My guest Dr. Rick Henriksen is a concierge medicine doctor with SteadyMD, my favorite online source of health care for our family. Dr. Rick is also Whole 30 founder Melissa Urban’s personal physician, which means he has an in-depth understanding of how diet affects health and a functional medicine approach to solving health problems.
Before coming to SteadyMD, Dr. Rick served on the faculty of the University of Utah’s School of Medicine. He also holds a master’s degree in Public Policy in the area of health. We’re going to dive deep into the state of health care today and why concierge medicine was the right way for him to move forward.
Episode Highlights With Dr. Rick Henriksen
- Why he left a successful practice to become a concierge medicine doctor with SteadyMD
- The approach he takes with families and new patients
- What you need to know about magnesium and vitamin D
- How billing practices affect the delivery of service
- Why compassion belongs in healthcare (and how Dr. Rick is bringing it back)
- The most frequent health complaints in Dr. Rick’s practice and what most of them have in common
- Two supplements almost everyone should take
- Root causes of stress and why it takes a deeper look to find them
- Simple and realistic strategies for getting better sleep
- How to get started with a concierge doctor
- And more!
Resources We Mention
More From Wellness Mama
- 174: How to Save Money and Get Better Healthcare With SteadyMD
- 284: Why Healthcare Sharing May Be the Future of Medicine With KNEW Health
- 270: You Don’t Need More Sleep, You Need Better Sleep With ChiliPad
- 224: How to Use Sound and Music to Optimize Focus and Sleep With Brain.fm
- Tips to Naturally Reduce Stress… Starting Now!
- Natural Ways to Get Better Sleep (Even If You’re a Mom!)
- Why Personalized Concierge Medicine Is the Future of Health
What questions do you have for Dr. Rick? Please let us know by dropping a comment below or leave us a review on iTunes to let us know. We value knowing what you think and this helps other moms find the podcast as well.
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Katie: Hello and welcome to the Wellness Mama Podcast. I’m Katie from wellnessmama.com and I’m here today with Dr. Rick Henrikson, who is a Board Certified Family Physician at SteadyMD and he treats, educates and counsels patients online using an integrative approach to health and wellness called concierges medicine. It’s what my family uses and we talk a little about that today. But we also talk about how he uses the principals of ancestral health, functional medicine and other modalities to improve long term health and whole body wellness in his patients and their families. He’s a Whole 30 certified Coach and the personal doctor to Whole 30 CEO, Melissa Hartwig-urban. Dr. Henrikson is currently accepting limited number of patients through SteadyMD and the link to find out more about that is in this podcast. But I think you will enjoy this pretty wide ranging podcast where we cover functional medicine for families, how to reduce stress in a practical and tangible way (and not just take a deep breath) and many other different topics that may be very relevant and tangible to your health. Dr. Rick, welcome and thanks for being here.
Dr. Rick: My pleasure. Thanks for having me.
Katie: I am excited to chat with you. As I mentioned in the intro, you are a concierge medicine doctor with SteadyMD and you are also Melissa Urban’s personal physician, which means that you have an understanding of Whole30 and functional medicine and are a great resource for families. I would love to start off by hearing your story. How did you get to this point? Because I feel like while I am a huge fan and use concierge medicine, it’s not a super common thing right now so I’m always love to hear the journey that got someone there.
Dr. Rick: Yeah, that’s a great question to start with. And it almost comes into two different things because there’s one like, “How did I get into functional medicine “and then “How did I decide to go into more of a membership base or concierge type medicine.” So they dovetail a little bit and they go together, but at the same time they’re a little bit separate. So I’ll start with the, “How did I get into concierge medicine or this membership-based practice?” So that actually starts in my previous job, I was on faculty at the University of Utah in their School of Medicine. I taught medical students and residents. And I actually have a background in Health Policy. I have a master’s degree in Public Policy. And so part of my main focus of my teaching was teaching Health Policy.
And I was teaching students, I was teaching residents on all about these new ways to pay for healthcare, different payment models. And it was always this theoretical process of, in the future maybe we could change and we can have these different ways of doing which are much better. And then finally I just got fed up and I was tired of doing a model and being in a model that wasn’t making me happy, that wasn’t making my patients happy, that wasn’t helping out anybody. I was like, “We’ve got to change.” So that’s when I decided to like take the leap, leave my very nice, very comfortable life and decided to open up my own practice and joined SteadyMD and to get into more of this concierge, very patient-centered focus that also is great for physicians. So that’s really kind of a nutshell. That’s how I went from a very traditional academic practice that I never wanted to leave to being unhappy, super stressed to then joining this new wave of physicians.
Katie: Yeah. And from the patient side I’ll say it’s been amazing for me as well. For anyone who’s not familiar with the concept, basically, you could probably explain it better than I could, but a doctor’s allowed to have many, a lot fewer patients and to give them a lot more one-on-one attention and it’s basically through concierge medicine, because you have doctors that you’re paired with that you can reach out to when you need them, you don’t have to go into an office visit. For me, it’s actually been financially really beneficial as well. I end up paying less, especially with the family. But can you speak to that from the doctor’s side of just how that reduces your patient load and let you give more attention to each of your patients?
Dr. Rick: Yeah, absolutely. So in the traditional insurance or fee-for-service model, a patient when they go see the doctor, they pay a certain flat fee or the insurance pays it for them. And so the doctors then… They don’t get paid outside of that. They don’t get paid generally for doing emails or for phone calls. And it’s only when a patient comes into your office that you get paid. And so the incentive for the doctor’s like, “Oh, I got to get patients to come in.” So the more patients you get in, the shorter your visits are, the more the doctor can then make a living. And so, really does not serve the patient well at all because then you have 5, 10-minute visits. You don’t still have time to go on any root cause analysis. And so on the opposite side of that is this memberships, almost like thinking of a gym membership for your doctor. You paid this multi membership fee, you go in or you have access to your doctor as needed, right?
And so it changes the nature of that relationship instead of having… When I was in a full practice or family doctors that are in the traditional model, we’ll have anywhere from 1,600 patients to 2,400 patients, so large number. When you reduce that down to doing a more of a membership base or concierge-based practice, you can have 400 to 600 patients. So you have fewer numbers of patients that you’re helping them on a deeper level because they have access to you outside of the visit. Oftentimes, you know, my patients, like you said, they can text me through the app. Take care of things that aren’t necessarily actually in the visit because when I get paid it’s based on that monthly amount number of patients I have. And so my goal is to make and help my patients to be healthy and happy long term so they stay my patients, so that I can get a set amount and a salary’s month. But also, I don’t necessarily just have to have a visit in order to get paid. So changes the way that I deliver care. I reach out, I do things that a doctor in a different system wouldn’t necessarily do and we can be more proactive and I can send messages, I can call my patients on their birthdays, things that like that I can do that would normally not get paid for. But because I am getting paid on a monthly salary more so it allows me to really dig in and to help families and patients out more on individual level.
Katie: Yeah, absolutely. It makes so much sense and it’s been amazing for us with eight of us in my family, whenever there’s something with the kids, I can text or video chat and it’s just so much quicker process and the doctor already knows our medical history. So there it just saves so much time. It saves the office visit and it saves money and, like you said, you check in with your patients. I think that’s the other beauty of it is because there’s no time constraints, you’re able to just have a lot more time and more focus with your patients. And I know that you also take more of a holistic functional medicine type approach with your patients. So I love, especially for families to hear a little bit about your approach. When you on board a new patient or a new family, what are some of the things that you look at specifically if they’re wanting just to improve health in general? Maybe they don’t have a specific health concern. What are some of the markers that you consider important to look at?
Dr. Rick: Yeah, sure. So when we’re looking at families, first off, I look at my own family and see what’s real life. And so I think that’s where my friends and families or friends in my family are doing the same things that my patients are. And so I have that frame to be able to say, “Okay, what is going on there?” And then also know as a physician, I know my patients really well and their families really well. So in that first visit, I really make sure I get to know their backgrounds. “So what is it that is making them or their life? How are they ticking? What’s going on?” And so in my first visit I spend so much time on sleep, stress management, nutrition, exercise, other fitness components. My patients always want to jump in. They’re like, “I have this problem,” they make a list. And they have like a thousand problems. I’m like, “Wait, wait, wait, hold on. Let’s go into the foundation first and make sure that I understand where you’re coming from. Because when you have Hashimoto’s or when you have a gluten intolerance or something’s going on, if I don’t have that other foundational piece, if I don’t understand that, then we’re missing out.” And so I always start there because I think for a lot of folks that are looking for solutions, sometimes easiest solutions are the ones that we all know, right? And so my patients know they need to be sleeping more, they know a lot of these things. Sometimes they’re just not implemented very well. And so making sure we’re staying focused on those before we jump into the more intricate detailed root cause of why they have Hashimoto’s or what is it about their chronic fatigue.
And so, that’s a step one that I would say. And then step two is then giving my patients the license for self-compassion. I think a lot of my patients and families come in and moms and dads are super stressed, and their kids are sick, or they’re sick, and they have so much stress and anxiety and they feel like failures. So number two, always self-compassion for making sure that my patients know, “This isn’t your fault. It’s not because you’re a bad person that you’re unhealthy. It’s not because of these issues, but this is just the way that life took you. And whether that’s an internal cosmos or whatever it is, or genetics or… This is where you are now. And having compassion for what you’ve been through, I think is also, for me, is step number two in that process.”
Katie: Yeah, absolutely. That’s such an important step.
Dr. Rick: Yeah, so then after that, step three then is really looking, “Okay, so then what do we do?” And then it’s looking at, “Do we need to get some more advanced testing?” Obviously, I look at what’s happened in the past. What’s testing has been done. And a lot of my patients that come in, they have 10 or 15 different pages of labs that they’ve done in the last few years. And so a lot of times they don’t actually need any more testing, but some patients do need to start there and we need to look at that. But sometimes they just need another set of eyes. If somebody’s looking at the data, maybe they’ve had that ordered on their own, which happens a lot. Or they ordered it with a provider that wasn’t necessarily super keen on understanding how those results work.
And so taking time to be able to look into some of those results and then really coming up with a plan, then for that patient to then undertake. So whether that’s changing lifestyle issues like nutrition, sleep, etc. Or doing some herbal treatments or doing some other type of medical treatment and then waiting for the patient to do it. I think that the next step four is being patient. And that’s what’s really hard I think for patients and families is that, we have a plan in place, we’ve got to give it a shot and changes in our body don’t happen overnight. So we’re talking four, six weeks at least to give something an option. And then after that time, we regroup. And this is where I love the model of concierge through SteadyMD, is that I love having that ability to then regroup.
So, and whether that’s through a text message or short time, but we can regroup easily, we can have that model. I already know what’s going on and we see like, “Is this working? Is our treatment happening? Do we need to be more patient? Or do we need to make changes?” And that’s the flow that you would see in a general structure with our patients at SteadyMD is assessing, coming up with a plan, having patients reassessing. And that side going through those cycles over the course of a year or so can really make some long-term changes.
Katie: For sure. And I think that’s an important thing to keep in mind as well is that. Like you said, these are long-term changes. I know that’s been my experience having Hashimoto’s and working through that over the last about eight years is, change is absolutely possible, but it’s not possible overnight. And I think that’s true with almost any health conditions. Certainly, someone has celiac disease and they remove gluten, they might notice a difference very quickly, but you’re not going to resolve any health condition overnight. So I’m curious with your patients and now being able to have this deeper relationship with them. What are some of the more common things, the more common issues that you’re seeing in the families and patients you work with?
Dr. Rick: Yeah. So number one would be gut issues for me. So I have a large number of patients that come in specifically for it. They have gut issues or it’s something that’s underlying that they didn’t necessarily think about, so easily that’s the number one thing that people are doing with us. The things that I think are a lot of people think are common are having loose stools and constipation that are super common. So a lot of times my patients will come in and they think that that’s normal. And then I’m like, “No, that’s not normal to have. It’s not normal to have diarrhea a few times a day. We’ve got see what’s going on under the hood and see if we can fix that.” So that’s number one is looking at gut health and making sure that’s tuned up.
And then other latent autoimmune diseases I think is something that’s also come up quite a bit for me in the patients that I work with, whether that’s Hashimoto’s, or Eczema or even Asthma, those things that express more often and are becoming bigger issues. Fatigue, not sleeping enough, insomnia, and migraine headaches. Those are all other ones that are hot topics that I deal with a lot and they’re all really revolving around very similar problems. And so when I’m looking at a patient, it’s really trying to look at all of their issues, boiling down to what are the things, maybe go into the background of all of those and then taking some steps to direct target each treatment. But oftentimes, it’s one treatment can hit in multiple different outcomes as well.
Katie: Gotcha. So when you onboard a new patient or a new family, are there any general guidelines that you start with that seem to be applicable to everyone or is it very individualized? In other words, are there dietary approaches that in general work for most people that you start with, or lifestyle factors or is it just you go completely case by case?
Dr. Rick: Yes, I think this is an interesting, I think… Yeah, there are definitely some general principles. It’s interesting because the patients that are coming to me oftentimes are already doing those general principles and so folks limiting our processed carbohydrates is obviously one of the best things we can do. Cutting out sugar out of our lives, sleeping more. Those are fundamentals that a lot of the patients that I see are already doing and a lot of your listeners I’m sure are already working on. So making sure those are intact and in place, those fundamentals, are the key. But you’re right, the nutritional changes, making sure that I don’t eat sugar, having a healthier relationship with food. So that’s also a big component too as this very much yoyo or a lot of anxiety, stress and low self-esteem relating to food.
That’s another one that at the beginning of conversations is very apparent. So yeah, making sure we work on those. But then specifics, most of my patients have low vitamin D, so I’m always starting vitamin D or testing vitamin D on almost all of my patients. It’s something universal. Very rarely do I see someone that has an optimal vitamin D level. I think often most of my patients are also very low on magnesium. So if I was going to give a blanket, this is something I always do with every patient is making sure they’re getting enough magnesium and making sure that their vitamin D is in check. Because I think those are also trying to create a foundation to make in other changes ubiquitously.
Katie: I absolutely agree. Those were definitely huge keys for me. I found out I had very low vitamin D toward the early part of my journey. Now it’s something I make a point to get moderate sun exposure and also have to eat vitamin D containing foods and to watch my levels pretty carefully. Let’s talk about magnesium because I’ve written about it a few times. I know from my own experience how big of a difference it makes, but I feel like a lot of people still maybe are not as familiar with it. So can you explain why magnesium is so important to the body?
Dr. Rick: Yeah. So I mean there’s a lot of it we don’t know, but a lot of it we do and magnesium is important in the regulation and how we use also and how we use calcium and vitamin D and they’re all intertwined. It’s this really great electrolyte, it’s this mineral that we get in our foods. Unfortunately, most of the foods we’re eating these days are low in magnesium. And so what’s happening is that these processes are starting just to break down and we don’t have the right ions and the levels that we need. And without going into too many specifics, magnesium is going to help you sleep better. It’s going to make sure that your bowels are regulated, that your gut is healing.
So all of these different processes rely on a stable amount of magnesium. And unfortunately, what happens is we’ll have providers or even my patient says, “Oh, can we check my magnesium level?” And we check their serum magnesium or even a red blood cell magnesium and you say, “Oh, looks like it’s good.” And unfortunately, those tests are really not super accurate for what’s going on in the whole body. Most of your magnesium is in the cells. And while red blood cell magnesium is a little bit better test than that it’s still not great. Your body tightly regulates how much magnesium is in the plasma serum of your blood. And so if you have a normal level there, what it means is like your body is regulating it and it’s pulling it out of the cells. And so it’s not able to do what needs to do inside of the cells either. And there’s all kinds of other processes and pathways that use magnesium also within the cell. So I think that’s one of the things that is helpful is that, I start some magnesium on folks and they tend to start sleeping better, their mental health improves, and a few other things that I can find usually help out with that.
Katie: Yeah, I noticed the sleep improvement for sure. And I know I’ve had friends who noticed improvements with anxiety and depression, mental health stuff. They saw a big change from magnesium. Is there a particular form that you prefer in supplements? And also, can you give us a primer of just some foods to watch out for that have magnesium in them that are good to consume?
Dr. Rick: Yeah. So as far as there’s several different types of magnesium, is another thing, is they’re always coming up with different formulations of it. And it really depends honestly on what’s going on for the patients. So if I have patients that have a lot of constipation, then honestly giving one of the like more Chloroforms of magnesium that are cheaper older forms like Magnesium Citrate, for example, can actually do better to help loosen the stool. So it really is somewhat dependent. But if you’re someone that has more diarrhea or you have loose stools and you want to start magnesium, then you definitely need to use something like magnesium glycinate, like a chelated magnesium. And the reason for that is that it’s going to reduce the amount of loose stools from that magnesium. It’s just more absorbable as the magnesium. If it doesn’t get absorbed through your gut lining, then it goes into your large intestine and it actually pulls water and causes osmotic loosening of stools and can cause diarrhea. I mean, it’s one of the things that we use when people are getting clean outs for colonoscopies, for example. So it kind of depends on that a little bit. Now as far as foods, honestly, while we like to say, “I think this is where you’re eating your greens and your vegetables and making sure you’re getting an adequate amount of those, is going to be really, really important because most magnesium we’re getting from there.” And so that’s why when I have patients that aren’t doing low carb or Keto or something, that they’re just not getting as many of those nutrients.
But honestly, even with folks that are eating a well-balanced diet, they can still be low in magnesium because of poor food quality. Right? The food or the way it’s grown, we just aren’t getting as much magnesium into our diets as we have previously. So unless you can carefully control the type of garden you have and you’re eating all your food from there and you’re tightly managing that is probably pretty hard to get to optimal levels without some type of supplementation, to be honest.
Katie: Yeah, that is my personal experience as well. And from what I read, you flush out any extra magnesium you don’t need in most cases unless you’re just taking massive, massive doses. So it’s one of those things that I always viewed as a little bit an insurance policy, especially when you read the things that can deplete magnesium levels in the body, at least in my research where things like caffeine consumption, and stress, and not sleeping enough. Like so many things that just go with modern life. It seems like a great… Just an insurance policy to have. And…
Dr. Rick: I was going to say the insurance policy, totally. And I think this is where I don’t want my patients to feel guilty, right? If they’re like, “I’m eating organic and I’m doing my best and I’m still having these problems, so I’m a failure.” And I’m like, “No, you’re not a failure. The environment has set you up to fail. It’s not your fault.” And this is one of those areas where I’m like, “Have some compassion for yourself. You didn’t fail because your magnesium is not enough and you have to take a supplement. It’s not because you didn’t do good enough buying the organic vegetables.” So I just wanted to say that up front.
Katie: That’s a good point. And I think a really good perspective and something I have to keep in mind as well because I often hear people say things like, “Why do we have to do all this supplementation and all these lifestyle interventions and be so careful with diet? Our grandparents just ate whatever they wanted and they were fine.” And I will come back to that. It’s like we’re dealing with a lot more, our bodies face a lot more in the modern world and even just a couple of generations ago. So we do have to be a little bit more proactive, but that also means we have to give ourselves some grace because we’re facing more than previous generations have faced and that’s especially true. I know a topic that you’ve talked about some before is stress, and I’d love to go a little deep on this because I’ve talked to so many people who they’ve got their diet dialed in and maybe they haven’t done a Whole30, they’re cognizant of what they’re eating. They’ve got lifestyle factors dialed in and stress is still the nemesis and I know it’s something so many of us face in the modern world. It goes hand in hand with the modern lifestyle. I’d love to hear your approach to stress because I’ve also…I’ve heard it and I felt in my own life, you can have everything else dialed in and if you’re not dealing with the mental and emotional aspects of stress, you’re still potentially going to run into some roadblocks.
Dr. Rick: Yeah, I mean, I think stress is one that’s so hard because everyone’s dealing with it. None of us really has the best answer for it. And I think fundamentally, it comes down to a few things. Number one, if you’re not living to your values or what you value in life, you’re going to be very stressed. So if you are in a job or workplace or relationship or something that or you’re acting in a way that you know is contrary to your personal values, it’s going to cause a lot of stress. And so I see this with a lot with folks that are in jobs that they just don’t like or jobs that are causing… They’re in a field that maybe they don’t value, that’s going to cause a lot of internal stress that you don’t really recognize.
So making those life decisions. And this is where I think for me, I was working in a system that was promoting these short visits, patients in and out. And I don’t know, it was hard for me to have a very clear, mindful understanding of what was happening. But each day I was getting frustrated. And I would get mad at my patients or I get mad at my medical assistants like, “Why aren’t they doing what I say?” And then I’ll get mad at myself and then I get stressed out that I’m like, “Oh terrible doctor.” Because I’m not helping people. And it really fundamentally came down to I wasn’t living in a system, I wasn’t living my values that I held most dear. And so that was fundamentally causing me to have this internal strife which then presented in anger and presented in blame for other people.
And so I think while I’m still stressful now and I have stressful things going on, right now, at least in my job, for example, I’m living the values, I am taking care of patients in the way that I like to take care of patients. I’m working on fundamentals. I have enough time to take care of my lifestyle. While I have stress and other things because related to that, running my own business and paying bills, right, is a little more difficult now. At least in this one area, I feel my values are aligned now with my behavior, my behavior is aligned with my values. And so that’s one thing to look at. If you are feeling a lot of stress, try and take a big look.
And that’s scary and this is very hard and this is where a life coach or a really good friend or a therapist is going to be very helpful for you is looking at what is going on in your core identity and making sure you’re living that. And then giving yourself a break. So if you are in a job that it’s not aligned with core values, but you have to be in there. And I think maybe even just understanding that, being cognizant and mindful of like, “I’m living in this job or I have to do this job to pay my bills now.” How can you work that into your system? How can you still appreciate that job that you have?” So this is where that mindful or that psychology component comes in and saying, “I know I’m here. I have to love and appreciate that I’m here and I’ll be a different place later, but I have to be happy where I am now.”
A lot of stress comes from families that have babies that are not sleeping through the night, right? That is a very stressful time and moms are stressed, dads are stressed, and the baby’s not sleeping and they’re feeling bad and they’re feeling like it’s my fault that the baby’s not sleeping and then they have to wake up, but then I have to get to work, right? This is a terrible time in your life, but at the same time, learning to appreciate this time and being mindful. This is a time where my baby, this thing that I brought into the world, needs me and I get to be there for them and loving and supporting that time that you have because that will pass.
And then trying to just change that mental attitude of this is something that I can use for a positive way, even though I’m not sleeping and I know I should be. But you can, you can kind of reframe a little bit of that life circumstance to help you out in that stressful situation. So those are two grand and very big topics that take years of practice and years of mindfulness training and meditation and work. But I think those are fundamentally going to be your best ways of dealing with long-term stress.
Now the more acute short-term things are like get more sleep. So I just used a bad example of the parents that couldn’t sleep, but if you’re not in that example, get more sleep. I have patients always ask me, “I’m sleeping X amount of time, how much should I be sleeping? ” And almost invariably, it’s X plus one. So whatever you’re doing, sleep an extra hour unless there’s obviously chronic fatigue and you’re sleeping 10 hours and that’s a different story. But so fundamentally getting a little bit extra sleep is going to be really, really important for that stress management. So anyway, I would probably start there. There’s a lot of other things that go into it, but reframing the experience, making sure your values are aligned. So making sure your behaviors are aligned with your values and then getting enough sleep. Doing those core fundamentals are really going to make a great impact on stress and happiness.
Katie: Yeah, I think sleep, you’re right, cannot be underestimated. And I’m curious if you have any specific tips to help with that. Because I know a lot of people struggle with sleep. It’s not something that I personally struggle with. Just making sure I have enough time for it. But my husband for instance, doesn’t get very much deep sleep. So he has trouble getting enough deep sleep every night, even if he sleeps enough hours. I know other people will have trouble falling asleep or some people will wake up every morning at 3 or 4 in the morning. Are there any things that you found that are helpful for people who are struggling with sleep?
Dr. Rick: Yeah. So I think that obviously is individualized too because there are a lot of different disturbed sleeping patterns. So if someone’s waking up really early in the morning, we have to look at that and say, “What’s happening in the evening or the days before or by habits?” And so right, it’s going to be individualized. And that’s why working with a doctor who is familiar with the different sleep patterns and working with a functional doctor or someone that can get to know you really well is really important. Is that you can go through that process now, go into your regular family doctor like, “I can’t sleep.” And they give you a pill, clearly that’s not the right answer. So first off, step number one is, find somebody really good to help you.
Number two is probably assessment and figuring out really what is happening. So keeping track on paper, buying one of those expensive devices can help not, they don’t always help. Sometimes they make things worse because there’re other things that are going on with your brain when you’re wearing a device. So taking an assessment of, “When are you going to sleep? And if you went to sleep at midnight, what is it that made you go to sleep at midnight instead of 11:30?” So reassessing your behavior before bed and maybe it wasn’t what happened at 11, maybe it was happened at dinner and why didn’t you start dinner at 7 because this happened. So re-evaluating what are the step by step process that really made you want to stay up later than you wanted to?
So in your case, it sounds like you can fall asleep easily. You just don’t necessarily make the time for it. So you’re a very different customer than someone that is in bed at 9 but can’t fall asleep until midnight. Right? So approaching those differently is going to be really important as well. So some quick things that can help out with sleep. So number one, I actually find doing some type of meditative practice to fall asleep can be really helpful. Before you fall asleep or after you fall asleep, some type of mindfulness or meditative practice to help your brain relax and ease that anxiety. Your brain is doing its job. It wants you to not forget things. So whenever you have things pop up into your mind before you go into bed, that anxiety thought. It’s your brain, it’s doing its job.
It’s trying to help you not forget things to do in the morning because you know that you feel guilt or you feel bad when you don’t do the thing you’re supposed to do. And so your brain is trying to remind you, remember that it’s just doing it at the wrong and inappropriate time. So giving your brain and your mind and your soul a time to reflect and remember those things it has to do tomorrow. Give it a set amount of time, say, 10, 15 minutes before you go to bed, review your day, review the next day. Give your time, give your mind time to say, “This is what I’m going to do.” And then at that point, hopefully with training and you can then relax and go to bed and you don’t continue to think about those issues.
So that’s one thing to do that can potentially help. There’s another really great thing and that’s… A lot of folks have found or they built habits of watching TV before bed or listening to the radio till they fall asleep. And this can be something that I think is a stop gap is, it’s not necessarily that you want to be having that device on or you don’t want to be watching TV, but what’s happening is your brain, you’re distracting your brain from the things that it’s thinking about. And so then you’re able to relax and you’re thinking about something mindless and that helps you fall asleep. So reading a book, right? Or reading like a scientific paper that’s really difficult are other things that people have suggested.
There’s also this really great app that I’ve been recommending to my patients. It’s called Sleep With Me. And it’s a great app. It actually is this guy that does a podcast. And he just basically talks about weird, unimportant things in a weird voice for an hour. And most of the time my patients fall asleep in 15 minutes because what’s happening is it’s giving your brain something to halfway focus on and help you drift to sleep, to give your brain some relaxing time. So now it’s not always the best thing to have devices around your bed when you’re sleeping and your phone, but sometimes this can be a band-aid until you’re able to figure out how to be more mindful before sleep. So a mindfulness practice before sleep is going to be critical.
And then also, there are other things like magnesium we’ve talked about can be helpful. Figuring out if you have some type of melatonin, cortisol disruption, if you’re not getting the surges in the appropriate places. Some melatonin could be helpful again for a stop gap. Valerian root is also something that I have found to help sleep quality in some folks that can also help out with some anxiety. So there are a lot of different supplements and herbs and things that we can try to help out with sleep. And I think this is one of those things too where we have to continue to reevaluate. Oftentimes we’re too quick to change something. I tried melatonin for two nights, it didn’t help and then you write it off forever. But I think giving things a little bit more time to see if they help out can be helpful as well.
Katie: Yeah, you’re right. I think it is like anything in health, it’s trying and finding the things that work for us individually. For instance, I found when I was doing a lot of intermittent fasting, when I pushed my window way too far in the afternoon and didn’t eat till 2 in the afternoon, it was like my body wasn’t getting the food signals that I needed for circadian rhythm and I was having trouble falling asleep. And so as soon as I adjusted that window earlier, I was fine. I think that’s something that may be different for a lot of people and it’s finding those things, like you said, in figuring out what’s going to work for you.
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Katie: Another thing I’m getting a lot of questions right now from listeners and readers about, and I’d love your take on is different versions of the Keto Diet. And I’d love to hear how you feel this fits in, in general to a healthy eating approach to a functional medicine approach. On a personal level for me, I found that I’m not able to eat that high fat, especially saturated fat just with a couple of genes that I have. I really don’t do well with that much saturated fat. But I have heard from people who anecdotally seem to do great on it. I’m curious what your take is.
Dr. Rick: Yeah, so I think like anything it’s a tool and I think we use a tool for the appropriate job. I think what happens is that we have folks that have found that this tool works for them, right? The hammer is hitting the nail in, they get faced with a screw or the other person is a screw and they’re trying to hammer and the Keto’s isn’t working. And so we keep trying it right? Or our lives change. And so oftentimes Keto is going to be very effective for a lot of people. So what happens, we come into Keto from a variety of areas, but a lot of people have been super high carb. They have terribly high insulin resistance. Their body is not adjusting well to then trying to sleep or trying to, putting on a lot of weight.
Your body, your hormones are out of whack because all these issues and so you start someone on a Keto Diet and in your… This you’re using it as a tool to then train their body to decrease the amount of insulin that is required. So then insulin resistance can come down to changing the way that you’re digesting and using the carbohydrates, you are increasing your enzymes that are going to be helping you break down that fat and then training your body to use that fat as a fuel. So Keto Diet has been extremely helpful in those folks, they come in and lowering the carbohydrate level. Now whether they need to go full Keto or not, I think this is something that can be hotly debated and some folks will be at the center of the fence.
But for me at least personally, I use it as a tool and I think it’s appropriate for some people and not appropriate for others. And it can be changed. I think sometimes also we get stuck in a pattern where I’ve been doing Keto for three years and I was doing great and now things are starting to fall apart. And that’s where we think we need to reevaluate and say, “Is there a seasonal change to the way we eat. Are there times when it’s okay to eat more carbohydrates but then cycle back into a lower carbohydrate diet.” And this is where I think it’s hard to do this alone and this is where it’s helpful to have a physician or somebody else to kind of walk you through that process because we do get stuck in this kind of narrow minded view on our own of what we should do and this has worked for me in the past.
So if I just do it more, it’s going to continue to working for me. So if 80 grams of carbs a day was good for me, I’m going to push it to 60, and then I’m going to push it to 40, I’m going to push it to 20 and you get into these deficits where sometimes then you have problems with your thyroid gland and all kinds of other issues. But reevaluating instead of just pushing harder and stronger, stepping back and saying, “Is this an appropriate tool for me to use right now or do I just need to change my psychological involvement with food and change the way I’m feeling about food and that’s going to have a better outcome on my happiness versus going stronger, harder into Keto.
Katie: Yeah, that’s an excellent point. I think you hit the nail on the head with that idea that with any of these, whether it be Keto, whether it be even people who go vegan, whatever it is, when you’re switching from just a high refined food diet to that, you’re going to see probably some benefits just because of that change and just because of hopefully getting more whole nutritious foods into your diet versus what you’re necessarily cutting out. And another example of that that I hear from people more and more about is the carnivore diet. And I personally, I have some concerns just because, that one, depending on how it’s done can be extremely restrictive. And I worry about the gut and not getting enough of different types of varieties of fiber to encourage gut bacteria. But I’m curious what your take on the carnivore diet is.
Dr. Rick: Oh gosh. To be honest, I haven’t worked with many patients that have wanted or tried Carno or I’ve never done it myself. So to be honest, I don’t know much about how that is going to affect. I think obviously it’s going to be a super low carbohydrate diet. Like you said, it’s going to help people at times, but I think also that restrictiveness can be psychologically difficult for a lot of folks. So I think folks that have eating disorders or going into this process and this is another way for them to exert control over their lives. I think people are using it sometimes that way. And so I would say this is something to obviously evaluate but other people they do have significant issues with plants.
Georgie is a good friend of mine. She doesn’t eat many plants, any time she eats plants she has severe issues. And this is something that for her has found to be a tool that helps her be happier. And so there are patients that I know that we just can’t fundamentally figure out what’s going on and the root cause of what’s causing them whenever they eat plants, they have problems. We can’t figure it out. And I think for those folks who say, “Well, maybe this is the best course for you then because at least with the tools that we have now, we can’t figure out why plants are causing so many problems.” So going to a more carnivore diet could be the right solution for that patient.
Katie: Cool. That makes sense. Okay, so I’m curious for I want to talk about the onboarding process a little bit. I know we started with talking about concierge medicine, but I want to talk about it, especially for families because the majority of people listening are moms. And I know, like I said, this has been really beneficial and time saving and money saving in my own life. And I know that it can be for a lot of others as well, but I also know that it’s not the norm and it’s an unusual thing for people who aren’t familiar with it. And so there’s a lot of questions. let’s talk about for a family who maybe is used to the traditional insurance model and the traditional doctor model making a switch into something like concierge medicine. I’ll share from my personal experience as well, but let’s just talk through like what that process looks like for the you and patient relationship.
Dr. Rick: Yeah. So that’s great. So someone goes to SteadyMD, they’re going to see that there’s a family plan available and having you decide, is this going to be the right fit for your family, I think this is a really good question. So the way it works is number one, first getting to know the parents, so the mom or the dad or both, preferably, getting to know both of them or mom-mom or dad-dad, however it is, whatever your family is. That’s cool. So getting to know whoever the parents are, the leads of the house and talking to the parents. So getting to know fundamentally your history, your health, and maybe even working together for a little while and then bringing the kids on.
Then we would have individual visits with the kids. And individual visits are important. And I do want to see, we have to see your kid on the camera. I want to make sure that I get to that relationship with them as well and get started with them. So going into their history, their background, at least getting that fundamental. So there’s several different levels when you do go through SteadyMD, there’s a couple of different levels where you can have a full plan for your child or you can have a backup plan and the family plan of adding a kid on where we can help out with smaller issues, things that come up, advice, but aren’t necessarily doing full functional medicine for your child. Right. So if you do have a very sick kid that has a lot of issues, then we’re probably looking at, talking to support at SteadyMD, and figuring out how… “Is this appropriate for us to help out with that child?”
Because there are things that are very specific for kids that we want to make sure that we’re not missing them just by doing a more cursory. So kind of making that decision and maybe even talking with your doctor to figure out if that’s the most appropriate course for you. Let’s just say that you have a family, two parents, two kids. The kids are relatively healthy. So in that case having a visit with them and then going through that process. But that onboarding always starts with the parents, bringing on the kids, making sure it’s appropriate that there isn’t any underlying issues that need to be addressed before that would happen. And then after that, it really is in some ways and coming on both the doctor and the parents to make sure that the kids are doing well. So I will reach out and make sure your family is doing great, but I also want to hear from the parents. I want to hear from the moms that, “What’s going on? How are the kids doing?” And being proactive kind of in both directions I think is helpful.
Katie: Yeah, that makes sense. And I’ll say from my end, none of our kids have any intensive health issues at all. And so for me it’s been like having a doctor in my pocket when there’s any small issue that comes up, whether it be a kid gets pink eye or an ear infection or after our neighborhood had an outbreak of Impetigo, which is a staph infection on the skin. It was a nightmare because there was 38 kids in our neighborhood and it kept just transferring back and forth. We were able to fight it without internal antibiotics because those are definitely a last resort for me and working with a SteadyMD doctor we were able to use topical stuff and natural remedies and really focused immune approaches and finally got past that. But I couldn’t have imagined having to go to urgent care to a doctor every time for every kid or every time there was, it got passed back and forth. And so it’s also such peace of mind. And I give it as we order everything else to our houses these days like Amazon or food delivery, everything just shows up at our house and yet we still have to drive to the doctor most of the time. Whereas now you guys can come to our living room too via video chat, which has been really amazing. Even just technology. There’s digital otoscopes that connect to my phone. So like my SteadyMD doc has seen my kid’s ear drums remotely. It’s amazing.
Dr. Rick: Yeah, I mean that’s a really, really great point. It’s like the doc in your pocket, you know, small things are going on or big things that you need advice on, that’s where I want to hear about what’s happening. I would rather hear from my patients and say, “Do I do X or Y?” And I can help work through that, rather than in two weeks from now I’m like, “Oh, we went to urgent care.” And I’m like, “Oh, I totally could help you out with that.” I think that’s where you’re right now. If it becomes more involved and there’s more things going on and that’s a different story because kids are special, we want them to grow really well. And so sometimes it does take a more involved process and so you’d have to talk to the SteadyMD doctor about that, but if it’s relatively healthy doc in your pocket those kind of things, that’s ideal for our for current set up.
Katie: Yeah, exactly, yeah, I think that’s a perfect way to put it for parents. And I should have mentioned at the beginning, and make sure it’s in the intro, but I’ll put the link to SteadyMD and especially to the quiz that helps you figure which doctor you match best with. I’ll make sure that is in the show notes at wellnessmama.fm. But Dr Rick, you are currently accepting new patients as well. Am I remembering that correctly?
Dr. Rick: Yeah, yep, I am. So that is one of the things about… You brought up that quiz, that’s actually one of the best things about SteadyMD that we haven’t even touched on is this alignment process. And your listeners, if you go onto the on the website now, the first thing you’ll do is take this quiz and that quiz helps provide alignment. Making sure that you are finding a doctor who is into the same things as you are, who addresses health the same thing where you are, and that person might not be me, right? So I’m here talking to your folks, but there’s probably another doctor most likely who fits better than me. I might be that person, but if I’m not, there’s going to be a doctor we’re going to help build that alignment.
I think that’s really critical in that healing process is finding somebody that you work well with that’s going to be your doctor friend. And so building that alignment, making sure you’re in the same wavelength is crucial. That quiz works that way. So I would love it if that’s me for you. So if your listeners, if you get on and you see me, see my face, click on me and I’d love to be your doctor. I am taking patients right now. I actually am quite a few weeks booked out. But we’re always opening up slots and there’s a new doctors coming on. So the service has been really great so far. So SteadyMD has been growing and we just hired a few, about 10 actually, we just offered 10 new doctors positions to open up because things are growing and people are really responding well to our service.
And so if there is not a doctor that’s fits for you in your state right now, hold on for a few months and there probably will be. So we just brought on, actually I caught another functional doctor and hired another integrative doctor that are coming hopefully on the service. I’m very soon getting them licensed up and so there are going to be new folks. Now the other thing too is thus far in our service, we’ve been doing more personal care with a functional medicine slant but focused mainly on the personal care. We found that doing full functional medicine, the full lab testing, like everything that goes into that. We were actually… It was taking a lot of time, too much, I mean, which was great, but a lot of folks that were very sick and a lot needed more help than we were able to support.
So we’re actually starting a new, and actually maybe by the time that this launches, we’ll have a new functional medicine service. So this will be a separate product kind of like our lifestyle product. And this service will then be specifically for functional medicine. Your doctor will have a background in functional medicine and in that way you’ll be able to spend more time. And so 60-minute first visits, will be 90-minute first visits. And so we’re very excited about this program. So right now we’re doing the trial version of it. Hopefully by the time this launches, it’ll be live. But we’re also making tweaks and changes to it to make sure it’s working for our folks. So keep a lookout on that too. And that’s pretty exciting that we’re ready to offer that. We’ve kind of dabbled in it a little bit to see how things work. And so I think we have it now tuned up to be a successful service line for your listeners and our patients.
Katie: I love that. And something else to clarify is because a lot of these doctors, they’re virtual, they’re not in your state necessarily. So you’re not going to see them in person. You’re going to see them via phone or video chat, but they are licensed in your state. So if you’re working with a doctor, they have the medical license in your state. And that’s something SteadyMD works with you guys to do. Is that right, to get licensed in the states that your patients need you in essentially?
Dr. Rick: Yeah, exactly. So because I don’t know if you knew this, but medicine is different in Nevada than Utah. So you have to go through it. It’s the same, but we have laws and whatever. It’s really frustrating. But that’s actually one of the biggest barriers of hiring new doctors, is licensing. So I started in licensing in Utah and then we were able to get me a license across the country now, but it takes a long time. It’s taken months to do that. So that’s actually one of the larger barriers in our model, unfortunately. But we’ve learned how to get past that. And so that’s one of the things that I think we’ve worked on where the others haven’t, is we’re licensed in the state, we have a doctor for each state and we’re getting doctors trained in functional medicine for each state as well.
And that’s coming, we’re almost there. So that’s another exciting thing, is that we can offer fully legal licensed, NDDOs in your state that can see you virtually. And if you happen to be in Utah and you want to sign up, then I’ll see you in person too. And that’s fun too, or people traveling through, I have patients that are sometimes in town and they’ll come and see me. And so yeah, that’s a big point and it has been a barrier, but it’s becoming less of a barrier because they are hiring new doctors and it’s going great.
Katie: Awesome. Well, I know just how busy you are as a practicing doctor and concierge medicine doctor with SteadyMD. And I know that you helped many people. I’m really grateful that you took an hour to share with us today and to answer all my questions. Like I said, I’ll make sure that the links we talked about are in the show notes at wellnessmama.fm. So you guys can see if perhaps Dr. Rick will be your doctor with SteadyMD or actually I haven’t met any of the doctors at SteadyMD that I don’t love. So all of the options are awesome, but I just really appreciate your time and wisdom in being here today.
Dr. Rick: My pleasure.
Katie: And thanks as always to all of you for listening and sharing your most valuable asset, your time with us today. We’re so grateful that you did. And I hope that you will join me again on the next episode of the “Wellness Mama Podcast.”
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