[Nathan Morris:] Yeah. It was a holy cow moment because we kind of get set in our minds what we think going to happen in life and then all of a sudden, you get this curve ball and honestly, these curve balls sometimes are the best thing that ever happened to you. And as I’ve been thinking about it since you called me, I realized that this has been my 20 years of practice. Every time I kind of get set and think I’ve got it all figured out, I get a curveball. And it always ends up that the next iteration of what I’m doing is even better. It’s really finding that space to allow the universe to make what’s supposed to be be.[Nathan Morris:] And that’s really what I took your call as is that, “Hey, it’s time to shift again.” But I cannot say it wasn’t a little frightening. It did create a lot of questions. What do we do now? And I think that is what is really exciting about this is me and you are going to explore what do we do? What is our first step? I mean, that’s the big thing. We see this long, long journey ahead of us a lot of times and we’re paralyzed. I think I really like the approach of, “What is our first step?” And that’s really everything as we talk about patients, as we talk about everything in our lives, what is the first step? Let us not get paralyzed with where we have to go, but let’s figure out what do we do next.

[Kara Ware:] Yeah, Nathan, and just to tell you back what I heard about that paralyze and feeling overwhelmed in that fear, that’s a lot of what our patients feel like when they first approach a functional medicine practice. And now as we are rethinking and reimagining the functional medicine journey and pivoting and taking practices virtually, it’s important to remember that that fear, it doesn’t sell, if we come across with that first step of, “We have to have functional medicine to manage susceptibility, to boost our immunity, to help to be proactive in these times,” it may not drive patients in the door like we think it’s going to because we’re feeding more into the fear that is happening on a global scale right now.

[Nathan Morris:] That’s right, Kara, I mean, really, fear is not a great driver. And I have friends who have created a great program, the MBN program and they use the same philosophy you’ve always use with your previous practice. And that was just one thing. And if we can do just one thing with these patients, if we can give them just a small baby step, because I have found that when I started incorporating a lot of your ideas of creating this foundation and then I build on it slowly, long-term, I had a lot more success and I think as a practice, we’ll have a lot more success because we’re doing that. We’re building on just one thing.

[Kara Ware:] We’ve been talking, “How are we going to do this differently this time around?” So, yeah, tell us about that, because this has really been your baby, your passion for a long time.

[Nathan Morris:] Yeah. Nutritional genomics. I think I started with nutritional genomics 10 years ago, got overwhelmed quickly because everybody made it so complicated. And then I realized, I had this epiphany that, “This doesn’t really have to be complicated. There’s so much information that’s such low-hanging fruit that can help the patient and help the clinician make decisions and you don’t have to understand everything about nutritional genomics. You can just understand these small things and make a huge difference.”

[Nathan Morris:] And so I think that’s where our first step is, is taking something that patients have a lot of confidence in, that their genetics are playing a role in their health. And then we create this ability for them to connect to their 23 and Me and their Ancestry report, which to this point has not really been that easy for them because those reports are not set up direct to consumer to give medical advice. And we can be that go-between to say, “Hey, you know what? This 99 or $199 test has a wealth of information that can help us get started on your journey and do that just one thing.”

[Kara Ware:] Nutritional Genomics is so relevant right now-our environmental factors of pervasive stress, loss of structure, unprecedented rates of unemployment- are interacting with our genes and can more than likely be turning them off to the adverse setting.

[Kara Ware:] We have a lot of details to iron out to transition from brick to click -today let’s dive deeper into how nutritional genomics can be a driver to reactivate old patients as well as engage new patients right after this.

[Kara Ware:] All right, Nathan, so we’ve talked about this first step, nutritional genomics, because truly if this new audience, the masses are going to even feel motivated to approach a functional medicine practice, it has to be affordable. We must have a service that’s a much smaller incremental step to onboarding into this functional medicine journey. The benefits must outweigh the cons for people to direct funds toward functional medicine.

[Nathan Morris:] That’s right, Kara, I think that’s the big epiphany I had early on in my functional medicine practice is that I had to make one, my visit affordable. I needed to make sure I did not overwhelm them with supplements. And most of all, I didn’t want to overwhelm them with tests, because a lot of patients were leaving a functional medicine practice with 2 to $3,000 average and all of a sudden they were able to go to one visit, but then they weren’t able to do another two to three years of a journey with you. And we’ve kind of missed the whole point.

[Nathan Morris:] We can have all the knowledge in the world, we can have all the greatest testing in the world, but if we lose them after that first visit, what good have we done? Now they are just going to file that back as, “Oh, that was not successful. I’ll never do functional medicine again.” So we have to create that step-by-step. You have to create this tiered program. And honestly, by following the tenets of working on the things that are so important in functional medicine, a lot of times I didn’t have to do all the expensive testing because the body’s an amazing tool that knows how to heal if you have the right information. And that’s where nutritional genomics can give you a lot of insight is, how do we help the body to heal?

[Kara Ware:] Yes. And just to expand a little bit further on losing the patients after the first appointment, I hear that a lot from both patients and providers. “We went through all this. It seemed to be going great. What happened? The patient never came back.” And the patient is being like, “Oh my God, I can’t do all of this. There’s no way. It’s not a match to my current ability. It’s way over my head. It’s outside of what I can reasonably do right now.”

[Kara Ware:] James Prochaska, he gives us the transtheoretical model of change, better known as the stages of change. And so if we really look to that as an insight of reimagining this functional medicine journey and taking functional medicine, the process, and breaking even further down into these incremental steps where the task is a natural fit to the patient’s ability and what’s more accessible than taking a look at nutrients to optimize expression and lifestyle inspiration, right, that we can add into our lives rather than asking them to do more advanced interventions than their pocketbook or their time or even their mental capacity, their emotional capacity’s ready for.

[Nathan Morris:] That’s right, and this is where we can take a very … Most people already have. I mean, millions of people already have their 23 and Me. Millions of people already have Ancestry.com. What if we take a test that they’ve already paid for, we charge them an appropriate 30-minute price for going through maybe four or five different things? Do they need more vitamin D? Yeah, you may need more vitamin D. Let’s get labs for that. You may have problems with vitamin A. And of course, the times we’re in right now, these are really important things to know. Who’s able to convert beta carotene to vitamin A? Hey, you may need additional testing.

[Nathan Morris:] And then with that question of additional testing, you can say, “Okay, let’s set up a functional medicine appointment for you based on your genetics. We may need to do more testing and we may need to explore through your history whether these things are really affecting you,” because genes don’t sit in isolation. They really can be affected by your environment and your lifestyle, and we need to dig further. It’s not something we look at and go, “Okay, you need to be on these things,” and we leave them alone. It’s just the beginning point to create that conversation of, how do we bring them a more robust, vital system?

[Kara Ware:] Nutritional genomics, it really is validation. Why do we go to the next step? Why do we need to order more labs? Why do we need to order these supplements? And when people understand that why and connect them with what’s important to them, what they value the most, and the next step, again, is reasonable for them, we’re going to continue them in the process and the partnership that makes functional medicine successful.

[Kara Ware:] Yeah, so again, and in episodes to follow, we’re going to bring in voices that are going to help us know really easy places to go into a nutritional genomics report and have the confidence of where to glean some information that’s relevant and important to talk to the patient about in that first appointment even if you’re not an expert in nutritional genomics. And I hear that a lot, Nathan, is that providers feel hesitant about really jumping in and having this as a service because this really is outside of their scope of study right now.

[Nathan Morris:] Yeah, I think that’s the biggest thing right now, Kara, is that a lot of people are intimidated with nutritional genomics because it’s been made so complicated, and I always say complicated sells. So if you make it complicated, people have to keep coming back to you for the information. And that’s been kind of the whole purpose of my journey in the last five or six years with nutritional genomics is to make it where you could take five snips or five polymorphisms that you really want to focus on and then we look at the patient across the table. That’s the most important thing about genomics. It does not sit in isolation. What is your patient across the table having issues with? Are they having problems sleeping? Are they having problems with weight gain? You don’t want to talk about something that’s not relevant to them. And I think it really is set up beautifully for a 30-minute telemedicine appointment, nutritional genomics, because we can take what we’re comfortable with and we can say, “Okay, these are things we need to look at. What are your issues right now?”

[Nathan Morris:] Maybe you have a questionnaire beforehand so you know what they’re struggling with and then you can look and pinpoint what you need to be talking about. And it doesn’t have to be astrophysics as such. It can really be quite simple. And I think that’s the beauty of this being our first thing to attract new patients, to reactivate older patients that haven’t seen you in a while. I think this is a great step, and what we’re going to do actually in Good Medicine is create this first step.

[Kara Ware:] Reactivation of patients is as important as attracting a new audience. And we can’t do everything all at once anyway.

[Nathan Morris:] That’s right.

Kara Ware: So just having new patient objectives and a few tangible places to go in the report to understand, and that’s what we’re going to be bringing on experts for the next episodes is to really give us tangible, concrete steps of using nutritional genomics and applying it to the patients with the polymorphisms that are well-researched and of course are relevant and then will be responsive to the nutritional supplementation.

[Kara Ware:] Let’s go ahead and summarize what we discussed today, Nathan, and then you’ll help us know where we’re going next. So more incremental steps. Let’s take this functional medicine journey and let’s break it up into easier, more accessible, more affordable steps to bring this new audience and to reactivate our patients in a time of unprecedented employment, of pervasive stress where they feel that they can put their money and it can be affordable to them. And so nutritional genomics is our driver to be this first step, and kind of following that theory of that transtheoretical model, the stages of change, that we’re preparing the patient for a deeper commitment, to have validation of why more out-of-pocket labs are important and they want to put their out-of-pocket expenses towards that.

[Kara Ware:] And then I see how this, too, is leading into the future of family medicine because as the parents learn these lifestyle changes and these nutrients that are good for them, it’s immediately going to be an aha moment of how their children have similar DNA and this is going to benefit the whole family as well as future generations. And then on our website Kara Ware: Ware Coaching, we’re also going to have some resources for you to reference on how do you do more research and also some short video clips of Nathan Morris: showing how to use the nutritional genomics in a 30-minute consult, which is not a lot of time, so you have to use your time wisely, to use this as the driver for the new functional medicine journey.

[Nathan Morris:] That’s right, Kara, I’m really looking forward to that ability to share what I know, which has pretty much a been hard-earned because it is a learning process, but it’s not overwhelming. And I think as we approached our children’s autism diagnosis to become better than we were before, I think genetics is kind of that same thing. We can look at genetics and we can understand, and we can have some aha moments for our children in which really, it’s been very helpful to me. So, I think you’re pointing out that this is a real insight into families. It is so dead-on.

[Nathan Morris:] And I think right now, genetics is more relevant than ever because one of the strongest tools I had in my tool bag was the genetics, the polymorphisms associated with mood and anxiety and focus. And I think that really brings us to a very important topic now, which is a lot of people are not able to connect as well as they did before, and they feel isolated. And we are going to see increased rates of suicide, abuse, a lot of things that are just really heartbreaking at this time. And I think that’s where our next speaker, Dr. Greenblatt, has been doing psychiatry for so long and been using genetics for so long to get these amazing insights. And so our next episode, I’m super excited about because he truly is an expert in this field, truly understands the role of neurotransmitters and how we can help people and address these issues which are really just so pressing right now, Kara, I mean, you can’t open the newspaper and without seeing more reminders that this is becoming a bigger and bigger problem.

[Kara Ware:] Yeah. The epigenetic influence is potentially going to be disastrous for a lot of people, so it’s more important than ever to take a look at those neurotransmitter productions and how we’re utilizing the dopamine and the serotonin. And I’m really excited to bring Dr. Greenblatt on for our next episode. All right, Nathan well, here we go.

[Nathan Morris:] All right. So excited, Kara.