Today, we are talking with Dr. Sunjya Schweig, you may know him as a leader in the Lyme and biotoxin illness space. However, over the last few years he has been working on an interesting project to bring functional medicine principles, and clinical nutrition to a very special population; firefighters and policemen. In this interview you’re going to hear about the main issues that affect those people in society, Dr. Schweig talks about the program that they’ve piloted, how they’re tracking their outcomes, what the outcomes have been, and there’s so much in here for anyone who’s listening to this who wants to be a part of their own reinvention of medicine, whether it’s in your own clinic or you have bigger dreams than that, so much to learn from Sunjya. He is a real treat, enjoy.

Highlights include:

  • Some positive and negatives when dealing with groups where there is preexisting social structure
  • The finances behind running a group like this. Who is paying the bill?
  • What impact Dr. Schweig has had with this new program and how to get involved
  • And so much more!



New Models #9: Functional Medicine for First Responders - ep263


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. We have a very special episode for you as part of our new models. Today, we’re talking with Dr. Sunjya Schweig, you may know him as a leader in the Lyme and biotoxin illness space, but over the last few years he’s been working on a very interesting project to bring functional medicine principles, clinical nutrition to a very special population, which is firefighters and policemen. In this interview you’re going to hear about the main issues that affect those people in society, where he’s going to talk about the program that they’ve piloted, how they’re tracking their outcomes, what the outcomes have been, and there’s so much in here for anyone who’s listening to this who wants to be a part of their own reinvention of medicine, whether it’s in your own clinic or you have bigger dreams than that, so much to learn from Sunjya. He is a real treat, enjoy. So a warm welcome to the podcast, Dr. Sunjya Schweig. Welcome, Sunjya.

Sunjya Schweig: Thank you so much, James. It’s great to be here.

James Maskell: I’m really excited to connect with you and to chat a little bit about what we have lined up for today. Now, for those people who don’t know that much about you, I know that you are a very well accomplished doctor in many different areas, but I know specifically, and I’ve sent actually patients your way in the sort of biotoxin illness mold, Lyme world, and yet today what I wanted to talk to you about is actually something that I’ve sort of witnessed and heard about through our friendship, and then I saw you actually present at the annual international conference for the IFM this year, and that’s working with a very specific group, which is first responders and firefighters. So I’d like to kind of just, I guess, start by diving in. Obviously, you could just do what you do every day and help people with complex chronic illness, what was it that sort of, I guess, got your attention in this direction?

Sunjya Schweig: Yeah, so to your point there’s just a lot of opportunity in the functional medicine space. There’s obviously huge numbers of different patients in different illness buckets that you and I know, and many of us know, really need help. And a lot of these invisible chronic illnesses are a place where functional medicine shines, obviously. But also, as you know, and as you’re passionate about, bringing functional medicine to the masses and using it as a preventive medicine approach is also really powerful, really exciting and really fun. And so, we were basically doing our day to day work taking care of patients in the functional medicine space, usually more sick, more complex kind of invisible illness patients, and it was actually about 2016 or so where we were approached by Amory Langmo, a gentleman firefighter engineer at the Berkeley fire department. And he had his own personal experience using ancestral health, paleo template diet, functional medicine for his own personal health optimization, and was really passionate about it, really forward thinking, forward minded.

And so he came to us and said, “Hey, we, as firefighters, have these unique health challenges that we’re experiencing and we need your help.” And he knew the power of this work, and so he had basically searched us up looking for a functional medicine, found us there in the East Bay. We met at a restaurant, kind of did this initial deep dive and we just both got super excited, super keyed up about the opportunity and the potential for collaboration, and we kind of… That first run, so basically we set to work immediately and started developing our sort of best in class wellness program, throwing all of our functional medicine ideas, our preventive lifestyle management learning theory, trying to help them basically with all the key lifestyle challenges that they face, and we can dive into more detail on what those are.

But we also hit this kind of sweet spot at the Berkeley Fire Department at that time where there was this kind of coalescing of leadership and of folks in the right place at the right time who understood the power of this work and who were motivated to push it forward. And so we initially rolled out a four month program, a wellness program targeted at their new recruit academy, which was really successful and really well received, and we’ve expanded it from there.

James Maskell: That’s really cool. So when you first sat down with them, what would you say are some of the unique challenges that firefighters face? And as you look at your sort of arsenal of tools, how did you start to then think about what tools in what order for these people?

Sunjya Schweig: Yeah, so firefighters and first responders in general have a number of really, really key health risks that they experience. The number one cause of on duty death for firefighters and most first responders is a heart attack, and that’s what kills them in the line of duty. There’s also a huge burden from injuries, from chronic inflammation, they work hard. We think of them as industrial athletes, and they’re putting their bodies on the line every day. And at the beginning of their career, frequently, they’re very fit and in shape, and many of those folks do maintain that throughout their career, but unfortunately a lot of them don’t and they gain weight and they enter into metabolic syndrome and obesity. Probably up to 70% of first responders, according to the statistics, have been shown to be overweight, and about two thirds, about 61% actually have metabolic syndrome. So the same thing that we see in our functional medicine, wellness metabolic populations.

In addition, because of the unique stresses that they experience psychologically from experiencing trauma on a day to day basis, and we think of both micro T trauma, small T trauma and big T trauma, these first responders are in the face of very, very difficult circumstances day in and day out. And so that builds up, it is a huge burden from behavioral health with these folks, anywhere from anxiety, depression, sleep disruption, all the way up to PTSD, and probably about 25% of firefighters experience PTSD at some point in their career. And then unfortunately leading all the way to suicide, suicide is the number one killer of first responders, especially firefighters and police. And as I’ve said over and over again, to me, that’s unacceptable and they should be given resources and given support in such a way to help to prevent that.

Furthermore, from a chronic inflammation point of view, sleep disruption, circadian rhythm disruption plays a huge role in their overall health in the inflammation and the disruption of hormones and predisposing them to a variety of different health issues and risk. And finally cancer, cancer is also one of the top killers of firefighters. And you might think, “Well, yeah, that makes sense, they’re exposed to toxins, they’re exposed to fires.” And certainly modern fires are much more toxic than they were in the past given that when buildings burn computers are burning, plastic is burning, the whole industry around flame retardants in furniture and clothing probably a big misstep, it doesn’t really prevent a lot of combustible fire activity, but actually does put a lot of toxins into the air, which the firefighters are then breathing and getting on their bodies. But almost even more important, relative to the cancer discussion, is all the other things that we think about in functional medicine, the circadian rhythm disruption, the sleep disruption, the inflammatory diet, the unchecked stress, et cetera, right?

So really we work hard to put all those components together to build a sort of 360 view of wellness, and we drip it out in sequence. We always start with the basic functional medicine tenant with them, which is the gut is the center of the universe when it comes to health. So we start with nutrition, we start with education around inflammation and diet, choices that they can make to improve that. We put them through a 30 day paleo template reset or on some of the less intensive programs we ask them to simply be gluten free and sugar free and alcohol free for 30 days. And so we go sort of step by step from nutrition, to recognition and command of stress, to sleep and shift work and circadian rhythm disruption, to metabolic interventions, intermittent fasting, fasting mimicking diet, and then to cancer prevention, looking at awareness and mitigation of what they can do day to day, right?

They can’t change the shift work. They need to work those shifts, they’re out there protecting all of us in society. But the small choices that they can make from a moment to moment basis, day to day basis when they’re off shift, et cetera, around sleep, around stress, around diet inflammation, toxin exposure, cosmetics and shampoo, soaps, et cetera, you name it. So we’re delivering this content to them, but we’re asking them to partake in pretty robust challenges around each module, around each content module. And we’re delivering this through our learning management platform, through our practitioners, myself, our nurse practitioners, through our health coaches, through our nutritionists, through our admin staff, so they get this really high touch experience with the team approach.

But then we’re also really leveraging this hightech approach, meaning we’re putting Oura Rings on them. We’re having them use wearables tracking fatigue. There’s a company called Fatigue Science that we’ve collaborated with. We’re measuring lab studies pre and post, we’re measuring body composition, either through DEXA scan or body fat dunk tank. And we’re working to create live dashboards that feed all that data back to them, ideally in real-time so that they can start to understand what those changes are doing, what their choices are doing relative to how they feel, but also what the data shows. And so that’s where really the power is, we just really love that high touch team approach combined with the high tech leveraging the technology in the best possible way.

James Maskell: Yeah, that’s super exciting. And I’m glad that we are doing this as part of our new model series because I think what you are really creating is, there’s sort of a vision of this new model of care where functional medicine sort of pairs with this high-tech environment to actually show that it works, right? We’ve got the right medicine, and obviously, when you start measuring everything, you start to realize that the way to improve the numbers on a wearable are through the kind of things that we’re doing, so I’m glad to feature it as part of that series.

I guess, one of my questions because I know a lot of practitioners have been listening to this will be thinking, “I would love to do something like this, and I would love to get involved.” But ultimately, they’re also dealing with the day-to-day of already running a successful clinic. And then this opportunity comes along where you have dozens, if not hundreds of people to now servic, tell us about sort of the mind shift and also, I guess, the resourcing that you had to do internally to then say yes to this and not at the expense of everything that you were doing before, and how you had to think about resourcing it in a way that you could keep the lights on in the practice and this wouldn’t be a huge distraction.

Sunjya Schweig: Yeah, that’s a great question. Well, so we’re a unique practice in a lot of ways, and obviously, the last year and a half to two years has really dramatically changed the landscape of how medicine is practiced. But going back to pre-COVID even, so 2016, from the start of our clinic in 2014, we have maintained a very virtual setup. And so we had all of our staff working from home. We had practitioners working from home. Pre-COVID our care delivery was, I would say 60% virtual and 40% in-person. And so as we started this wellness program we initially we’re running our first rounds with the Berkeley Fire Department, we did later in 2019 a more robust rollout with the Santa Clara County Fire Department. These were local to us, we would go onsite, we would deliver the content, there was more of a physical presence that we had onsite.

And we realized through COVID and also through the demand that the program starting to get, that while there’s certainly benefits to that, the scalability is not great, it’s hard to scale when you’re trying to go onsite for each program. And so we really started to look at, how can we leverage the technology, prerecord a lot of the content, deliver it to them where they can watch it on their own time, but then still maintain the immediacy and the stickiness of that real-time live interaction?

And so what we’ve started to do is again, have that mix, that hybrid of prerecorded content on-demand, but then also have regular check-ins. We have either weekly or every other week, an online group meeting that’s live, it’s recorded in case obviously anyone misses it. We have regular check-in with our coaches through texting, so we found that texting is one of the most seamless and sort of best ways to get to what we call the edge user, the individual out there in the world. And in some ways, and in the data dashboard feeding back visibility on what’s happening to them, in some ways I think that’s really the future, that’s the way that medicine needs to be practiced. And the thing we also realized is, as you’re in functional medicine for a long time and you’re asking people to make these health behavior changes, whether it’s diet or mindfulness, stress reduction, breathing, sleep changes, metabolic changes, you can tell people what to do, but much of the time it’s hard to put those changes into place in a robust manner.

It requires focus and dedication and support, so really this mix, this hybrid of electronic and immediacy of texting, group visits, discussions. And also sort of taking that content and that information and that task that we’re giving people and spreading it out over time, making it more of a longitudinal experience with the group experience, right? So the community of the group support and the feedback they get from each other, I really get excited about that. I think, and you know this, I think that’s where we have the chance to really actually move the needle on making these changes stick. And so it’s been a learning experience, we’ve iterated over and over with this program and we keep continuing to grow it and we sort of parse different pieces and we’re playing with how we can improve the outcomes even more. But I think it’s that hybrid of both the technology with the high touch that’s going to really make things work.

James Maskell: Yeah, I’d love to understand from your perspective, that obviously when you come into a community that already exists, these firefighters know each other, and they’re already kind of friendly and you have some benefits of a significant sort of physical location where they’re all coming to, what are the sort of positives for the group dynamics? And are there any negatives? Like if you’re really trying to get people to be like vulnerable in groups, is it better that they know each other, or do you find that there is some hesitation there because they know each other? And what’s been your experience in sort of facilitating those group dynamics?

And I ask that mainly because when we’d been working… Last month on the podcast we heard from HealCommunity and kind of what we’ve been doing there to essentially introduce patients of different doctors to each other that don’t know each other, right? They all go to the same doctor and they all get put in this group, but they don’t really know each other, they may live in the same area. You’re dealing with a different dynamic, which is more sort of like an employer kind of model where people do know each other, and I’d love to get your insight on the sort of positives and negative of dealing with groups where there’s almost a preexisting social structure.

Sunjya Schweig: Yeah, super interesting question, that’s a great thing to think about. And we’ve done it from different ways. Most of the time when we’re doing this program, we’re doing it like you said, with a group that has an internal connection already. They might not know each other well, for example, when we’re dealing with a new recruit academy, this is going to be 12 to 14 people who have just got thrown together into this training and they don’t yet know each other, but they quickly become familiar, they bond, they understand strengths, weaknesses, they’re going through a pretty intense experience altogether, so there’s some bonding there as well.

We did one cohort with Bellingham, Washington, this last cohort that we did, it was a mixed cohort of fire, and police. So a little bit of half the group knows each other somewhat well, but the two separate groups, fire and police, don’t necessarily know each other across the department lines. And so we’ve seen it both ways. And I think there is a lot of power. One thing I will back up and say is that first responders, and firefighters, in particular, are very, very community-minded, right? The police are a little bit more sort of lone wolves and kind of in their own patrol car or going about their days business investigating, et cetera. The fire departments they work together, they take shift together, they eat meals together and so there’s already very much a built-in community. And they are not very receptive, understandably, from somebody coming in from the outside and saying, “Hey, we know what you need. You should do X, Y, and Z, and this is why.” And, “Hey, I’m Dr. Schweig and yada, yada, yada.” That’s not going to work, right?

What really we found, and this is where I get really excited about training the new recruits, is that they learn from each other, and they want to know, “Hey, what are you doing? Because you look like you’re in really great shape and you look rested and you’re responding well. And what’s making things work so well for you and for your body and for your experience that maybe I’m not doing?” So they’re always kind of trying to hack their own bodies and figure out, how can I be better? How can I be stronger? How can I be faster?

And so what we get really excited about working with the recruits and building that knowledge base for them as a group is almost like this trickle up phenomenon, that they’re then going to go enter the department and then train or expose the rest of the department of 200 plus people possibly to this work, right? And so they become the ambassadors. They become the success stories that everyone wants to learn from. Especially on the fire department side, these folks, and all the police, they understand the risks that they’re up against. They understand that heart attack takes down a lot of their partners and friends. They understand that people are lost to suicide. They understand that people are lost to cancer. And they don’t want that, they want change. And they want that individual, and they want that at the level of the department, and even the government is starting to see that, right?

But they also can be conservative, can be not as exposed to nutrition and to mindfulness and meditation. We have to kind of couch things in terms of performance terms in a lot of ways, like this is going to make you better at being fit, better at doing your job, et cetera. But again, that idea of it to the end-user, having them then bring it into the department. And I do think that when we’re working with a cohort where they’re interacting with each other, I think there is a lot of power to that. But again, I think that goes across lines, there’s all sorts of online communities for firefighters, et cetera, where they want to learn from each other, right? So it’s spreading already, and the motivation is clearly there.

James Maskell: Yeah, that’s really cool. All right, so before we get into the… I want to kind of dive in a little bit into who’s paying the bill, and how you guys got paid and that kind of thing because I’m interested in that too. But let’s get into it, what happened, what kind of impact were you guys able to have with the program over what period of time? And then how has that then led to more people wanting to get involved? So let’s just start with the outcomes themselves. Because I guess I just want to… I know that you are getting outcome data just by the nature of the way that you’re creating the program, right? If you have this high-touch information and you’re getting this rich data stream from them, you have a lot more data than most practices. And if you are housing it inside a technology stack, you are also then able to keep that data.

And I just think that’s one of the sort of Achilles’ heel of the functional medicine movement up until now is that each individual practice has not really had made it easy or been incentivized to track their outcomes. And if you look at the organizations that have like Cleveland Clinic or Parsley Health, or Dr. [Cheng Ruan, the outcomes are amazing and then kind of infect the rest of medicine. But there are so many amazing functional medicine outcomes that are just sitting in the paper file or EHR of a functional medicine clinic and not really seeing the light of day. So I’m excited to ask you, and I ask you that question knowing that you already know.

Sunjya Schweig: Yeah, no we’re really passionate about the data and trying to have the data motivate the work, and prove the workout because we’re trying to build this program and provide enough data for it so that it becomes a no-brainer, so that the powers that be, the departments, the government, the health insurance companies, they understand, they begin to understand that, yes, you’re going to pay for this upfront, but it’s going to save you so much money on the back end that it’s just a no-brainer, that you should just do it, right?

And so we track data and we see outcomes and we’re still working on data visualizations and different models to keep digging into it, to keep asking questions of the data as we build cohorts. But we see body composition changes, interestingly not as much on the weight side, although average weight loss of anywhere from six to 15 pounds per person. But really we saw a redistribution of weight, and so a significant loss of body fat, a significant gain of lean muscle mass, lowering relative body fat percent by almost 45% in some participants.

We see the data also on the wearable data, things like the Oura Ring, the Fatigue Science ReadiBand. We’re showing changes in HRV, right? So for the pilot, we just did with Bellingham, the group cohort, 14 people, the average start HRV was about 26 milliseconds, and at the end was about 75 milliseconds, a change of about 188% improvement. Deep sleep markers based on the wearable data, the average start about 0.4 hours, at the end, about 1.3 hours, so a 225% improvement. Sleep onset, at the beginning a cohort average of 24 minutes, at the end, about 18 minutes, a 25% improvement of sleep onset time. Awake time, a 70% improvement. And so outcomes in terms of the individual user, over 93% of people saying that this program was really helpful to them. Lab data improvements across markers like CRP, Lp little A, homocysteine, vitamin D, B12, the functional medicine markers that we’re tracking.

Interestingly when we track the blood sugar data and the lab markers, we were actually seeing less of a robust change than what we might have thought. And what we realized is that we’ve been running this program on a volunteer basis, and so we’re kind of skimming off the top of those folks who are already pretty healthy-minded, and we’re running it at about 12 to 14 people at a time. And so while we’re seeing improvements in those markers in those folks, I’m super excited to see what happens when we get to start running this program with larger numbers of people and also people across different departments in America where they might not be as healthy-minded at the baseline, and I think that’s going to really prove out super robust outcomes in that regard.

James Maskell: Yeah, I want to ask you about that because through my research we found that workers comp for these groups is pretty strong, like if you became a firefighter and then you got heart disease on the job, right? Most people think about workers comp of like, “Oh, chiropractors helping people who had a car accident.” But my understanding is that if a firefighter or for a policeman in most states if they have a heart bill, that if they got that, if they acquired that illness one way or another on the job, then the heart bill is really there to pay for it. And you said earlier just the percentage of people who get a heart attack in these groups is high. I guess I’m hoping that there’s going to be some innovation in payer models, and we’re already seeing it a little bit with HealCommunity where through workers comp that pays 120% of Medicare there may be some opportunities to deliver programs like this in groups in firefighters and police and have a sort of a more predictable payment mechanism.

Sunjya Schweig: Yeah, I think that’s right, and I get really excited about that along with you. From where we sit, that’s just a total no-brainer, but we are working uphill a little bit against a lot of the forces that be in the mainstream system. But money talks, and I think as we start to prove out the model on your side and on our side, it’s pretty clear that… Yeah, the work comp side, absolutely, right? And some of those are longer-term outcomes are harder to track if you’re talking about heart attack or metabolic syndrome or cancer, suicide, et cetera. But if you start to show short-term improvements on sick days or short-term improvement on sick day utilization, or short-term improvements on injuries and recovery time, because the sympathetic stress is lower and the inflammation across that person’s body is lower.

Those I think are easier to start to prove out, and those are huge numbers, billions of dollars per year, right? And the cost to train and get one of these first responders into the field is super high, and so the potential loss of revenue or tax money, et cetera, to the department, to the state, to the federal government is huge, right? And so if we can move that needle at all, which I think in the shorter term we can start to, I think we are going to wake up a lot of people’s minds and get them interested.

James Maskell: Yeah, I think that brings a bigger conversation about this shift to value in healthcare generally, right? We’re seeing accountable care organizations and other groups that are looking for value in healthcare. And you can see that if we can measure it properly and we can organize, there’s nothing more valuable than taking someone who was on a trajectory towards early retirement, or not being able to work at the top of their game, if you multiply function by years, the cost is really high. And ultimately you can see that if we are to take this kind of preventive care to the masses, we really need better ways to be able to sort of predict future costs and show that those can be transformed through some of these programs. But in order for it to happen, the results have to stick.

And I guess one of the things that I’ve been becoming more and more sort of infused about or vocal about is that… And this is a question, for every doctor and practitioner that’s listening to this, if you engage with a patient and you do your functional medicine episode of care, whether that’s one appointment or three months or six months or a year or longer, what is the health of that patient in five years? And I think that unless we’re having that discussion we’re really missing out on the opportunity, because if we know what that is, if we can actually create long term, almost full transformation in a patient where their life is forever changed by coming through one of these programs because not only is it the right information, but they have the right supportive community in which to participate and then they have like long term accountability, which is totally possible, especially in this opportunity given that these people are going to see each other every day for the next 5, 10, 15 years, we have to be working at that level to be able to make those kind of claims.

And my suspicion is that most people that go through a functional medicine episode of care will sort of regress five years later because they don’t have the right support or system to support it, and also the sort of acuteness of the diagnosis has maybe faded away into the background, and so there’s none. And I can certainly see that not just from working with clinics, but in my own life. It’s taken a lot for me to be able to push through and make long-term changes when the acuteness of the need is not there, and I think that must be an issue for many patients, especially now.

Sunjya Schweig: Huge point, and there’s a lot to that, a lot that comes up in my mind. And so, we have a data dashboard that we put together for this last Bellingham cohort, a friend of mine, Rory Stanton over at Aila Health helped us to put together a real-time dashboard. And so we’re showing changes in HRV, showing changes in sleep markers, showing changes in resting heart rate, changes in movement, steps, and also tracking compliance score daily for each individual. And so we see this really amazing rise of some of these positive markers. Thinking about heart rate variability, a marker of sympathetic/parasympathetic balance, how resilient is your body? High HRV is good, as most of us listening know.

When we started the 30-day nutrition reset, we saw this huge jump of HRV. The cohort baseline at the beginning was around 30, by two weeks into the nutrition reset, also getting them moving more, they were at 56. So a nearly doubled cohort level, HRV. And other markers like deep sleep and sleep onset and awake time, cetera, sleep efficiency, all improved markedly.

In preparation to talk with you today, I went back to that dashboard, it’s still collecting data in real-time, but we’re sort of post-intervention now, right? We’re in October now, so it’s been about a couple of months since we had a touchpoint with that original cohort. What do we see? HRV’s starting to drop, the resting heart rate is starting to go up. Sleep markers, deep sleep is worse. Sleep onset is back up to basically similar to the start of the cohort.

So to your point, even with this really robust six-month intervention, we let our foot off the gas and sort of let them go back to “normal” life. They’re moving less, their daily movement is down. So it really does have to be multiple touch-points over time, and this really longitudinal experience, I believe, that’s just how health behavior change has to work, right? People who are embedded in their home with their families and their partners and their coworkers and their commutes and their day to day stresses and sleep patterns and alcohol, whatever it is, that’s going to be a friction, it’s going to be a grind on their body achieving optimal health.

So what I get excited about, just seeing this data is really cool just to understand what we can achieve and then sort of what the tail off is. We want to track outcomes going forward, we’re working on that. But I start to think about, “Okay, we really need a tune-up.” We sort of need a little wellness check-in or a little micro popup intervention. Okay, this week we’re going to remember about nutrition. This week we’re going to remember about sleep. And just really push on those levers over and over again so that people start to be able to who really understand how they feel differently repeatedly over time, because they all felt great on the program, right? But it is going to require sort of an ongoing work and an ongoing effort.

My friend and colleague Ryan Provencher at Bellingham, who’s another amazing, amazing person, super like-minded on this work, he tells us the analogy of let’s talk about bringing a new fire engine into service, right? So here’s this amazing piece of equipment, it costs a ton of money. You put this equipment into service and it has a very regimented, very detailed, very mapped out schedule in terms of all the maintenance that’s going to be done on it. When it’s going to be done, what’s going to be done, what will be changed, what will be checked, et cetera, et cetera, et cetera. You put a firefighter or a police officer into service, you give them an initial four months of training and, then it’s kind of like, “Okay, good luck.”

James Maskell: Yeah

Sunjya Schweig: And so, we need that maintenance, we need that systemic maintenance schedule and interventions and mapped out all the way across their career, and that is what is going to help prevent some of the health outcomes that we’re seeing.

James Maskell: Yeah, that’s amazing. Well, cool. Well look, I think this is the perfect way to finish our series that we’ve had here on the new models and this year of the reinvention of medicinebecause what you’re talking about is this reinvention of medicine, it’s a fully integrated system for keeping people healthy at scale across populations, and so I’m super excited to have you on here. Tell us a little bit about the vision for this moving forward, because obviously you’ve got a couple of good crews, you’ve got some exciting pilots, it sounds like. Give us what you think this project is capable of becoming in the future.

Sunjya Schweig: Yeah, no, there’s a lot that I dream about, future direction. And, for one, we’re spinning off some of the work we’re doing at the clinic and starting a 501(c)(3) arm so that we can apply for grant money and try to get government funds and even tech, startup funds and really push this research forward. And also some of the work, a lot of the research that we want to do around patients with invisible illnesses and the functional medicine paradigm and what we can learn from it. So getting more funding, looking at more research, doing controlled trials, IRB-approved trials based on an intervention group in the first responder work, along with a control group where we’re tracking data on both, but only intervening on one.

There’s a lot of amazing work being done on cancer in particular, so looking at microRNA changes. Dr. Jeffrey Burgess out of Arizona has shown that as compared to new firefighters, veteran firefighters have elevated microRNA changes in their bloodstream, pro-carcinogenic microRNA changes. So my thought would be, “Okay, well, let’s see if we can show that nutrition interventions, that sleep and circadian rhythms, stress, that we can reverse those changes, that we can start to potentially reverse some of the risk that’s happening from a biomarker, that’s sort of a holy grail.

I’m always passionate about the data, and so I’m just always dreaming about how we can build a more robust data dashboard that starts to leverage artificial intelligence and machine learning to kind of really pull up what’s the one or two or a few things that you need to pay attention to on a day to day basis, that if you want to you can dig into and look at all the downstream data on, but really just sort of rise up a few metrics for the individual end-user to help guide them on their wellness journey and really reemphasize the importance of this work.

So, yeah, there’s a lot there. We just want to, again, try to prove out that this works, that it’s going to decrease injuries, that it’s going to decrease work comp claims. And really at the end of the day, the goal is to protect those who are protecting us, to give back to them, to serve them, and prevent early death or injury or morbidity from their really amazing, amazing choice to be out there on the front lines protecting all of us in society. So thanks for the opportunity to be here.

James Maskell: Yeah, absolutely. I just want to echo that I bought a new house actually and moved up into the Hills here in California in the middle of August, and the day that I moved in was the beginning of the Caldor Fire, literally, it started the day that I was here. And so we were kind of inundated with fire teams from all across the state and actually from other states coming in and helping out with itbecause it was such an intense situation and moving so fast. And yeah, I’m just filled with gratitude for people who choose that as their profession and choose that, and we do have to take better care of them. And I think that you’ve identified some really significant threats to the ability of those people to be able to serve their communities moving forward. And it’s the same threats that threaten all of society, but it’s just so much more important in the professions that they’ve chosen.

So thank you for your commitment to this work, thank you for leading the charge and creating this new model. And we’re excited to not only follow this project moving forward but also just to follow more of what you’re doing because I believe that even in the Lyme and biotoxin illness world the people who have been working in that world are almost defacto the leaders in this long COVID world as well, because it’s the same kind of thing, and finally now the world is paying attention to these downstream effects of acute infection.

And so really excited to move into 2022, a year of growth with some of these themes and just rounding out our year of the reinvention of medicine. I think anyone that’s listening here today that is passionate either about clinical nutrition, functional medicine, technology, data or otherwise see how you’re putting it together in a model that could really be transformative for a lot of people. So thank you for that commitment. Thank you for being part of the Evolution of Medicine podcast. This has been our series on new models, we’ve been here with Dr. Sunjya Schweig. We’ll have more details about how to get ahold of him and be in touch with him in the show notes. In the meantime, this is the Evolution of Medicine podcast. I’m your host, James Maskell, 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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