Sandi and Steve Amoils are medical doctors who have built a multi-disciplinary functional medicine clinic in Cincinnati, which includes chiropractors, acupuncturists, energy healers, therapists and doctors. They share the first steps they took to achieve their vision, how they made their business work as a cash-based model and why they are partnering with a larger hospital system. Their clinic also runs an accredited fellowship integrative medicine program.

Download and listen to the full episode to learn more about:

  • Their insights on how to build a highly successful, multidisciplinary practice
  • Increasing patient demand for functional medicine
  • Building credibility through positive patient outcomes
  • Why a large hospital system wanted an integrative health clinic
  • And much, much more!



Building and Integrating Functional Medicine into a Hospital System | Ep 282


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 the podcast. This week, we have Dr. Steven and Sandra Amoils. They are integrative and functional medicine leaders from Cincinnati. And this is the year of growth, so, we’re going to talk about their origins and how they got into integrative medicine, how they discovered functional medicine and how that’s made it into their clinical operating system. We talked about some of the innovative ways that they built such a successful practice working with a lot of different practitioners. They talked about their ACE method, which is acupuncture, chiropractic, and energy healing, all being done in one appointment every time, which I think is really interesting.

And then we talked about their big plan, which is to integrate with a hospital and to scale up the delivery of integrative medicine inside Cincinnati. So, perfect topic for the year of growth, so much good stuff in here from a practice management point of view, from a clinical point of view. Really inspiring couple with a really strong story, and I think you’ll get a lot out of it. Enjoy.
So, a warm welcome to the podcast for the first time Dr. Steve and Sandi Amoils, welcome doc.

Dr. Sandi Amoils: Thank you. Thank you, James. Good to be with you.

James Maskell: Good to have both of you here on the podcast and in this year of growth. I guess I wanted to start by sharing, for those who don’t know much about your practice, I think maybe the most successful and longest running significant integrative and functional medicine practice in Cincinnati. So, tell us a little bit about that journey. Why medicine for both of you, and then, why integrative medicine?

Dr. Steve Amoils: So, we both grew up in South Africa. I came from a big medical family there and had decided fairly early on that I didn’t want to do the conventional medical route. I was more interested in preventing disease, and then, Sandi and I met at medical school, and we realized we had a common interest in finding… We’d found people that had achieved success with medicine, where conventional medicine had already helped, and they’d gotten better.

So, we started looking for what we called miraculous cures, and we defined a miraculous cure as someone who’d defied conventional medical wisdom, where they had a cancer or autoimmune disease or something that seemed incurable to medicine at the time, and then how they’d gotten better. And in the early 80s, we spent a couple of years traveling around the world, living in various cultures, looking for these kinds of people, meeting them and finding out what their stories were.

And their stories were always not the same. They all had some kind of alternative therapy that they’d learned. And we started immersing ourselves in different cultures, different kinds of medicine throughout the world. Some were in very weird and wonderful places, in exotic places, remote places in the Philippines, or we lived in Japan for a long time studying acupuncture.

And eventually we brought this into our conventional medical practice, moved to Cincinnati initially to get a job and then stayed here. Both of us did family medicine and were using a combination of conventional medicine as well as acupuncture, manipulation, nutritional supplements, lifestyle changes in our primary care practices. Both of these practices ultimately belong to different hospitals. The hospitals combined into something called the Health Alliance in the late ‘90s. And they approached us to form an integrative center, and we started what was called the Alliance Institute for Integrative Medicine in 1999. And it received some accolades as one of the top centers in the country.

And what we did is we went around and looked for the best therapist we could find in the city, from chiropractors, nutrition, psychologists, and we put them all together in a group. And we decided that the group would teach itself. We would learn to feedback. And as part of this, we had the best acupuncturists in the world come. We had a lot of leading people and eventually became friendly with both Jeff Bland and Patrick Hanaway. And they both came, and they really excited us and stimulated us into understanding this concept of systems biology and how you could use functional medicine.

What we did differently in our center was incorporate these other healing modalities, such as acupuncture, chiropractic, et cetera, into a practice. And what we find—or what we found—is that people were changing their lives, or they were transforming their lives. And we coined the term transformational medicine to say that people would ultimately go from a state of imbalance to a state of balance or a state of disease to a state of wellbeing. And this has been our journey. So, I’m sorry to take up so much time, but we will let Sandi carry on.

Dr. Sandi Amoils: I don’t get many words. Can you tell?

James Maskell: Sandi, who was ready for integrative medicine in Cincinnati in 1999?

Dr. Sandi Amoils: Very few people really. We were quite nervous going into our practice because the hospital system encouraged us and actually made us become a cash business. And we didn’t take any health insurance at all, which was a big change for us and a very bold move back in 1999. So, many of the traditional medical offices around us and even some of our partners who worked with us said, “Oh, they’ll be gone within a year.” Well, here we are, 23 years later and we have a really successful, wonderful community and business. And I think we are very lucky because we’ve cultivated a really lovely culture in our office. We have many different therapists. We have physicians who are all trained in acupuncture and in functional medicine and have a very good knowledge structure of all forms of alternative and integrative medicine.

We have chiropractors who are more than chiropractors and who we’ve trained to do many other things. They don’t do a lot of functional medicine. They do a lot more of the manipulative therapies for our patients and rehabilitation. We also have energy healers who have worked with us for many years. We have a cadre of massage therapists who sort of sub-specialized in different things. We have rolfers, and we’ve used many psychologists over the years and have done MBSR programs. But I think our patients come to us largely word of mouth, and over the years, because we’ve been a very credible practice and we have a good reputation as primary care physicians in the city, we’ve never really been scorned by the medical community. But what has changed is there’s suddenly an understanding and an awareness within the medical community that what we do actually does matter.

And as a result of this, we were approached by one of the very good, I would say, probably one of the most prestigious hospitals in the city last year, who wanted to purchase our office and incorporate what we do within the hospital system. So, we are busy making that transition. We are really excited about it because we feel that we have much more credibility within the medical community now. And as a result of that, we hope that we can sort of create a bigger footprint in the city and make the type of medicine we do much more sort of amenable to other conventional doctors but also more accessible to the community in general because the stumbling block always is insurance.

And I guess if we can show that we get good results and—which we’ve done, we’ve been part of a large practice-based research network called the Bravewell for many years, and we’ve participated in many of those studies. We’ve shown that we have really good results on pain and that kind of stuff. But we get very complicated patients I would say. They come to us because they don’t know what else to do. They’ve tried everything else and it’s very satisfying the results that we get

James Maskell: That’s exciting.

Dr. Sandi Amoils: That’s where we’re at James.

James Maskell: Well, look, I want to get into all of that shortly here in a minute, but I think that next step that you’re taking is only possible because you took the last few steps very well. From 1999 until here 2022, you built this really successful practice, and I’ve actually had the fortune to actually walk into the practice, unlike many practices that we have here on the podcast. And I was struck by a couple things. One is, as we walked around, I felt that the space had been really well organized and designed around the kind of care pathways that you created. And then obviously now it’s a beautiful space as well with the retail and all the other things that you’ve done in there.

I would just love to get into kind of that part of the story because what you’ve created and that the vision of having all these therapists under one roof and you sort of running the show and pushing everyone through, a lot of doctors have had that vision, but it hasn’t worked a lot. Around the country, it didn’t work. A lot of doctors would have the vision, they’d go out, and then HR stuff and trying to get everyone moving in the same direction would be a really tough lift for an entrepreneur, never mind a physician who’s trying to sort of practice in a new way.

And so, I saw the sort of wreckage of many practices that had the right vision but just the implementation of it and trying to get everyone lined up in the right way and trying to work out how everyone gets paid and how everyone referred to each other, all those kind of things can be tough nuts to crack. So, can you share with our audience who may be at the beginning of wanting that first part of the vision, what are some key things that you learned along the way about how to make an interdisciplinary team work?

Dr. Steve Amoils: So, thank you for your kind comments. And I agree with you. We’ve been both lucky and I think we’ve done some things right. The interesting thing was, here in Cincinnati, which was the last place we ever thought we would see in integrative medical center do well, we’ve been able to not only survive but thrive. We have about 30,000 patient visits a year, and this has been consistent over the past few decades. And the reason people come is because they feel the sense of well-being. We try to optimize that right from the beginning, so that when someone walks into the center, there are smells, there are sounds, the whole ambience is meant to evoke that sense of healing.

And then what we did right, I think, we didn’t make it ever about Sandi or me. It was always about: here’s the vision and how are we going to coalesce around the vision. And the vision was about creating a new kind of healthcare that incorporated the best of conventional medicine but had all these other parts. So, the difference between our center is we were never trying to be alternative. We were always… As a baseline, we wanted the best medical care available, and we always make sure people get that. And then we go, “And what else can we do?”

And so, right from the beginning, our physicians, we all went to the functional medicine programs together. And then, we would come back, and we all would meet with the different reps together. And then we would discuss afterwards, “What do you think? And let’s try something.” So, when we try a new process, we would normally have watched someone do really well with it. So, we weren’t just shooting from the hip, we were looking for successes elsewhere in functional medicine, then we would adopt something. And then we would quickly be able to see between six doctors who was getting great results.

And then from those we started creating protocols, and these protocols then became easy and easier to institute. So, we now have a Fellowship Training Program. It’s an accredited integrative medicine program. And as our fellows come in, it’s been much easier. It’s no longer such a haphazard process. We’re able to give them a more formal training. So, they go through the Institute of Functional Medicine, they get training there, they get training at any other functional medicine programs, and then, they work with us. And then, we keep refining these protocols.

And so, because we have such a big throughput of patients, we are pretty quickly able to see what’s working and what’s not, and our physicians have not been motivated by ego or money, thankfully. We’ve all been working towards a larger purpose of doing better medicine. And I think that’s one of—

James Maskell: Can I ask you a question on functional medicine? Because one of the reasons why I chose to call the show The Functional Forum, as opposed to integrative or otherwise, is that I kind of recognize when I first saw the timeline and matrix and the whole structure… I was like, for a team to grow, they really need like a unified clinical framework by which to sort of work together. So obviously, the different nodes of the matrix, whichever one comes up as a priority, can then trend the care pathway. So if it’s structure and function, that person probably needs to see a chiropractor but maybe not everyone needs to see the chiropractor.

And I just love to get your thoughts on that because that’s just sort of an intuitive moment that I had sitting in 2013, seeing the timeline of the matrix and realizing that, in most cases, one of the things that stops practitioners being able to work effectively together is that they all speak a slightly different language, even though they’re trying to do the same thing.

Dr. Sandi Amoils: I think that’s a great point. So I think there are a couple of things that distinguish us. First of all, our physicians all do acupuncture themselves. We’re all trained in our members of the American Academy of Medical Acupuncture. So, we all speak the same language. And the difference is, when we think somebody needs acupuncture—and majority of our patients do get acupuncture—we’re not just sending them out to an acupuncturist, and they’re going to Never, Neverland and then come back six months later. And you don’t really know what the effect of the acupuncture’s been on them.

So, we as a physician are doing the medicine, the functional medicine and supplying the acupuncture to the patient himself. So, I think that makes our integration process a little different. The second thing we did was we created a program called an ACE treatment, which stands for acupuncture, chiropractic and energy healing, which is sort of a signature program that a lot of our patients go through because the vast majority of patients have a significant amount of stress, physiological stress in some manner. They have pain, and we find that this ACE treatment is the most wonderful thing to provide to our patients.

But it’s not only for the patient, but the therapists too. Because the patient comes in and is first seen by a chiropractor. And following that the physician comes in to see the patient, goes over any medical issues, functional medicine issues and does acupuncture. And then a nurse or an energy healing therapist works on the patient whilst their acupuncture needles are in place. And this visit can take an hour and 15 minutes for a patient. But I think it created an incredible relationship between those therapists because we had a single focus. We were all trying to help the patient feel better. And we realized that it’s not a sum of one and one and one making three, but one and one and one equaling 20 because the effect of us all working together was much better and larger on the patient.

And patients love this as a treatment. In fact, most of our staff are given free treatments every month as part of their working environment because we feel it’s very important to look after our staff too. And many of them will come in just for ACE once a month, but it’s the most wonderful place. And it was one of the things we started right at the beginning. So, I think that helped us tremendously in terms of people talking to each other and working with one another.

So, some of our patients still come in a lot for their treatment. And we do a lot of an ala carte stuff too, where the patient will come in and just have acupuncture and functional medicine stuff with me. And then I’ll send them off for chiropractic if I feel they need it. And the chiropractor will refer back to me because we know it’s not a competition. The patient is the common goal. And I think the way we structured the pay for our staff has helped us to do that.

James Maskell: Can you get into that? This is something that… Obviously, this is a podcast for other doctors, and these kinds of conversations don’t always get into, and it’s pretty clear. I think a lot of practitioners, they would love to have everyone on salary, but then they have to fill everyone’s books. And then if they do it as a sort of, if they come on as an independent contractor, then there’s concern about the way that people refer. So, how did you manage to overcome that?

Dr. Steve Amoils: So, let me go back to, I think, your last question: the concept of the timeline in the matrix. Sandi talked about how we had developed. When we initially developed as an integrative therapy, this was in the late ’90s. And then when we added functional medicine and started going, this is an aha. The concept of the timeline in the matrix, when people get that, it adds a whole other dimension. Now, what has been more fascinating to us is the interplay between the functional medicine matrix and acupuncture.

It’s very common that when someone says, “We find that there’s something affecting their liver meridian,” that their detoxification needs would be high, or they may have snips on their liver phase I, phase II pathways. And then we’re able to create a language that has metaphors of crosstalk between the acupuncture program and what’s going on. So, where someone will come in, and their liver meridian will be off, they’ll have headaches, they’ll have all kinds of bizarre symptoms. And then we start talking about the liver, and then we start getting into detoxification, and then we start getting them into ways that they can empower themselves.

And that’s where functional medicine is so wonderful because it allows that patient to then take control, and they see themselves as part of this team that’s getting them better. And this is the languaging that we’ve been able to… Instead of someone kind of feeling judged or like they are this constellation of symptoms that no one understands, we break that down into, “You need some detoxification, you’ve got some oxidative stress from a leaky gut.” And then they get this aha about how they can move forward. So, that was a huge thing for us.

The next thing is your question about what do we do. We realized in the beginning that putting people on salary would just put us under. So, what we did is we created a system initially when doctors came on, they were often in primary care or they were in other practices, and we put one foot in our practice. So, they come on a few half days a week and then eventually develop a full practice. And that way they were able to eat what they had killed with us. In other words, they in general… Most therapists get 40% of what they earn, and they’ve been able to do pretty well with that. As Sandi said, we’re all cash pay. People get their CME, they get medical insurance and all the benefits, but their salary ultimately is dependent on how many patients they’d see.

Dr. Sandi Amoils: I think one other thing I should mention, James, that I think is really vital. We created our Fellowship Training Program many years ago, and we were fortunate to be part of The Bravewell Collaborative at the time, and they sponsored us to help us in fellows, to Andrew Weil’s Intergrative Medicine Program. And we developed our own sort of Fellowship Training Program as a result of that. And I think the difference is, when our physicians train with us, when many physicians in the community go out, they learn either acupuncture or functional medicine. It’s so stimulating, and it’s so exciting. And you think you can just go from doing a course on training and jump straight into a different way of practicing, but taking that step is really difficult.

So, learning acupuncture and then putting it into practice or learning functional medicine and then putting it into practice can be very overwhelming if you’re a solo physician. But being part of our program, they’re doing the training and the learning, and at the same time, they’re seeing us doing this to the patients. So, they really learn how to integrate the whole process into their practice in a really healthy manner. And I think it’s almost like we are a clerkship or a clinical training program that a lot of courses sort of missed because it’s one thing sort of getting the clinical data material. It’s another thing putting it into practice and being effective at doing it.

James Maskell: That’s such a great point. Well, I guess let’s take us all the way up to today. So, you have this sensational clinic. You’ve worked out the details. You’ve had it running this long. You’ve got the financial pieces of it working. And I guess I want to just take us all the way up to today because, from what you shared there at the beginning Sandi, you guys are taking a big step to go beyond the four walls and to try and take integrative and functional medicine into the heart of Cincinnati and further afield. So, how did that come about? And out of all the opportunities that you could be given, why was this such a yes for you?

Dr. Steve Amoils: Well, a few things happened. One very unfortunate thing in that our 28 year old daughter a few years ago was diagnosed with stage four ovarian cancer, which we knew would be terminal. And this resulted in a huge upheaval in our lives. Sandi for while stopped practicing medicine, went to live with her in Los Angeles to look after her. And it made us realize the vulnerability of what we built. And also really, we had done this in order to leave a mark on medicine. We wanted to show that there’s a different way to practice medicine.

Our results had won out. We have people all the time getting better from all these bizarre or immune diseases, gut problems, pain issues. And we realized we wanted to create some longevity. And we were actually working with a businessman to really blow this up and maybe put it around the country. Then, at the same time that this hospital approached us and looking at it, we felt that with the longevity that the hospital had, the clout that they had in the community, that would be a better way to leave a longstanding process in place for the community.

And what the hospital wanted from us was to create a unique process where we develop well-being for their patients. They realized that their patients were being treated for illness and that no one was touching wellbeing. And for most hospitals, the idea of well-being is a massage room down the back of the hall with some granola there. And really, they had no idea what they’re doing, and what we wanted to do was bring in well-being. And I’d like to thank you, and also because we were both on a program a few years ago, teaching physicians about changing their practices and incorporating well-being into their practice.

And at that time, I was thinking, “Well, how do we do this? How do we create it?” And it allowed me to think a lot about what we’d like to do. And so, I had already had these principles in place, and we are now… So, when the hospital came to us and they said, “What do you want to do?” We said, “We can develop a primary care program focused on well-being for you. We can also develop a unique pain program that includes everything from chiropractic, acupuncture, body work to prolotherapy stem cell injections. And ultimately, if people need surgery, they can go there. And the hospital understood that this was a big niche that people wanted at the moment and that was the cornerstone of us developing the program for them.

Dr. Sandi Amoils: I think I should also say we’d been approached by the same hospital system a couple of years ago.

Dr. Steve Amoils: A decade or more.

Dr. Sandi Amoils: A decade ago or more, and it didn’t happen because some of the physicians at the hospital didn’t want it to happen. So, it’s been a real change in attitude, and we’re just very fortunate and lucky that the hospital that we have partnered with has a fantastic reputation in the city. And we work well with a lot of the specialists and team leaders within the hospital system. And they’re so excited to have us as part of the community. It’s just quite amazing to see the difference and the change in attitude.

James Maskell: Well, so I was with you there, I think in the beginning of May. And then since then, I’ve actually spoken to a couple of other people, and the same story has popped up a number of times that happened there, where I feel like all around the country, I think these bigger health systems and hospitals are realizing that patients want it. They don’t know what it is, and they need to get it together if they want to maintain or grow their market share.

And it’s amazing, obviously you guys can see it with as context, more context than I can see it from, but I can see it in 17 years context to say that is a significant moment for the movement where it’s now realizing that demand is outstripping supply. And we need to get supply together sooner rather than later and work out innovative ways to scale. So, it must be a pretty exciting and heartwarming to see that happening in your city.

Dr. Steve Amoils: It’s wonderful. And I think the other issue too is that the medical staff are so burnt out within the hospital systems. And a lot of them are trying to do programs to try and help the staff. So hopefully, that’s a significant part of who we can affect too just in terms of their diet and lifestyle and teaching them tools that they may not know about.

James Maskell: Amazing. Well, we’ve had a chance to spend some time together now, and I think through that conversation we’ve talked about some of the ideas that I have about what it means to scale integrative care, what it means to scale participatory care to most people. So, now you have all of the tools at your disposal. What’s the vision? Tell us the vision for the growth of the integrative medicine in Cincinnati. And this is the year of growth. This podcast is on the year of growth. And I think that there’s no better example in my mind right now of our movement growing into the mainstream. So let’s hear it. What do you think?

Dr. Steve Amoils: So, we’ve always said that integrative medicine is a verb. It’s a process and ultimately should go away. That integrative medicine should just become good medicine and good medicine should just be incorporated into what we do. And I think we seeing that happen right now that the anathema that most physicians had of using a supplement is gradually starting to change. They may not quite understand it. Leaky things like leaky gut are now mainstream terms. And acupuncture’s being incorporated as a form of dry needling in physical therapy. So, these systems are starting to have different verbiage, but they’re starting to come together.

We are hoping, and my long-term wish would be, that we did a side-by-side study looking at our patients versus conventional patients and seeing how they do long term. I’m pretty sure I can tell you the results because we’ve seen it over the last 20 years. We’ve seen what happens is people spend more upfront dollars. They frontload their healthcare and their backend is much better. They have less referrals, less MRIs, less specialist needs. They generally do better. Their quality of life is better. And their diagnoses, the ICD-10 boxes they fit in, kind of dissolve because as you create, as you balance these underlying systems, the diagnoses go away.

So, ultimately, my goal is that this becomes part of mainstream medicine. We want to develop all around the city, in primary care offices, our pain program. I think it’s kind of balancing between primary care, PMNR, orthopedics and neurosurgery, all the pain kind of specialties. But we will be a referral source, and we’ll be able to see how our patients do in each of these categories, but I think they’ll do better.

Dr. Sandi Amoils: So, I think an answer to your question is: We are used to being entrepreneurs and working independently on our own, and we could make a decision and things would happen very quickly. When you’re part of a hospital corporation and culture, things are much more slow moving. So, it’s going to be a little bit of a challenge getting everything going, but we’re having to do it in a responsible and stepwise manner. So, the one thing we’ve done is created this, as Steve said, we’re busy creating this different pain program, which will work very nicely in conjunction with the hospital using a lot of different modalities.

We’re hoping to develop a direct primary care model that is focused on wellness and training primary care physicians to help us provide that care in a different manner. This is a big lift and a big task. So, we are trying to do it very thoughtfully and carefully and slowly, so we do it correctly. Part of that is using our Fellowship Program to train some people who are very well trained in using all modalities of integrative medicine, including functional medicine. And we have a foundation that has raised money to help us provide that. And hopefully, as that happens, we’ll be able to expand our footprint in the city as Steve said.

The other thing that we’re kind of toying with and, as you well know, is we are hoping to do some of the long-term group visits that you’ve developed. And we are hoping to do sort of a trial study on some patients at the hospital with a population health group people. And we are hoping that we can have that influence on the physicians who will then be the kind of physicians for your program.

I am also working on an endeavor of trying to help patients going through their chemotherapy and survivorship programs and oncology department, providing them with more functional medicine matrix and hoping that they can even incorporate something like the program you’ve developed into either a survivorship program and/or for patients who are actively going through chemotherapy as a sort of group peer support visits.

So, we have big dreams, and I think the other thing we didn’t really mention is we have nutritionists and health coach who work with us and very closely with our patients. So, we are hoping that they too can be involved in this process with us. For instance, the oncology department at the hospital wants me and our dieticians to come and speak to their dieticians about the difference in how we perceive diet. It’s happening in a few weeks time. It may be a really interesting conversation, and we hope we can influence people in a different way, in a non-threatening, in really good ways. So, we seem to be getting a good reception but TBD and just give us time. We have to be patient.

James Maskell: Well look, I’m really excited to host this conversation because I feel like just in what you just said there Sandi, I would just say that kind of all bets are off. Anything that was true before is maybe not true anymore, like a hospital wanting to start a direct primary care program. That’s not something that you typically see both of those as different ends of the same spectrum, not coming together. Structures being created to scale up different specific areas like chronic pain, like oncology. Very exciting. And I would just say I’m grateful because I know that all around the country, so many hard yards have been put in by so many integrative, functional providers to build credibility, to build a sort of a critical mass of data and good feeling around their practices.

And what I just want to salute for both of you is the desire to then take that and leave a lasting legacy. And I think that this is happening all around the country. I think more and more physicians in our space are getting the confidence to go and share their vision and their dreams for bigger systems. And health systems are realizing that this is what people want. And so it’s a really exciting time. So, if there are people listening to this, how can they get involved in the vision for you? And how can they participate more broadly?

Dr. Steve Amoils: Well, we are looking for good physicians. So, if anyone is interested in joining us, they can just call our office, Alliance Integrative Medicine. (513) 791-5521. And ask for Sandi or me, and we’d be happy to discuss it with them.

Dr. Sandi Amoils: I would like to add one thing. I think we are very lucky that we work together as a team, and it’s helped us a lot. I think to do this on your own would be a very difficult endeavor. And I think we’ve been very fortunate because we understand we both have the same passion, and we bring different strengths to the table. And it’s been just a joy for us to do this as a lifelong part of our careers and our life. So, I’m very grateful to Steve for being my partner.

Dr. Steve Amoils: Me too. And to you, James, we are very grateful for the work that you do. I think you’ve done a phenomenal job in just bringing functional medicine to the four. And you are probably one of the single-handed, big movers for functional medicine in making it become as popular as it has been. So thank you for all the work you’ve put in.

James Maskell: No problem. Well look, hey, thank you for sharing that and saying that. And I want to give my own plug is that, what I spend my time doing, I like doing these podcasts. It’s really awesome to be able to feature people, but literally, what I’m doing all day every day for the last two years, and particularly the last six months, is having conversations with health systems about how to integrate some part of participatory medicine into their programs, whether it be just behavior change or whether there be some additional functional, integrative services.

And so, I would just say to anyone who’s listening: it’s not the same. Things have changed, and there is an opening for this kind of care inside the kind of health systems that you probably think there isn’t. And even if you don’t feel it at the physician level, it’s at the boardroom level for sure. All the way across the country, these health systems are trying to work out, how do they stay relevant in the next decade? And the answer is clearly doing the kind of work that we’ve all been doing here. So, if you work in another system in another city and you’d like to sort of see if that could be moved along, feel free to reach out to us too.

Doctors, thank you so much for being part of the Evolution of Medicine podcast. It’s been great to get to know you a little bit better in the last year and looking forward to all of the exciting projects that we have moving forward. Cincinnati will never be the same again. I’m really grateful for our time here today. And thanks so much for being part of the Evolution of Medicine Podcast. We’ve been with Dr. Steve and Dr. Sandra Amoils, and you can find out more about them. I’ll put all the details about their practice in the show notes. Thanks so much for tuning in, and we’ll see you next time.

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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