In this podcast episode, James Maskell speaks with Swathi Rao, PA-C. She is the owner of Be Well Family Care in Indianapolis, and she was featured in James’ book, The Community Cure, to showcase her successful implementation of group visits.

We explored the clinical applications of vitamin K2, which range from musculoskeletal and immune health to aesthetics and longevity. Swathi also shared how her knowledge on vitamin K2 nutrient therapy has developed throughout her career, how to identify patients who may benefit from vitamin K2 therapy and the benefits of combining vitamin K2 with vitamin D, including dosing recommendations.

Swathi emphasized the importance of patient education to enable informed decision-making when it comes to controversial health topics like vitamin K2 supplementation. She also provided insights on building a successful practice and the role of non-MD professionals in healthcare.

Please download and listen to learn more about:

  • The forms of vitamin K and which are most beneficial
  • When it is appropriate to recommend this nutrient
  • Swathi’s experience with local Functional Forum meetups
  • Vitamin K2 uses for aesthetics and longevity
  • And much, much more!

Related resources:


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Swathi Rao: So, MK-7 has two primary components. MK-7 or vitamin K2 is a co-factor for vitamin D dependent carboxylase. So, it makes two different kinds of proteins active. One is called osteocalcin, and the other one that I’m really profoundly interested in is called matrix Gla protein, or MGP. Osteocalcin is really important for putting calcium into the bones. So, that was probably the introductory point for me for vitamin K2 was, “Hey, what can we do about bone health?”

Because we all love vitamin D, we all know how much support vitamin D gives for our immune health, for our bone health, for anti-inflammation, antioxidative stress. But the bottom line is, vitamin D mobilizes calcium. Where that calcium is getting mobilized to is not really all that effective. But when you add vitamin K, especially in the form of MK-7, to your vitamin D supplementation, now you have very targeted standpoints on osteocalcin and also MGP, which is that matrix Gla protein.

So, I always say, vitamin K helps basically take that calcium and take it from your bloodstream, which is not so great for calcium to be in your blood, right? It can cause kidney stones, it can deposit in your coronary blood vessels, Alzheimer’s plaquing. I mean, there’s just so many implications for that. And basically takes that calcium and shoves it into the bones.

That component is the osteocalcin. But the component that’s fascinating to me is this matrix Gla protein. Because what vitamin K2 does, is it basically activates that MGP and protects your smooth muscle. It protects the ability for you to form calcium deposits in all of these different areas, and including, even, in your skin. So, some of this newer research is really showing that high dose K2 can actually prevent wrinkles and can help you with collagen issues. It’s really, really cool.

James Maskell: Welcome to the Evolution of Medicine podcast, the place health professionals come to hear from innovators and agitators leading the charge. We cover the latest clinical breakthroughs and health technology, as well as practical tools to help you transform your practice and the health of your community.

This podcast is brought to you by the Lifestyle Matrix Resource Center, who provide a range of options to help you deliver successful, effective functional and integrative medicine. To find out more and to get started, go to goevomed.com/lmrc. That’s goevomed.com/lmrc.

Hello and welcome to a very special podcast. This week we are speaking with Swathi Rao. She is a physician’s assistant and the owner of Be Well Family Care in the Indianapolis area. She has built an exceptional practice, but is also one of the leading clinicians when it comes to the use of vitamin K2. And in this podcast, we’re going to go a deep dive into vitamin K2, how it’s used, all the different areas that it affects in the body, and then just talk about how she implements it in her practice, talk about group visits, talk about how it’s dosed.

So, it’s a deep dive onto the front lines of how K2 is being used in family medicine generally. So, hope you enjoy it, and look forward to hearing your feedback. Enjoy. Welcome back to the Evolution of Medicine podcast. Swathi Rao. Welcome, Swathi.

Swathi Rao: Hey James, how are you?

James Maskell: Super grateful to have you come here and be part of the Evolution of Medicine podcast. Again, I’ve got so many things that I want to ask you. I know we’re going to be talking about vitamin K today and jumping into some of the research on the different forms and the practical uses of it. I think last year or the year before, we had a podcast with Dr. Leon Schurgers on vitamin K, and I think it was one of the most listened to podcasts of the year.

A lot of practitioners want to know about it, so we thought we’d get someone in who could really speak to using it on the front lines as opposed to sort of that side. But before we get into that, I’d love for you just to share with the audience a little bit about your practice and the journey. Obviously, we featured you in the book, The Community Cure, because of your innovative works with group visits, but maybe you could just share a little bit about your clinic as it is today, because I know that this has been a really significant journey for you, and you have a pretty significant practice now.

So, yeah, I’d love to just share a bit about that with our audience first.

Swathi Rao: Yeah, it’s always great to be with you, James, and it’s been too long. Yeah, you’ll have to come and visit. So, we started out as a pretty small functional medicine practice with two practitioners. We’re up to six practitioners now, we just actually signed a contract with the seventh. So, we will have now some doctors, PAs, nurse practitioners, and we’re just really trying to put all of the things that we talk about during these podcasts into practice. At this point in time, our group visits happen all over the place. We built a teaching kitchen, as you know, which I’m so proud of, and we can fit about 22 people in there. So, we get hands-on and we get really a lot of discussion going on while we’re cooking.

In the last month, we’ve done several kids’ classes, we’ve done group visits with adults where we actually cooked, we’ve done meditation, tapping, just all kinds of fun things, and it’s been so, so, so fun. But we’re actually expanding. We’re doing a little bit of aesthetics now, which is kind of cool because I can kind of pull in how we’ve been incorporating vitamin K in our aesthetics practice, because there’s so much great data on even anti-aging. So, it’s just been a really fun place. If you guys ever have the chance to visit our website, bewellfamilycare.com, it’s just a really, really fun thing, and I’ve been doing a lot of mentoring and realizing that there’s just so much to give.

James Maskell: Wonderful. Well, this is such a great theme for this month, because we had Dr. Robin Berzin on the forum recently, and just amazing to see when you have a practitioner that has a clear vision and is able to start from a strong foundation, that over time this catches on, and that leads to all kinds of other opportunities, and it just takes clarity and obviously a lot of thought as to how to grow and the best way to grow.

So, yeah, I just want to salute you, to start with, for the pioneering work that you’ve done to build the practice, and now on a great trajectory to make even more of an impact. So, yeah, check out the website if you’re listening to this. It’s such a great example of the way that you’ve been able to grow, and I think the group visit stuff really ties everything in together, though, so congratulations.

Swathi Rao: Thanks, James.

James Maskell: Yeah, I wanted to talk a little bit more about vitamin K today. As I mentioned, we’ve had a lot of interest in it, and a lot of practitioners are interested in it. Why don’t we just start at the beginning, how you got interested in it and your journey in using it as a clinical tool?

Swathi Rao: Yeah, absolutely. So, I’ve been doing family practice now for a long time, so the first time I really ever heard about vitamin K was when we were learning about warfarin. So, if any of you guys are having flashbacks to all of those dosing calculators for Coumadin dosing and everything else, it was so interesting to me even just being in school way long ago, that warfarin blocked vitamin K dependent steps in the clotting production and clotting cascade.

And what I remember thinking even back then was, we used to tell patients, “If you’re on Coumadin, avoid green leafy vegetables.” It just always seemed like a bad idea to me. And then eventually, those of us that have been doing this for a long time know that there was definitely, for those patients on warfarin, increased risk for fracture, increased risk for coronary calcification, heart disease, and now just knowing the physiology of vitamin K just all makes so much sense.

But back then, it was one of those things that I always thought of was just a risk factor that came along with this med. So, it was fun, because when I was doing this podcast, I went and talked to a couple of practitioners that I have a lot of respect for and I said, “What’s your elevator pitch? What do you know about vitamin K?” They’re like, “Well, I know it prevents heart disease. I know that it’s great for the bones, but I think it comes from some kind of bacteria.” I was really surprised. These people that are just phenomenal in their knowledge did not really know the depth of vitamin K. So, I thought this was a really fun thing.

Actually, vitamin K, really from a standpoint of vitamin K1 or K2, was something that I got turned onto when I heard Bruce Ames speak, which was, that was probably, what, 12, 13 years ago? Just so phenomenal as he was talking about the differences in these nutrients. And I’ll just never forget that.

So, vitamin K is kind of like the B vitamins, I think, of the 2000s. So, they’re a family of vitamins. The most abundantly found in our food is actually vitamin K1. So, with vitamin K, that’s found in our green leafy vegetables, that is what warfarin actually blockades, and that’s why we were telling our patients back then to basically not have those vegetables. It’s metabolized only in the liver, and it becomes part of the clotting cascade.

High doses can affect bone health, but I think where I typically hear about vitamin K most is in newborns, because vitamin K has a terrible transport against the placenta, and so newborns have a really, really high propensity for vitamin K1 deficiency, so they can have vitamin K dependent bleeding.

So, the American Academy of Pediatrics, for as long as I’ve been in medicine, has always recommended a vitamin K shot for newborns. So, that’s kind of what I knew about vitamin A, before I got into functional medicine, before I heard Bruce Ames speak. So, really it was very much this kind of broad thing, “Hey, if you’re on Coumadin, don’t take this, it has something to do with bone health and clotting factors.” But in reality, the vitamin K that we really utilize, and it’s come so far in this last 25 years for me, in my journey, is vitamin K2. Basically, you put up a double bond on a vitamin K1, and you get K2. The more double bonds you put in, the more different kinds of vitamin K2 that you get. You’ll hear about all kinds of different ones.

MK-4 is a form of vitamin K2 that has four double bonds. MK-5 has five double bonds, and then MK-6, -7, all the way up to MK-14. But MK-7, that is really the vitamin K2 derivative that has really, I think, turned, for me anyways, my practice on its side and has really affected change. So, vitamin K2 as MK-7 is not easy to find. It actually is made in the gut bacteria, but the most profound source of K2 is something called natto.

We’re always talking about the Japanese, right? “What are they eating out there?” Because their heart disease risk is low, their bone health is so great, we’re always trying to model after that. Well, they have this superfood called natto. It’s stinky. It’s sticky. I don’t know how much of a hit it would be in America, but that natto is a phenomenal source of vitamin MK-7.

It’s made by a bacteria called Bacillus subtilis, I think I’m saying that right. Basically is from fermented soybeans. So, when you give these kinds of K2, they’re well absorbed in the body, and available throughout the body, and way beyond the liver. So, when we do our group visit on K2, I call it, basically vitamin K double bonds that reach far beyond coagulability. So, we just basically talk about the fact that this is so far beyond.

So, for me, the most studied forms of vitamin K are MK-4 and MK-7. We use MK-7 because, quite frankly, it’s almost 48 times better absorbed than MK-4. And MK-7 also has a pretty long half-life, so it can be dosed once daily. So, it’s pretty easy to give. But if you could kind of imagine the body, and you imagine K1, it only lights up in the liver, and really only affects clotting factors unless you’re using it at very high dose. If you look at K2, there’s probably very little portion of the body that K2 doesn’t affect, and so there’s such a systemic effect.

James Maskell: Let me just ask you a bit more about that. So, are you saying that you have to dose it with those specific derivations in mind, or does the body naturally take the K2 and turn it into those derivations in the gut?

Swathi Rao: With MK-7, your body naturally already affects that. So, MK-7 has two primary components. MK-7 or vitamin K2 is a co-factor for vitamin D dependent carboxylase. So, it makes two different kinds of proteins active. One is called osteocalcin, and the other one that I’m really profoundly interested in is called matrix Gla protein, or MGP. Osteocalcin is really important for putting calcium into the bones. So, that was probably the introductory point for me for vitamin K2 was, “Hey, what can we do about bone health?”

Because we all love vitamin D, we all know how much support vitamin D gives for our immune health, for our bone health, for anti-inflammation, antioxidative stress. But the bottom line is, vitamin D mobilizes calcium. Where that calcium is getting mobilized to is not really all that effective. But when you add vitamin K, especially in the form of MK-7, to your vitamin D supplementation, now you have very targeted standpoints on osteocalcin and also MGP, which is that matrix Gla protein.

So, I always say, vitamin K helps basically take that calcium and take it from your bloodstream, which is not so great for calcium to be in your blood, right? It can cause kidney stones, it can deposit in your coronary blood vessels, Alzheimer’s plaquing. I mean, there’s just so many implications for that. And basically takes that calcium and shoves it into the bones.

That component is the osteocalcin. But the component that’s fascinating to me is this matrix Gla protein. Because what vitamin K2 does, is it basically activates that MGP and protects your smooth muscle. It protects the ability for you to form calcium deposits in all of these different areas, and including, even, in your skin. So, some of this newer research is really showing that high dose K2 can actually prevent wrinkles and can help you with collagen issues. It’s really, really cool.

James Maskell: That’s really interesting. So, I know one thing, the Japanese have got a lot of good things going on, but one of the things, actually, is obviously longevity. I think they’re either number one or number two with Norway on longevity. So, obviously that’s a thing that a lot of people are talking about these days. Do you feel like this is a big part of that conversation, if we’re not going to eat natto, that this is an important part of a diet?

Swathi Rao: I really do, and it’s been interesting. I think we’ve been using K2 in our practice probably since around the 2005, 2006. And it used to be, “Oh, the people that had osteoporosis, the people that needed bone health,” and then it became, “Oh, these are people that are high risk for calcification in the arteries.” And then it became, “Oh, this is something that is really anti-inflammatory and really helps the mitochondria. It’s antioxidative.”

So, then we were using it for patients that have risk factors for cancer, mitochondrial issues, fatigue, and then it kind of became like, who don’t we use this on? And to be quite frank with you, it’s probably one of our number one selling supplements, is our vitamin K2 plus D.

James Maskell: You mentioned that you do a group visit on it. So, what kind of patients get invited to that group visit? Is it just one off, or is that part of a longitudinal group visit series that you’re doing?

Swathi Rao: Well, I found with our group visits that if we can really catch them, then they’ll come and then you can give them all the knowledge once they’re there. So, honestly, we do group visits on bone health. We weave this into a lot of our group visits, but probably our most popular group visits, when we’ve really talked about some of our vitamin K slides, are in our bone health classes, in our longevity classes.

And we do a couple of group visits that are really fun, that are really kind of promoting organic skincare and really aesthetic. How do you really take care of your body outside in? And we promote that vitamin K along with it, because it’s so important. We even use a product in our office that I actually love that incorporates that Bacillus species that I was telling you about that has vitamin K and additional vitamin K2 as MK-7. And we actually promote that in some of our group visits where we’re talking about wrinkles and collagen and staying young and keeping your skin looking beautiful. And let’s face it, I don’t think I’ve ever met someone from Japan that did not look gorgeous.

James Maskell: Do you feel like, by adding in this other part of your practice, aesthetics and longevity, it’s helping you access a different part of the community that perhaps wasn’t going to come in for a chronic disease reversal?

Swathi Rao: Because I think it’s a lot sexier, I guess, to have someone that comes in and talk about skin and wrinkles and longevity than it is to talk to them about coronary calcium plaquing and prevention of heart disease and what happens when your CRP is elevated and what is your IL-6. I dig that stuff, and I would show up to that group visit, but I’m realizing not everybody really loves that. So, yeah, we’ve been kind of seeking it in, but I will tell you, our group visits get pretty detailed.

So, even if they’re coming in for that type of thing, we do talk about the full picture, which I think is cool, because then those patients leave, and I love it. I had a cardiologist that I was sitting… I went to a dinner the other day and there was a cardiologist sitting next to me, and we were just saying, “Hey, can you pass the butter” or whatever, and someone said, “Swathi, would you do this for me?” And he said, “Oh, are you Swathi Rao?” And I said, yeah. And he said the strangest thing to me. He said, “Your patients are so knowledgeable when I see them, they know so much.” And at first I was kind of like, “Was that a compliment?” I don’t even really know what that meant.

James Maskell: That’s a compliment. I can’t see it any other way than a compliment.

Swathi Rao: I totally agree. I was like, “Thank you so much. That is the coolest thing you could have ever said to me.” And he just said, “Sometimes they come in and they educate me on these things.” And I think that that is what’s fantastic about, one, doing functional medicine and family practice. Which, still, every time I mentor, it’s in my heart.

I just feel like so often, when we have the best of our minds do functional medicine, they go into very specific specialties. “I’ll do Lyme, I’ll do mold, I’ll do this.” And I think just in good, traditional, functional medicine, family practice, you can just incorporate so much. Utilizing visits to help us with that has just really, I’m hoping, gives our patients more skill and more tools to make better decisions.

James Maskell: Absolutely. When you dose this vitamin K to your patients, how do you dose it? How do you recommend it? What other things should you watch out for? Are there any interactions with medication or other supplements that you need to watch out for?

Swathi Rao: So, honestly, I’ve been slowly increasing the amount of vitamin K2 that I use in patients. Because honestly, I still come from a very traditional medicine world where vitamin K was really affected by… It was a clotting factor issue and that type of thing. So, I think over the last probably 20, 22 years, I’ve noticed my practice, we’re using higher and higher and higher, in a very gradual sense, higher and higher forms of vitamin K2.

So, we typically start out with vitamin K2, I think, with our kids. We usually give them K2, somewhere around 10 micrograms per every 10 pounds. And we use, usually, a drop that has a K2 plus D, and then typically get them up into probably the 50 to 70 microgram range. And then for our adults, almost all of our adults, unless they’re taking Coumadin, are taking around 180 to 200 micrograms of vitamin K2.

And then something that I’ve been doing here probably in the last six years is we’ve actually been adding the MK-7. And all of these are MK-7 for me, but we’ve been adding an additional 300 micrograms, along with our more Bacillus species, to really promote that. So, how I choose how much of that to do is based on age.

The only person that I still feel a little restrictive on vitamin K is if someone is taking Coumadin. I only have one or two patients anymore, because we now have non-vitamin K dependent ways for anticoagulation, even for our patients with Afib. So, those patients, I do still watch that a little bit closely. The studies for me, and I don’t know if you’ve seen something different, James, I never see a study that says absolutely a hundred percent you can take vitamin K2 with warfarin.

There’s studies that say “We don’t think that there’s really that big of an effect, and when you’re taking MK-7, it really avoids that,” but I just never see that. So, I do use caution with that. I personally take 300 micrograms, and then usually somewhere around 180. Yeah, I take about 500 micrograms every day of K2.

James Maskell: I’d like to ask you a question, and this is just based on something you said earlier. So, my first daughter was born at home, my second daughter was born at home, but we had to take her to the hospital because, different things. We just had to go there. And then when we were there, the nurse came round with the vitamin K shot and said, “Hey, this is the vitamin K shot. We give it to all the people, do you want it?” So, I said, “Well, just bring me the packet, bring me the packet.” And I look at it, and I think it’s a milligram, right? A milligram of vitamin K in there, but there was a thousand milligrams of propylene glycol. I’m just looking at the side of it and I’m just like, “I don’t know, doesn’t seem…”

That, to me, was a hard no. And I was like, “Okay, well, I’ve got vitamin K at home, we can start doing it straight away,” and I don’t know that much about this. This is not my thing. But to me, the injection of propylene glycol is kind of a hard no, knowing what it is and where it binds and how hard I work to avoid it in toothpaste and other things. So, I’d just love to get your thoughts on that, because that was just a moment where I was like, “I’m in charge.” The mother, my wife, was still at home resting and I was the only one there, and so I was in charge, but I was just like, “No, look at this.”

And I said to the nurse, “What is this? Why is it here? Why is there a thousand times more of that than the active ingredient?”

Swathi Rao: Than the active ingredient.

James Maskell: He just looked at me like I was crazy, but I’m like, “This is what?” This is a seven pound or six pound baby. That’s why we were there, it was a six pound baby. So, what are your take on that just briefly? And I know this is a little bit off script.

Swathi Rao: But you know what? This is why family practice I think is so important. Because that’s something that your practitioner, your family practice doctor, whoever was talking to you guys about preparing for this beautiful baby to come home, this is something that we actually discuss with our pregnant women, to our fathers that are getting in there. It’s family practice.

So, we talk about the fact that this is what to expect on that first day. Let’s talk about the good and the bad. Because vitamin K1 does have a very low propensity to cross the placental barrier. How often are blood clots a real issue in newborns? Not as often. How does this feel for you? And we do talk about the fact that here’s what you get when you get this injection. I just think that for me, informed decision-making is the most important thing, and we don’t talk about those things sometimes when we’re so specialized in what we do, because it doesn’t seem like it’s that important.

But I hope that every one of my young patients that has decided to have a child… We talk about the experience of, “What do you want that to look like? Let’s talk with your OBGYN about it now, so you’re not the dad that’s sitting there with this beautiful baby scared out of your mind that you’re going to do something wrong.” Because it’s a no-win situation at that time.

I kind of feel that way with almost all of these things that we talk about that are controversial, whether it be vaccines, whether it be the K2, the vitamin K injection, even the erythromycin around the eyes. These are things that I feel are so important to talk about before you go into the hospital, way before, to have that plan kind of set. And obviously it doesn’t always work out that way, but that’s where my heart is, is in functional medicine. So, for me, it’s informed, just, “This is what you’re getting, this is what the risks are, this is what might be beneficial, and these are the risks.”

And I think that then just helping every patient make that own decision and really respecting that decision and understanding what the sequela are. It’s kind of a cop out, right?

James Maskell: I like that answer. Thank you. And I felt good about it afterwards and I felt empowered, and I’m glad we had the stuff at home. You mentioned, when you talked about dosing, that vitamin D and K2 is added together. So, what are the benefits of them being dosed together? Obviously it’s fall, and we’re having more viral issues come back, so D is critical.
I mean, hoping we learn from the last round of COVID just how critical vitamin D levels are to not having a tough case of COVID. What are your thoughts about the benefits of dosing it like that, and are there benefits specifically to the deployment of K1 and K2, or K2 in that dose? And then what are the ancillary benefits of having D along for the ride?

Swathi Rao: I rarely prescribe K1 anymore, but we also have a teaching kitchen. And so, I am really telling patients, “Let’s get your K1 from your green leafy vegetables, from your spinach, your kale, your heavy greens.” But I will tell you, as much data as we have on really helping our immune system become smarter, not just stronger, with vitamin D, K2, I think, actually takes that up a notch. Because that’s the real research that’s coming about is vitamin K2 with the antioxidative effect, reducing alpha/beta induced apoptosis.

So, really, especially with COVID, when we’re talking about neuronal damage and neuroinflammation, we know the vitamin K2 improves vascular health. So, what’s happening at that endothelial level with COVID, we know that it makes a difference in mitochondrial rescue, which we’re seeing so much. I feel like even these recent strains of COVID, James, I’m feeling like the inflammatory component is a lot less, but the neuroinflammatory and the mitochondrial component is still strong.

I just still feel like people are like, “Boy, my stamina after I was sick for a little bit, just never really came back,” and that neuroinflammation. And there’s just so much data on both vitamin D and K2 for all of those factors. So, I just feel like it’s so important. And to be quite frank with you, I just want to limit the number of pills I have to take. So, we typically go ahead and just do them in blend, only because it makes it easier for our patients.

But I think that the data that we had from D, I feel like that’s the data that we’ve been getting here in the last probably five, seven years with K2 from a standpoint of, just that capacity for immune modulation, reduction of inflammation, reduction of oxidative stress, and really making the body more resilient. We have so few people anymore that just take normal D.

James Maskell: That’s great. That’s a good insight. Well, look, we’ve talked about a range of different things. I’m really excited that your practice continues to go from strength to strength. Is there anything else clinically that you want practitioners to know about K2 and about how you use it and about why it’s important?

Swathi Rao: I think just to know, if you were like me and you were a little nervous about the whole clotting risk factor thing, I’ve been using it now pretty consistently for the last, probably at least 20 years, and we’ve really had very few side effects with it. It’s pretty well tolerated, seems to be a pretty easy thing to give, and patients really do feel great when they’re on it.

And I guess my biggest thing for some of the people that I mentor is just continue to visualize your practice and see how you can connect with your patients the best, and follow your heart in terms of growth. Because it’s fun, it’s scary, it’s always like jumping off a cliff, but in the end it’s always a great ride.

James Maskell: Awesome. I’ve got one other question I want to ask you, and you’re not prepared for this at all.

When I first came into the industry in like 2005, I could foresee a situation where non-MD professionals would build a successful practice and then end up hiring MDs into their practice because they built the practice, they have the patients coming in, they’ve built the brand locally, and then you could bring people in. And I’d just love to know, as someone who came through their training as a PA, now running this seven-provider clinic with other practitioners in there, can you just talk a little bit about the journey of someone with your training as a PA now stepping into that role? And maybe a thought for other NPs, PAs, even chiropractors who I’ve seen go on this journey where they build a brand, build a clinic, and then bring in physicians into the team?

Swathi Rao: Yeah, absolutely. Honestly, I think that my journey is… I have been so blessed in my entire life to be surrounded. Well, you know Indianapolis. It is a mecca of just the most amazing providers, and I’ve been blessed to have several mentors through my journey that probably believed in me more than I believed in myself. I remember my first doctor that I worked under, I’d call and say, “Dr. Richards, I’ve got this question and that question,” he’d say, “Swathi, what do you want to do about that?” And just gave me a lot of autonomy and independence to be able to see my own patients and gave me that respect.

So, ever since the beginning, even before the functional medicine journey, really started to kind of have my own practice and just slowly grew in. I think my biggest recommendation for those of you mid-level practitioners out there is, know your limits. Always make sure that you have the support that you need. When in doubt, and actually for anybody, this is for anyone, use your fellowship and use your mentors to guide you. And when you feel comfortable to take that next step, do, but always do it with caution.

For me, in my heart, I make every decision based on patient care. So, if I feel like this is a confident thing that I can do and I can help my patients grow better, that decision is a yes. If I feel like there’s anything that I feel uncomfortable with, that decision is, “I need to learn more. I need to have more mentorships. I need to have more fellowships.”

One of the things that I did that, again, I felt very blessed because people allowed me the chance, is ever since the beginning when I graduated PA school, I typically had a day off in the week. And I would just call doctors that I respected, or nurse practitioners or PAs and said, “Can I just come and shadow you?” And I did, and I just felt like I learned so much from them. And that has been more of my growth to become kind of where I am today than anything else.

But look up your state laws, make sure that everything that you’re doing is legit with Medicare laws, with Anthem, with all the insurances, it’s a big pain in the butt. But if you do your research, then you can have your dreams really come true.

James Maskell: Yeah, that’s amazing. And I guess the last question I want to ask is, do you think that Indianapolis has a disproportionate number of awesome practitioners, or do you think that you just know all of them because of Toni and the community that she’s created there over the last eight years or whatever?

Swathi Rao: Oh, man. No, I think we rock this. I think we have phenomenal practitioners. Because Toni has done an amazing job, but honestly, these practitioners that have been here for years before I have been here have really created an environment where functional medicine has been very accepted. And I think as we’ve come in, we have a journal club, we have Toni’s club, we do a lot of meetups. It’s a phenomenal place, you guys. If you ever get a chance, come and see us, come and Zoom in with us with one of our journal clubs.

It is just a phenomenal place, and I think it’s a place where there’s a lot of collaboration that’s here. There’s competition too, but there’s a lot of collaboration here. And I feel like the doctors that have been here, or the PAs or the nurse practitioners that have been here, really care about the success of our patients in Indianapolis, Carmel, in this area, and I think it’s the best place to be.

James Maskell: That’s great. It was great coming there last year and just feeling the energy of how many and the collaborative energy there. It was really great. And like I said, met so many great practitioners making journeys into so many great areas. So, really grateful for you to be part of the podcast, and thanks for sharing your wisdom.

And yeah, check out Be Well Family Care, check out the website, see what they’ve got going on. Really interesting model. Really interesting use of group visits, and a model for other practices that want to create access but also grow successfully in deploying this. So, thank you very much for being part of the podcast, and look forward to our next trip to Indianapolis.

Swathi Rao: Thanks, James. Can’t wait to see you again.

James Maskell: Take care.

Swathi Rao: Bye-bye.

James Maskell: 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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