This episode’s guest is Dr. Michelle Thompson, the medical director of the Lifestyle Medicine Institute at the University of Pittsburgh Medical Center (UPMC). This conversation explores how Dr. Thompson is bringing lifestyle and integrative medicine into major health systems.
She began her journey practicing integrative medicine but leveraged the six pillars of lifestyle medicine to bridge the gap with conventional medicine. This hybrid path allowed her to excel at practicing in traditional settings and facilitated introducing integrative and lifestyle medicine principles into larger health systems.
Dr. Thompson also shared evidence that there is growing momentum behind the integrative and lifestyle medicine movements, including acceptance and adoption of its principles within health systems. She encourages physicians who may have previously left the system to consider returning and joining a hospital system that is open to change and supportive of these modalities.
Building upon recent podcast conversations, such as the episode with Dr. Joe Pizzorno, this episode emphasizes the importance of unity amongst the many disciplines within health-promoting care.
Download and listen to this episode to learn more about:
- How clinicans can transform medicine by being bold and authentic in how they choose to practice
- The responsibility of clinicians, residents and medical students to help shift the culture in medicine to better align with the principles of lifestyle medicine
- The importance of showing empathy towards patients and letting them drive their own health journey
- Physician burnout and the importance of clinicians prioritizing self-care
- And much, much more
- American College of Lifestyle Medicine: About the UMPC Lifestyle Medicine Program
- Whole Hearted Medicine: Meet Dr. Michelle
Dr. Michelle Thompson: And a lot of times when I was young, I guess I would be frustrated when a person came to me and they weren’t ready to make the change. And I would feel like, “Oh, what did I do wrong?” But now I just tell myself, “They’re not ready. It’s not their time,” or, “I’m not the person and that’s okay.” I interview. All my patients essentially say, “This is what I do. Why are you here? What do you need from me? We may or may not work good together as a team, and that’s okay. I’m still going to send you love and well wishes and be part of your journey if ever you need me again and the time is right for you.”
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 and 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 host Dr. Michelle Thompson. She is a leader at the University of Pittsburgh Medical Center. She’s the medical director of lifestyle medicine. She has a number of different hats in that regard but is also centrally involved with the Academic Consortium for Integrative Medicine. She’s also involved in psychedelic medicine and mind-body medicine and is just a true pioneer who is making waves and having impact inside one of the biggest health systems in the country.
We haven’t really talked about this kind of person historically on the podcast because our thesis was all around people leaving the system and going to start their own journey. But I think what you’ll hear today is just some things that I’ve been hearing for the last three years as I’ve been out spending time with doctors who are in the system, that there is significant change afoot in medicine. And I would really encourage anyone who’s listening to this to take some of what Dr. Thompson is sharing to heart and maybe think about what your role is in the evolution of medicine. And it may not be the same as everyone else’s. And really inspiring podcast session. I think you’ll love Dr. Thompson. Enjoy.
James Maskell: A warm welcome to the podcast, Dr. Michelle Thompson. Welcome, Doc.
Dr. Michelle Thompson: Hey there. I’m excited to be here with you.
James Maskell: I’m very excited to have you. Since we first met a little over a year ago, I’ve been really excited to get you onto the podcast. Over the last year, I’ve been referring to doctors who really get it, that find themselves in major health systems and are making change for the inside as like these diamonds in the rough because I’ve just had the experience of seeing the potential of transformation at a much bigger scale. And you are working at one of the bigger health systems in the country, University of Pittsburgh Medical Center, multi, multi, multi-billion dollar system, and wearing hats across the lifestyle medicine leadership over there as well as being involved in integrative medicine and some of the areas there.
So, talk us through it. I know a lot of doctors and practitioners who listen to this have broken free of the system and are doing their own micro practice or building their own practice, and you are staying the course in the organization. Give us the history of how you ended up straddling this lifestyle medicine and integrative medicine world and also operating near the top of those fields.
Dr. Michelle Thompson: Yeah. I asked myself this question too. How did I stay in this for 20 years, right? I’ve hung in there. And honestly, I will tell you I’m so glad I did because right now, I feel like I am seeing something that I never thought could happen in my lifetime, and I’m seeing healthcare completely transformed before my very eyes and I get to be part of it. So, I’m really excited about that. And the big thing, we all think about leaving and what does it look like on the outside, but really the big change happens from a global standpoint inside. It happens in medical education. It happens in residency education. It happens in speaking with the attendings who have been out there for all these years, reaching somebody who’s hit burnout, who needs the change, who wants to do something different.
And so, for me, I came out in 2006 into a traditional practice that is in my hometown near Hermitage, Pennsylvania. And I took this traditional practice and I essentially walked in the door and said, “I am an integrative medicine physician, and this is the way I practice. And if you like it, that’s great. And if you don’t, there’s a lot of doctors out there who do traditional medicine.” And really just started following my heart and just saying, “This is the way I’m choosing to practice medicine, putting self-care in the center of healthcare, putting the patient in the driver’s seat, making them take onus of their health and their well-being.” And so, people left and then lots stayed and then more kept coming and kept coming. And then I was teaching and started getting involved in the residency program and hospital leadership and physician burnout and wellbeing and things like that. And then ultimately, took over as medical director of lifestyle medicine for entire hospital system where we’re driving and we’re putting self-care in the center of the way we do everything.
So, that’s a big job. We have almost 100,000 employees. We have forty-two hospitals. We are global. We have hospitals in Croatia, Italy, Ireland. And so, we’re really changing a broad band. And so, that’s so exciting to me because I just think to myself, “Wow, I get to be part of this.” And I’m just this little girl who grew up in Sharon, Pennsylvania who came from poverty and nobody in my family was educated. And I really get to be sitting in this space where I don’t know what I’m doing every day, right? Because nobody’s ever changed an entire healthcare system. And I just close my eyes and put my hands over my heart and say, “Follow your heart. What seems right? What feels right? How do we want to take care of ourselves? And then how do we want to see the world take care of themselves? And then how do we want to take care of each other?”
James Maskell: Beautiful. Yeah, absolutely. I love that. Can you give us just a scope? I would say that, and I’ve said this before in the podcast, that lifestyle medicine specifically is having a moment where major health systems are all putting their hand up to say, “We want this.” There doesn’t seem to be any objections from conventionally trained doctors. In fact, they’re embracing it in a way that nothing holistic or integrative has been endorsed at this level in anyone’s lifetime. Can you give your thoughts on that in the context of all the things that you have going on? You mentioned residencies there. I know UPMC is one of the leaders in terms of lifestyle medicine residencies in the country. And what else do you think that’s driving this moment for lifestyle medicine?
Dr. Michelle Thompson: Yeah. I would love to talk about that because again, I was integrative first before I went and got lifestyle supported because integrative goes way back and lifestyle medicine wasn’t necessarily a thing back then. But then lifestyle medicine comes along and they just start talking about the basic six pillars of health, sleep, exercise, nutrition, substance use, stress management, and connection with others. We can’t deny that, that those are the six basic things that all of us as human beings on this planet should do.
There was a lot of question with integrative medicine, right, because there are people who were saying it was not evidence-based, and then we’re talking about this yoga and qigong and tai chi and sound therapy and art therapy. And there’s all these people that go, “Ah, that’s hocus pocus.” But when lifestyle medicine came about, you couldn’t deny those six pillars. It started being really, I believe it’s the way that we got this change happening in healthcare.
So, I was one of the first of the Health Systems Council. I was one of the first hospitals along with the team of the Health Systems Council. And so, there was just a few when I joined, and now we have a hundred hospitals across the United States that are saying we have lifestyle medicine somewhere in our hospital system, whether it’s in medical education, whether it’s in residency, whether it’s just somebody in the hospital is doing lifestyle medicine or trying to create a movement, creating a lifestyle medicine interest group for the community, whatever that looks like. And honestly, that is what is shaking up the system because one, now we’re saying, “Okay, these six pillars, right? Okay, how do we deal with stress?” And then we start to look at the integrative modalities, and then we start to look at mind-body medicine because we know that we could sleep better, we could eat better, we could move more. But we didn’t have to do that mind-body medicine thing to connect with ourselves to figure out how to do it.
It’s hard to be human. We have to wake up and we have to just say, “Okay, today I’m going to take care of myself.” And what does that look like in the midst of taking care of my family, my friends, my patients, my students, everybody around me? But we have to be that change that we want to see in the world. And I always say for me, everybody’s watching me especially. They’re like, “How’s she doing it? Is she doing too much?” But I really do take my own time for self-care, and I think about, “What does Michelle need the before Michelle goes out and takes care of the rest of the world?”
James Maskell: Yeah, that’s critical and profound and valuable. And I can see actually now the way that you say it, that integrative medicine became a big tent for everything outside of conventional care. And it’s unreasonable to think that that wider tent could be just suddenly embraced by the mainstream given that so many of those things are counter-cultural at best in that way. And I do think that building on a solid foundation of what is undeniable when it comes to health is a good strategy and certainly is opening up a lot of doctors. Let me ask you this. Have you found with—because I know you run retreats and you’re passionate about integrative medicine and use stuff on the academic consortium—have you seen lifestyle medicine be like a gateway drug for doctors to open up to other things in the toolkit?
Dr. Michelle Thompson: Yeah, it really is. And even I will say I do belong to the Academic Consortium of Integrative Medicine and we’re really talking more about lifestyle medicine within that integrative consortium, because I think some of the systems still can’t figure out how to make this big shift. And I think that once they start to put that lifestyle medicine in, they’re going to get more buy-in from everybody else around. And I think initially when I started doing breath work practices with physicians, I’ll never forget, I was sitting in the room, I was doing a physician burnout talk for our medical staff, and it was a department of medicine meeting and I had physicians looking at me like I was crazy. They were sitting there with their arms folded, kind of like huffing, and they’re like, “I can’t do this breathing thing. I can’t quiet my mind.”
And now, they see they have to quiet their minds. We learned this during COVID. We have to pause, and we should slow down. And once you do that and you’re able to gain some awareness of yourself, and then you’re able to go, “Okay, let me give this a try for two minutes. Let me listen to what this crazy doctor is telling me about this whole breath work practice.” They breathe and they’re like, “Oh, look. My heart rate went down. My blood pressure went down. My shoulders are not up in my ears. I feel more relaxed and comfortable. I’m able to think more clearly. I’m able to make some better decisions.” So, I really think it’s that. We’re able to go, “Oh, maybe I could use that breath work practice when I’m going to go to sleep at night. Maybe I’ll get a more restful night’s sleep. Or maybe I’ll use it when I wake up in the middle of the night and that will help me fall back to sleep.”
And so, I think it’s again connecting back to yourself because I think, and physicians in general, physicians lose themselves in the midst of caring for others. And I learned this big time in my psychedelic training. I was sitting in a room with 10 physicians and 15 mental health workers, and the mental health workers really didn’t want the physicians to be the ones holding space in the journeying with the psychedelics because they didn’t feel like physicians were capable of holding space from a compassionate level. And I thought, “Wow.” And then the more I thought about it, the more I thought, “Well, we’re trained to walk into a room and save a life. We’re not trained to hold hands with the patient, cry with the patient, be with the patient on that level.”
And so, again, that’s where we need to start to redefine this level of care, open up as human beings, which COVID did. The pandemic allowed us to all be equal where none of us are spared a pandemic. We are all there. And then we have to get real and be vulnerable and then see how do we need to change our own lives, really look in the mirror and say, “What do I need to do to care for myself? Because I got to care for myself, that it has to start there.”
So, in all of that, and really in the psychedelic work, I was really seeing how physicians can’t. They get so disconnected because they have to just put on that hat and run that code and take care of that person that’s dying. They don’t eat when they need to. They don’t go to the bathroom when they need to. They don’t sleep when they’re supposed to. They don’t take good care of themselves, eat the right things. They just grab and go. And so, it’s that way physicians were taught. And the only way we’re going to break that is to start at the beginning in medical school and residency programs and then get back to the physicians.
And I just had a student who said to me, “This is great, but how do we get our attendings to understand this when they’ve been out for 25 years and they don’t want to hear that I need to go to the bathroom or I’m sick and I’m not coming today or I…” And I said, “You just have to use your voice and you have to be brave and you have to be strong and you have to be courageous, because this isn’t just for you. This is for humanity. Things need to be done differently.
James Maskell: Absolutely agree. I want to just come back to something you said there about the psychedelic therapist and holding space. Because as someone who’s been involved centrally now in group visits for a decade, but ultimately particularly the last four years, as we started to think about how to scale group visits, one of the things that became clear is that physicians had to unlearn a lot to do that. When I met Jeff Geller and Dr. Shilpa Saxena, who I think are amazing physicians who have… When I got to know them and poked a little bit, what I came to understand is that they had to go through essentially an insane deprogramming in order to facilitate. Geller, not so much because he was into it from day one, but Shilpa for sure has told me in conversations just the level to which she had to deprogram herself from her doctoring in order to be a good facilitator.
And as I’m sitting there at dinner with her, I’m like, “This can’t be the plan, large-scale doctor facilitation.” I’m sure each doctor needs this, but if we’re talking about scaling and operationalizing lifestyle medicine across a whole organization, we can’t wait that long for all of the deprogramming to happen because all of the issues that are going to come up are going to come up in the next 20 years, and it’s going to take 20 years until those residents that are in the UPMC lifestyle medicine residency have enough authority to change the system. And so, that’s why we started working with health coaches in the same way as in mental health you might work with therapists, because they play this half a peer role where they’ve been through something themselves. They’re really able to learn how to hold space and coach. And so, it’s interesting you say that.
It’s not that the doctors can’t do it. And any doctor that goes on this journey, absolutely, this is a human journey that is critical for you to go through and I super encourage it. But if you want to put 10,000 people into group visits in the next year, let’s get people who don’t need to go through that whole deprogramming because you are taught, if you’re a doctor, basically you’ve been getting A’s since you were nine years old and you’ve been taught to have the answer for everything. And having the answer is in a group situation can actually undermine the coherence within the group because there’s one central point of authority. And part of the coherence that gets created in a successful group is having lots of points of authority that are all supporting each other in that journey. So, I wanted to share that because it mirrors my experience so clearly.
Dr. Michelle Thompson: I love it. And when I met you, I know I said this to you. I loved that you had the mind-body medicine background and that we think the same way. And so, when I started my mind-body medicine training and I was working with Dr. James Gordon for the Center for Mind-Body Medicine, he would always ask me. When I would ask a question, he’d say, “Well, ask your wise guide. Ask yourself.” And so, through my mind-body medicine journey, I kept learning more and more. The answers are inside of me. Nobody’s going to give me these answers. I have to really connect in with myself.
And so, that, I really do believe that anybody that wants to run a group should have this mind-body medicine training and this coaching background because it is a mindset. We’re trying to dig into people to figure out how do we get them to make the change. I always ask my patients, “What’s going really, really well and what are your struggles? And if you have a struggle, what do you think is getting in the way? Tell me what you think because it’s not what I think. It’s what you think.” And then it’s that creation of that new dialogue of the physician is not this hierarchy talking down to the patient. The physician is just holding the space in the room, which really, I now love some of the work that Dr. Geller was just talking about recently. The physicians are facilitators and participants, and we’re not talking about a doctor-patient relationship anymore in these group visits. We’re talking about a facilitator who’s also a participant and the participants.
Because we are not perfect. No one is perfect. I’m not perfect. You’re not perfect, sorry to say. But we’re not. And we’re always working on something. I know I am every day of my life, and I will be until the day I die. And so, the more we start really being vulnerable with people and saying, “Being human is hard and this is a journey and I’m on this with you,” the more we’re going to be able to get people to create change. And we need coaches. Yes, we need to scale this. We need to. And I struggle with that in a big system, and we’ve talked about that. It’s hard to get outside people to help me scale in an inside space. And that is huge.
James Maskell: Yeah, that’s huge. And can you just give, I guess, the audience an idea of the current internal scale of lifestyle medicine in UPMC, the residencies, the physicians, the education, the care delivery?
Dr. Michelle Thompson: Yeah. We have about 200 physicians in our lifestyle medicine physician group, and they’re all different specialties. A lot of primary care, but different specialties. Some in pain medicine, some in cardiology, some in geriatrics, etc. You name it. We probably have one that is interested. We have a lifestyle medicine interest group that is not just UPMC but it’s the community and it’s other hospitals. And it’s not just physicians, it’s not just medical students, but we have occupational therapists, respiratory therapists, pharmacists, health coaches, anybody that’s interested. We have about 200 in that that are involved in that. We have eight, nine… Okay, so we have residency programs. We have eight family medicine residency programs, almost 200 residents, and they have a lifestyle medicine track that they’re able to be part of. We have an internal medicine program that also has a lifestyle medicine track. We have physical medicine and rehab that has a lifestyle medicine track. We have lifestyle medicine in our Pitt Medical School curriculum and multiple practices that are doing lifestyle medicine somehow inside of the practice.
And then we have our group medical visits. So, our group medical visits, we had a really hard time getting them launched. And you helped me. Thank you. A lot of people helped me. A lot of people put on boxing gloves behind me and said, “We’re standing behind Michelle to help her get this.” And I’m so grateful. And that was part of the ACLM and the Health Systems Council and the connection with others, because trying to create change inside of a system is difficult and challenging and get buy-in. But we are running groups every day of the week. We have groups in mind-body medicine as well as weight management and metabolic problems. So, hypertension, diabetes, hyperlipidemia, really trying to teach mindful use of foods and substances and movements and really putting mind-body medicine and integrative medicine into our lifestyle medicine program because there’s no way to separate it out. And being an integrative physician, you can’t unintegrate me. You can’t take the breath work practice out of me. It’s just there. You can’t take the mindfulness stuff out. It’s just there. So, it’s the way I view everything.
We have five physicians as well as two physician assistants, a dietitian, and a project manager on our team. We do not have a health coach yet. We have one that’s ready to be hired. But again, we were waiting on the new Medicare rules and what’s happening with this and reimbursement and things like that. So, I can’t wait until I have a team of health coaches to help me because it will make my job a lot easier.
James Maskell: That’s wonderful. If I’m a patient and I live in Pittsburgh and I have UPMC as part of my health plan, if I just suddenly say, “Hey, I just want lifestyle medicine now,” there’s enough capacity that that can be deployed by someone amongst all those people there?
Dr. Michelle Thompson: No. I mean slowly. We’re trying really hard to build fast because you get on a list. And so, if it just so happens that you opened your email on the day that we’re opening a program, yeah, you’re going to get. But we haven’t come up with a really great solution of how we can get all these people plugged into the correct time spots and all of that. So, we’ve been still messing around with what is the best time of day for groups. Some groups are at 4:00, some are at 5:00, some are at 5:30. I want to try some at 7:00 A.M. I want to try some at noon just to bounce around and see what that looks like. Because you just don’t know. We generally don’t do things on Fridays. Most people are like, “Have you even heard a new thing about no meetings on Fridays? Let’s just be more relaxed and chill on Fridays.” So, the goal is to be able to just say, “Oh, yeah. We could put anybody in at any time.” And that’s my hope at some point, but fingers crossed.
James Maskell: Yeah. Let me ask you this. I know there’s probably people listening to this who at some point in their career tried to make some sort of bigger organization change, got frustrated that it didn’t, and left. And I’m just wondering if you have advice for them given that I think the world has changed. And I think that particularly lifestyle medicine is having a moment where there is openness to it almost unanimously, I think, and especially some of the things that the ACLM has done in order to make it easy for organizations to prescribe the learning of lifestyle medicine to their doctors and their practitioners. Do you have any advice for people who may have struggled historically to get up and give it another shot?
Dr. Michelle Thompson: Yeah. I think don’t lose hope. If you feel like you want to go back in, go back in. The thing is I think we never know unless we try. And that was why I stayed. I was offered many times to leave where I am, and I really, I trained at UPMC. I am from this area. I really wanted to stay in. I have a lot of faith in my system that I work for. Even though there’s struggles in this system, but there’s room for more physicians to come back in that want to do this. We need more educators. We need more champions for lifestyle medicine. And it’s very supported in a lot of these hospital systems. And I get people reaching out to me all the time. They want me to come and do talks, and I’m only one human. I really have to ask myself, “Where is this talk going and how big of a scale is it going to hit? And do I think that I should be spending one hour of my life in this way?” And so, that’s really how I gauge my own time.
So, we just need many more voices inside of these walls to really help me create the change that we’re doing. The students want it. The residents want it. My residents are engaged. They’re excited. They’re fired up. And we have lots of attendings that are as well. I’m a vice chief of staff of UPMC Horizon and Jameson. I was in a major leadership meeting last Friday and they were talking about access. And we were with our main hospital president and I stood up and essentially said, “It’s groups. That’s how we’re going to improve access to care and quality of care, and we’re going to change the system.”
And so, many people came up to me afterwards and said, “Yes, we want to do this.” Many physicians want to run groups. Why? Well, because you can truly educate your patient in that one hour, and it’s going to bring back your joy in medicine because you actually see the change happening before your very eyes when you’re running these groups. And people come back and they say, “Oh, I tried this new recipe and it was really good,” or, “I’m sleeping better,” or, “I’m moving my body more,” or, “I’m more connected with others.” And they’re even connecting in the group. They may have been really fearful to come into a group situation, but they’re really connecting and finding themselves, feeling that sense of connecting to another person and feeling inspired to continue to do that. I had a person in my mind-body medicine group last and she was very nervous to come in. And at the end she says, “I decided I’m going to go take an art class because I want to be amongst more people and in person,” because our groups were virtual.
And so, I was so excited about that because one of the things that COVID definitely did was social isolation for so many of us. And that’s such a poor determinant of health. And even though we’re connecting on the screen, we still need to connect as human beings in person. And so, I just think that don’t give up. Come back in. Give it a try. Join a hospital system that is fired up and ready to change. There’s still going to be some struggles and hurdles, but there’s a lot of days that I think about what would it be like if I were in private practice. And I just think to myself, it wouldn’t be doing this true life-changing medicine that I’m doing now because it’s such a smaller scale. I’m able to do it at such a big scale now where it’s like moving a tanker really by myself, but…
James Maskell: You’re the trim tab of the tanker for sure. It’s like a small little thing that can change the direction. It’s interesting. I saw on Medscape this morning, I saw an article and it was called, it’s that the title of the article was Love More: Why Doctors Should Promote Social Connection. And Dean Ornish was quoted in there. He says, “It’s invariably the part that’s the most meaningful, that sense of connection to community that can come when bringing total strangers together.” Ornish said, “The ‘love more’ part in many ways is not only as important, but in some ways even more important because everything really flows from that.” Patients in a support group who can quote-unquote, “Let down their emotional defenses and talk openly and authentically are much more likely to make and maintain healthy changes,” Ornish said.
So, I was really interested in this because so much of the, quote-unquote, “division” in our world is created about the very intricacies of the diet choices. And yet that there’s a, well, there’s a universal piece here which is that ultimately that pillar, the social connection pillar, when executed in this kind of structure creates a structure for everyone to make all those changes in all the other pillars. And I think that it’s also something that’s, unless it’s in a group structure, is the least obvious to a doctor about, “What shall I do in order to create this connection?” Because in many cases, stuck in a system where it’s very difficult to create connection because of the short nature of the visit. So, it was really interesting to see that and see the quote essentially love as medicine. And I remember in the book, I shared one of the best quotes there is, “The best thing that you can do to really love someone is to listen to them.”
Dr. Michelle Thompson: Yeah. And I love Dean Ornish, by the way. Actually, he spoke at ACLM and I went up to him and I just said this about the same thing. I said, “Thank you for talking about love as medicine.” We need this. This is what makes the world feel more held and comforted and yummy and all of that. His book on Do It is incredible because it’s also a gentle way. We don’t want things to be so harsh. We want things to be more, again, by the heart. That’s the way I live my life, is I follow my heart. And there’s many times that even in the past year, I had an ability to change positions and the pay was more and the responsibilities were more. And it was like, “Should I do this?” And one of the things I did is I closed my eyes and I put my hands in my heart and I asked myself, “If you did this, are you living with your heart or your ego?”
And I had to really think about that. And I really tried to live with my heart, not my ego, because I don’t want to be President of the United States. That job’s too hard. My job’s hard. But I think that sometimes we just start to think, “Oh, it might be better up there,” or, “I make more money there,” or, “I’ll do…” But really, maybe that’s not where your heart is. So, I really do believe that my heart is in education and transformation. And even if I walked away tomorrow or if something happened to me tomorrow, I can say, “Wow.” I’ve done a lot of stuff in my years of life, I haven’t hit 50 yet. And I hope to have a good health span, not life span. I want to live healthy and long and well and with my heart full, with lots of wonderful people like you around, that really getting to be part of a change that I’m seeing happening, which is so beautiful. And it’s so amazing.
And I feel like that’s the other thing. We talked about passion and purpose. I think the physicians that maybe are outside that want to come back in, come in because you can share your passion and your purpose and you can share it in whatever way you choose to. Years ago, we were told as physicians, “You have to do it this way,” right?
James Maskell: Yeah.
Dr. Michelle Thompson: I’m a family medicine physician. So, you had to treat ear infections and you had to do pap smears and you had to deliver babies back in the day and you had to treat diabetes with insulin and all this stuff. We don’t have to do that now. You just have to decide, feel with your heart. What do you feel like doing? And if you just want to hold group space with patients and teach them mind-body medicine or teach them how to better handle their headaches or their stress or their cooking classes with them, culinary medicine or whatever it may be, there’s room for you in this world to do that.
So, I think again, just tapping back to yourself, your connection with you, because again what feels right to me today doesn’t feel right to me tomorrow. One of the things I’m doing right now is the mind-body medicine, but I’m doing a group medical visit starting in menopause because why? Well, I’m a woman who’s going to need to share that information with the world and menopause really is finally getting some more light. And women need to look at their lives and not think, “Oh no, I’m dying and this is the disease and it’s the end for me,” but, “How can I live beautifully and age gracefully with some tools and be supported in this group setting?” So, yeah, that’s next on my to-do list. But I just keep asking myself, “What do I feel like doing tomorrow?”
James Maskell: Yeah, that’s awesome. Well, it’s great to develop that and I can tell everyone who’s listening from me from spending time with you that I have no doubt that you’ll hit that health span goal with the way that you are with yourself.
I want to ask you about something that came up actually this month on the podcast. So, I interviewed Dr. Joe Pizzorno, a legend in so many ways, a founding naturopathic doctor, a leading environmental doctor, on the board of the Institute for Functional Medicine, been involved in integrative medicine centrally for a long time. And I had him on the podcast and we were talking about a number of things, but one of the things he had written, an op-ed to reassert his concept that unity amongst like-minded, salutogenic practitioners would be helpful in galvanizing the movement. Because if you just take stock of what we’ve got, you’ve got lifestyle medicine that’s growing like wildfire, making its way into health systems, and opening the doors for a lot of new thinking as it relates to creating healthy humans.
You’ve got integrative medicine that has this big tent of all the professionals and advocates for chiropractic and acupuncture and all these other things, and has this wide tent. Also has these academic centers all across the country in large organizations. You’ve got functional medicine that has a functional medicine doctor in every town in the country and has contributed so much in terms of books and podcasts and summits and the information going out into the world. Then you’ve got naturopathic doctors now licensed in 30 states and meeting some of the need of the lack of primary care by delivering a healthy version of that. You’ve got environmental medicine really starting to understand some of the super chronic multifactorial chronic illness people and working out how to unpick some of that. And all of this is in my mind, in the same path, which is salutogenesis, which is essentially vitalism one way or another.
And his op-ed really spoke to me because that’s been a dream for me for 10 years. The whole point of the Functional Forum at the beginning was to bring like-minded people together to see that they’re quite similar and find ways to work together. And I’m not sure how well we’ve done on that generally, and I may have picked the wrong name from the beginning, but to create unity around. But I would love to just get your thoughts around that idea and that concept, and are we missing the opportunity to really move forward more quickly by being in some ways in competition with each other for the hearts and minds of the physician community?
Dr. Michelle Thompson: Yeah. And I think, again, this is some of the deprogramming. Because when you are a physician, you come out of your undergraduate education competing with everybody else to get into medical school. And then you come out of medical school competing to get into residency spots. So, you become this competing individual and you start to think that you can’t be on the same page with these people. And really, we need to have this unity. We need to come together because together we are stronger and together we move mountains.
And so, we can’t do it alone. And I really do believe that there’s room for all of us in this. We have a healthcare shortage. We have physicians who have left with the pandemic that have retired because of that, because of the electronic medical record that they just don’t want to do it any longer. They don’t want to keep up with the rigors of the CME and all of that stuff. But really, a true team-based approach looks at all of that, the environmental, the functional, the integrative, the primary care. There’s a need for everyone that is in this because nobody does it all. Nobody does it all.
But again, that goes back to that old school mentality that physicians would have that hierarchy where they felt like if you went to somebody else for a second opinion, “Well, that’s it. You’re not coming back to me because you wanted somebody else’s opinion.” But truly nobody on this earth knows everything and has all the answers. And again, a lot of times it’s just who is it that’s going to get to the person who’s going to resonate with the person that’s going to allow the person to go deeper in themselves to make the change within themselves?
Sometimes that’s not, maybe won’t be me. Maybe they don’t like my delivery or my approach. Maybe they like somebody else’s approach. Maybe they resonate more with them. We don’t know how a person is going to receive the information. Or at the time, what else is going on in their world. I lost my stepmom. She died during the pandemic. I come from a bad family of drugs and alcohol in my background. And during that time, I feel like I was heightened. I was a doctor frontline, family medicine in the pandemic. I was dealing with my stepmom who lost her life. I was dealing with my family who was grieving. And I feel like even for me, I felt like I didn’t understand quite the heaviness of what I was carrying in that moment until three years later, I look back and go, “Wow, I was carrying a lot in that moment and I was doing the best I could.”
But we all are humans dealing with things in our lives, so we don’t know what the next person is going on in their life. Maybe they’re going through a divorce. Maybe they’re going through health problems. We just lost a physician. He died of cancer recently. And so, you just never know. And I think that everybody has to come together and know that they matter. We each have a gift to share with the world. And I always say that. Even the garbage man, aren’t you really excited that the garbage man comes, or garbage person I should say, because down this probably garbage movement too, but they come and take your garbage. And the mail people, every one of us has a purpose in this world, and I think we all need to work together as a team to make the world a better place.
James Maskell: Totally, yeah. That is funny how that came up last night. I was at a meeting for the educational project that my kids are part of, and we operate in consensus decision-making so there’s not a hierarchy. And one of the things that I’ve had to learn through that journey and I’m constantly learning is how do you make decisions in consensus? And something that you said really resonate there, which was no one has the single source of truth. Everyone has pieces of the truth. And the only way that you actually come to the truth is by everyone having an opportunity to participate and working it out. And it can at the beginning take longer because it’s unfamiliar and people are used to just making decisions and moving forward. But we are consciously going about trying to build something through consensus decision-making.
And it’s a great learning process for unity and connection. And I’m very grateful for everything that it’s taught me because most of the rest of the time I’m spending my time in companies where there’s someone in charge, and it’s very clear who does what and who tells other people to do what. And when you have big decisions, like let’s just say an election where people and the majority wins, ultimately that ends up being divisive by its nature because you have winners and losers. And it’s been a great journey in consensus to really understand what is possible. Can everyone win? What does a win economy look like?
Dr. Michelle Thompson: Yes, a win for our world. And I think that too. And a lot of times when I was young, I guess I would be frustrated when a person came to me and they weren’t ready to make the change. And I would feel like, “Oh, what did I do wrong?” But now I just tell myself, “They’re not ready. It’s not their time,” or, “I’m not the person and that’s okay.” I interview. All my patients essentially say, “This is what I do. Why are you here? What do you need from me? We may or may not work good together as a team, and that’s okay. I’m still going to send you love and well wishes and be part of your journey if ever you need me again and the time is right for you.”
So, I think that, again, knowing there’s a season for everything, that we all don’t wear the same eyeglasses. We can’t switch eyeglasses with another human being. We never know what’s going… And then truly, if you’re integrative, we look at all the factors. We look at the environmental factors. We look at there’s so many different things that are under the integrative lens that you can never be sure. But I think that we just all need to come into the whole working together and believing in the system and believing in change because the world is changing. You can’t deny that. Just open your eyes and look around. You’re watching it happen.
And patients are demanding it. They’re lining up for it. People wait a year to get in to see me. I opened up my schedule today to see a few patients because I’m going to see my son for Thanksgiving. So, I was just trying to make up. And I had a guy who has been trying to get in, considering coming to me for a long time, and he was able to call yesterday and get in today. And I was like, “Oh, wow, that doesn’t normally happen.” And he was so grateful. And I said, “This is no mistake. You’re here today. Let’s get started and what do you want to do? What feels right for you?” And I was excited to be with him and he was excited to be with me. And the time was right, and the time was now.
And again, I always tell people too, “What do you want to begin to work on? It’s up to you. It’s not up to me.” I think that’s the other thing. You come into your physician, the physician would say, “Well, we’re going to talk about your weight today. We’re going to talk about your blood pressure.” Maybe the person wants to talk about stress. And the stress is really the cause of their blood pressure and the cause of their weight. So, if we just listen to the person and come back to that whole listening, we just listen, we’ll get to the answer.
James Maskell: Beautiful. Well, Dr. Thompson, thank you so much. And I really appreciate you coming to be part of the Evolution of Medicine podcast. This has been going for a decade and for many of the early years. It’s really just in the last couple of years that we’ve entertained this kind of conversations where it’s like doctors who are working it out. And that’s because I think for the first time, we are seeing an acceleration of change at the system level, and I’m excited to see that. But I also think the work that you’re doing across lifestyle medicine, integrative medicine, mind-body medicine, psychedelic medicine, there’s tons and tons of interest in all of those things. And I think they all are gateway drugs to the evolution of medicine.
Because once you take a few steps down that path and you see what’s possible when you can empower people with those tools, then it’s a journey of rediscovery for physicians and their patients alike. So, thank you for your pioneering work, and we’ll put some links in the show notes so people can find you and really look forward to an exciting 2024 with all your work with the Academic Integrative Consortium and Lifestyle Medicine and everything you’re doing at UPMC. And thanks so much for being part of it. This has been productive.
Dr. Michelle Thompson: Yeah, thanks.
James Maskell: Go for it.
Dr. Michelle Thompson: Yeah, thanks. I just want to add one more thing. There is actually in the traditional medicine, American Academy of Family Medicine, they’re starting to look at integrative medicine divisions inside of the traditional medical systems now. So, in the family medicine groups. It’s happening. We’re just watching this happen. So, thank you so much for the work that you’ve done, the groups, working with men in general, all of the things that I’ve watched you do in the mind-body medicine arena and integrative medicine arena. It’s just, it’s very inspiring and empowering and wonderful to be with you. So, thanks. I love being part of this all and this evolution of medicine and healthcare.
James Maskell: Beautiful. This has been the Evolution of Medicine podcast. I’m your host, James Maskell. We’ve been with Dr. Michelle Thompson from University of Pittsburgh Medical Center and many other things. Thanks so much for tuning in, and we’ll see you next time.
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