Every year, Evolution of Medicine picks a theme, and this year’s theme is Growth. And who better to kick off our year of growth than Dr. Mark Hyman? In this episode, we talk about the growth of the movement and the surprising places where functional medicine is really starting to take off. We also talk about food as medicine and why personal growth is such a critical part of not only getting people well, but also growing the functional medicine movement worldwide.
Highlights include:
- Dr. Hyman’s thoughts on where we are in the transformation of medicine
- The pandemic as an impediment or an accelerant of growth
- How personal growth can impact community growth
- And so much more!
James Maskell: Welcome to the Evolution of Medicine podcast, the place health professionals come to hear from innovators and agitators leading the charge. We cover the latest clinical breakthroughs in health technology, as well as practical tools to help you transform your practice and the health of your community. This podcast is brought to you by the Lifestyle Matrix Resource Center, who provide a range of options to help you deliver successful, effective, functional, and integrative medicine. To find out more and to get started, go to goevomed.com/lmrc. That’s goevomed.com/lmrc.
Hello, and welcome to a very special episode of the Evolution of Medicine Podcast. Every year on the podcast, we have a theme for the year. So 2020 was resilience, 2021 was the reinvention of medicine post-pandemic. And now the year 2022 is all about growth. And so to kick off the year who better than Dr. Mark Hyman, played such a massive role in growing the functional medicine movement. In this podcast, we talked about the growth of the movement, the surprising places where functional medicine is really starting to take off. We talked about food as medicine and we also talked about personal growth and why personal growth is such a critical part of not only getting people well, but also the growth of the movement as well.
There’s no one better to kick this off, if you don’t know Dr. Hyman, you know that he is a leader advocate, educator, speaker in the world of functional medicine. He’s a 14-time New York Times bestselling author. He pioneered the Cleveland Clinic Center for Functional Medicine. You’ve probably seen his podcast, The Doctor’s Farmacy. We refer to a couple of episodes in that last year that were really spectacular. So enjoy. It was a really amazing kickoff to our year. I think you’ll get a lot out of it wherever you are, whoever you are. We’re super excited to be facilitating this growth inside the Evolution of Medicine with helping doctors move to functional medicine, but also building communities of practitioners. And if you want to find out how to join or start a community locally, go to functionalforum.com, enjoy. So a warm welcome back to the podcast, Dr. Mark Hyman. Welcome, Doc.
Mark Hyman: Thank you. Thank you. How are you doing, James?
James Maskell: I’m really, really great. Great to kick off 2022 with you and to be talking about a topic that I think is super exciting for everyone in the industry. And you, more than anyone else that I know, have been a catalyst for the growth of the functional medicine movement. I want to just tap into—
Mark Hyman: I’m just the loudest mouth, I think. Maybe.
James Maskell: Yeah. Well, look, I guess I want to start off by, we’re going to talk about all aspects of growth, to kick off the year. But I know that one of the things that we’re always trying to do is to give the community confidence that the movement is growing and that functional medicine is making it into new places that it’s never made into before. And I guess I want to start with that, from your unique perspective, where do you see that growth and where’s the most exciting progress that we’re making as a movement?
Mark Hyman: Well, I think what’s exciting, James, it’s really global. Everywhere I go in the world. I mean, I did an Instagram Live the other day and there were literally thousands of people. It was in the middle of the night in Turkey. I mean, so it was the middle of the night in America, but I was in Turkey with Dan Buettner and there were thousands of people on, I’m like, “Wow, it’s amazing. The whole world is turning on to a new way of thinking about medicine.”
And in the United States, I think there’s clear signs of change. I see this over and over again. Obviously, Cleveland Clinic was a big advance in bringing functional medicine to the center of healthcare, but we’re in conversations with government, we’re in conversations with many universities, I’m helping consult on a brand-new medical school that’s being started that’s going to be essentially a functional medicine medical school. I’m seeing research popping up. I’m seeing innovators and a whole field of people that weren’t really even aware of or in the space. And now when I go in a room and I say, “Who’s heard of functional medicine?” 80% of the people raise their hand, whereas 10 years ago it was maybe one person or nobody.
So I see the change happening. I see the interest in my work and in functional medicine just growing and growing. I see the disruption of the old paradigm really profoundly through some really important changes in our understanding, for example, of the microbiome or genomics or systems biology and there’s a new textbook, for example, from Harvard called Network Medicine that just really describes functional medicine.
So I see the traditional world moving in this direction. I see the Department of Nutrition Psychiatry at Harvard and Metabolic Psychiatry at Stanford. I see people thinking about things that were not even in the radar, like how does the microbiome affect your mood? Or how does sugar and diet affect your mood? And I see also, rheumatology colleagues real openness. I got a call the other day from a patient who wanted me to talk to one of her doctors who’s a rheumatologist and to get on the same page. And I’m always a little wary of those conversations. I’m usually ready to explain everything and be patient and bring them along and pull them along. He was like, “Dr. Hyman, Dr. Hyman. I’m so glad you called. I’ve been using your dietary approach and it’s amazing. And when we use in combination what we’re doing, we see dramatic resolving.” He wouldn’t stop going on and on about it.
And I get referrals from Cleveland Clinic specialists all the time, a rheumatology referral recently, and very understanding of the limitations of our current model. And I think the old paradigm’s breaking down, the new one’s emerging. I think there’s real interest in things like food is medicine, there’s a whole food is medicine working group in Congress. I started a nonprofit called The Food Fix Campaign to drive awareness in education around food is medicine, regenerative agriculture in policy centers. And I see there’s now a medically tailored meals bill in Congress. There’s regenerative ag hearings in Congress. There’s a whole shift that’s happening that’s bringing people to understand that food is a huge issue.
I mean, even Politico, which is a pretty conservative platform, talked about the role of diet and COVID and how America had pretty much neglected that. And in many other countries like the UK there’s of course Johnson was like, “Hey, I got COVID because I was fat. And I was in the ICU because I was fat and I need to lose 20, 30 pounds. And you all do, too, and we’re going to change policy. We’re going to end food marketing to kids. We’re going to do changing labels. We’re changing our regulatory and legislative actions to actually promote wellness and health.” So things are shifting. There’s an awareness that we can’t just keep going the way we’re going.
James Maskell: Yeah. Do you think the pandemic, you mentioned COVID there, has that impeded growth or accelerated growth?
Mark Hyman: Well, I think it’s both in a way, because what’s happened is unfortunately the media and the government messaging has been very focused on vaccines. And now on a few medications that may be helpful. And I understand why from a public health perspective and we can debate pros and cons of vaccines all day, I think that’s just a rabbit hole I think we shouldn’t go down our right now. But I do think that what’s happening at the same time, is emerging phenomenon long-COVID. And I think it affects probably 20 to 50% of the people who get COVID, even people who are healthy and don’t get very sick. And when you look at the modalities that are available to help these people, it’s basically nothing from traditional medicine. And there are clinics popping up, they’re overwhelmed in major medical centers, they don’t know what to do. And so now at Cleveland Clinic and other universities, there’s integration of functional medicine and traditional care with these long-COVID clinics.
And I think the Institute for Functional Medicine has been an incredible leader in helping prepare a cogent science-based approach to a functional medicine perspective on COVID using diet, lifestyle, right nutraceuticals and other therapies that actually can be important in preventing, mitigating and actually helping to help reverse past COVID-19.
I mean, this one study came out and I mean, this is one study, but it was pretty compelling, which showed that…and there was a lot of other studies on vitamin D and COVID, but this one was compelling because it showed if you had a blood level a little over 50 nanograms per deciliter, your risk of death was zero, which is better than any vaccine. So I sent a note to one of my political friends and said, “Hey, maybe we should have a vitamin D mandate.”
James Maskell: Totally.
Mark Hyman: That would be good. That would be good. So I do see there’s an interest in functional medicine from, how do people say healthy? People want to build their immune systems, people are understanding that they’re at risk if they’re unhealthy. So there’s an increasing awareness that we need to address the root causes of chronic disease and obesity.
James Maskell: Absolutely. Yeah. I know long-COVID, I had as an idea of where clinically functional medicine was making it into new places. And back in November, that podcast that you did with Dr. Leo Galland was really sensational. I mean, he’s such an amazing thinker and has given so much to the functional medicine movement, but some of the stats that came up there about like vegetables and long-COVID were pretty spectacular. Where else, other clinical areas that you feel like maybe the world or physicians are waking up to the importance of this kind of strategy?
Mark Hyman: Well, I think the microbiome is the great disruptor. Because I think for cardio metabolic disease, everybody understands that lifestyle and diet play a role. People understand that. But I think for the microbiome, it’s something that’s been the focus of functional medicine before it was even called the microbiome.
James Maskell: Yeah, for sure.
Mark Hyman: For 35 years or more. And we have really focused on how do we restore the gut to normal function as a way to treat a whole series of complex disorders, everything from obesity, heart disease, to cancer, to autoimmune disease, to allergies, to obviously digestive disorders, neurogenerative disorders, mood disorders, attention disorders, autism. I mean, the list goes on and on and on. And so when you have the science butting up against the old paradigm and you have the science saying, wait, if you’re a heart patient, maybe we should look at your gut. If you’re a rheumatology patient, maybe we should look at your gut. If you’re a dermatology patient, we should look at your gut. And so on. Then that’s really breaking apart the old ideas. It’s unfortunate that most doctors don’t know what to do about it. They understand there’s a link, they don’t know how to diagnose any imbalances like that. They don’t know how to treat it, but I think there’s an increasing awareness that we can’t ignore the complex bio systems that we are.
And the emergence of systems biology, the emergence of people at Harvard and Leroy Hood, the Institute for Systems Biology and others are really pushing the envelope on this. And there’s groups moving up all over the place, trying to look at this, whether it’s the Human Longevity Institute, whether it’s Foundation Health, which is another group that was developing longevity clinics, everybody’s biting at the heels of functional medicine, because they understand that’s it really the only coherent model at this moment for translating systems biology science into clinical medicine and creating positive outcomes. So that’s really what I see happening. And I don’t think we’re going back now, but it could take five years, 10 years, 20 years. I don’t know. Will I still be alive? I’m working on getting to 120. So hopefully by the time I die that every medical school will be teaching functional medicine, that would be a good thing for me. But I don’t know, if we’ll get there.
James Maskell: I was just watching back actually, when you came on the functional forum, the first time May, 2014. When—
Mark Hyman: Oh, yeah. Oh, God.
James Maskell: …you ran from Cleveland. And the first thing you said is, “Look, we don’t have to apologize anymore for the medicine we’re practicing.” And it was the announcement the Cleveland Clinic Center for Functional Medicine. Just see, even in that time seven and a bit years, how far things have come. For the doctors who are watching this, who are in practice, doing functional medicine in towns and cities and villages, all across the country and all across the world, where do you think there are some opportunities for them locally to bring functional medicine that maybe didn’t exist five or 10 years ago as well?
Mark Hyman: Well, I mean, I think one of the silver linings of COVID for functional medicine is that it really is the only pathway for people to get better. And I think, we’ve seen where there have been post-COVID clinics open up, they’re just swamped. So, if people are looking to get people interested and connected and find a doorway into functional medicine, I do think that talking about advertising, marketing around being able to help people with post-COVID and you have to do that delicately, but you’re not going to say, “Oh, ozone cures most COVID.” Or something. You have to be smart about it, but you can actually start to create awareness that there is a way out. And I think that the more functional medicine practitioners do that, I think it’ll help to include more people in the fold.
But I think it’s happening naturally. There’s just a natural…I mean, we have 1000 people on our waiting list for next year. And we have five doctors. I mean, it’s just overwhelming, the demand. And I can’t keep up with it. And I thank God there’s more and more doctors doing this and I can say, “Go see this one, go see that one, because we’re full.” But I think there is an expansion and there’s more and more people really focused on the functional medicine world and it just makes me really happy.
James Maskell: Yeah. Well, one of the things that we’re excited about in 2022, I guess the thing that I’m proudest of, of the functional forum is creating communities of practitioners all across the world where doctors would get together and talk about functional medicine and see locally who the other doctors were. What we’re super excited about in 2022 is expanding that, so that a safe place in every community where once a month or once a quarter we can invite new doctors in and share some of this new science and spread the message locally. Are there any surprising areas that you’ve seen growth where you thought, “Okay, this is not an area where functional medicine will make it,” and now you see things are okay putting up that you didn’t expect?
Mark Hyman: Oh, that’s a good question. I mean, I never, for example, expected that the military would be so into it. And I work with special forces and we work with a whole team called Task Force Dagger, which is for vets who’ve struggled with their health, with various issues. And it’s quite an amazing thing to see the interest in looking at high performance, what works.
And the other one I’m seeing is in athletics, a lot of people are looking at how do we engage high performance? I think a lot of private equity companies and investment companies are investing in this space. I see a lot of technology and business innovation around the healthcare space that is really driving these frameworks through whether it’s Levels, who is inspired by functional medicine or whether it’s company like Hu Chocolate or Human Coach, another one that’s inspired by functional medicine or whether they’re a technology companies like Salba looking to solve big problems like gut issues. So there’s a lot of companies out there that are using the functional medicine DNA to create products and services to make it easy and accessible for consumers.
James Maskell: Absolutely. Well, look, I want to switch tracks a little bit here because I know that the movement is growing and ultimately we’re super grateful to you in taking the flag forward and planting it in new places. And everyone in the movement is super excited just to hear about that. I guess, one of the things I wanted to-
Mark Hyman: Oh, by the way, yeah. In Turkey. I was in Turkey recently and I was literally on the front page of the paper every Sunday. I’d forgotten about this today, there’s somebody who asked me, “Can we use your blogs or your podcast?” “I mean, sure, whatever you want, I don’t care.” And then I go to Turkey and there’s face on the front cover of the newspaper, it’s like the go-to New York Times of Turkey. And then every Sunday, there’s a huge two page spread about some functional medicine topic. And we’re opening a functional medicine clinic. There actually is a functional medicine clinic now in the American Hospital, which is like the Mayo Clinic of Turkey. So it’s amazing to go up there, it’s this functional, which is really how they spell it, it’s very funny, but I have a picture of it, but it’s pretty amazing to go to Turkey and just see a functional medicine clinic in a major hospital.
James Maskell: Yeah. That’s super exciting. And I definitely feel that worldwide energy just from the way that we interact with groups around the world too. I guess, one of the things I wanted to talk about in this year of growth was actually also personal growth because ultimately what I’ve come to realizing now seeing group visits, work out, a lot of what’s happening and being in my own group, being in my own men’s group is realizing that for real healing to occur, there’s a personal growth component to healing. And also there’s a personal growth component to being a successful physician entrepreneur. So I guess, you’ve been quite open about your journey in personal growth over the last decade and talked about how you work. So what are your thoughts on personal growth and how that affects the whole growth of the ecosystem, but also the growth of each individual patient as they’re healing?
Mark Hyman: I think people are more and more open to different things. I think the whole psychedelic research infrastructure that’s being developed, billions of dollars flow into psychedelic investments and companies as a way to treat trauma and mental illness and affect everything from birth to death. I think it’s really promising for me because it means people are curious about how to heal and people are eager. We went from the opioid epidemic to it’s the psychedelic revolution. And I think there’s no accident in that. And I think there’s really interesting things happening around this culture and people waking up to the way we’ve been doing things in terms of our social engagements is not right. I mean, how we structure our lives, how we live, how we’re isolated, how we are overworked and over pressured and stuck in vicious cycles that don’t serve our wellbeing.
And I think COVID really blew that all up. It was like God said to humanity, “You’re being bad, go to your room, it’s time-out until you come out and figure out how to have a better life.” And so for me, it’s been very transformational. I really was on a plane two, three times a week for years and years spreading the message, like a traveling evangelist. And it was costly for me personally. And it really took a lot of my force and energy out. It undermined my health in many ways, relationships. I didn’t get to spend time with my friends as I wanted.
And so it really woke me up to how I need to reimagine my life to be more effective, more productive, but in a different way. And I think this podcast is an example, I would make sure I would be in-person or have you come. It’s like you spend a whole day or two days going traveling, as opposed to just, this is good. This is good enough. We still get the word out, the message out. You can see me, I can see you. And we end up having great conversation without having to disrupt both of our schedules and the lives and travel around.
So I think there’s a place where for me, it’s been very, very healing. And it’s also given me more time to reflect on what matters and my meaning and purpose and what I want to be doing and how I don’t have to do what I’ve been doing. I can reimagine my life at any moment. And I’ve been doing that and I’ve been taking time to heal and to repair my body from all that damage, as well as my heart. And even the work on my spiritual growth as I’m getting older, I’m like, “Okay, well, what really matters? How do I spend my time? How do I engage with the world? What are the patterns that I have that I still have to heal from childhood?” And I’ve been doing a lot of that work and it’s been very powerful.
James Maskell: Yeah. What are the modalities that you’ve found, that have made the biggest impact for you so far?
Mark Hyman: I think for me, it’s just really creating some space. I mean, my schedule was literally booked from the minute I woke up till I went to sleep for years and years. And just create spaciousness where I can be. I don’t have to do, and I can reflect and I can think. I’m taking a month on a writing retreat, a spiritual writing retreat up in Vermont for a month and I’m going to be completely off-grid, no phone, no computer, no books other than just me and my mind and my body. And I want to just feel what that feels like. I’m almost 62, I’m going to be 62 soon. By this podcast out I’ll be 62 already. And I want to just pause for a minute and reflect on my life and where I’m going and where I’ve been and what I want and get really clear about the things that matter and take that time, which is really rare. I mean, I’m really privileged I get to do that, that I can take a month and go do that.
But I do think it’s important and people’s only, whether it’s five in the morning or 10 minutes or more time on the weekends, whatever it is that you can take to just be without doing. I just was listening to a podcast with Tim Ferris and Eric Schmidt from Google. And Eric was like, “Well, we went to North Korea a few years ago.” He was talking about artificial intelligence and the way we’re all so hyper connected, we never get off our phones. And he said, “We had to leave our phone in China. And we couldn’t go to North Korea with our phones. So we all left our phones and we all got on a plane and we all went and we all became best friends. We talked nonstop, everybody was present and enjoyed each other and had a great time,” and became best of friends in a very short time because they weren’t on their devices. And as soon as they landed back in Beijing, they all grabbed their devices and they were lost again in that digital portal, which is very so robbing.
And he was reflecting on how meaningful those interactions were and how often we don’t do them. So for many of us, digital detoxes are so important. Who are we without our devices? Who are we just being? And I’m old enough to remember what it was like, and you just were, there was nothing. I mean, you want to go to a movie? You have to go to the movie theater. You want to watch TV? Well, you had to wait till the fricking show came out on Thursday night at 8:00. You want to see the next episode? You had to wait a whole week. And then there was only like three shows on the television. So there was like three newspapers.
So it was really pretty slim down series of inputs that allowed for more being and less doing. And I think for me at this point in my life, I really want to be intentional. And I was reading a book by Seneca, who’s an ancient Roman—
James Maskell: Yeah. Poet.
Mark Hyman: …philosopher.
James Maskell: Yeah.
Mark Hyman: And he was writing about this book called the [On the] Shortness of Life and how we will protect our property to the death and we will protect our money to the death, but we don’t protect our time. And we don’t protect our own time for ourselves and our leisure and our ability to actually be and how we can create more meaning and pleasure and joy and connection in life. That to me is the most important thing, is what are we doing it all for? Save the planet for what? Fix climate change for what? Get healthy for what? It’s because it allows us to be more fully engaged in life and do the things that matter. How to love better, how to interact with our friends better, how to create more creativity and beauty in the world. Those are the things that really matter. And so if we advocate the necessity of time to actually be, and reflect and think and have spaciousness and be in the moment, we’re missing so much of what’s going on and it’s important in life. So I feel like that is reorientation for me about what matters.
James Maskell: Yeah. Well, one of the big moments I think, of 2021 was obviously when the research came out in the BMJ about the groups at the Cleveland Clinic, showing that not only was the outcomes better than one-on-one, which is better than conventional, but also the cost is way lower. So finally we have a delivery system that could actually become the standard of care because it’s efficient enough and it’s scalable enough. I’ve spent the last year—
Mark Hyman: Well, James, it’s more striking than that, because the study, just for those people haven’t read it, was looking at shared medical appointments for chronic illness using functional medicine Intel Inside. It was basically two hours a week for 10 weeks with some follow-up. And what we found was that in a previous study, our family docs and internists were able to do better in terms of the promise score outcomes, these are patient report outcome measures that’s an NIH standardized metric. They were able to do better than one of the greatest clinics at Cleveland Clinic in primary care. So it’s not some clinic in Mississippi with a doctor who barely finished medical school in Afghanistan, it’s basically the top doctors. And performed better—
James Maskell: Gold standard in conventional medicine basically.
Mark Hyman: Yeah. We performed better across the board in physical and mental, global outcomes than the conventional docs. And the shared medical appointment study didn’t compare our outcomes to those docs. It compared it to our docs, seeing the same diagnosis. In other words, if we did a group on diabetes or on digestion or on whatever, that those docs, same doctors who are running the actual groups, those same doctors, one-on-one were compared to the doctors doing the groups and the groups did better than the one on business with the same doctor. That’s striking to me.
James Maskell: Well, having been part of this men’s group now for two years and just seeing, this is not a health group, but seeing significant health changes as people are accountable to their goals, their own goals and have that support, and I’ve seen a tremendous amount of personal growth in the other men in the group and for myself as well. And I guess I just wanted to touch in with you about the role of groups in personal growth, because it certainly feels like as long as everyone needs a coach, it’s not very scalable for us to deliver this kind of thing, but certainly there’s something that happens in this peer to peer dynamics that’s healthy for everyone and doesn’t cost anything to anyone.
Mark Hyman: Yeah. I mean, I know Rick Warren, who I created The Daniel Plan with, which is a faith-based wellness program, where we got a quarter of a million pounds off of 15,000 people in a year and many health benefits, obviously, he said, “Everybody needs a buddy.” And the other way I say it is, “Getting healthy is a team sport.” Or, “Everybody needs an accountability buddy.” And I think it doesn’t have to be a group. It can be your best friend. It can be your sister. It can be anybody. It’s the stranger that you meet. I mean, I met someone the other day who I just met and she’s working on a similar project I am, and it’s a writing project and we were like, “Okay, let’s help each other.” And we shared, be accountable and encourage each other.
And I think that is always how life works. We are tribal beings. We’re meant to be social organisms. E. O. Wilson wrote a beautiful book called The Social Conquest of Earth, really about the nature of the need for community and groups in every species, to actually survive. I mean, if you throw a human alone in the woods, kind of rough. But if you have a tribe, then you can do a lot of stuff together. So really, really important for us to understand that community is medicine, just like food is medicine, community is medicine. And I think we can’t ignore that fact.
And in fact, when you look at the data on behavior change, I mean, listen, I’m very good at changing biology. If you gave me a patient, nine times out of 10, I will correct everything and know what to do. And I’ve been doing this for almost 30 years, and I really understand how to change the dials and tune up a human system. And I’m good at it, but it doesn’t matter if the patient won’t do it. I just met with a guy who’s in his late 90s and he’s like, I know what to do to make all this better. And he’s like, “Yeah, well, I don’t know, I’m 90. I don’t know if I want to do that.” I’m like, “Okay, you’re entitled. But I’m just saying there’s a road.”
So I think that it’s so important to have that accountability and we know from the science that it doesn’t have to be a professional. The only reason we did the shared medical groups was because of the current reimbursement model that we had to bill, and we had to justify the doctors and the nutritionist and everybody’s time, we had to bill it as a shared medical appointment. But the truth is, if you look at the data, for example, on the diabetes prevention project, they found that whether it was led by a doctor, a nutritionist, a physical therapist, a health coach or a layperson, the outcomes were no different.
And my favorite study, which was really, I found very amusing, which is they found a group of overweight, metabolically unhealthy people who are mentally handicapped with low IQs. And they said, “Okay, here’s the things you need to do to get healthy, and you can do them together.” And they gave them the instructions. And they met every week and they support each other and they had better outcomes and objective metrics of blood sugar, blood pressure, weight, everything else than any traditional medical one-on-one visits. And this is without anybody except themselves helping each other, as we found in The Daniel Plan, it wasn’t a professional. It was just, they had the right intel inside, the right content. And they were able to support each other. And they weren’t health coaches or anything. They just had the information, the right knowledge to change biology. And they had the tool to change behavior, which is the power of community support, accountability and feedback.
And there’s a book called Join the Club by Tina Rosenberg, from New York Times who talks about this phenomena very clearly, how we are made to actually be in community and we’re made to actually have a change through this power of connection, whether it’s AA or whether it’s, she talked to some of these church groups in the book, whether it’s Rage Against the Haze, which is a teenage group that was inspired to come together to act against tobacco companies, because they thought they were taking advantage of them. So they got indignant that they were being oppressed by tobacco companies by like Joe Camel and stuff. So they just found whatever was the catalyst, and they were able to actually get people to change. So that’s really how things change.
And we see this over and over. It’s what Paul Farmer figured out with his model in Haiti about curing TB and AIDS, wasn’t the need for better drugs or surgery, it was the power of community. He called it accompaniment, that we accompany each other to health. And to me, that is the most important thing. So I always say, we need to change the way we do medicine and the medicine we do. So the way we do medicine is how do we deliver care? I mean, through a whole range of different strategies, but also it has to be democratized. It has to be in the community. It has to be putting people and communities in the center of healthcare, not doctors and hospitals, it has to be using the power of these groups. So the way we do medicine is that, and what we do is functional medicine. So we have to change both. We have to change behavior and biology.
James Maskell: Absolutely. I’m glad you mentioned insurance there at the Cleveland Clinic, because I think one of the things that’s constrained the growth of the functional medicine movement, and it was totally legitimate, was to opt out of the payer system. And I myself spent like a decade trying to help doctors leave the payer system and go and start their own functional medicine practice, because it was very different to execute it. But one thing that happened in 2021 that I think is a shift that we’re going to see continued in 2022 is the way that insurance is paid and organized, CMS starting to realize, okay, things like chronic care management, if we get coaching prescribed by a doctor, then they’re good outcomes. That’s where they’re increasing the reimbursement for chronic care management.
It does seem to me that there is a shift happening where more and more functional medicine could be delivered inside the payer system, commercial payers, Medicare, Medicaid. And obviously you’ve innovated on that in the Cleveland Clinic in order to facilitate that. Where do you see the openings then? And can that exponentially increase the effective demand for functional medicine if we do it right?
Mark Hyman: Yeah. So one of the things I’ve been working on, I wrote a book called Food Fix: How to Save Our Health, Our Economy, Our Communities, and Our Planet–One Bite at a Time, about the need to change our food policies that are driving disease. So as a doctor, I can’t cure diabetes in my office. It’s cured in the farm, in the kitchen, in the supermarket. And I began to realize, I have to go upstream. And this functional medicine is all about root cause and root cause analysis and the cause of the causes. So what’s the cause of people being sick? It’s the food. What’s the cause of the food? It’s the food system. What’s the cause of the food system? It’s the food policies. What’s the cause of food policies? It’s the food industry. So you had to go all the way up that rabbit hole to get to upstream solutions.
And so that’s really why I created a nonprofit called The Food Fix Campaign and Food Fix Advocacy. So I’m actually a lobbyist right now, it’s somehow hysterical to say that because I always decried lobbyists, but lobbyist for the good guys. And I remember I was with Tom Harkin years ago during the Obamacare, we were working on policy around then. And I said to him, “This is what we need to do, and the obesity and diabetes.” He was like, “Yeah, this is great. This is great. So who do you represent again?” And I’m like, “Well, the science and my patients.” And he’s like, “Wow. That would make too much sense.” Because they’re not used to seeing people show up who aren’t funded by a huge lobbyist. I pay my way. I mean, the hotels are expensive in Washington; it’s like five, $600 a night for a hotel, and the flight, and everything.
So I think we really are seeing now in Washington, a real shift. And I think there’s a food as medicine working group as I mentioned, there’s a medically tailored meal bill in Congress. We’re working on regenerative ag. I’m working with Cory Booker, who’s now on the Senate Ag Committee. He’s the chair of the nutrition subcommittee in health. And he’s read my book and he’s super engaged and we’re working collaboratively on various hearings and strategies to actually move this forward and change our food policy. In fact, the Government Accountability Office, which is the government watchdog that actually is bipartisan, that looks at existing policies and whether they’re working or not working and does the financial and social impact analysis.
I asked my friend, Tim Ryan, who’s a congressman from Ohio who I assume, I think will be a senator from Ohio, I asked him would he get the GAO to do a report on all of our food policies and all the agencies that are involved in any food policy and whether they’re working together or not, what the impact on our health is, what the impact on our economy is. And he’s like, yeah.
So he, and I think another congresswoman asked the Government Accountability Office to do this report. It finally came out after two years, which was great, takes them a while. And I was even shocked because James, what they found, I thought there was nine and maybe 10 agencies involved. And I don’t know how many programs, but there was 21 different groups involved in the government or agencies with over 200 different programs. Most of which were completely disconnected and uncoordinated. For example, we say, oh, we should be eating half our plate as fruits and vegetables, according to the US dietary guidelines, but less than half a percent, less than half a percent of government support for agriculture go to growing foods and vegetables.
On the other hand, we say, oh, we should be cutting down on sugar and processed food and yet the government says that in one hand with the USDA and the dietary guidelines and on the other hand, they provide snap or food stamps to over 40 million people, $7 billion is for soda, which is 10% of the budget. And about 75% of the budget, which is the biggest line item budget in the entire USDA, which is huge, by far. It’s probably three quarters of the entire budget, it’s for food stamps and 75% of that is for process junk food. So just the disconnect is so big. So now this report came out, the Congress has to respond to it, which is really, was my goal to try to move this forward. So it’s a slow, arduous process, abolition didn’t happen overnight and neither the civil rights or women’s rights or gay rights, but you got to do the work.
And so I’m doing the work and that’s really a lot of what I’m focused on now, because if I can, for example, get doctors to prescribe food and food be reimbursed as medicine, that’s a huge breakthrough. Because then doctors will get reimbursed for that, there’s onus to do it. We need to drive more change around different digital technologies and reimbursement for that. I mean, Virta Health now I think is getting covered. I’m working with Anthem, Blue Cross Blue Shield on all kinds of innovations that they’re interested to start to bring these in because they can see this is just the whole infrastructure and the foundation of our healthcare system is probably not just the what we do, but just the methodology that we are engaged in is causing incredible costs and patients are getting sicker and it’s just not working. So I think there’s a real openness now more than there was.
I mean, when I started this, I mean, honestly, I give these talks to faculty and I can go talk on obesity or metabolic syndrome and I have to change my freaking slides every year because, okay, it was three out of 10 is chronic illness, it was four out of 10, it was five out of 10, it’s six out of 10. It was 20% obesity and then it was 25, then it was 30, then it was 35, then I was 40%. I’m like, “Geez, I keep having to change my slides because it’s getting worse and we’re not doing anything about it.”
James Maskell: Well, it’s interesting what you said there, it was also almost the response to that Politico article, which was saying, hey, nothing’s happening in America. And all these other places, the pandemic has pushed everything forward at a political level. And so I’m really grateful to hear that because ultimately, where it seems like America’s lagging behind, it certainly seems like from what you said, there’s some hope that things are moving forward. And I guess, just want to acknowledge all of that work because I know it’s a lot. I was on a similar treadmill of conferences and wrote things for a long time. And I know it’s a lot, so I just want to acknowledge the amazing work that you’re doing to put this in everyday and take the whole movement forward. And I’m excited to hear about your writing retreat too, so you can balance it all out.
Mark Hyman: Well, I just do what I got to do. I don’t know. I don’t really know what I’m doing. I’m just seeing an opportunity, see what needs to be done and just do it. And I’m stupid enough to not realize that I’m probably barking up a tree that’s very hard to move, I don’t think know if that’s the right analogy, but I can’t help myself. So I just keep doing the work, keep moving it forward. And I just see that…I feel very hopeful. I mean, I see real shift happening. I see more and more interest in this kind of medicine. I mean, I’m going to give a talk to this private equity company this week and it’s fascinating because their whole portfolio is all about food and disruptive health technologies and food is medicine. And I get really excited when I see that, because not only is it the right thing to do, but it’s also economically right. And I think when the economic shifts in favor of what we’re doing, it’s all going to be rolling downhill. So it’ll be easy.
James Maskell: Absolutely. So 2022, the year of growth, give us some goals that you have for 2022 where you think, hey, if we get to achieve this in this year, it would be a significant step forward for the movement. And can you look at out into the future, maybe it’s five years, but what would a year of growth mean that you felt like we’d been really successful in progress?
Mark Hyman: Well, I mean, that’s a big question. Because I can’t speak for everybody else, what they would do or want to do. But I think the things that I see that are emerging are more integration of food is medicine into medical school curriculums. I mean, my daughter just started medical school this year and she said, “There’s a food is medicine group.” And I’m like, “Yes. Okay.” I see there being increase in interest in academic institution. I see that there’s more science being done around this. I see that there’s actually real disruptive changes in the health and food tech and business innovations that are moving things forward in the right way. And I see in Washington, policy changes that are starting to move an inch towards the right direction. I mean, change doesn’t really start in Congress, it ends in Congress, but you still got to educate and work on them.
So I see, hopefully in two or five years that our Food Fix Campaign will have been successful in driving policies that reimburse functional medicine, that reimburse food is medicine, that actually help patients create health, that change the economic incentives for doctors. And I think that’s really possible. And I’m, I know it sounds crazy, but I’m trying to raise a fair bit of money. We raised a few million dollars, but I think we need multiples of that, maybe a hundred million, 200 million to really drive the change we need to see.
So I’m trying to create a movement in the grassroots and also grass tops really through changing those 2,000 minds in Washington that are holding levers of power to change our policies, to promote health and wellbeing, both of humans and the planet. And I think the beautiful thing about this is that if we…food is something universal. Food is something people can get behind. Food is of central therapy and functional medicine. And it’s something that if we can start to get people connected to and move towards in the right way, I think, and reimbursed for that, within healthcare, I think it’ll start the domino effect. It’ll move it all forward.
James Maskell: Beautiful. Well, Doc, thanks so much for kicking off year of growth, 2022, super grateful for all the work you’re doing. And for everyone who’s listening, so many opportunities to bring this into your local community, to enroll new doctors, to change the food is medicine scene locally, to support the industries and infrastructure that is bringing true health to people in your community and super excited for the year ahead. Thank you so much for being part of the Evolution of Medicine Podcast. I’m your host, James Maskell, and we’ll see you next time.
Mark Hyman: Thanks for what you do, James. We appreciate you.
James Maskell: Thanks for listening to the evolution of medicine podcast. Please share this with colleagues who need to hear it. Thanks so much to our sponsors, the Lifestyle Matrix Resource Center. This podcast is really possible because of them. Please visit goevomed.com/lmrc to find out more about their clinical tools like the group visit toolkit. That’s goevomed.com/lmrc. Thanks so much for listening and we’ll see you next time.
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