A New Kind of Doctor Patient Relationship
Dr. E's Highway to Health Show Episode 23
In This Episode:
Dr Nick holds an MD degree and is a board certified primary care physician who practices in Colorado and consults patients via telemedicine throughout the United States.
His view of healthcare and modern doctor-patient relationships is a much needed breath of fresh air for an already stale model of sick-care.
Original Air Date: August 7, 2019
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- Only change as many habits as you feel you can sustain for any given time.
- You lose fat in the kitchen and you gain muscle in the gym.
- Study how you eat. And most importantly, the motivations behind how you are eating.
Questions About This Episode:
- [00:03:48] Continuity of care is very important for Dr. Nick as a physician and the reason he went into family medicine.
- [00:04:09] Seeing the changes that can be accomplished by patients when they act as a unit with their doctors is only possible when there’s trust and a solid relationship between doctor and patient.
- [00:04:50] Many Americans use Urgent Care as their primary care and that does not allow for a relationship to be built.
- [00:06:14] Dr E believes that patients who trust you as a doctor adhere much better to their treatment plans.
- [00:06:47] Dr Nick will not prescribe anything to his patients without them fully understanding the reasoning behind that prescription.
- [00:08:02] Encouraging patients to disagree with you as a doctor is a way to ensure buy-in, compliance and adherence to treatments.
- [00:09:03] Dr E thinks that as doctors we need to disclose what we think is the best course of action but always leave a door open to discussion with our patients.
- [00:09:59] The three conditions to select treatments are:
- Ensure that the treatment is proven safe and effective
- Incorporate learnings from your own clinical experience and expertise
- Consider patient preferences.
- [00:10:58] If a patient does not like a course of action, it does not matter how much you insist, they will probably not follow it.
- [00:12:43] Without patient buy-in they will not follow the treatment and you will become frustrated and not be able to help them.
- [00:13:54] As a physician, it is very important to go where patients are. And that includes social media which is why Dr Nick is so active on Instagram.
- [00:14:47] Dr Nick understands that patients will come to his office have searched their symptoms and gotten information from usually unreliable sources.
- [00:14:59] Instagram profiles that Dr Nick recommends:
- [00:15:22] Although social media followers are not Dr Nick’s patients, he feels it is his role to help them from a health, fitness, nutrition and mindset aspects.
- [00:16:00] Dr E notes that these doctor influencers not only preach but actually follow the lifestyle they recommend.
- [00:17:43] Patients notice when their doctors are clearly not following themselves the advice they give out. And that shatters any notion of trust between them.
- [00:19:22] Doctors and health professionals should be health educators first and health “fixers” second.
- [00:20:34] Your doctor is not only responsible for your health but for the health of the community.
- [00:21:30] Health professionals need to give a better example of ideal health. And we need to be very vocal about it.
- [00:22:45] If doctors don’t go out and educate the public, any other YouTuber will. Or they will be educated by the ads that food companies put out.
- [00:24:00] We live in an obesogenic society according to Dr Nick.
- [00:25:27] As consumers, we need to let companies know that they need to start putting out better products. We let them know by not buying the garbage they currently produce.
- [00:28:00] Actionable advice
- [00:29:58] Being dehydrated can trigger hunger because your body knows that there’s water in foods.
- [00:31:20] There are several benefits to working out in the gym, but it is not the way to lose excess body fat.
- [00:33:47] If your goal is to lose body fat, you do that in the kitchen, not in the gym.
- [00:34:06] But you can only increase your metabolism in the gym. By lifting weights.
- [00:35:51] How to work with Dr Nick
- [00:39:10] You need to choose your doctor based on the trust they inspire you.
Dr E: [00:00:01] Hello and welcome to The Highway to Health Show. In today’s episode, I’m joined by Dr. Nicholas Nwabueze, also known as Dr. Nick or The Fittest Doc, if you follow him on Instagram. Dr. Nick is a medical doctor who specializes in family medicine. By the time you listen to this episode, he will probably be practicing in Colorado. And I say that way because when we recorded our interview, he mentioned that he was about to relocate from Illinois to Colorado for work. However, that doesn’t really matter, because if you’re in the United States, you can be doctor Nick’s patient regardless of where you live. Thanks to the Internet, he’s also a telemedicine provider helping patients as their primary care physician all throughout the country.
Dr E: [00:00:37] But before we go in to listen to my interview with Dr. Nick, let me remind you that last week’s episode was all about food addiction. In it, I was joined by Emily Boller, whose remarkable story of identifying and overcoming her food addiction helped her lose and most importantly, keep off more than 100 pounds. Since then, she’s been inspiring hundreds of men and women to accept food addiction for what it is and learn how to overcome it. I really loved talking to her. Some of the things she shared were all too familiar to me after growing up in a food-centered family. Make sure to go back and listen to episode 22 and see if it rings true for you as well.
Dr E: [00:01:15] I also want to remind you that I’ve decided to not rewrite that digital booklet I had written some years ago about choosing a stem cell clinic, but instead I want to write a proper book about stem cell treatments. This book is intended to be a guide for the everyday person to understand what stem cells are, why and how they can help achieve and maintain optimal health, when to use them, when not to use them, and obviously how to choose a stem cell clinic. How can you tell if your doctor is trained and qualified to provide such treatments and so on? If this is something you would like to read, I will make sure you get a copy for free when is done and released. All you need to do is sign up for that at DrE.show/book. Like I said, I will make sure you get a free copy of the book if you sign up now. And I will also keep you updated on how the book is coming along and you even get to contribute to it with your questions. Once again, that is D R E Dot show forward slash book or just open this episode’s description and tap on the link that you will see there.
Dr E: [00:02:16] And now that we’ve gotten that other way, here is my conversation with the fittest doc, Dr. Nicholas Nwabueze. And remember, you’re on The Highway to Health and I’m your guide to get you there.
Intro: [00:02:26] Are you ready to live ageless? Want to discover alternative health choices? Cutting edge nutrition and fitness for the entire family? Welcome to Highway to Health Show with your host, Dr. E. ‘The Stem Cell Guy’. Where Dr. E. helps you live ageless. And now here’s your host, Dr. E.
Dr E: [00:02:54] Hello, everyone, welcome to another episode of The Highway to Health Show.. I’m your host, Doctor E ‘The Stem Cell Guy’. And joining me today is Dr. Nick.
Dr E: [00:03:02] He earned his doctorate of medicine from the Ohio State University College of Medicine in Columbus and completed his family medicine residency training at Edmonton’s Hinsdale Hospital in Illinois. He was just sharing with me that he’s about to move to Colorado. He provides as well Telemedicine services through SteadyMD, where he helps his patients overcome disease with lifestyle modification before trying medications, which is something that you guys know, I advocate for very strongly here in the podcast and really in my everyday life.
Dr E: [00:03:32] So I’m very happy to have him here. Nick, welcome to the show.
Dr Nick: [00:03:36] Hi. How are you today?
Dr E: [00:03:37] I’m doing great. Thank you so much for joining us.
Dr Nick: [00:03:39] I’m glad to be here. I’ve definitely been looking forward to having a conversation with you.
Dr E: [00:03:43] Good, good, good. So tell me a little bit about you. What made you get started into family practice?
Dr Nick: [00:03:48] So my undergrad training actually is in mechanical engineering and I finished engineering. I knew I wanted to go to med school. I did not know that I wanted to go into family medicine. I think the thing that kind of prompted me most strongly for family medicine as opposed to any other specialty was the continuity of care.
Dr Nick: [00:04:09] So, the fact that in family medicine you can establish with a patient, whether they’re young and then you kind of are their doctor, for the rest of their life into their old age, or you start with them in their middle age. I’ve just always been fascinated by the changes, the positive changes that you can make as a unit with your patient when they completely trust you, because there’s a relationship there, because you guys over months, over years have developed and kind of know that the subtleties and the nuances of one another, as opposed to the alternative that I know a lot of Americans these days are utilizing, which is using kind of their urgent care as their primary care doctor or using the emergency department as their primary care doctor. And the disadvantages of both of those are, unfortunately, is that they don’t know you. They don’t know your family history. They don’t know your past medical history. They don’t know your medication. So, in my opinion, the care that you can give a patient will always be optimized when you know them very intimately from a pass and from their history and you, as well, know their preferences. You know, you mentioned earlier medications. Some patients, admittedly, they just want a pill. They just want you to prescribe something so they will get over it. Others are very, very adamantly against medications and against pills. So all too often, I will hear from patients that they will go to the urgent care or they’ll go to an emergency department doc and they will just kind of give them medications. And the patient doesn’t like that. Well, unfortunately, what has truly happen there, the underlying problem is that there was a difference in alignment. There was not kind of alignment between the doctor and the patients in that the doctor did not know the patient.
Dr Nick: [00:05:59] That’s not really something that you can blame the doctor for because that preexisting relationship was not present. So ultimately, family medicine drew me in, and because of that continuity of care and establishing a long running relationship with my patients.
Dr E: [00:06:14] Exactly. And it helps you on your end, obviously get to know your patients, but it also helps them adhere better to their treatment because like you said, they already trust you. It’s not like when they go, they’re going to the emergency department like you just mentioned. What’s gonna happen is that they’re gonna meet a doctor that may say, you know what? OK, I kind of kind of okay with this guy. But I just met him. I’m not entirely sure he said this, but I don’t necessarily agree with it. Where if it’s the other way around. They’ve known you for years. They’re not going to be second guessing as much. Is that something that you’ve noticed?
Dr Nick: [00:06:47] No, I would absolutely agree with you. I think one thing that you didn’t mention that I have found with my experience is that the doctors who they do not have a relationship with, because this is someone, like I said, who they either met in the emergency department or the urgent care, they are not as willing to step back and explain what is going on to the patient, actually take their time and break things down to the level of understanding of the patient. In my case, with all of my patients, I am not happy with prescribing either an intervention, whether that’s lifestyle modification or a medication, –I don’t want to prescribe something unless the patient understands why I’m prescribing it. Because ultimately adherence when it comes down to the patients going home and doing whatever the intervention was, I can’t be there for that patient. They have to do it, whether it’s taking a pill or doing some type of physical therapy or whatever, they have to do it. And I found that people, not just patients, but people in general, are so much more likely to stick with doing whatever the plan is, if they fully understand why you chose the plan and you’re not going to have that with somebody who you don’t have a pre-existing relationship with.
Dr Nick: [00:08:02] And they don’t understand you and they don’t understand that you like to know what’s going on. You know, I truly feel like the days in the past of patients saying, you know, I’m going to do this because my doctor told me and they’re the doctor, who am I to argue with them? I told my patients when I’m right here that that’s nonsense. Like, I’m sorry, but you have absolutely every right to argue with me as my patient. You have every right. This is your health. Yes. I am absolutely a guardian of your health. But this is your health. This is the most precious thing to you. The thing without which you cannot live and enjoy the rest of your life. So if I ever say something to you that you don’t understand or you don’t agree with. We should be able to have a conversation and hopefully meet in the middle. If you don’t want to completely agree to whatever plan I propose, that’s fine. But we should be able to come up with a new plan together that you will agree with. And I will agree with. And you can stick to so that we can see you get better.
Dr E: [00:09:03] Yeah, absolutely. It seems to be a theme here recently with a few of the doctors that I’ve had on the show where we agree that health is the responsibility of the patient. And as physicians, we are obviously facilitating that because we have that understanding and we can guide them or we can help them. But really, it is them who have to go on that journey. It is an active process that they have to be seeking out every day. And like you very well said, I believe that it is our job as physicians to say, listen, this is the best scenario or the best alternative that I see for your care. But if you don’t agree with it, let me know. Don’t just skip on it. Let me know. And then we can find other alternatives. You can say, you know what? This is the way you should be eating or this is the way you should be exercising. This is the way you should be doing this. And the last thing you want is your patient to just nod silently and then walk out your office and throw your prescription in the trashcan and then not follow it, right?
Dr Nick: [00:09:59] Absolutely. And I’m sure you’re very well aware of this yourself, too. But this all goes back to kind of the evidence based medicine kind of triad of practicing. Right, where evidence based medicine essentially implies that on one end of the triad, you have to always keep in mind the most objective and verifiable studies that have been completed that will guide your clinical decision making. But that’s just one end of the evidence based medicine triad. The other end is what are your experiences as a doctor with the patients that you’ve seen? Sometimes you will have experiences that will tend to go against what the evidence says, and you then have to balance between the two and use your clinical judgment. But then the last piece of that evidence based triad, that is absolutely important that I feel that some physicians forget is, the third part is, you need to keep in mind patient preferences. So, you know, if the patient does not prefer a certain modality of treatment, then, hey, doesn’t matter if you as the doctor want them to do, hey, this is what we should do. You need to be able to be flexible. You need to be able to understand that this is not what they prefer. And as long as you are completely conveying to them the risks and the benefits of every available treatments, including the treatment that you recommend, and they want to go with something else like we talked about earlier, this is their health. So as long as you can keep that triad in mind between the three and come to a decision that your patient is onboard with, then in my opinion, we’ve done our job as doctors.
Dr E: [00:11:41] Absolutely. I think that’s tremendously important. When I first started at the clinic in Cancun, that stem cell clinic that I used to run, the only kind of treatment that we were able to do at the time was stem cell treatments from both marrow aspirates. And there were people who simply didn’t want to have a bone marrow aspirate. And we learned very early on that it doesn’t matter how much benefits you were talking to the patient about, how much time you spend with them, how much you shared with them, how they could improve, or how this or how that if it was not something that they were inclined doing, it simply wasn’t going to happen.
Dr E: [00:12:16] And of course, we’re talking about a very specific kind of therapeutic approach that people would fly from all over the world to come see us. But when you also start considering or you stop to consider those things in your everyday clinical practice, then it becomes a lot more powerful. Because like I said, if you don’t consider that the patient is going, you will give them prescription. They’re going to nod their head and they’re going to walk out and do whatever they want.
Dr Nick: [00:12:38] Yes, exactly.
Dr E: [00:12:40] So that’s just waste of time for everyone. So it’s really good that you acknowledge that.
Dr Nick: [00:12:43] And then they’re going to come back and see you. You’re going to say, hey, how are things, you know, how’s the treatment going? And they’re going to say, hey, doc, you know, I fell off the wagon and this was a month or two. So now as a doctor, you’re frustrated because it seems like nothing that you suggested is helping when in reality. As a doctor, you should have done your homework a month or two ago and truly found a plan that that patient was on board with, that they were not simply giving you a courtesy nod and then going home and then doing whatever they wanted.
Dr E: [00:13:13] Or whatever they could do a lot of the time, because many, many times it is like you said, it’s a courtesy nod. It’s not that they’re trying to be rebellious. It’s just simply that they feel bad disagreeing with their doctors. They go like, okay, yeah, sure, I’m going to do that. But in reality, we both know what happens. Right?
Dr E: [00:13:30] So switching gears a little bit, I’ve seen you. Very, very active on social media. Do you notice this to be also a motivating factor for your patients? Is this something that your patients talk to you about? They see you there as a role model? And I’m talking obviously about, you know, the time you spend at the gym, you take great care of yourself and obviously you transmit that to your patients. Do you see this as an important action that doctors should be taking?
Dr Nick: [00:13:56] Absolutely. A couple of years ago, I came across a doctor, Dr. Spencer Nadolsky. I don’t know if you’re aware of him on Instagram. His name is @drnadolsky. He has, I believe, a hundred and sixty or seventy thousand followers. And he definitely made me think and understand what was going on, unfortunately, with the Internet.
Dr Nick: [00:14:17] I’m sure you’re well aware as a physician of your patients coming in and having information from Google or information from wherever on the Internet, telling them things that they should be doing in manners and ways that you do not agree with. And now as a physician, you have to combat the Internet and kind of patient preferences and whatnot. So in my opinion, I think that the best thing that physicians can be doing in this day and age is doing everything they can to combat that.
Dr Nick: [00:14:49] There is a lot of falsities and nonsense and absolute things that, in my opinion, actually hurt people and hurt patients as opposed to helping them. And there’s a lot of that on the Internet. So, you know, I think that from Doctor Fit and Fabulous to Dr. Nadolsky to Dr. Joshua Wolrich out in the U.K., these are a lot of doctors who have a massive social media presence. And I have enjoyed kind of watching how they use it, because they use it in a very proactive and positive manner. Obviously, we can’t given that medicine is a very personal thing. I can’t say that, you know, all of my followers are my patients, but I can absolutely do what I can from a health and fitness and nutrition and mindset aspect. I can do whatever I can to help them understand and put themselves in a better position. So it’s kind of a unique position that I’m in and that other doctors are in. And I definitely enjoy it because the messages that I get from people that are very effusive and very positive and thankful that people like me are out there and that I’m a role model to them and I get very positive feedback. And it makes me definitely want to continue to be whatever I can to them on the Internet.
Dr E: [00:16:03] That it’s really good to hear because from talking to so many different doctors, I was sharing with you earlier how I have another business where we help doctors with their branding and marketing, and running their practice basically, and talking to a lot of them there seem to be two very distinct camps. There are the ones that are all for it, and there are the ones that are completely against almost being on social media. And they think that that belittles third degree and that kind of takes away from their prestige or their qualities as doctors to be out there. But I have to agree with you in the fact that there is so much bad information out there that it is part of our job as well to be out there educating and helping patients discern the good information from the fluff. And then it’s not just about being out there. But the thing is, all of these doctors that you mentioned and yourself included, who have all these big followings, the thing that strikes me as common with all of you is that you also live the life you preach. So it’s not just telling me: “oh, this what you need to do”, but you’re actually I mean, every doctor that you mentioned, they’re in good shape and they work out and they exercise and they eat well. And I think that is just as important as simply just going out there and saying, this is how you need to behave. This is what you need to take. This is what you need to do. But then you turn around and you’re living your life completely different.
Dr Nick: [00:17:24] Like you’re a hypocrite, essentially.
Dr E: [00:17:26] Well, exactly. Exactly. I think that’s part of what holds a lot of doctors back, because once they become as public, out there, now they have to live up to that every day 24/7. And a lot of doctors aren’t really following that example. And I’m sure you’ve noticed that as well.
Dr Nick: [00:17:43] Absolutely. Absolutely. You know, and not only have I noticed and not only have you noticed it, but patients have noticed it. I can’t even tell you the amount of patients who will tell me to my face. You know that they switched from their old doctor because they were making recommendations that it was very clear to the patient that the doctor wasn’t following themselves. And this all goes back to what we were talking about earlier. You want to invoke as much change as possible, as much positive change as possible in your patient’s life and actually get them to change their habits and adhere to the plan that you guys made together. You need to be representative of that. You cannot be. Probably this is way back in the day before you and I were doctors ourselves. But I’m sure you’ve heard back in the day, doctors used to be in ads smoking cigarettes and saying that there was nothing wrong with that. Right? Essentially, these were physicians who were not living a healthy lifestyle and were kind of unfortunately, probably invoking the public to do the opposite. Yes, I completely agree with you. And in my opinion, the upsides of social media as a doctor who lives what he preaches is that people can tell that you’re very honest, that you’re very real, that you’re not a hypocrite. And with that, they’re much more likely to listen to you and much more likely to follow. We simply do not live in a world anymore, in my opinion, where people are simply willing to follow you one hundred percent because you’re the doctor and you tell them something. No, if you don’t represent that lifestyle then their B.S. detectors, for lack of a better term are going to alarm and they’re not going to listen to what you tell them.
Dr E: [00:19:22] Yeah, exactly. It’s like when you see these diabetes conferences and they’re sponsored by Coca-Cola or they’re sponsored by something like that. And you don’t like what’s going on here? Are the doctors consuming those things right there and they’re supposed to be caring for these kind of patients? It honestly just baffles me how this whole system has gotten to the point where it is. But we’re at a point where, part of our role as health educators really, is what I see it, is that we need to educate the public on all of these things as part of our responsibility. We do have that knowledge, and if we don’t, then the next YouTuber will.
Dr Nick: [00:19:55] Yeah.
Dr E: [00:19:55] I mean, the only requirement right now to be an influencer is to have an Internet connection. Right. And a little bit of charisma, obviously. But that’s all you really need. And that’s what we’re seeing all these crazy people out there talking about eating just fruits or the light diet or this diet or that diet. In reality, what’s happening is that it might have worked for that one particular person, but it turns out that that one particular person is a 17 year old boy and he’s being listened to by a 33 year old woman who is trying to get pregnant. So we really aren’t comparing apples to apples and we’re giving credibility to the wrong people. So I think it is part of our job to really set the record straight.
Dr Nick: [00:20:34] I completely agree. Community health. Population health. I think that many people don’t understand that when you go in to see your doctor, they do not only have a responsibility for your health. They have a responsibility for the community’s health. So I absolutely agree with you. We have a responsibility as physicians for the entire population. Every decision that we make when someone I don’t know comes in and they have a positive chlamydia. We have to report that. Right. We have to report that locally simply because that is data that essentially helps to set into motion decisions that will protect the population at large. So whether it’s through social media or simple decisions that you do in the clinic, we have a responsibility towards the population.
Dr Nick: [00:21:52] And to comment on another thing you said, I think you know just as well as I do, spending any time in the hospital and break rooms. But health care practitioners, not just doctors, but nurses, techs, respiratory therapist. You go in the break room of any hospital and it is just junk food galore from donuts to cake to pizza. And that has always shocked me specifically, even in the cafeteria of so many hospitals around the country. The amount of junk food, right. From Coca-Cola vending machines to junk food, when we have a veritable almost epidemic on our hands in this country of diabetes, of type 2 diabetes, and if not that, at the very least, metabolic syndrome and insulin resistance. So essentially, in my mind, this is exactly when we need to be as vocal as we can be because diabetes is not slowing down. It’s actually accelerating. The prevalence of it in society of the incidence is absolutely escalating. This is not slowing down. This will simply get worse before it gets better. So this is the time when people who live the lifestyle and people who can connect with patients in ways that can invoke change. This is a time when people need to be very, very vocal.
Dr E: [00:23:13] And can influence and educate them in a positive manner, because in reality, what happens is that if we don’t go out there and educate them. Like I said, the next YouTuber will. Or the ads will. And they go out there and they get bombarded by ads in their social media and in their TV and in their YouTube and everywhere else, they’re hearing what they should be eating. And spoiler alert, those ads are being made by the companies that manufacturer these Franken-Foods. They want us eating that, that is addictive. And that, like you very, very well have noticed, is not getting us any healthier. And actually, that opens a door to something that I think you are uniquely qualified to talk about being a primary care physician. Why do you think that we are as unhealthy as we are currently as a society? What do you think are the top reasons for that?
Dr Nick: [00:24:03] Well, that’s a Pandora’s box. So in my personal opinion, you know, growing up, my dad was always very much against processed food. And I did not understand it at the time. Why? Now, kind of post medical school with a couple of years of practice under my belt, at least in my opinion, I think processed food ads, specifically the amount of added sugar in our food is a large part of it.
Dr Nick: [00:24:30] You know, we live in what I would call and I’m sure that you’ve heard it as before, we live in an obesogenic society from the pushing to minimize the amount of physical exertion that we do in terms of, you know, hey, take the escalator, take the elevator, don’t take the stairs to parking us close to the store as possible to Amazon and to day deliveries. So you don’t even need to leave the house now to shop and to stock your refrigerator. And then, OK, that’s just a physical exertion side of things. But then if we’re talking about food, I’m sure you know this. But the chemists, the food chemists who work for these companies, it is their job, as you said, to kind of return a profit for the company. So they actually will design foods around a marker called the Bliss Point. So essentially, they want to get it as sweet and as delectable as possible, such that you come back for more.
Dr Nick: [00:25:29] They’re literally designing foods that are hyper palatable and will make people want to not just have one, but have the entire bag, go out, buy another bag and keep buying and keep buying it. I understand from their perspective, listen, I get it. You know, they’re running a business. They want to maximize their bottom dollar. They want to profit. But in my opinion, as a physician, I don’t care about their profit. I care about the population health and I care about the health of my patients.
Dr E: [00:25:56] In the end, most of these companies, if we start waking up as a society and if we start influencing enough patients that they stop buying their products, these companies aren’t dumb. They’re not doing this because they’re evil and they want everyone sick. They’re doing this because people have shown that they will keep buying it. But if people stop buying it, it’s what I always tell people, like you need to start voting with your dollars, because if you stop buying it, then these companies will turn around and say, listen, we still need to make money. So now let’s figure out. People aren’t buying this crap anymore because although they are hyper palatable, they’re unhealthy and they’re aware of these. So what do we need to do? OK. We need to source better ingredients or we need to cut the sugar or we need to do these things. They have geniuses in their staff. These food engineers, just like they’ve made foods hyper palatable. They will be able to make food hyper healthy if it becomes profitable for them. I’m not one to believe in conspiracy theories that the industry is against us and they want us all sick. I just think it’s a result of the system that we keep buying.
Dr Nick: [00:26:54] I agree. I mean, it’s literally what you said. Unfortunately, what we have taught them through essentially positive reinforcement is that, hey, you make these foods very sugary and very hyper palatable. We will continue to buy them. Unfortunately or rather, fortunately for us, if we vote with our pocketbooks and we say, no, we’re not going to buy that and we buy alternatives. These companies aren’t going to die and disappear, as you suggested. They will adapt. They will adapt and make positive changes to their foods if they want us to keep buying them.
Dr Nick: [00:27:28] And it’s as simple as that. If you want to survive in this capitalistic society, you will need to change your foods and you will need to adapt and fall in line with what society wants.
Dr Nick: [00:27:38] So, no, I completely agree with you. I don’t think it’s any. It’s not any kind of overt evil or maniacal plan on their perspective. It’s simply them doing what is aligning their pocketbooks and what is getting them a profit. And if they can learn to still make a profit quarter after quarter with healthier components. I’m all for that.
Dr E: [00:28:00] Exactly. Exactly. I could agree with you more. Now, let’s switch gears a little bit. I know that like we’ve discussed so far, you take great care of yourself. You spend a lot of time in the gym. I’m sure that patients and people seek you out for that. What are normally your top two or three recommendations for somebody who comes and see you and says, you know what? I’ve been overweight for many years. I really need to get in shape and I want to hit the gym hard. And I know we’ve touched upon that a little bit before we started. What are your top two or three recommendations for someone like that?
Dr Nick: [00:28:31] I actually see a lot of these patients on my SteadyMD. And one thing that I make the recommendation to people to do is to change only as many habits as you feel that you can sustain at any given time. So, for example, if somebody is a couch potato and they are inspired by something they saw on TV and now start going to the gym and they want to eat healthier, I will instead talk to them. OK. You know, what’s your number one goal? And if the number one goal is to lose weight, I fundamentally believe in any number of words I managed to convey to my patients that you lose fat in the kitchen and you gain muscle in the gym. So we will sit down and kind of just go over how they eat. I think that an important thing when you talk to someone about how they eat is also kind of what are the motivations behind how they eat?
Dr Nick: [00:29:27] Are they often stressed out? Are they depressed or are they clinically depressed or simply in a depressed mood? Do they eat in front of the TV? Do they eat in a hurry? How many meals a day do they have? So essentially there are various components of food that we can look at and I don’t ever advocate for changing everything at once. As we kind of implied earlier, adherence is the name of the game, in my opinion. You have to figure things out that are sustainable because none of us make positive changes in a snap. It doesn’t happen immediately. You need to be working at it for months and years at a time and then you will start to see the changes take place. So from the very get go, you should always be thinking about what can I sustain? So hopefully your doctor is talking to you about changes in your food that we can make habits that we can develop slowly but surely. I like to kind of implement a habit with a patient and have them do that habit for maybe two to three weeks.
Dr Nick: [00:30:27] For example, drinking an adequate amount of water for a man my size, I need about one hundred and forty fluid ounces of water a day. And that is something that most people do not drink that much water. Most people simply do not drink the minimum amount of water that they should be drinking on a daily basis. And many people are unaware that our bodies crave, You will actually start feeling hungry simply because you’re dehydrated. Your body knows intuitively there is fluid. There’s water in most foods that you eat, especially vegetables. So if they’re always feel hungry, kind of the first thing that I look at is, hey, what’s your fluid consumption like? What’s your water? Are you kind of constantly dehydrated?
Dr Nick: [00:31:13] And if they are that, hey, that’s one habit that I can change, and then I will kind of have them change that habit and stick to it for two or three weeks and then come back, we’ll talk some more. dWe’ll change another habit.
Dr Nick: [00:31:26] So ideally, by the end of a two to three months, we’ve completely changed all their bad habits and completely replaced them with positive habits that they are able to sustain. And over months to years, they’re able to see positive changes with. Now as it pertains to the gym, I definitely will encourage people to go to the gym, but in my opinion, actually, there is data.
Dr Nick: [00:31:50] There was a study that came out in 2018 that in no uncertain terms stated that we do not burn enough calories at the gym to be appreciable in any manner for us to truly burn fat. You know, there’s thirty five hundred calories in one pound of fat and you can go out and, I don’t know, a doughnut. It’s 400 calories. Right. So if you’re telling yourself, OK, I’m going to have a couple of doughnuts and then I’m going to go to the gym and be on the treadmill for an hour, I just over two hundred pounds. Being on the treadmill for about an hour will burn just north of 500 calories. So if there’s thirty five hundred calories in one pound of fat and you just eat a couple doughnuts and in your mind, oh, I’m going to burn the soft by getting on the treadmill. That’s not how it works. So I will not sit here and say, oh, don’t go to the gym, definitely go to the gym, but know that there are benefits from sleep to energy to overall strength and functional ability, to endurance. There are many other benefits that the gym will give you. But when it comes purely to losing fat, you do that in the kitchen by changing how you eat. Changing how you address kind of your nutrition.
Dr E: [00:33:07] Exactly. And that’s what I wanted to get to because we’ve alluded to that before. But most people seem to think that. Well, you say that because you’re not in the gym. You’re not like the gym type person. But my trainer said otherwise. So now that we have you here, I wanted to see you know what? Here’s another guy who’s clearly in the gym quite more than me at least.
Dr Nick: [00:33:27] I’m a trainer, too. I’m CFMDL1 qualified.
Dr E: [00:33:30] There you go.
Dr Nick: [00:33:31] Yeah. So, you know, I don’t listen, if a trainer is telling you that, in my opinion, this may be a little pessimistic, but it might be they’re just trying to do whatever they can to keep their revenue source, to keep their money coming back to them, because that is not necessary to burn fat. Now, you have to keep in mind, when many people think to themselves kind of what their ideal body is, they don’t truly think about their ideal body as simply being without fat. Most people want muscles in a certain way. They want their body shapes in a certain way. So with that in mind. Absolutely. You need to go to the gym. You need to. You actually need to lift weights for that. You need to be very focused at how you’re lifting weights so that you can gain muscle. So I’m not sitting here saying, don’t go to the gym. I’m just saying if your only objective is to lose fat, you do that in the kitchen. But when you want to add muscle, when you want to increase your body’s basal metabolic rate, which is essentially the amount of energy that you burn just sitting here and talking –your metabolism–. Actually the only way that I know to increase your metabolism isn’t by taking a fat burning pill. It isn’t by doing a detox. It isn’t by doing any of this nonsense as advertised. It is quite simply to add muscle, because one pound of muscle burns very much more energy than one pound of fat simply to exist.
Dr E: [00:34:58] Yeah, I totally agree. And that’s the reason I wanted to touch up on that, because people think that in order to lose weight, in order to get back in adequate health, that they need to hit the gym and then they might start eating better. When in reality it should be completely the other way around it, like, listen, spend some time eating well, relearn eating habits, relearn how to eat and source your food adequately, how to prep your food and then start adding the gym. Don’t just start changing everything like you very well said. And then once you start adding things slowly start with what you’re putting in your mouth every day, then change your lifestyle and then add the gym because just like you very well said: what you eat is so important. But there are also other factors in play like just physical activity. Doesn’t necessarily mean go to the gym, but maybe you want to go up and down the steps a few times instead of taking the elevator. Maybe you want to park a little bit farther. Maybe you do want to go out for a stroll at one point. Maybe you want to start getting better sleep hygiene.
Dr Nick: [00:35:54] Or you have kids and you just want to keep up with your kids, you know?
Dr E: [00:35:58] Exactly. So all of those things are super important and that’s a reason why I wanted to touch upon it. Now, before we wrap things up, I know that you provide telemedicine services so people all throughout the US can literally consult with you as a physician. Is this just available for people in the US or can you also legally consult with people outside of the U.S.?
Dr Nick: [00:36:19] For right now it’s only available in the United States.
Dr E: [00:36:21] And how do people get in touch with you? If they were so inclined if they wanted to learn more about that.
Dr Nick: [00:36:26] So I am a physician for Steady M.D. is the company. So you would simply go to a www.steadymd s t e a d y m d dot com slash drnick.
Dr Nick: [00:36:42] Steady M.D. is a great company.
Dr Nick: [00:36:44] I’m very happy to work for them because I think it’s very important to have alignment with your doctor to find a doctor who, you know, people like to act like all doctors are the same. But we’re not. We’re human beings. So you need to find a doctor who aligns with your lifestyle and whose method of communication you appreciate and who you feel is out for you, has your health as their top priority. So I’m very, very happy to see patients through them.
Dr Nick: [00:37:13] And one thing that I didn’t mention and I don’t think you did either that I love with Steady MD is patients essentially have 24 hour access to me by way of texting, calling or video chatting at any point in time. You don’t have to go to your local doctor and wait in a waiting room for an hour, only to be seen by your doctor. And then it’s like a 10 minute rush appointment. No. On Steady M.D., we have hour long appointments and I can truly be there for my patients and understand the entire scope of their lives and then come to a decision and a plan with them that they can kind of stick to.
Dr E: [00:37:46] That’s great. And I didn’t even know that something like that existed. And this is like full kind of like, do you have at one point to see them physically or how does it work? What kind of conditions can you consult?
Dr Nick: [00:37:56] Its primary care. It’s like I’m a family medicine doc that I can see them for any number of issues. The first appointment is a mandated face to face appointment by video chat where we see the patient. We go for past medical history, family history, surgical history, medications, any issues, any pertinent issues that you have at the moment, preferences for care. Essentially, we try to get the full scope of the patient that first visit. And then after that at any point in time. Like I said, you’re able to video chat, to call, to text. The patients who appreciate it the most I found, are those who do not like waiting and waiting rooms. They like to have enough time with their doctors to actually convey what the issue is and convey what they would like to do. And then the third kind of person who I’ve found definitely loves that are those who are just constantly traveling or in a rush and they’re in a hurry. And they are able to message and say, Hey, listen, I think I have, I don’t know, a UTI. Or I think I’ve an upper respiratory infection. And then we talk about their symptoms, how long it’s been happening, and I can prescribe antibiotics or whatever else that I need to prescribe. The only thing that I cannot prescribe and I think that it’s notable for some patients are narcotic medications or scheduled medications. But other than that, I definitely love the relationship that it helps me foster with my patients.
Dr E: [00:39:19] Absolutely. We touched upon that. But it’s great that you can also build upon that through telemedicine service. And now that we were talking, I was thinking about. We spend a good amount of time whenever we’re starting a business, for instance, and we’re deciding we want to partner up with someone or not or when we want to start dating or marry someone and all these things. Even when you choose your accountant. But a lot of the time we just settle for the doctor that the system assigns us. What you were just saying is so incredibly important. You need to talk to the doctor and just like he or she interviews you, you need to interview him and make sure that, like you said, not every doctor is the same because we’re all human beings. And you might simply does not have the connection and you need to have that connection. Doesn’t mean that he or she is a bad doctor. It just means that you couldn’t connect and then you should find somebody that you will be able to have that trust and that understanding. I think that is a tremendous piece of advice that pretty much anyone can really grab and take with them.
Dr Nick: [00:40:16] Yeah. Picking doctors out of a rolodex, you know, or being randomly assigned a doctor, that’s not when it comes to optimal care for yourself, optimising and increasing your quality of life as much as possible and living a life that you enjoy. You can’t just have some random person who you don’t even know that you have a connection with.
Dr Nick: [00:40:32] And then from what I have seen, when that happens and patients are randomly assigned, then you will start to have patients who, hey, they should at least be coming in at least once a year for their yearly physical. Right? And they don’t even see you for that, because at that point they’re like, I don’t feel a connection with my doctor. I don’t enjoy seeing him. Why would I go out of my way to see him or her? I absolutely can understand that. It’s I think alignments with your doctor is something that’s very important.
Dr E: [00:40:59] I think that’s one of the key things that we learn from this conversation. So having said that, I do want to take the time to acknowledge and recognize you for taking the time out of your schedule. You were just sharing with me how you’re in the middle of a move and you’ve got still a job and your telemedicine practice. So thank you so much for taking the time for being here. Any parting words for our audience?
Dr Nick: [00:41:19] No, other than as I noted. Yeah. You can find me online at www.steadymd.com/drnick and my Instagram name is thefittestdoc.
Dr E: [00:41:29] Perfect. I’ll make sure to link to all of those for everyone listening. You can also find the links in the description to this episode. You just scroll to the description of this episode. You’ll be able to click on the links for a SteadyMD and for Dr. Nick’s social media profiles. Having said that, thank you everyone for joining us. This has been another episode of The Highway to Health Show. I hope you have a great week and I’ll talk to you next week.
Dr E: [00:41:51] So there you have it. This has been episode twenty three with Dr. Nick. If you enjoyed the episode and would like to learn more, make sure to check out the show notes and links to everything we mentioned in this episode’s description. And before we go remember to also sign up for a free copy of the book I’m working on about stem cell treatments for patients. Just visit DrE.show/book to sign up now and I will make sure you get a free copy once it’s released. Thank you all once again for tuning in. I look forward to seeing you here next week. I’m Doctor E ‘The Stem Cell Guy’. You are on The Highway to Health and I’m your guide to get you there.
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