This week, we are talking pharmacies, pharmacists, and the reinvention of medicine. Melody Hartzler, PharmD, BCACP, BC-ADM is a pharmacist on the frontlines, organizing a new model of functional medicine-trained pharmacists integrated with primary care and specialty care. This community of functional pharmacists play a critical role in the reinvention of medicine. I learned a lot from this conversation and there’s some exciting opportunities for more education as we move forward.

Highlights include:

  • Hearing how Melody started as a pharmacist and her journey to functional medicine
  • What a “de-prescribing pharmacist” is
  • How pharmacists can fit into a team approach in the reinvention of medicine
  • And so much more!

Resources mentioned in this episode:

Pharmacists on the Front Lines ep253


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 are talking pharmacies, pharmacists, and we’re talking about the reinvention of medicine. Melody Hartzler is a pharmacist and has been on the frontlines, organizing this new model of how functional medicine trained pharmacists can integrate with primary care and specialty care to really play a role in de-prescribing and doing a number of things that absolutely necessary to the reinvention of medicine. Learnt a lot in this time and there’s some exciting opportunities for more education as we move forward. Thanks so much for listening and enjoy.

So a warm welcome to the podcast, Melody Hartzler. Welcome, Melody.

Melody Hartzler:  Thank you. Thanks for having me.

James Maskell:  So yeah, I’m really excited to connect today and over the last couple of years, we’ve become increasingly interested in the role of a pharmacist, and this year our theme is the reinvention medicine. And so I know that encased in the stories of so many practitioners, is this reinvention of medicine in their careers. So why don’t we just start there. Tell us a little bit about your background and how you got started as a pharmacist and the journey from there.

Melody Hartzler:   Sure, sure. So I started working in a pharmacy as a teenager. My mom was a nurse, and that spiked my interest in, sparked my interest in medicine and healthcare in general. But something about the pharmacy component with the chemistry and the biochemistry and how all that worked in the body together was super interesting to me. So I started my journey as a pharmacist in a primary care type role. So I’ve actually been working in primary care for the last over a decade now. And the really cool thing about being a pharmacist in primary care is, I’ve been able to work with a lot of chronic disease patients because pharmacists have evolved the role in primary care that allows for them in many states to manage complex drug regimens, help de-prescribe medicine for those patients and help them get to their goals.

And so much of that conversation over the last decade has been about lifestyle things and has been about dietary things, especially as it relates to diabetes and metabolic syndrome. And so then when I found functional medicine, as a passion for myself and my own health, and then I started really incorporating that into my interactions with patients. So over the last five years, I was able to switch practice sites and move into a private family medicine office and really start implementing the functional medicine, some of the testing, into my day to day interactions with patients. And it’s been so cool to watch them reverse metabolic conditions and to really get better, because so often we were just managing someone to keep them at a certain A1C level, but now, they’re really getting their goals faster and thriving.

And so that’s really exciting to watch that. So really just, a lot of practitioners started with functional medicine through their own health story and mine included SIBO and yeast things, and a lot of gut things after having my first child. And then she had allergies, and food allergies and gut things, and so just between learning about both of our journeys, that’s really where I started. And so it’s been an exciting road the last five years to dive into functional medicine and how that can really play a huge role in our patients’ care.

James Maskell:  Yeah. Wow. The de-prescribing pharmacist is certainly a role that I think is super interesting for this reinvention of medicine. But I guess that’s an incredible job that you get to do. And I’m sure there are many pharmacists who are out there or listening, would love to be in that kind of role because, just in the last year, since I came to that first pharmacy conference, I never really been inside a pharmacy and never took any drugs. I didn’t really understand what the role of the pharmacist was because I didn’t really interact with it.

But just to the last year, just dealing with family stuff and other things with the pandemic or otherwise, I’ve actually had to go into CVS a couple of times. And what I witnessed in those sort of pharmacists is just sort of super, super high volume, organization of the prescription, and a lot of stress, and things coming in at every moment and the drive-through pharmacy and so forth. So can you just give us an idea, I know, you’ve been in this for a while, obviously what you’re doing is sort of at one end of the pharmacy spectrum. But life of your average pharmacist, what does that look like? And do they have a spark that there might be something different out there?

Melody Hartzler:  Sure, sure. So the really exciting thing is over the past few years, there has been just such a growth in pharmacists learning about functional medicine, acknowledging it, and moving into… I get contacted and that’s actually why I started my website, functionalmedicinece.com, is because so many people kept asking me, pharmacists, “Hey, how do I get continuing education in this topic?” Because a lot of the big organizations weren’t offering continuing education specific to pharmacists. And so we’ve had more and more conversations about that. My friend, Lauren Castle, has been leading the charge as far as pharmacists in gathering them in an organization with FMPHA, the Functional Medicine Pharmacist Association, or Alliance, excuse me. But what I see in the pharmacy is that we, obviously the job of a pharmacist, fundamentally, is to make sure when a drug is prescribed, it is the right drug, it’s going with the right dose, appropriate dosing, it’s a safe medication for the patient.

So certainly, it has that drug focus, but we’re also taught at the same time to evaluate a patient when they walk up to the counter and ask a question about their health. What’s the history of the present illness? What’s the assessment that we’re going to do, and recommend an over the counter product? So pharmacists for years, have been recommending dietary lifestyle changes over the counter products and supplements. And so really, it’s about helping them reframe what that is. Does your body really need MiraLAX OTC or omeprazole OTC? Or is there something else going on in the gut that we can address that’s going to alleviate the patient’s heartburn or constipation.

And so, one of the other things that I think is really exciting for pharmacists, and so many pharmacists have started to get into this, is looking at medication-related nutrient depletions. So many drugs, I mean, we have the big ones, like statins deplete CoQ10, we’ve got a lot of other blood pressure medicines that deplete CoQ10, other medications depleting magnesium, and really important nutrients in our body.

And so oftentimes those nutrient depletions can really lead to some of the side effects that we have with the medications. For example, the statin example, we have muscle cramps that can happen. And some of that can be related to the CoQ10 depletion. So, so when we’re…Pharmacists can absolutely integrate those conversations into the mainstream pharmacy. Yes, it does take time, but the law in many states requires that pharmacists counsel their patients on new prescriptions.

And so really it’s just about inserting this conversation into their counseling. We also do what’s called medication therapy management, and so this is a term that isn’t included in Medicare plans. So all of the Medicare patients across the country generally have a once a year comprehensive medication review that they can do with their pharmacist. And this is not like they walk up to the counter and they ask a question, it’s a, we’re going to sit down with you, or we’re going to have a phone conversation for an extended period of time that the pharmacist gets, the company that they’re working for, gets reimbursed for.

And so those are perfect opportunities as they’re going through the drug plan, talking about, are there ones that we can take off of here that you don’t think work anymore for you? Or that they’re missing doses they could…And it’s not that the pharmacist is making that decision on their own, they’re certainly talking with the care team, the physicians and nurse practitioners, whoever the prescriber is, and the patient, in gathering information.

But those opportunities where they get to sit down in those MTM consults are really a great opportunity for inserting this conversation about lifestyle modifications, dietary things, nutrient depletions that may be occurring. So it doesn’t have to be the full-out consult from beginning to end that a lot of us are doing in different environments, like myself in primary care, or in consulting environments where you might do the whole workup and the labs, and make recommendations on supplements and GI regimens.

But there’s definitely things that we can do at that pharmacy level, because the pharmacist is one of the most accessible healthcare professionals. You can just walk up and talk to the pharmacist in most places, and so arming the pharmacist with the knowledge to be able to point the patient in the right direction, even if they’re not the one that has time to sit down and have that extended conversation, having them know the functional medicine process and where they can point the patient to getting that kind of care, is really important.

So I think there’s a lot of great opportunities, and hopefully… The independent pharmacies are really starting to see this. And because low reimbursement related to product is happening across the country, and so much of what pharmacists have given out over the years, the knowledge that we have, so most providers you go and you pay for the physician’s knowledge that they are going to diagnose you and give you the right treatment. But the way that pharmacy started, our counseling sort of came with the product and the product was the only way that we were getting reimbursed.

And so now that there’s not a good reimbursement on a lot of products due to a lot of issues that are outside the scope of our discussion today, pharmacists sort of have to rethink how the structure of something like this is going, and sort of independent pharmacies that might include offering consultations that you can schedule an appointment and pay to sit down and talk to the pharmacist. Or sometimes, I know a pharmacist in Kentucky that they have their own pharmacy and they’ve hired a nurse practitioner to work in their pharmacy and do a collaborative practice with the pharmacist and do functional medicine. So, so many cool things are happening, and as this evolves and the pharmacists are getting more involved in functional medicine, has been really cool.

James Maskell:  Yeah. That’s great. I’m glad you mentioned about the functional medicine CE, because I know that that has been a limiting factor in getting CEs, it’s a big driver of credits into the functional medicine space. And I think a lot of doctors have found their way there because of those credits. So I’m glad that you’re spearheading that, but I know you also have another program or business, called Pharm to Table, with a PH at the beginning of farm. So tell us a little bit about that on what it does, and why you started it and what you guys are up to.

Melody Hartzler:  Yeah. So, because a lot of pharmacists are coming to me, saying that I want to get involved in functional medicine, but I don’t know how to do it, I was like, okay, so how do we do this? And I have a friend locally that wanted to work in collaboration with an OB GYN and work with her patients. And so I started to think about this. How can I create sort of a turnkey way for pharmacists to really join a team and sort of dive into consulting in a functional medicine fashion?

And so we pulled together a team of pharmacists because we are licensed professionals, with the tele-health regulations and we do have to practice in our state. And so my thing was like, well, I could try to get a bunch of pharmacists I know here in Ohio to get licensed in all these places, but that doesn’t make as much sense as building a team with people that’s already licensed across the country.

So we cover over 30 states right now. And so we’re still working towards that 50, but we are a team of lots of different diverse experiences in functional medicine. And so that’s been really cool too, is teaching each other, as we have patient consults, we have grand rounds once a month. And so, we can present difficult cases, other people on the team can weigh in. So you sort of get the bonus of having this background group supporting the clinician. And so that’s been really cool to interact with the team.

And we also provide the consults telehealth. So we have a really simple platform. The patients can sign up, they get a chance to fill out the deep intake form or long intake form, that really helps us to see their story because really a lot of the key to functional medicine is really listening to that patient’s story and figuring out what their timeline of events was and what might’ve been triggers for certain things.

And then we have a way for them to easily upload any previous records, we do our assessment with the patient and then come up with a plan. And we do have physicians that work with us to help order labs, review lab results. And when we need prescriptions prescribed, we do have the opportunity to tap into some of those physicians on our network as well. So it’s been really cool to have this online collaborative practice because I get to do that all of the time in person. And so to be able to do it in an online format, certainly 2020 was the perfect time to launch something like that and make it available for people to be able to do from home.

But our goals are really just to help people thrive, to get rid of their chronic symptoms that they’re experiencing and get that personalized care that really addresses their underlying causes of their disease or whatever they’re…It may not even be a disease that they have. And I think that’s the thing about functional medicine, it’s so important that people realize that even if you haven’t been diagnosed with something, if you’re not feeling well, there’s likelihood that things can be optimized in your biochemistry and how your body’s working.

So we really just want people to thrive and be their best self and be able to use functional medicine in that process. We also have health coaching, and we have a team of pharmacists that do provide health coaching as well. So it’s been really, really fun and getting to know the team for me has been really a good opportunity. So it’s really an easy way for pharmacists to get involved in it because they don’t have to set up their own website. They don’t have to do all the business things, they can just contract with us and we’re able to sort of be the front part of that.

James Maskell:  That’s certainly cool. So do you work with, so doctors who need someone in that role would come to you and say, “Hey, we’re looking for someone in this team?” I guess, one of the questions I have is like, it’s very clear to me, one of the reasons why I love functional medicine is because there’s that co-operating system, right. If someone comes in and whoever’s doing the intake notice, all right, there’s a sort of a deficit here in structure and function, it’s a very easy handoff to a chiropractor to take care of that specific thing. So where do you see the pharmacist fitting in, in that sort of team approach?

Melody Hartzler:  Yeah, I mean, if we think back to like education, pharmacists are really well-versed in biochemistry and chemistry things. And so certainly some of the energy detoxification type things are really well suited for pharmacists. Obviously, if there’s medication issues or de-prescribing that needs to happen, pharmacists would be a key player there. But as far as the other functional medicines, things like gut health and other things, I mean, we learned so much about how the body, the receptors in the body react to drugs and react to phytonutrients and chemicals. So there’s so much of the, what we already get in our education that overlaps with functional medicine.

And I think the other piece is that pharmacists are the ones that see the whole picture. And so that’s one thing we talk about in functional medicine a lot, is looking at the whole picture, not just the cardiology specialty and the rheumatologist, and the primary care person, and everybody that’s sort of in their own wheelhouse, but the pharmacist is the one that’s getting all of those prescriptions, or seeing everything that the patient has.
And so we’re already trained to look at the whole patient and look at everything that’s going on. And so that fits really well with the functional medicine process as well. So certainly, we can do, we’re not physical assessment driven as far as our education. Our education is much more on…We learn the pathophysiology and why what’s happening is happening, which is so important to the functional medicine process. Why it’s broken. But as far as listening to heart and lung sounds, we do some of that, but we’re not the experts in that like the physicians are. And so there’s a lot of overlap in what we do learn and what the physicians learn. But like I said, there’s certain areas where maybe the pharmacist got more training, which might be the drug therapy, the biochemistry components, compared to the anatomy and the physical assessment things on the physician side.

So it’s not that we’re wanting to take over certain things from other providers. It’s really figuring out who’s specialized in certain areas, and honestly, it may also be how something is structured, and as far as the business model, and who has the most time to commit to a patient and their…For example in my practice, I always telling my physicians, a lot of them could do a really, a better job with diabetes management if they had 45 minutes to sit down with a patient, but they don’t. They have 15 minutes in the traditional medical model. And so, because I have 45 minutes with the patient, and I can dig into lifestyle factors and sleep and their gut and what’s going on, I have a better opportunity to influence some of those outcomes.

So really…And it’s also dependent on the person. So my background in metabolic syndrome and gut stuff, and then starting to get more well-versed in hormone things, might pair well with one particular physician, they’re interested in more pain and other things. So I think too, it could just depend, where the pharmacist’s fits, might just depend on their specific specialties and the physician’s specific specialties, and how that might be a pair. But our teams certainly would love to provide back-end support for any offices that might need additional help in functional medicine, or might have certain cases that… Related to drug therapy that are difficult for them from a de-prescribing standpoint or nutrient depletion standpoint. So there’s lots of opportunity for collaboration.

.James Maskell:  Yeah. That’s super interesting, and I think there’s a lot now that I could see there. So yeah, I mean, how does…Just to dig into that, how do you end up with so much time with patients and what can all clinicians learn about structuring that?

Melody Hartzler:  As far as how…The interesting part, is pharmacists historically have not been, so we’re not considered providers on Medicare nationally. So we can’t bill under our own… And we’re obviously not talking about a bunch of billing codes here, but we can’t bill under our own MPI number to Medicare, but so there’s incident to, in some cases, shared visit models and other cases. And there’s also, in some states, so Ohio, California, North Carolina, some other states that have recognized pharmacists as providers. So we do have provider status with Medicaid in Ohio and the Medicaid managed plans.

So that becomes a little bit different of a billing model, but essentially, I mean, it’s figuring out what works for the practice. I mean, sometimes the pharmacist coming on board, isn’t a…And annual wellness visits is another area where a pharmacist can come into primary care and help to increase profit that might cover, sort of like, we had a small conversation at the beginning, we were talking about where we can bring in the money and then, can that

cover the services that maybe don’t bring in as much, and so where can that balance out?

And so we found that Medicare annual wellness visits are an area where pharmacists can do a comprehensive medication review and do all the requirements of the wellness visit, take that off the physician’s plate. But then, we have those funds to fund the pharmacist, to be involved in the chronic disease state management and other things.

So there’s lots of ways to work that in different…But it’s definitely being creative. It’s not a by the books thing like it is for NPs and PAs and physicians. But because of that, pharmacists have been so innovative in developing new ways to make it worth, health systems have been innovative. They find cost reductions and having pharmacist in certain clinics and decreasing hospital readmissions and recognizing that that’s huge savings to the healthcare system. So there’s lots of different ways to skin that cat, but there’s different ways that you can go about it.

James Maskell:  Yeah. It’s such a good point. Yeah, I guess I was just reflecting on the fact that, so much of the time we think that medicine will change if we just did the first part, right? When I think of the patient, gets to the doctor and the doctor comes up with a different diagnosis and a different treatment plan, and gets them back to self-efficacy, as opposed to on drugs for forever.

But I think one of the things you’re illuminating is that there’s a lot of healthcare that needs to be reinvented, from when people are seeing a bunch of doctors and are on a bunch of drugs, which is like what’s happening right now, their journey forward is in equal need of reinvention than just the onboarding phase. And actually, there’s millions and millions of people right now who are in the, “I’m on a bunch of different medications from different specialists, and I don’t really have anyone that is taking the time to think through how all those things are coming together,” because that would obviously…It used to be the family medicine or primary care person, but that person is not always there with a history and can’t take that kind of time. So I really start to see now, I guess, how that pharmacist can play a role in solving that piece, especially because the people that used to do it, don’t have time to do it.

Melody Hartzler:  Yeah. And there’s some other pieces of the primary care, they’re referring out to their specialist and then if they would…All the specialists they refer out to, they’re like, oh, well, this isn’t working and they change things. So there’s some, they don’t want to step on the specialists toes, oftentimes, if they’re going to do something different.

And so I think that becomes challenging in this primary care centric, specialist on the outside sort of piece. So not always, I mean, obviously physicians are committed to providing the best care for the patient. If they had a huge issue, they would address it. But a lot of times there’s like, oh, well, they know what they’re doing with this particular thing. And I’m going to let them do that. So yeah, I mean in primary care, really, I mean, if you think about it, it’s everything. And so they really can’t take the time in that 15-minute model that we have in America to really address everything. But that’s why there’s lots of innovation in that too, with different models that physicians are employing in their practices.

James Maskell:  Absolutely, yeah. Well look, one of the things that really enlightened my understanding of this whole world was a couple of years ago, coming to a conference that was specifically for pharmacists who are interested in functional medicine. And I see upcoming, soon here, in September, there’s the Functional Pharmacy Symposium. And I know that your team is collaborating on it. Can you tell us a little bit more about it and how it works, and who it’s for?

Melody Hartzler:  Yeah, so we are gathering in September, on September 18th, 2021, in Chicago. So it was online last year and during the first wave of the COVID pandemic, and this year we are going to meet in person. And so we have some great speakers, including many names that you’ve probably heard before. Andrew Heyman, Jim LaValle, who’s a pharmacist, Lara Zakaria is a pharmacist as well. And then we have Dr. Saxena who is a physician that is on IFMs teaching. And then Dr. Heyman, like I mentioned previously, he speaks a lot for various organizations, including A-forum. And then the day is being led by Jeff Robbins, who is a pharmacist who has been doing functional medicine related things for a really long time. So we’re really excited about that. The topic is engineering immune readiness, and so talking about how pharmacists can really be at the front lines of this pandemic, and somewhat my thought was, well, we’ll hopefully be over with the pandemic by September, right?

But that’s not proving to be the case. So it’s still really important information and so much of what we need to teach our patients is related to supporting their immune system, optimizing, detoxification, supporting their stress. So much of that, we’re going to talk about the vulnerable populations, people with immune risk, we’re going to talk about the long-term complications of COVID that we’ve been seeing in our patients and chronic inflammatory conditions that have been arising.

And Dr. Heyman’s going to focus on that. And then Jim LaValle is very much into nutrition, nutrient depletions, some of those things. So he’s really going to talk about the over-medicated and undernourished, and really help the pharmacists in attendance really see how this plays a role in the immune system.

So how does the fact that we’re not getting the right nutrients, or our nutrients are depleted from these medications influence immune dysfunction. And then, again, more about the micronutrients piece. And then in the afternoon of that day, we’re talking more about mitochondrial pieces with these key nutrients. And so with the mitochondria being our powerhouse of the cell and the healing cycle process that comes with that. And then really leading into the gut piece and so strengthening the gut barrier.

So Dr. Zakaria is going to be really focused on the immune piece with phytonutrients and gut health. And then Dr. Saxena always brings the group education piece home, which I know you probably have talked to her many times about group medical appointments and how that piece can fall really well into, not only physician practices, but even in pharmacies.

So there’s the opportunity to make the…Even if we are charging a cash-based price for visits, if we can do that in a group fashion that can reduce the cost for patients and allow them to get the education, the care that they need. So it’s going to be a really great day for helping, not only just this pandemic, but really help patients get their optimal nutrition, optimal nutrients that are going to support having a strong immune system for future, and keeping the patients thriving.

So this is in Chicago, and if pharmacists are interested, I mean, anyone, any healthcare provider can attend. The credits, as far as continuing education credits are for pharmacists, and so they can check out our website at functionalmedicinece.com, and then you’ll see it as one of the options on the home page, or you can do functionalmedicinece.com. And yeah, so we’re excited about that. And my team’s doing a retreat the next day. So I’m excited to see my team in person because we haven’t gotten together since we’ve formed.

James Maskell:  That’s cool. Well, look, if I sat in Jim LaValle’s lecture, what I’m expecting to learn is that one of the reasons why America did so poorly in the pandemic is because of those nutrient depletions, like that’s what I would expect.

Melody Hartzler:  Yes. And I mean, and the pharmacists are really at the front lines of seeing what medications they’re on, what nutrients are being depleted, like we talked about before. And everyone in America is vitamin D deficient until proven otherwise in my books. So I mean, maybe if you live in the south and don’t wear sunscreen, you might have a D level above 30, but that’s not even optimal in most cases. So yeah, if you’re not taking vitamin D or getting your vitamin D checked, definitely talk to your provider about that. And I feel like at this point in the pandemic, it’s like malpractice not to check a patient’s vitamin D level for all that we know about the role of vitamin D.

James Maskell:  Can I just ask you quickly, I mean, this is slightly off topic, but not really. I mean, obviously there’s been a lot of controversy in the, “Hey, what should we be using for COVID?” And I would imagine, you’ve been, you and your pharmacists across all the states have been fulfilling prescriptions for things, like hydroxychloroquine and ivermectin, and those kinds of things. What are your just thoughts on where we are here right now, and the role of antivirals in stopping the epidemic, or the pandemic?

Melody Hartzler:  Yeah. And I will say I’m not super well versed on the drug therapy components of those, just because I don’t dispense. And so I haven’t had to get really up to speed on that. But I do know it’s been a conversation, and part of it too is, at the beginning, when the hydroxychloroquine piece, it was like, okay, well, we have patients that really have another condition that they need this for. And all of a sudden it’s being written for all these other people. And so it was the pharmacists trying to figure out like, okay, is my other patient that’s on this all the time going to have a flare up of their autoimmune disease if we are dispensing this all for COVID and we don’t have the stock.

And so there was a lot of that conversation. But I do think we need further, studies and we need support from, not only to study those antiviral drugs, but there’s a lot of nutrient pieces of this. And it’s really, I mean, the vitamin D specifically is…There’s so much out there and there’s even studies, like the one study in Spain where people got it at a mission and did so much better and prevented ICU admissions, prevented ventilation in some cases. I mean, again, it was a small study. It wasn’t, they were also on hydroxychloroquine, both groups, because it was standard of the care at this hospital at the time. But it just makes me so sad that there’s such a push for other things as prevention mechanisms and not a push for the nutrition piece.

That the government isn’t saying, “Oh, let’s check everybody’s vitamin D level when you go back to school,” instead of the other things that they want you to do. And so it’s really, I mean, I wish that our country could learn from, like you said, with Dr. LaValle is going to talk about, I mean, that so much of this could have been so much less severe, I mean, not that people, there wouldn’t have been death, and we’re not saying that vitamin D is the end all, cure all or whatever, but so many people could have had a better outcome if we would have addressed this from a national level with the nutrient depletion piece and the anti-inflammatory diet piece.

And so hopefully, we continue these conversations and more will come, but as far as the specific drugs for…I don’t know the data well enough to speak to it on a podcast about those specific things, but I could definitely connect you with someone on my team that might have been diving into that more.

James Maskell:  Yeah, no worries at all. Well, look, this whole year, the theme is the reinvention of medicine. And I guess I’d just like to finish with, you’re obviously a pharmacist first, but also a systemic thinker on how we solve these problems and what role the pharmacy community can play at a bigger level, and that’s why you build these things. So I would just love to get your thoughts on, when I say the words, the reinvention of medicine, what does that mean to you?

Melody Hartzler:  Yeah, I think that we have to reinvent and make it back to these personal connections. We know that one of the tenants of functional medicine, and the tenants of pillars of health is having connection with people. And I think that’s what you talk a lot about in your work with the group visits, is how much that community connection is so important to our health. And so much of what we’ve experienced recently is a lot of isolation and not having those community support. But I even think, I’ve had some conversations recently, I live in a really diverse neighborhood, and so my neighbors are from Nigeria, I have other neighbors in the community from India.

And to see how, when someone has a baby, for example, how those cultures take care of that mother, and how the culture that we live in the United States, takes care of the mother, where they go back to work in six weeks, regardless of how they’re feeling and all of these things, it just shows…And a lot of those, that’s sometimes the trigger for when moms start to have these issues with their health is because they’re under so much stress to go back.

And so I think, one of the things that we can do is come back to some of those roots and really support each other during those life events on those things. But even just providers having…I mean, I would love to see them have a little bit more time with their patients and be able to actually have quality relationships, but in order for that to happen the payment model really has to shift more to…It’s shifting to pay for performance versus the visit, in various programs are being tested for that, but we’re just not quite there yet that we’re really able to fully shift out of that small number of it.

I mean, I say 15 minutes, maybe it’s 20 minutes that you got with your physician, but on the average, I think it’s 15 minutes. So until we can…And really implementing, I mean, the group visits work wonderfully in primary care, especially when you have an NP, a PA or physician that can be a billing practitioner to be able to have these conversations and get the education out there and allow people to interact with that and find those accountability partners.

So I do think community is super important to reinventing medicine and just relationships and getting back to having those quality relationships and conversations.

James Maskell:  I love that. Well, thank you, Melody. And if anyone’s listening, I’m excited to share that we will be there in Chicago. We’re going to bring the cameras and we’re going to make an episode of the functional forum from it because we just really feel like this is a conversation that has to happen and has to get as much… We have to get this out to as many people as possible because ultimately, this is the part of the reinvention of medicine.

I appreciate all the work you’re doing to bring pharmacists along and make it easy for doctors and clinics to see and access the value of these providers. And I’m definitely feeling aligned about your vision for the reinvention of medicine. So thanks so much for being here on the podcast.

Melody Hartzler:  Awesome. Thank you for having me. Have a great day.

James Maskell:  All right. We’ve been with Melody Hartzler. She is the team from Pharm to Table and also from Functional Medicine CE, we’ll put all the links in the show notes. If you want to find out more about her organizations on the…Is it the 18th of September? Yeah—

Melody Hartzler:  Yeah, 18th of September.

James Maskell:  …in Chicago. And we’ll also have notes about that in the show notes. So thanks so much for listening. Thanks 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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