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Dec 26, 2017

Dr. Susan Wilder possesses more than a vastly educated mind; she is passionate, emotional, dedicated and focused to her practice, her clients, and her constant learning.  Today on the EO Podcast, Dr. Wilder discusses the holes in our current healthcare system, her solution towards patient-focused transformative care, and 3 steps you can take for a permanent improvement to your quality of life. Tune-in to hear Susan’s critical call to action, and to learn how she weaved entrepreneurship with healthcare to provide a better option for her patients.

Time Stamped Show Notes:

  • 01:12 – Susan Wilder, M.D., has a practice that doesn’t go through typical insurance and creates a very different experience for her clients; it is her “dream practice”
  • 01:45 – She is 100% focused on health transformation in the market
  • 01:59 – She was an air force officer, deployed to Africa, left as a major, and relocated to Arizona to focus on family medicine
  • 02:14 – Founded the Mayo Clinic’s Family Medicine Residency and serves as Director of Clinical Genomics Education and was recognized as the Family Medicine Educator of the Year
  • 02:48 – Is highly educated: she has a long list of qualifications, extensive learning platforms across various fields, and has taught at various colleges
  • 03:38 – Currently teaches Med students at the University of Arizona and Southwest College of Naturopathic Medicine
  • 04:25 – Education is non-stop for Dr. Wilder; her twins are in their first year of med school and she tells them that Chemistry still makes her cry
  • 07:00 – Why doesn’t she take insurance?
  • 07:15 – You don’t use insurance for preventative maintenance on your car; insurance should be there for rescue (i.e. cancer or heart disease)
  • 07:37 – Our healthcare system is out of whack is because our system focuses entirely on rescue and not prevention
  • 08:24 – Over half of the deaths in our country are highly preventable or could be staved off until later in life
  • 08:34 – Our nation beats out every other nation in per capita cost; it accounts for almost 18% of our GDP, crowds out every other spending priority, and is sinking our corporate climate
  • 08:49 – Warren Buffett quote, “Healthcare is the tapeworm of the American economy,” because other nations’ companies don’t have to shoulder the investment like ours do
  • 09:03 – Our return on investment is the worst in the developed world because we are so focused on the rescue
  • 09:40 – Primary care is high-volume, hit-and-run, throwing drugs at symptoms, and our system is socialized and profitized, not free-market
  • 10:01 – When she worked with insurance, her qualifications, patient demand, or office space and extended hours didn’t matter, she was paid the same someone just out of their residency who passed their boards on the third try
  • 10:38 – The price is fixed by the payer (insurance), but the costs of surviving as a business go up
  • 10:50 – The only way to survive is to increase the volume of people you put through the system, and this is lose-lose, for the patient and for the provider
  • 11:04 – Her patients value time, access, comprehensiveness (genetics, risks, root causes), and they wanted to get well without a bunch of medications; the system was putting them at odds with what their patients valued
  • 11:33 – They had to cut out the middle man and work directly for the patients; concierge medicine of this type is a free-market response to a broken system
  • 11:45 – Many companies invest in concierge medicine for high-value employees because they focus on health transformation rather than monitoring deterioration
  • 12:14 – How can this system be fixed over time?
  • 12:40 – She was involved in healthcare reform for over 15 years on both sides of the isle and believes there are no simple answers because it is highly complex
  • 13:09 – Medical/Industrial complex is bent on maintaining the status quo - physicians, pharmaceuticals, hospitals, the insurance industries - this whole system outspent oil/gas and defense/aerospace in terms of lobbying
  • 13:40 – A baby step she recommends is that we all become responsible stewards of our own health; we want our cake and to eat it, too, and this is flaw in our culture
  • 14:03 – We value instant gratification over long-term payouts
  • 14:25 – You can’t delegate your health to your doctor, to our schools, to our employers, or to our government; you must learn how to eat and live healthily
  • 14:50 – Basics are avoiding tobacco, drinking moderately, learning how to step away from electronics and engage in sleep, play, social interaction, breathing
  • 15:04 – She believes we’d cut chronic disease in half and reverse type II diabetes
  • 15:40 – If we invest in transformative healthcare, we can head off a lot of problems for patients
  • 16:20 – What does it mean to drink moderately?
  • 16:38 – Think: Why do we like alcohol? It is a direct neurotoxin (brain toxin) that disinhibits us that begets a lot of negative behavior
  • 17:05 – When Dr. Wilder was in the military, she did a study on STD issues and found that alcohol was the root cause of risky sexual behavior
  • 17:56 – Moderate drinking for women means no more than 7 drinks a week, or 1-2 at any given sitting
  • 18:09 – More than 2 in a sitting for women, and more than 3 for men is considered heavy alcohol consumption
  • 18:20 – Brain health is largely impacted by heavy alcohol consumption
  • 18:29 – Discussion about sugar...what’s wrong with Cheerios?
  • 18:52 – Food policy has taken a very corporate-friendly stance, so determining safely in chemicals found in food is left largely in the hands of companies; there isn’t much policing done
  • 19:10 – For example, Monsanto’s Round-Up is dumped on food crops, yards, golf courses, etc., and everyone is exposed to its chemical, glyphosate
  • 19:43 – Consumer Reports studied the food supply and which have the highest levels of glyphosate, and Cheerios were at the top of the list
  • 19:58 – Phthalates are a group of plasticizing chemicals found in pacifiers, baby bottles, etc. and in Kraft Mac and Cheese
  • 20:24 – These endocrine disruptive chemicals are definitely attributing to autism, ADD, “diabesity” (obesity and diabetes), Parkinson’s and Alzheimer’s
  • 20:45 – Parkinson’s is definitively linked to 9 different pesticides and herbicides and is clearly a disorder of environmental toxicity
  • 20:56 – We have 87,000 chemicals put into our exposure annually
  • 22:30 – How much would you have to use/ ingest to have a negative effect from these chemicals?
  • 22:48 – Corporate comeback is often that the exposure levels are low and aren’t likely to cause an adverse effect
  • 23:00 – The chemicals are cumulative over time, like alcohol, meaning their effects accumulate over time
  • 23:27 – Cumulative things apply day-after-day; the average woman applies 80 chemicals before she leaves the bathroom in the morning, the average teenage girl puts over 120
  • 23:58 – Your skin is your largest organ, and if you put chemicals on it day after day, you are consistently being exposed to endocrine and hormonal disrupting chemicals
  • 21:17 – People still have levels of DDT, and that was banned decades ago; it takes a long time to clear from the system
  • 25:00 – Lancet Medical Journal did an article saying that the disease cost of endocrine disruptors in the U.S. is $340 billion annually driven mainly because of IQ points lost in intellectual disability due to chemical exposure to these toxins
  • 25:30 – Look at the number of autism and dementia and you can see the issue; consumers are starting to wake up and ask for healthier options
  • 27:15 – If there were a few things that the average person can do to extend their life or improve their quality of life, what would they be?
  • 27:30 – The “Vitality Prescription”: Learn how to breathe, relax, and destress
  • 27:48 – Dealing with stress in a healthy way reduces inflammation, increases mortality, slows aging, etc., and will improve the quality of your life and relationships
  • 28:44 – Eat more plants: preferably buy organic (especially the “dirty dozen”); plants help detoxify the chemicals we are exposed to, and ketchup and fries don’t count
  • 29:10 – Eating more plant-based increases the quality of life and reduces risk of chronic disease
  • 29:55 – Eat for the soul on occasion, but don’t do it regularly
  • 30:15 – Practice gratefulness and kindness: “The Tale of Two Patients”
  • 30:38 – She had two patients with similar ailments but one was negative and the other was always grateful and kind: “Life-o-suction” vs. “Life infusion” person
  • 32:00 – Happiness is a verb, attitude is a choice, and gratefulness is the action plan; it’s a process and practice
  • 34:26 – Dr. Wilder’s business is LifeScape Premier; her relationship to her patients is unique and bizarre because a “doctor” is close to and emotional with her patients
  • 34:52 – She brought her staff to training at Ritz-Carlton and Disney Institute for Service Training and had a Disney Imagineer design her office and services
  • 35:30 – Most of her patients have high-deductible health insurance so would still pay a lot out-of-pocket anyways; concierge medicine still offers a lot of variety
  • 36:27 – Direct Primary Care is a free market with options; hers is a value-centered practice that is innovation-focused
  • 37:07 – She is learning new things and studying new health options, rather than having to learn regulatory things that don’t pertain to patient health
  • 37:29 – She couldn’t do that if she had 3,500 patients rather than her current 350
  • 38:31 – What is the average annual spend for concierge medicine?
  • 38:50 – Larger companies might charge between $1,200 - $2,000 annually, her practice is at a higher price-point but there are others way above that with very high-end clients
  • 39:40 – It really depends on what the client values; she just had a 78-year-old client reverse her diabetes, and a high-level executive reverse ADD, insomnia, anxiety, and depression (4 drugs and 5 medical problems RESOLVED in one year)
  • 40:33 – She has bus drivers, teachers, people on fixed income, and they value this as a form of preventative and transformative insurance: A different kind of insurance
  • 41:06 – Patients who engage in quality primary care have lower need for the “rescue” insurance and save money on medications and “reactive” care
  • 41:32 – Pharmaceutical industry has pushed back against functional medicine providers, but  functional medicine is patient-centered
  • 42:30 – She’s read the entire Affordable Care Act and knows what it says, but she believes we primarily must be better stewards of our own health
  • 42:44 – We must require our government not to spend what we don’t have, we must think long-term and value necessity over luxury, and work to shift our culture in this direction

3 Key Points:

  1. Concierge medicine focuses on “health transformation” rather than “monitoring deterioration;” Dr. Wilder’s saw an opportunity to open her own, independent practice when the market put her at odds with what her patients valued.
  2. There’s a lot more to longevity than just the food you eat – Learning how to breathe, destress, and practice gratefulness are key to the “Vitality Prescription.”  
  3. We must become responsible stewards of our own health and not rely on the government or big businesses to keep us healthy.

Resources Mentioned: