The Dr. Hyman Show - Creating Health Outside Of The Doctor’s Office

Episode Date: May 28, 2021

Creating Health Outside Of The Doctor’s Office | This episode is brought to you by InsideTracker Even before the coronavirus pandemic, we were facing a loneliness crisis in America. And we know that loneliness is correlated with a range of negative health outcomes. While this information can feel a bit depressing and overwhelming, it also offers insight into how we can make essential shifts towards a healthier and happier society. Community-based healthcare offers amazing potential for creating long-lasting improvements to individual health and has the ability to revolutionize healthcare. In this mini-episode, Dr. Hyman speaks to Dr. Vivek Murthy about how loneliness is affecting us. He also speaks with Tawny Jones about why community-supported healthcare is so successful; they dive into the amazing benefits that a group approach can have when it comes to reversing disease.  Dr. Vivek Murthy is the current Surgeon General of the United States and also served as the 19th Surgeon General between 2014-2017. As the Vice Admiral of the US Public Health Service Commissioned Corps, he commanded a uniformed service of 6,600 public health officers globally. During his tenure, Dr. Murthy launched the TurnTheTide campaign, catalyzing a movement among health professionals to address the nation’s opioid crisis. He also issued the first Surgeon General’s Report on Alcohol, Drugs, and Health, calling for expanded access to prevention and treatment and for recognizing addiction as a chronic illness, not a character flaw.  In 2017, Dr. Murthy focused his attention on chronic stress and loneliness as prevalent problems that have profound implications for health, productivity, and happiness. His book Together: The Healing Power of Human Connection in a Sometimes Lonely World was published in April 2020. Tawny Jones is an accomplished Administrator at the Cleveland Clinic. For over 20 years, she has served as a well-respected leader, managing patient concentric care initiatives, creating value, and delivering results in quality improvement, efficient resource management, and health system optimization for various clinical departments.  Currently, Tawny leads clinical operations at the Cleveland Clinic Center for Functional Medicine where the goal is to establish the efficacy of functional medicine, demonstrate its cost-effectiveness, and its ability to improve health.  Her passion for the promotion of preventative health services and community-based interventions gave impetus to the development of several clinical programs. The Functioning for LifeTMshared medical program for chronic disease management is her brainchild and has proven to be a successful model for addressing lifestyle and behavior change. Tawny is also on the African Employee Resource Group Steering Committee and is committed to helping minorities achieve their career goals. This episode is brought to you by InsideTracker. If you’re curious about getting your own health program dialed-in to your unique needs, check out InsideTracker. Right now they’re offering Doctor’s Farmacy listeners 25% off at insidetracker.com/drhyman. Find Dr. Hyman’s full-length conversation with Dr. Vivek Murthy, “Why Loneliness Is A Public Health Issue” here: https://DrMarkHyman.lnk.to/VivekMurthy Find Dr. Hyman’s full-length conversation with Tawny Jones, “The Love Diet: Healing Through Community” here: https://DrMarkHyman.lnk.to/JamesMaskellTawnyJones

Coming up on this episode of The Doctor's Pharmacy. Patients walk in the door with an expectation, the doctor is going to cure me. He is going to heal my condition. And what we have done is shifted that thinking to say, actually, we're going to heal each other in this group setting, and we're all going to be part of the strategy

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let's get back to this week's episode of the doctor's pharmacy hi i'm kea one of the producers of the doctor's pharmacy podcast when we think about health we usually think about things like diet and exercise but having a sense of community trusting relationships and the feeling of belonging are vital elements of whole body health. Just before the coronavirus pandemic, Dr. Hyman sat down with Surgeon General Dr. Vivek Murthy to discuss the impact that chronic stress and loneliness are having on our individual and societal health. I'm just so glad you laser focused on this issue of loneliness because in the early part of my career, I focused on food

as a big driver of chronic disease. And still it's what I'm focusing on and functional medicine to take care of the individual. But I realized that I could not really get my patients better unless I deal with the social issues that they're facing. And I began to realize that there's another medicine that's just as powerful as food, and that's love and social connection. So I would say love is medicine, food is medicine. That's how we're going to help the world.

And you really lasered in on the love is medicine through looking through the lens of loneliness. And how did that all come about? When I was in medical school, and I suspect that you and many of us had the same experience, loneliness was not part of the curriculum. Nope. Emotional well-being was not a class. Loneliness 101, no. Yeah, this was not part of, for that matter, neither was nutrition. But what happened that really changed things for me is when I began my time in office, I began with a listening tour. Yeah. Traveled to all of these cities and towns all across America with the simple question, how can we help? And I tried to just sit back and listen to what people said. And what they said was fascinating because I did hear stories I

expected about addiction, about obesity, about depression and anxiety. What I didn't expect to hear that within those stories were these threads of loneliness. Like loneliness, like hunger or thirst is a signal that our body is sending us that we're lacking something that we need for survival and if we react quickly to that and fill the gap you know with social connection healthy social connection in our life then that feeling of loneliness goes away and we're and we're okay the problem though is when that state of threat which is effectively a physiological stress state persists for a long period of time like we know that stress is not good for us you know when

anyone but it's only in the case of it being there for a long period of time or an excessive amount it's adaptive in a small yeah small amounts can actually be quite good like before we give a big speech or take an exam or you know take on any big tasks or go out on a date that we're really excited about, we might feel some stress. And that might push us to perform better and to actually bring out the best in ourselves. But when we're chronically stressed, that actually is when our body starts to break down.

That's when we have elevated levels of cortisol and other stress hormones flowing in our body. We have increased levels of inflammation. And that over time damages tissues, blood vessels, and leads to higher rates of heart disease and other illnesses and so loneliness when it's chronic when it's long-standing puts us in a chronic stress state and it's from that that we see so many of the negative consequences but what we see overall is when you look at the data at the impact of loneliness on our health, what you find is that loneliness is associated with a reduction in our lifespan. And that mortality impact is similar

to the mortality impact of smoking 15 cigarettes a day. It's greater than the mortality impact of sedentary living and obesity. Wait, we gotta stop there for a minute. Because what you just said was remarkable. That loneliness is a bigger risk factor for a shortened lifespan than smoking, obesity, or lack of exercise. Well, it seems to be just-

That's like headline news. And what I kept coming back to again and again, guided both by the conversations I had with people around the country and the science that I was reading, was that our connection with each other is actually one of the most powerful and important resources that we have, not just for our health, but that affects our performance in the world, in school, in the workplace, that impacts whether we talk to each other or not in communities, and even has an impact on our politics. And that's why I wanted to work on this. And here's how it affects us. When we are connected to each other

our threat levels are lower our levels of stress are lower when we are lonely it increases our threat level and actually shifts our focus internally towards ourselves because if you're in a threat state you want to focus on yourself for your own your safety and survival um but it's hard to optimize our output it's hard to be the best person we can be and bring our full self to the task, if you will, if we're in a constant state of stress. And if we're so focused on ourselves that we're missing what's happening in the outside world. While this focus on loneliness can feel a bit depressing and overwhelming, particularly given the specific challenges brought about by the pandemic,

it is also instructive for designing an effective healthcare system that prioritizes group-based solutions. Dr. Hyman shared how he came to appreciate the power of community-based healthcare in this conversation with his colleague, Tawny Jones. Yet it's your social networks that are more powerful than your genetic networks in determining your healthcare and your health outcomes. That your zip code is a bigger determinant of your health than your genetic code. And so I began to think about this

and I had read this book called Turning the World Upside Down, which was written by the head of the National Health Service from the UK, Nigel Crisp. And essentially the book was, in order to solve our first world problems, we need to learn from the UK, Nigel Crisp. And essentially the book was, in order to solve our first world problems, we need to learn from the developing world about how to put people and communities

at the center of healthcare, not doctors and hospitals. And then this guy walks in my office, Rick Warren, who's the pastor of this big church in Southern California, and he's just like, well, I wanna get healthy. I'm like, great. He was really overweight. I said, how about we have dinner after? He's like, sure. So we had get healthy. I'm like, great. He was really overweight. I said, how about we have dinner after? He's like, sure.

So we had dinner and I'm asking about his church. I'm like, I'm a Jewish doctor from New York. I don't know anything about, you know, evangelical churches in Southern California. So what's going on? He says, well, we got 30,000 people. I'm like, oh, 30,000 people. He's like, we meet five every week in 5,000 small groups to help each other live better lives.

And I was like, oh, this isn't a mega church. It's thousands of mini churches. So we created this program called the Daniel Plan. I said, why don't we put in a faith-based wellness program? And he's like, great, because I was baptizing my church last week and after the 800th one, I'm like, we're fat. I'm all fat.

We better do something about this. So we created the Daniel Plan. We thought a few hundred people would show up. 15,000 people signed up. It was bigger than anything they'd had at the church, the 9-11 service, the Obama-McCain debates. They turned 2,000 people away. And after a year, people working together in small groups without even a health professional.

They literally just had each other with content and a curriculum and a little video. We created a year-long course. Initially, it was six weeks. They lost 15,000 pounds. They reversed all sorts of diseases. One guy came up to me and says, you know, I was in the hospital nine times and on 10 medications. Now I'm on one medication and I haven't been in the hospital all year. And I began to realize this is the solution for healthcare. It really led me to rethink how we need to take functional medicine and not just deliver it one-on-one in clinics,

which can be very expensive and very difficult. But for 80% of the problems, functional medicine delivered through groups can be a powerful model for transforming people's health. And I always say, you know, getting healthy is a team sport. We do better together and that we need to think about that as a future of healthcare. So Tawny Jones is my colleague here at the Cleveland Clinic. She's our administrator at the Center for Functional Medicine. And she heads up our center, which is not just about providing one-on-one care. It's about providing care in the community, about providing care in a different type of way. And she spearheaded the development of the Functioning for Life shared medical program for chronic disease. So how did you sort of get excited about this and how do these group visits work and why do patients benefit from it?

Yeah. So the Cleveland Clinic has actually been doing group visits since 1999. And today there's about 200 different shared medical appointments facilitated by about 100 practitioners. And so the idea of bringing groups together is not a foreign concept. We kind of jumped on the bandwagon as the industry shifted. However, doing it with a functional medicine approach, this multidisciplinary- Nobody does it like we do it. Absolutely not. We're the gold standard in shared medical- It's true. Everybody's been looking to us, how do you do this? How are you going to- Yeah. So we're going to set the bar a little bit higher for this type of initiative.

And what we have done is embedded, obviously, lifestyle and behavior change, the medical management component. But the most powerful piece of it is the medicine that happens in the room amongst the patients. The community is the community is the medicine. Medicine is medicine. Absolutely. So patients walk in the door with an expectation, the doctor is going to cure me. He is going to heal my condition. And what we have done is shifted that thinking to say, actually, we're going to heal each other in this group setting. And we're all going to be part of the strategy for getting ourselves better.

And they can not only do that here at the clinic, but they can adapt that same mindset in the communities they live in with their families, with their friends. So you're absolutely right. It's a unique way of thinking and a unique approach for us, but it's peer-based learning that is the strongest component of it. I think that patients who are in the room listening to each other's stories can now put their own issues into perspective. That's not something that you get in a one-on-one visit. They learn self-management skills. Again, physicians think when they give the patient a treatment plan that that's adequate training and knowledge for that patient to walk away with and implement those changes. It's not. It's been proven again and again that it's not. And so in that group setting, they absolutely can learn from each other. And they're also learning from those practitioners

who they otherwise, you know, wouldn't have asked those questions or wouldn't have considered certain aspects of what they're being asked to do to change their health. It's amazing how fast it is. You know, when you combine like the superpowers of functional medicine to create health, along with the superpowers of the group to actually motivate and get people engaged and change behavior, it's like a rocket ship for people's health. It's pretty amazing. Absolutely. So exactly what you're saying, the alchemy, the magic happens within that group setting. And they're so highly motivated

to support each other that they're truly advocating. And there's a healthy sense of peer pressure as well. Yeah, so true. I mean, we had a patient come in who was severely obese. I mean, her BMI was 43. Normal is less than 25 and over 30 is obese. She had type two diabetes on insulin. She had heart failure. She had high blood pressure. She had, you know, a whole host of things and medications. I was costing the healthcare system enormous amount of money. She was about 65 years old. And she had been eating junk food her whole life because that's what her family taught her. She was very educated. She was doing great things in the world, but just could not function anymore. And probably maybe only had a few months to maybe live.

She was on her way to a kidney transplant. Her kidneys were failing and they're on her way to a heart transplant. And she joined one of our groups because she couldn't get into the one-on-one visit because we had a typical waiting list and people think, Oh, it's less than, Oh, I'm going to go to the group cause I can't get into see the real doctor and real one-on-one visit. And it was extraordinary. When three days she got off her insulin and three months she got off almost all

our medications reversed, almost all our diseases by a year. She lost 116 pounds and had no more medications no more diabetes no more heart failure no more kidney failure no more liver failure she was doing this in a group she was so powerful in her willingness to make these changes with the group that she then began to send like 58 patients to us from everywhere because she saw how powerful this was and we had an extraordinary experience of seeing that happen. And so when you take even someone that sick, she wasn't getting one-on-one visits. I mean, she did a little checkup with the doctor in the group, but it was really minimal.

And it was just the power of learning about food and self-care and basics. When we join up with others who have the same values, struggles, and goals, some really amazing things can happen. And our health is actually more strongly influenced by our peers and social networks than our genetics. Yet many of us know how difficult it can be to break out of a rut of loneliness. It turns out that service is a powerful way to stimulate the reward center of our brains and promote feel-good chemicals. That means that devoting some time to helping others is actually beneficial to our own personal wellness goals. Another step we can take is committing just 10 to 15 minutes a day to talking to someone we love, whether it be over the phone or in person. When people come

together, they can create real lasting change. While it might seem intimidating to branch out of loneliness, it can do wonders for your health, attitude, and mindset. If you'd like to learn more about anything you heard today, I encourage you to check out Dr. Hyman's full-length conversations with Dr. Vivek Murthy and Tani Jones. If you enjoyed this episode, please consider sharing it with a friend and leaving us a review below. Thanks for tuning in. Hi, everyone. I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not

constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their Find a Practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.