Morning everyone!

Welcome to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health. 

This week I’m going to introduce something I’m calling “The Performance Medicine Way”.

Ever since I formed Performance Medicine 17 years ago, I’ve been developing a way of delivering healthcare that I think is important. 

In fact, the reason I started Performance Medicine was because I wasn’t satisfied with the way I was doing things. 

I felt like the way we were taught wasn’t the best way. 

When I went out on my own I wanted to do things differently and better. 

One of my goals is to teach you how to do everything from how to choose your health insurance to how to interact with your doctor, whether that’s me or someone else. 

I want to help you get the most out of your healthcare. 


The Preventative Approach 


One thing I’m always talking about is preventative care. 

In traditional medicine we’re taught to prescribe you medicine. 

We’re taught to label you with a disease, find a code for it, and treat that with a medicine. We’re taught to TREAT PEOPLE. 

As medicine has become more complex, more crowded, and with more sick people (mostly because people are fatter than they used to be and living unhealthy lifestyles), I decided to focus on prevention and find out the root cause of your illness or symptoms.

My focus is on why you’re hurting and why you’re tired. 

It seems like the system is set up in a way where we actually want to find new diseases so that we can label patients and find new drugs for them. This clearly benefits the pharmaceutical industry, makes insurance more expensive, makes you poorer and dependent on medications for the rest of your life. 

This is a problem. 

We have a major healthcare crisis in this country, mainly because of obesity and drugs (both prescription and illegal), and we need to address these or we will never fix the problem. 

It’s up to you to fix the problem because traditional medicine (government, insurance companies, pharmaceutical companies) are not going to. 

In other words you can’t depend on our healthcare system to fix this for you. Believe me I’ve observed this my whole life, ever since my dad was a doctor, and it’s getting worse every year. Look at the current Covid crisis for our country and how that’s been handled. 

This is why I went back and did a fellowship in integrative and functional medicine, which basically means trying to find the root cause of your problem. 

A lot of times it’s simple:

  • You’re overweight 
  • You live a poor lifestyle 
  • You don’t sleep well 
  • You’re too stressed
  • You’re body doesn’t move correctly 
  • You don’t have the right ergonomics 
  • Your hormones are off

Plus, things happen as you get older. 

I’m not downing medicines at all. They save lives and I use them everyday! There’s also been tremendous advances in medicine for special problems. 

Sometimes I feel like we as a system over test and over treat, but there are screening tests that you need to get.  

Most of my practice is focused on baby boomers and people in their 40’s, 50’s, 60’s and beyond who are starting to need some help in the aging process. 

Your body deteriorates with aging if you don’t take care of it. 

I’ve learned that by being 66 years old, and seeing so many patients in my 35 years of practice. 

You can start to predict what’s going to happen to people. That’s one of the beautiful things about screenings. You can get ahead of things. 


Basic Screenings To Get ( At Age 45)


  • Colonoscopy (If everything checks out you need to get this every 10 years)
  • CT Calcium Scan of your heart (male or female) 
  • Hormone Levels 
  • Vitamin Levels 
  • Bone Density Scan 
  • Prostate Exam (and a PSA)
  • Pap Smear
  • Mammogram

A Cleveland Heart panel is something I run on most all of my patients. It gives me almost everything I need to know about your metabolism, hormones, inflammatory markers, and so much more. 

It’s a great way to start the relationship with my patients. 


The Patient Doctor Relationship 


Approaching healthcare as a patient is difficult these days. Even getting in to see your primary care physician can be a monumental task, much less have an appropriate amount of time with them. 

A lot of it is because of the concern over insurance and navigating the healthcare system. 

What’s the copay going to be? Does your insurance cover this?

This is one of the reasons I got rid of all insurance when I started Performance Medicine. It’s not only made me a better doctor, it’s eliminated the red tape and bureaucracy I had to go through. 

I just focus on my patients and try to make it affordable. 

Patients can file their own insurance. I’m just not going to spend my time talking with an insurance agent over the phone that has no medical training and is trying to tell me what to do. 

I only want to do what’s right for the patient. I don’t have to worry about whether or not a third party is going to pay me for something. 

The patient doctor interaction is the most important thing in medical care, in my opinion. 

This all starts with the primary care physicians. Unfortunately, these are the doctors who have been put under the most stress in the current healthcare system and are the most burned out. 

They have to go through almost all of the red tape in healthcare. They are  like the quarterback of the whole system. 

They have to understand the codes and insurance, plus see 30-40 patients a day and deal with Electronic Medical Records (EMR) which takes about half of their time up. 

In this situation, it is difficult to be effective in finding the root cause of problems. 

It’s okay if you’re only putting patients on medications and getting them out the door, but if you really want to do good medicine you have to spend more time with the patient and actually listen to them. 


Health Insurance


I advise people to get a High Deductible Health Plan (HDHP) so YOU can determine how you spend your money and not worry too much about your copay. 

It’s important to use your healthcare dollars wisely. Don’t throw them away! 

Invest in your health by taking preventative measures. Invest in preventing things like Diabetes, Heart Disease, Cancer, and Dementia (to name a few).  

A lot of it is tied to what you eat, gut health, movement, sleep, how you handle stress, and managing your declining hormones. 

Only about 10-15% of what’s going to happen to you is family history and your genetics. 


How to Talk to Your Doctor or Mid-Level Provider


They need to be able to listen to you. 

Here is a good tip for this:

Try to go into a visit with the 1-2 problems you want addressed, unless you’re there for an annual. 

When you’re there for a routine visit limit it to 1-2. 

If you come in with a litany of things you want to discuss, I guarantee you, that physician is going to lose interest. 

It sounds terrible to say, but that’s just the truth. 

Sort out problems one by one. 

A lot of times it’s simple. It usually comes down to a habit or food that you thought was healthy but actually isn’t. 

With that being said, go to a provider who knows nutrition. It’s the most important part of your health. What you put in your mouth determines your health! The other things are secondary. 

Here are some other things to look into: 

  • Supplementing with vitamins. I take a lot of vitamins. Vitamin D is paramount over all of them, and then gut health and your bowel habits. Both very important.
  • Look at your skin. 
  • See how vital you are. If you’re tired all of the time, aching or hurting, that means you’re not healthy. Figure out why your body is inflamed and what you can do about it.  


Traditional Plus Alternative 


I use herbs as well as real medicines. It’s a blend of traditional and alternative medicine. I look at it as the best of both worlds. 

Both are good. You just don’t want to go too far on either end of the spectrum. 

You need to use some common sense with these things. There are things that work and  certain patterns you can look at with people who get sick a lot. 

It’s more costly to treat sick patients than it is to prevent illnesses. There isn’t as much money in prevention in the healthcare industry as there is in treatment. 

So think about that. 


Lifestyle Medicine 


I’m all into a healthy lifestyle. 

Stay lean. Get good sleep. Balance your gut. Look at your hormones. Audit how you exercise because you can over do it. It’s important to know you can over exercise and keep your body inflamed. 

Also, look into what your doctor is like. 

Are they trained in integrative medicine? Are they really listening to you? Do they look tired? Non Caring? Grumpy? Irritable? Overweight? Impatient? More concerned with the computer than you? If any of these are true, then you should find a new provider. Remember, you’re the customer. 

There are certain things you can do to help that process. Start with writing down your main concerns. 

Remember that it’s always easier to catch something early rather than later. 

It’s lifestyle medicine. It’s preventive medicine. 

This is how you should approach the patient doctor interaction. 

This is healthcare the Performance Medicine Way: A preventative approach to medicine that helps you live a long “healthspan”.