID doesn't exist. I'm like, I'm sorry, buddy. It's here. It can't deny it. It's around. It's causing real disease. And there's this battle and it's been really, really weird. The medical community is just, we're not trusted.

And granted, did stuff happen during it that were not trustworthy? Absolutely. But we're trying to make amends with that, and we're trying to kind of recover from that. We're not even back to norm. We're not even back to 2019. Like, this is, we have a even back to norm we're not even back to 2019 like this is we have a long way to go yeah um i'd also and this is probably an entire show but as we're uh talking about this stuff what are your thoughts on all of the ozempics and wagovis and um

a i actually want to have you back on to just if you're cool talking about it for like an entire show about this because I couldn't be more confused. I feel like morally I would do anything to have people lose weight, even if sitting on the couch and like slowly starving themselves

or not digesting food or whatever it is. I don't care. Just like if you are unhealthily at a healthy body weight, you're still significantly healthier. No matter how you get there, 200 pounds is better than 300. Absolutely. Um, the long-term effects of it. Do we like, what, what are your thoughts on all this? It's tough. So, I mean, the, the class-1s, I mean, they're a fantastic class. They've actually been around a lot longer than this.

I mean, some of your first ones were your Bietas, your Bidurions, your Victozas, Truelicides, all those. But the company that makes those, Zempic, Semiglutide, they stumbled across an interesting sort of product. And I mean, to be honest, my patients that are on them, they work, man. And they work great. It doesn't work for everybody, though. That's kind of the interesting thing.

This is not a panacea. This thing doesn't fix everything and doesn't fix everyone. And then you get the new one, the new kid on the block, you know, the Terzepatide or Manjaro, also known as ZepBound. And that one's even better so far than, remember, Semaglutide is going to be your Ozempic and your Wagovi. And then you got your Terzepatide, which is your Manjaro and your ZepBound. And those are our two big ones. There's going to be another one even coming out on the market soon.

These things work great. But the thing that I've noticed with my patients so far is that they work great while you're on them and then I've had the patients that have stopped them because of side effects because of GI stuff you know it slows down your gut it slows down your energy you have this really odd weight loss pattern and you can kind of see it in the person's face that that's the thing that you notice is if you start looking for it and you start looking through pictures and look for GLP-1 face or look for like Wagovi face or ZepBound face, you'll see it. What it is, is you start losing some of the fat in the cheeks and some of the musculature of the, but what they'll have is they'll still have the muscles of mastication

and they're really prominent. And it's a very unique look. And once you see it, you can't unsee it. It's just around, they're there. And it's this very unique look. And once you see it, you can't unsee it. It's just around. They're there. And it's this abnormal weight loss where you're losing probably 50% fat, 50% muscle. And for a lot of these people, losing muscle is not a good thing because your metabolism is shot. You're not doing well if you're doing that. So I like them for what they're doing. Like you said, I'm getting,

my best patient in the clinic was over 500 pounds. He's now down close to 200. You know, he's lost almost 300 pounds. And I'm just like, holy shit, this is amazing. But is he going to have to be on it for the rest of his life? I mean, I think the cost of these things is like $1,000 a month. I mean, we'll make the whole healthcare system go broke. If you have half the country on, we'll go over year or, or is that bound? Yeah. Um, it, it isn't, it's a really interesting, uh, dynamic when obviously eating and training and making lifestyle decisions is the long-term path to being healthy. But yo, if there's a cheat code to getting healthier yeah maybe we should like really uh as it maybe as like the fitness industry

not demonize the shortcut um but use the shortcut and then teach good habits along the way it's a real i i like i, obviously we're, we're not, I'm not like on it. Nobody in my family is on it, but I, um, I could imagine if I, if they were, and there was like, or if, if my options are going on, um, semaglutide or type two diabetes, I think that's a very clear choice. Yeah. I don't think that I could, um, be like, no, actually just keep this thing going and let's, let's try and figure out how to eat more protein. Yeah. We can do that on the way down. If you can couple the two. Absolutely. I mean, I think that's, that's where medicine I does its best work, is when you truly couple a medical

approach with the lifestyle. We have to stop thinking about lifestyle as a separate thing. Lifestyle is medicine. And if we're truly chasing it down, lifestyle is the key to living a long, healthy life. Sure, some of us are going to need some medicine along the way, but we can thwart a lot of that. We can just kind of avoid that if we put enough energy into that lifestyle it's just for now you think about it think about you know think about the golds think about the valleys and that kind of stuff it's been around since like the 80s and 90s right yeah we're still getting a lot fatter because we have really poor eating habits we don't exercise enough we don't walk enough we don't lift heavy shit and it's like, yo, JFK was up there doing his, or RFK jr. Was doing his,

uh, his little talk in front of Congress the other day. I just wanted to be like in his ear, like put a little earpiece in there and go, dude, tell them they need to be meatheads. Yeah. Tell them they need to be meatheads.

All the movies. We're going to have awesome meatheads. Every commercial meatheads. We're going to have comedies on like Tuesday nights on ABC. And the dad's going to be a meathead and not some doughy soft dude getting dominated by everybody we need more meatheads in this world eat the meat eat the vegetables eat the fruits go lift the weights you just need more shows around meatheads that's gonna be i'm running for office next year call me hit me up in in west virginia i'll be there. More marketing for meatheads.

That's me. I'm ready. Garrett, this has been fantastic, man. Absolutely. I have thoroughly enjoyed having you with us for the last two and a half years. And just from a business owner, you know, you're taking a shot on this brand new company

that happened like three, three, three and a half years ago. And you've been with us over two and a half years now. We did. I'm positive we didn't get everything right at the beginning. We still tried to get better every day. But man, did we have a steep learning curve at the beginning of this that you stuck with us and trusted us with all this stuff? And just I love having you here, man. So you guys got an awesome team man yeah you guys have done fantastic work thank you i appreciate it um if people would

like to learn more what about your youtube channel uh the work you're doing all the things where is there a place that they can come find you yeah the biggest rolling stuff in your backyard well that that'll be my personal stuff i might put a few up there on that, but the big stuff right now is going to be the odd fellow manner. That is my biggest project. I'm on Instagram, on YouTube, and that's my life project. That's my second mountain. That's the thing I'm going to be chasing from now until the day I die. It's a great book right there. You just dropped in there. It is. There you go. Douglas E. Larson. Yeah, you bet. Garrett, good to see you, brother, and appreciate you being on the show.

You probably didn't know this, but when you first came in here two and a half years ago and we all heard of your crazy sleep schedule with bouncing back and forth between the two hospitals and doing the day shift and the night shift and the whole thing, our whole team, nobody was like, oh, fuck, what are we going to do for that guy? The whole team was like, this

is rad. This dude has the most insane schedule and we are going to crush this. Everyone was so excited to work with like such an extreme case. Cause we, we knew, we knew you could help you. We knew that like getting help, like with that degree of difficulty, it was going to be hard to find anywhere else. And it was like right in the sweet spot of what we could do. And we were all stoked to have you here. Yeah. I mean, you guys saved me with that kind of stuff, man. I mean, I saw my A1C starting to go up and everything and like you guys adjusted my diet, everything else. And it's like you guys saved me with that kind of stuff, man. I saw my A1C starting to go up and everything, and you guys adjusted my diet, everything else. I have always that underlying fear of, I'm going to get sick again. When I was 20, I had lymphoma. I battled cancer. I already went through that. I was like, shit, I don't stay on top of my health I'm not going to make it through I'm gonna get sick again and so you guys I mean you guys kept me on my game you had me eating right had me exercising and you know like hopefully I'm not too much of a pain in the ass for you guys but

you're the best man it's awesome you're bad dude uh again appreciate being on the show I'm on Instagram Douglas E Larson and I am Anders Varner at Anders Varner and we are barbell shrug to Barbell underscore shrug. And make sure you get over to RTA lab dot com. That is the signature program inside Rabbit Health Optimization. And you can go and find out more on all things lab lifestyle performance, testing analysis and performance over at RTA lab dot com. Friends, we'll see you guys next week.