This week’s podcast continues our “Success Leaves Clues” series with “Alaska Goes Functional” and features Jill Valerius, MD of Now Health Functional and Integrative Medicine, from Palmer, Alaska, and member of our Practice Accelerator program.
Dr. Valerius was one of the first medical doctors to be certified in functional medicine through the Institute for Functional Medicine, and has created a successful practice in a small Alaskan town utilizing what she’s learned in the Practice Accelerator.
Tune in today and discover:
Announcer: 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 transform your practice and the health of your community.
Now, here’s your host, James Maskell.
James Maskell: Hello, and welcome to the podcast. On this week’s podcast, we continue our series, Success Leaves Clues, with one of my oldest friends from Functional Medicine, Dr. Jill Valerius. As you’ll hear in the podcast, Jill and I have known each other for six or seven years, since the first Heal My Practice Conference.
Jill has built a successful practice now in Alaska. Through this series, we’ve heard from physicians who have been building their successful practices. In this session, we talked about the journey from family medicine to functional medicine, and some of the key learnings along the way as far as the model, the mindset, and the community, and what it takes to build a successful practice.
It’s been a great journey to get to know Jill. I think you’ll get a lot out of it. Enjoy! So, a warm welcome to the podcast. Dr. Jill Valerius. Welcome, doc.
Jill Valerius: Hey, thanks James. It’s great to be talking to you today.
James Maskell: I think you’re the first doctor that we’ve ever had on this podcast from Alaska. So, I think that’s a first, too. A very warm southern California welcome to you.
Jill Valerius: Thanks so much.
James Maskell: For people who are listening to this, Jill and I have actually known each other, probably almost the longest of people in the functional medicine space, almost than anyone. Because, I got my first break speaking about practice management at this conference called Heal Thy Practice, which was a practice management conference that I think went on for five or six years, that was run by Holistic Primary Care. I showed up as a … I don’t know, I was a 30 year old with a small company that I just started called Holistic Practice Development, the year before. All designed to help practitioners build successful practices. Eric Goldman chose me to come and do a talk there.
On the very first forum, that’s where I met … The very first event there is where I met Jeff Glad, and also I met Jill. So, Jill, even back in 2011, you were sort of on the search for a new model of practice. It’s been … Here we are sort of six years later and it’s been quite a journey, I’m sure.
Jill Valerius: It’s been a great journey. 2011 was kinda the year that I really made my biggest turning point, I would say, in my career, at this point. That is the year that I started with my IFM training. Through the IFM training, I actually met Nicole Masley, whose husband is Steven Masley. If I recall, it’s through Steven that I learned about the Heal Thy Practice conference. So, that’s how I ended up there.
At the time, I was employed in a single specialty family medicine clinic. It was a practice that I had helped to start back in 2003 in Alaska. And, just had kinda gotten to the point, I was 10 years into my family medicine career and was either a bit bored and partially burned out on feeling like what I would call, basically, a glorified drug rep, is kinda what I felt like in family medicine at the time.
So, functional medicine was something that I’d been introduced to back in my residency training. At the time, of course, I was trying to figure out how to come up with two weeks, and $2000.00 to go and do training, which apparently was … It was monumental at that point, so it didn’t happen then. And all along, it just kept crossing my mind. I think, obviously in 2011, was kind of my breaking point. I figured out that the timing would work. I could go to IFM’s AFM CP course down in Tampa that year, and kind of the rest is history.
James Maskell: Yeah, the rest is history, and it’s a great history. I think for both of us, we’re also just getting started here. I know that once you know that there’s another possibility, you know about it, you start seeing patients differently. What were the kind of patients that you would see when you were still employed at the ‘glorified drug rep’, that you would just know, “This person needs a different kind of care.” Was there a particular patient that sort of made you jolt into taking action? Or was it just a combination of lots of patients over a period of time?
Jill Valerius: I would say, it was a combination of lots of patients over a period of time. My undergrad degree was in athletic training. And so, I practiced as an athletic trainer before I went on to medical school. So, I’ve always had this more preventative minded focus, and certainly very active focus, nutrition important, that kind of stuff.
I attracted, for the most part, a lot of those people, so I had a lot of healthy folks. But then, I also had those folks with diabetes, and rheumatoid arthritis, other autoimmune conditions. So, I just felt like there has to be something more. And, even for the healthy folks, the focus of a well visit in family medicine, or primary care, if you will, is kind of … It’s a checklist. Have you had a pap? Have you had a mammogram? For guy if you’re over 50, have you had your PSA done, or a prostate exam? Colonoscopy? All those things. It’s this checklist, and it’s not really like, “Hey, where do you see where you’re at on your health journey? And where would you like to be?”
It was never really super kind of health focused, or even recognizing your patient, and patient goal focused. Some people … I had one patient, I’ll never forget. We were talking about his diabetes, poorly controlled. He told me he’d rather die than change his diet. So, I was like, “Okay. I know where you stand. All I can do is kind of encourage.” But, at least I know where he stood.
Most other folks, when posed a question like that … that’s what really was my tipping point and when I gained so much of from functional medicine, is that finding out and actually asking people what they want. “What is your health goal?” And people just light up, or they’re almost like a deer in headlights, cause they’re like, “Well, I don’t know. Nobody’s ever asked me that.”
James Maskell: Interesting that you get the time to ask the questions that no one else can.
Jill Valerius: Oh, yeah, absolutely. I think, I used to spend a lot of time. I had the luxury in my previous practice to take really as much time as I wanted. Certainly, your income is visit driven, which I just tend to be more patient focused driven. I’ve never been, unless my prior life experience in ER and urgent care where you’re just seeing whoever walks in the door, but that’s not ever been my MO for functional medicine because, I’ve practiced run with the folks doing that, and you can just see the disservice that is happening.
James Maskell: Absolutely, yeah. Alright, so now you’ve decided that you want to come in this direction. I know that you’ve been through all of the IFM training, because I’ve seen you at all of the conferences. How much of the training at this point have you gone through?
Jill Valerius: Oh, I’ve been through all of the IFM training.
James Maskell: So, now you’re certified?
Jill Valerius: Yep. I was part of the first certifying class. So, once I started, over that two year period of time, I just dove in. During the same time, I also got boarded in integrative medicine, as well. So, I jumped in with both feet and never looked back.
James Maskell: That’s great. So, you’ve got the clinical side down, you’ve got the integrated, you’ve got the functional. You know, you’ve got all the tools in your tool kit. Let’s talk about the model and how that’s evolved. Because, I know when you first came to Heal Thy Practice, it’s kind of like a kid in a candy store, right? You may have some concerns about the legal, I know they were always good at putting up a legal speaker on there. They always put it after lunch, right? Very difficult to stay awake, but they always have the legal speaker.
But then, you start to hear from different people who are building different practice models. So, how’s that evolved for you? What are some thoughts? What kind of model did you think you would have and what’s it evolved into now?
Jill Valerius: When I was starting this whole journey and when we met, James, I was still employed in this family medicine clinic. And, in May of ’14, I left that clinic and opened my own. And so, I am an insurance based practice, which right now, is the right practice for me to be in. I think as things are evolving here with healthcare, that is going to change. Right now, with an insurance based practice, I see initial appointments are an hour, and my followups are a half hour. For any new patients now that see me, they go through the Living Matrix. And, that’s something that I require. A lot of patients now, in order to get into seeing me, actually see either my nurse practitioner or PA first, which has worked out really well. Because, a lot of times they’re really happy with those two providers and that’s great. Because there’s three of us, we work really closely and well together.
So, it took me until just a year ago, so two and a half years into my practice, to hire a nurse practitioner, who I’d worked with as a student. And, that has just been a blessing for me, for my patients, and for the clinic in general. And then, last January, I was able to hire a local physician assistant as well, who had six years of integrated medicine experience, coming to me. So, we have a pretty robust practice at this point. We’ve got a massaged therapist as well. So, just trying to navigate the current climate, which is changing here. We’re a bit behind things, I would say, here in Alaska, as compared to the lower 48.
James Maskell: What are sort of the major issues, Jill, that you see coming through? Have you sort of developed a niche for any type of patient? Or, do you see a range of the same kind of issues that you saw in your family medicine practice?
Jill Valerius: I see a range of patients. I would say, I still see ‘bread and butter’ family medicine. But, my focus now and the people that are coming to me, are probably a bit more complex medical issues, is what I would say that I’m seeing. Or, the coolest thing is, is anybody who walks in my clinic, they want to be better. And, it’s really cool and it’s very, very different from your standard primary care practice. Because, folks don’t come into our office, for the most part, looking for a pill. They are like really, really interested in what can they do to reverse their diabetes? What can they do about their hypertension? How can they get rid of extra weight? How can they manage their autoimmune conditions better?
And so, I would say, a lot of it is still similar. But, I get referrals from other local providers, I get referrals from my former partners. And I think, as a family practice Doc, the patients that I see now in functional medicine, are the ones that the average family practice Doc is super frustrated with, because they don’t know what to do. And, I think unfortunately in medicine, kind of the MO is that if we don’t know what to do for a patient, we kind of write … We push it back on the patient and kind of write them off for ‘crazy’, or something. And really, it’s our lack of listening and understanding what is happening and where this person is at. And still, I see a lot of those folks who’ve been to everybody else in my area.
James Maskell: Yeah, absolutely. You know, I’d love to just pick up something you said there, because I think it’s really important. In some cases, people don’t need the physician. And, one of the things that I’ve seen over the last few years with the most successful functional medicine practice, the best organized … If you look at someone like Jeff Gladd or Sachin Patel, the way they think about things is, “What is the minimum possible input that we can create to create the maximum possible output?” And, one of the things that I see, is that for many physicians, they just can’t think about a system where they’re not right in the middle of it.
And yet, you said there are a lot of patients that just see the nurse practitioner, or maybe even just the health coach. And, they just start getting better, because they start implementing the quote on quote, ‘functional medicine lifestyle’, right? They start doing it and then they start getting better. What’s been your thought process on that over the six years that you’ve been thinking about the model, the clinical model?
Jill Valerius: That’s evolving. I would say, that’s evolving every day. Because, when I started, I started by myself. I just knew, at that time, that I couldn’t stay where I was, because I was tired of fighting a system. So, I’m continuing to evolve. And now, I’m thinking about some programs where I can help create groups of people, some more group visits type structure, where I can help people. And, I think the best way sometimes that we can help people, is to help each of them, or us individually, identify variables that are either promoted health or causing disease for us. You know, I think about when we utilize a timeline in functional medicine and the Matrix, and how people can start to see how just different events play a role in their own health. Because, we think of so many things as having to be physical events.
And so, in moving forward, my goal will be to figure out how to empower more people. And, that will likely be from group visits. Right now, I give talks, like at our local gym, which are generally well received. And, just basic things, like health tips through the holidays. And, I think the other tool I’m learning, which utilizing the accelerator, learning how to use some of these other tools like soapbox, and getting better about just putting videos online, and putting just more information out there on my website, that kind of stuff, just to engage people. And also, just to empower people that really, each one of us is responsible, and actually capable, of improving our health on our own.
James Maskell: Yeah, absolutely. Yeah, it’s putting it back in the patient. You know, ‘patient centered medicine’, it’s a phrase that’s banded around a lot, right? But, if we really want patient centered medicine, the patient has to participate. And, we have to have the right structures in order to do that, and it takes awhile to work out these new structures. Because, ultimately, the old structure was not really built for patient participation.
So, you mentioned the accelerator. And, we were thrilled to have you in the first pilot, right, last year? So, we did a pilot last April, where we took 100 doctors into the system, and practitioners, so that we could work out the systems. Maybe just share a little bit about your experience with the content that we provided, and the concepts, and the ideas, and what you’ve been able to implement from there? And then also, just your thoughts on the community too.
Because, one of our goals is being … In an accelerator, if you understand that terminology from technology, it’s like, get a bunch of people who are all trying to do the same thing in a room together, and help them to accelerate the process. And, that was our goal at the beginning. It’s like, “Let’s just get all of the individual practice owners who are trying to build their own functional medicine practices all around the country and all around the world, let’s get them in a group together, use some of the community structures that we know about, and see what happens.” And, I’d love to get your thoughts on that journey from you.
Jill Valerius: I actually was in the, I started a year ago. So, I wasn’t in that very first cohort. But, it is really cool, what you had just mentioned, James. Probably one of the most valuable things, is the community of like minded practitioners. And basically, it’s people’s cumulative knowledge and experience that helped so much. And, I think for a lot of us moving forward, certainly for me, you have all of these ideas, but how to actually implement them, the challenges, is we’re all really busy practicing, and running our practices, and then trying to implement these other things.
So, I really think that our online tools that we have through the accelerator, to be able to start using auto responders, and learning how to use some of these things like zoom, and soapbox. I mean, I can only speak for myself, I think this technology is really cool, but it’s not what I went to school for. So, it’s really, really helpful …
James Maskell: Yeah. What’s her respond to training and family medicine residency, I can’t believe it.
Jill Valerius: I know. There’s barely coding in training in family medicine residency. So, it’s so helpful to have this community. And, I just think of the different things that people have introduced into the accelerator, on top of what you guys have provided, kind of as this format, it’s really helped. Because, it can help you take some of these ideas and actually implement them. Cause, as I had gone along previously, I had kind of tried to teach myself how to use Hootsuite, and then two months later, you don’t remember how to use Hootsuite. And, all of these different things that you try to teach yourself how to do, and then you don’t do it for two months, and then you’re like reinventing the wheel every single time you’re trying to do it.
So, a lot of that is super helpful. And then, it’s also really helpful to see what other people are doing and how they’re doing things. Like, for me, I feel like we still have a pretty well insured population up here. We have pretty good insurance reimbursement. And, what I’m seeing so far, is people … You know, there’s always a hand full of people who are willing to pay for whatever it is they need and want. But, there’s a significantly larger handful that are like, “Well, I want my insurance to cover this,” Which, I guess I understand. Because, those of us who don’t get insurance through our work, are paying a ton on the marketplace, because we have one insurance provider in this state, which is Blue Cross. And, it’s kind of held us captive.
So, yeah. For me, it’s also learning about different things that I could maybe structure two different entities, to be able to kind of work better with patients in the current setting that we have right now. So yeah, back to my main point is, it’s the information that you guys have helped and constantly update and bring us, and it’s the community that we have that is super engaging, and super motivating.
James Maskell: Awesome, I’m so glad to hear you say that. And, one of the exciting things is, I know that that innovation is really continuing. We have a lot of practitioners in the group, who are now getting to a point where their practice is maybe full, they have a lot of members and they’re working out the system to bring on the next people. And, I could just see that, ultimately, what we were looking for, is like, “How do we make it exponentially easier for the next, and the next, and the next doctor to come across?” So that, there’s a certain point in time, where it’s just such an obvious thing. You know, the average family medical doctor is thinking about doing it straight away, and they don’t see all of the same blockages.
I mean, if you compare the ease of what it takes to build a functional medicine practice today, with the low overhead format, and all of the structures that we have, compared to showing up at a conference like you and I practiced six years ago, where amazing information … You know, some people who were doing it, but not really like step by step systems, and no real established best practices that are being transferred across clinics. You know, it’s kind of a different world today.
Jill Valerius: Absolutely. You know, the other things that’s been really great with the Practice Accelerator, is the accountability groups that have been set up. I really feel like that has been a really, really big help. You know, just in learning how important that is, I think we all think about that when it comes to our exercise, and some of that kind of stuff, like having an accountability partner. But, certainly in business, it’s really, really helpful.
James Maskell: Yeah. Talks us through a little bit about that. So, the accountability group is something that we decided to do based on my experience of actually being in a group of five entrepreneurs earlier this year, where I just realized that a group of strangers is actually a really good way of providing accountability. Because, I felt strangely accountable to people that I hardly knew, because I wanted to maybe empress them, or I wanted to follow through with the agreements that I had made on the call. And, I would also make bigger agreements on the call than I would if I was just like making an internal note in my head of what I was trying to do.
So, tell us a little bit about your group. And, what were some of the things that you got from that group that you weren’t expecting?
Jill Valerius: Well, there are three of us in our group. The other two are actually on the East coast. Which, is pretty interesting, because we’re four hours apart, time wise. Sonza Curtis in my group, and she was just honored as ‘Best Functional Medicine Practice’ in the Atlanta area, which is really cool. And, Lisa Gengo is up in Connecticut, and she is a naturopath. And, she’s in my group as well. And I think, not only is it the accountability, over a time, we started together in that first accountability group, and then decided to continue on. And so, we have like a little living google sheet that we keep track of what we’re doing and when we’re getting things done, which has been pretty fun, so that we can keep referring to it during the week, to see what it is we said we were gonna do by next Tuesday. So, that has been really cool.
The other thing is, is it’s the same thing that we have in our community at the Practice Accelerator … It’s just each of us in different settings and in different practices, sharing ideas. And sometimes, it’s ideas that’s not even necessarily something that the other person is doing, but it’s us listening to one another, and being able to process and reflect, and say, “Hey, wait a minute. Did you think about doing something this way?” So, that’s been really helpful, just to kind of see what each other is doing, to kind of prod each other, to get a blog post done that we were going to do, or finish the website, or finish the interview, those kind of things. So, from that standpoint, it’s been really, really great. And I think, if there were more time, it would even be better to be in more accountability groups, really. But, you’ve also got to be able to get some things done, too.
James Maskell: Yeah. I mean, one hour a week spent on focusing what you’re gonna do on the other two to five hours a week that you’re gonna be in your business and on your business, is critical. And, it just helps to be so much more focused with the time. And, one of the things as well, is that if you have doctors that are in different stages of the group, then ultimately, the lessons that maybe you learn in 2015, are valuable for someone who’s learning those same lessons here. And I said, that peer to peer engagement is super valuable.
And, one of the most exciting things that I start to see is that, I think because it’s got people thinking in a different way about the power of peer to peer, now you have people in the group starting to innovate on the patient peer to peer side. Like, you mentioned the group visit a minute ago, we’ve seen some … In the podcast a few weeks ago, we had Dr. Laura Salyer, who’s doing sort of the functional medicine group visits where everyone is filling out their Matrix as a group. And, that just hit me as something that was super innovative, because the Matrix can be a stumbling block to getting people into the practice, right? Because, it’s gotta be an hour or an hour and a half, it’s gotta be with the main physician, potentially.
And so, again, we see innovative practices either having an intake specialist … Like Andre, had an intact specialist forever, where it’s not the main provider that does the intake, because it’s slow and it’s a process that can happen with other ones. Whereas, Laura here, has now 18 people in a room together, all filling it out at the same time. And, guess what? When people fill out their Matrix and they really get an idea, the first person to sort of help them to get on a piece of paper, their health history, then they’re like, “Well, can you help me improve these numbers?” “Well look, that’s the point of what I do.”
So, I’m really excited to see that sort of innovations starting to happen. Because ultimately, we’re getting to a point now where functional medicine is starting to reach the middle of the bell curve of America. And, I would imagine, that when the Cleveland Clinic research comes out next year showing better outcomes at lower costs, there will just be a rush for this care. And so, we’re just trying to get all of our practices set up in an organized and scalable way, so that that rush doesn’t mean headaches for you, but means just an opportunity to really influence the health of the community.
Jill Valerius: Absolutely. Laura’s g Matrix classes have been pretty motivating for me, thinking about that. You know, the folks that come in to see me, into my practice, I have them go through Living Matrix, which helps me. And, I think of a gal that I saw a week ago. I know from my staff, she wasn’t very excited about having to fill something out. In fact, she was trying to refuse it, and I just said, “Well, the patient wants to see me. But, I’m not the one who’s trying to get in to see somebody.” And so, I held by ground. And, the best thing is that, when I walked in with her Matrix and timeline, and started to talk with her and just introduced myself, and what I do, and how I do things, she just lit up. And was like, “You actually look at that?” And I’m like, “Yeah!” Yeah, I did, because it’s a three part questionnaire. You know, it’s the 20 plus page, it’s an intake.
And then, when I was able to lay it out and show her what she had created by answering all of these questions. Then, she was like, “That’s a buy-in right there.” She was trying to decide whether she wanted to switch practices, wasn’t sure, you know? And, that right there, that was like, “Yep, I’m good here. I think we’ll work well together.” And I said, “Great.” But, it’s really fun when people actually see that. Because I think, most of the time, you walk in and you fill out some form. In the average office, that might be two pages, it’s fairly worthless for the provider, and it’s kind of a pain in the butt for the patient, and nobody ever looks at it.
James Maskell: Yeah, no one looks at it. It’s so funny that it’s a remarkable experience for patients to actually have their doctor look at their intake information.
Jill Valerius: Yeah, absolutely. I mean, for this gal, who a few days prior was angry already with me, she hadn’t met me yet, but that she had to fill this out, because that’s my rule before you meet me. And, even if you’ve seen my nurse practitioner or the PA that works with me, if you’ve seen one of them for whatever, and you haven’t filled out the Living Matrix, you’re gonna fill out Living Matrix before you see me. And so, sometimes you get some push back. But I would say, 90 plus percent of the time, when patients realize how I’m utilizing that information, and that we can utilize that information to impact their health, or wellness, or disease, or whatever our focus is, then they kind of go, “Oh, okay, that’s kind of cool.”
James Maskell: Yeah, no, exactly.
Jill Valerius: What Laura is doing with the group Matrix thing, I think is absolutely brilliant.
James Maskell: So, one more thing I’d like to ask you, Jill. Maybe we can finish with this. You know, if you were to speak now, you have an opportunity on this podcast to speak to practitioners and doctors all over the world who are starting to build up, starting to think about moving in this direction. What would be your best advice for someone who is coming on this journey, wants to come on this journey, but is still kind of sitting on the sidelines waiting? They feel maybe a moral obligation to the medical/clinical side, but they just haven’t been able to make the leap?
Jill Valerius: So, you’re thinking in terms of functional medicine?
James Maskell: Yeah, to your doctors maybe who are your average primary care, or family medicine, or internal medicine doctor who gets it, right? Gets it, clinically, but just is employed and can’t break free.
Jill Valerius: I was there. And, I’ll be really honest, I thought about leaving the practice that I’d been with six years before I did. So, that took me a long time to get where I needed to be. And you know, the best advice that I would give somebody, is take the leap. If internal medicine, or honestly, whatever medicine or version of how you see your career going and what really excites you, go after what really makes a difference for you. For me, it was functional medicine.
And I think, if you’re really practicing what you believe in, truly, people can see that in you, they see your excitement about things. And, that alone, is going to draw the right people to you. And so, I would say, make the jump. There’s this saying that says, “Leap, and a net will appear.” It really will. And that being said, my next leap will probably be, be out of the insurance model, potentially. So, I’m just trying to figure out when to leap. But I would say, if you’re really passionate about something, share that passion with everybody around you. And,
follow that passion. Because, if you are super passionate about it, you’re gonna attract the right people.
And right now, if you’re thinking about it at all, people are beating down your door, because they’re looking right now for anybody who will help them reverse their diabetes, deal with their autoimmune disease in a way that’s not using some anti rheumatic drug. People are really, really looking for this right now. I mean, I think that we’ve done a good job. People are starting to hear, like, “Wait a minute. I don’t have to be on drugs for the rest of my life for this problem?” You know, that’s what the drug companies and most of western medicine is telling people. And, they’re starting to learn that that’s not the case, So, if you’re offering anything other than just straight prescriptions, people are gonna beat your door down trying to get in to see you.
James Maskell: Thank you. Yeah, I appreciate it. Well, that’s the truth, and I hope that people are listening to this. Jill, I just want to share my appreciation for showing up. You know, for the last six years, you do show up at the conferences, you build your community, you learn the best practices, doing great clinical medicine. And so, I’m just absolutely thrilled to be able to watch your journey. And I know, that this journey that you’ve gone on will make the next journey of every doctor coming through, that much easier.
And, our thesis at the beginning, was that the quickest way for medicine to adapt was many small practices, individually physician owned practices, making the shift, delivering the care locally. And, what’s really exciting all the way through this podcast series, is that it’s been doctors from Idaho, Wisconsin, Alaska, Georgia. You know, it’s New York, it’s not LA, it’s not Chicago, it’s not the major cities. And, the small box revolution is definitely happening. And, it takes people who care enough to do things differently. And, to just forge the way ahead.
But, I would encourage anyone who comes across Jill at an IFM conference, to sit down and chat with her, because there’s a wealth of knowledge in there, clinically. And, the journey of the business model has been great too. So, it’s been great having you as part of the practice accelerator. And also now, we have a successful meet up group in Alaska, right?
Jill Valerius: We sure do.
James Maskell: That’s awesome, I love it. Jill, thanks so much for being part of the Evolution of Medicine podcast. This has been part of our Success Leaves Clues Series. Our goal here on this series is to interview those doctors who have made it to building a successful practices from wherever they’ve been, and share some of the best practices along the way. So, thanks so much for being part of it. I’m your host James Maskell, we’ve been with Dr.Jill Valerius. Thanks so much for listening, and I’ll see you next time.