Kara Ware: (00:31)

Already, before even coming to a functional medicine practice.

Dr. Nathan Morris: (00:35)

That’s right. And then we’re asking them to layout quite a bit of money to get well, and it’s just really, on top of being ill, then having some financial pressure put, it’s just so much.

Kara Ware: (00:47)

Yeah. I know like you, Nathan, a lot of providers, I know they’re good at circling priorities and checking with their patients to see what’s reasonable and what can be left for future considerations. But as always, we’re re-imagining how can we be more proactive? How can we play offense to make functional medicine more approachable, affordable, and sustainable? So how can we be more proactive to set up our patients for success for this long journey of transformation? And that’s what we’re going to talk about today. That’s why we’re introducing the new modifiable lifestyle factor, finances. Finances, they burden sleep and stress and relationships and blood pressure, digestion. Finances really affect everything.

Dr. Nathan Morris: (01:32)

They really do. And today we’re really acknowledging, and it’s kind of like the thing that needs to be acknowledged, is functional medicine is expensive, and it can prevent patients from joining the practice and sticking around long enough to actually get better because it’s a long journey for most people. So this is really important and I’m just so happy you’ve identified this, Kara. You identified it in my practice and you really pointed it out to me because we don’t like talking about it. We have to help patients navigate their finances and take a look at their finances as a part of the comprehensive care plan. And we’re not doing that in functional medicine. And how do we do this without being financial advisers?

Kara Ware: (02:12)

Yeah. That’s a very important question. And it’s a very sensitive topic, right? How are we going to bring this up with patients?

Dr. Nathan Morris: (02:18)

Exactly.

Kara Ware: (02:18)

And that’s exactly the question we are going to explore in today’s episode. Hello and welcome. I am Kara Ware, a national board-certified health coach, and business advisor.

Dr. Nathan Morris: (02:43)

I’m Dr. Nathan Morris, a certified functional medicine practitioner.

Kara Ware: (02:48)

Functional medicine, it’s not something we’re trying. It’s a lifestyle. It’s a journey of transformation. And that’s what I always say to patients. This isn’t something we’re trying. This is something we’re going to start and only get better at. Functional medicine, it’s not just the cost of the doctor’s visits, the supplements, and the labs. It’s bigger than that. It’s water filters, air purifiers, organic food, gym memberships, yoga classes, bodywork. I mean it requires patients to deliberately directing the funds they have toward this comprehensive plan that makes up the functional medicine lifestyle.

Dr. Nathan Morris: (03:23)

And we better prepare the patient to be ready to co-create their personalized plan with their chosen medical provider in incremental steps. That’s really important. I’ve been in long enough so I can say incremental steps are really key here. And we have to match those incremental steps to the patient’s current financial and emotional ability. This is the one way we are making functional medicine less overwhelming. If we want to reach the masses, we have to look at this because if we’re not looking at this, then we’re really cutting out a lot of the population. And I think we’ve talked a lot in this season about where to meet the patient where they’re at with group coaching visits and different entry points, but we really need to discuss this as an organization of providers.

Kara Ware: (04:10)

Yeah. And it’s a sensitive topic, so no one’s talking about this elephant in the room. So, typically when a provider and a patient are talking, the patient is just kind of nodding their head and in agreement because they know everything you’re saying is right on, but really in their mind, they’re thinking, how am I going to do all of this? And we want to be more proactive to help them connect with their voice, to know how to co-create a reasonable livable plan.

Kara Ware: (04:37)

And so how do we bring up finances without being financial advisors? Remember, that’s the question we’re answering. If you’ve been listening to earlier episodes in this season, you’ll remember that we recommended patients see the health coach first, and we know this is kind of a radical idea. So if you haven’t, please go listen to the earlier episodes, particularly episode four, where we explain how I would see patients before you in more detail to better prepare them. And one of the advantages to seeing a health coach first is that we are trained in motivational interviewing like we talked about in our last episode, episode five, and that makes us a great skilled professional to talk finances with your patients.

Dr. Nathan Morris: (05:23)

Right. And Kara, let’s just be honest. I’ve come from an insurance model, and I moved to a cash model, and I was completely apologetic in that it’s really kind of a scary thing. And as providers, we’re almost ignoring the fact that in a lot of functional medicine practices, we’re asking a lot financially. So we don’t bring it up. And I think that’s a real downfall in our visits.

Dr. Nathan Morris: (05:48)

And we’re not really good at it. Let’s just be honest. Doctors are not really financial whizzes. So having you there, having that health coach there, is really, really important because it gets that hard conversation out of the way. The patient’s ability to ask these questions and not feel embarrassed by asking it. And I think that’s really important is removing that social or that emotional stigma of bringing this up. And we’re not going to do it as financial providers. We’re not going to say, “Can you afford this?” because we’re kind of embarrassed ourselves because we’re [crosstalk 00:06:20]

Kara Ware: (06:20)

[inaudible 00:06:20] your sales. That’s what we talked about in the last episode. A lot of times, you are placed in that uncomfortable position because they do have to purchase out-of-pocket labs and supplements and office visits. So, how do we address that?

Kara Ware: (06:36)

One of the ways is what we found worked really well when we combined our unique skillsets in your practice was when I drove that patient’s first encounter, I would inquire to them, we would be talking about what is a comprehensive care plan and what are all the components that go into a personalized plan? It’s all the modifiable lifestyle factors and the mental, emotional, spiritual components. There’s a lot that goes into a functional medicine lifestyle. And I would ask them, I would say, “Hey, may I ask you a question regarding the finances, your financial threshold, because we want to make sure that Dr. Morris and you are working together to co-create a plan that’s within your current ability, within your current financial threshold. Are you confident in saying to the provider, to Dr. Morris, ‘Hey, this sounds like a lot? I don’t think I can do all this. I feel like I can do this, this, and this right now.’ Are you confident in saying that?”

Kara Ware: (07:36)

That’s how I introduced this elephant in the room, which is very non-intimidating and it opened up the conversation to start talking about the importance of making sure that the plan is within their current financial threshold.

Dr. Nathan Morris: (07:51)

Yeah. And I think that’s just so big, Kara. I mean the elephant in the room, I love that, because it really is. And the fact that you really include this as part of your comprehensive plan, I think is just so empowering to the patient. So I can’t say enough how much it transformed my practice and made it easier to have these conversations with people that I was scared to bring up before.

Kara Ware: (08:13)

Yeah. And they were quiet about it because they’re uncomfortable with it. Finances can be embarrassing. And then I would ask them, “Okay, so you’re confident because we want to know. Our goal for you when you walk out of Dr. Morris’s appointment is to be like, ‘Yes, I can do this.’ And so we need your voice in mutual participatory medical, I’ll make sure we’re creating a personalized plan just for you.”

Kara Ware: (08:36)

And then I asked them, “Hey, are you budgeting? Is that something that you would like support with? Or do you already got that? And you already have every dollar directed to exactly be aligned with your values and your needs? Where are you at with that? Is there any place I can offer additional support?” And then that allowed them to either invite me into their financial world or say, “No, thank you.”

Kara Ware: (09:00)

Because again, we’re just getting to know each other and building trust and rapport. But I found that a lot of people were actually relieved I was addressing this elephant in the room. And then I would say to them, “Hey, I’ve created a functional medicine care planner because I’ve been on this journey for almost 15 years and as a single mom with two children and being the only financial provider, I had to make sure that I was really on top and not spending outside of my financial threshold, which would cause more damage to my family. And so would you like a tool that will help you to organize and document and track and budget, so that we’re sure each three-month plan that you’re making with Dr. Morris is a good fit to your current ability, both emotionally and financially.

Dr. Nathan Morris: (09:44)

We actually, all my new patients, get the functional medicine care planner to help them with that process. So I thought it was a really nice tool to use. The financial discussions help patients understand that functional medicine is not a medical cure just right off the bat, but this is going to be a journey. This is something we need to pace. And it’s something that helps the doctor also realize that we don’t have to fix everything in one visit. And it’s going to help a lot with their concerns, but at the same time, it’s not a cure-all right away, but it’s this journey that we talk about. So it’s important to plan how to make this affordable and sustainable for their lifestyle and that they will have to continue to evolve and improve as confidence and competence grows and co-create a livable plan and a reasonable plan.

Kara Ware: (10:35)

Yeah. And that’s the magic right there, their competence and confidence. We’ve been talking about patient readiness and current ability this entire season. And this financial discussion really is what helps us co-create with a patient a reasonable livable care plan. It’s actually a really exciting conversation.

Kara Ware: (10:52)

So up next, we’re going to share more about how we talk about this elephant in the room with your patients, Nathan, and steps a practice can do and what the patient can do to make functional medicine more affordable and sustainable, right after this.

Kara Ware: (11:24)

This podcast is sponsored by the Atrium Innovations family of professional brands, offering evidence-based supplements, advancing scientific research, and providing clinical protocols and technology to empower practitioners globally. Atrium Innovations brands include Pure Encapsulations, the number one trusted and recommended brand by practitioners, Douglas Laboratories, Genestra Brands, and LivingMatrix, the fastest growing digital patient management system for functional medicine.

Kara Ware: (12:04)

All right, Nathan. So what can the practice do to make functional medicine more affordable? We just talked about how we can position a health coach and how the health coach can help to bring, introduce, this topic, this new modifiable lifestyle finances into a comprehensive care plan. What else are we doing?

Dr. Nathan Morris: (12:23)

Well, Kara, I think me and you both realize that we were really cutting out a lot of the population. We set up the visits just for what we consider the typical functional medicine patient that has like five to 10 things going on a lot of times.

Kara Ware: (12:40)

The most complicated cases.

Dr. Nathan Morris: (12:42)

The most complicated cases. And that’s really going to be a financial barrier for so many people because we have to plan for a two and a half-hour visit. It ends up being quite overwhelming for a lot of people that really want it. So we created different levels of entry into our practice. We have the advanced, for that patient I just mentioned, we have the proactive where this person is really just trying to tune-up. And actually, it’s interesting since we’ve introduced these bundles, that’s probably one of my most utilized introductory bundles, Kara. It’s really been great. And then there’s that patient that knows they need functional medicine that has some issues going on and not real sure where to start. So if you give them a two and a half-hour visit, they’re going to be overwhelmed and you give them that price tag, they’re going to be a little overwhelmed. They’re not real sure about functional medicine, but they think it can help them with what they’ve got going on.

Dr. Nathan Morris: (13:31)

And then the thing I’m really excited about, especially after seeing a lady in the gym parking lot, and she was asking me about what I do and I was telling her some hot tips on what she should do. And she asked, “Well, so how much is it an hour?” And I told her, and she just got in her car.

Kara Ware: (13:46)

They’re heading for the hills.

Dr. Nathan Morris: (13:46)

They’re heading for the hills. She’s like, “That sounds good for somebody, but that ain’t for me.”

Kara Ware: (13:53)

Pushing up against that financial threshold.

Dr. Nathan Morris: (13:55)

That’s right. And I was like, well, I didn’t have Kara there to explain all [crosstalk 00:13:59]. But this group coaching event would have been good for her because she had some really good questions, but you know, we’re going to introduce this group coaching, which is a lot more affordable, that’s going to be a really good use of our time and help people understand what it is that we do. Because I think that lady if she could understand what I do, besides just give supplement advice in the parking lot would have been much more. So, these things help build momentum, engagement, and activation to be a better partner with the practitioner. And what we’re talking about is also how do we make this more affordable and it does. And that’s what I’ve really been glad to see.

Kara Ware: (14:39)

Yeah. So that’s another thing that we’re doing for your practice to address this financial conversation and to add to the group coaching events that we’re creating for 2021. You and I have already have done this. And when I had my practice Integrated Connections open, that we’ve talked about the season. And I would love to give our listeners an example of what’s possible in these group coaching visits.

Kara Ware: (15:03)

So I’d love to talk about a patient you and I collaborated on where she and her husband came to me and said, “Well, we can’t afford functional medicine. We can’t afford Dr. Morris.” And I said, “Okay.” I said, “Well, are you open to taking a look at… are you budgeting? Are you open to taking a look at where your finances are going, what your current resources even are?”

Kara Ware: (15:24)

And fortunately, they were. They invited me into that conversation. And that opened the door actually for another family to suggest that I offer Dave Ramsey’s Financial Peace University as a group coaching outreach program at Integrated Connections. And so we went through this series with Nancy and her husband, and they discovered that they were spending $700 a month on fast food.

Kara Ware: (15:53)

So here was a family whose son was very affected by autism, very disabled by autism, thinking they couldn’t afford functional medicine. But when we took a look at where their finances were going and inquired if this indeed aligned with our values and our needs, they were just hitting the value meal because he was in so many therapies. And in order to sustain his therapy schedule, they were hitting the fast-food line.

Dr. Nathan Morris: (16:20)

Which ironically was making his disease worse [crosstalk 00:16:22].

Kara Ware: (16:21)

Which was making his disease worse.

Dr. Nathan Morris: (16:22)

I just couldn’t pass it up. I’m like, holy crap, they were spending $700 to make him sicker.

Kara Ware: (16:27)

But this is what’s happening. This is very common. And so when we began to allocate that $700 to you, Nathan, all along as they were budgeting, I was working with them on the modifiable lifestyle factors, and we are beginning to clean up their nutrition. And they took this on as a family program and they led by example and their son, who at one time was so resistant to the gluten and dairy-free diet, just there was no resistance because the parents were leading by example. We did so much groundwork for them to partner with you. And over the last seven years, they have made tremendous clinical outcomes and have made their journey sustainable. And remember, that’s one of our most important three words we want to take away from the season.

Dr. Nathan Morris: (17:15)

That’s great, sustainable. And I think that’s hopefully where our bundled programs will come in. They’ll align with patients’ emotional and financial readiness and their current ability, and it’ll be something that’s sustainable. I think that’s the biggest thing that functional medicine needs is that sustainability because so often our stories are well, I saw that patient for one or two visits, and then they were lost because we didn’t make it sustainable. And I think every provider out there has that. What happened to that patient? Was it something I did, but it’s usually quite honestly, it’s going to be financial. And if we’re not addressing that, then we’ve not created that sustainability. We’re not matching their financial readiness to their current abilities.

Kara Ware: (17:59)

Yeah. Because this is a lifelong journey. Functional medicine is a journey of transformation to really experience those profound results.

Kara Ware: (18:13)

And so that leads us into a good conversation of, well, how can we help the patient be better prepared to make their functional medicine journey sustainable. I used that story we just shared with Nancy with other patients. And when I would inquire and say, “Hey, have you lately taken inventory of your spending habits, and are you budgeting? And do you know where your money is going? Because you know, actually it’s really common to not know because we’re just trying to survive. Are you okay to talk more about that?”

Kara Ware: (18:45)

And an idea for the patient or even the practices is to offer that Dave Ramsey Financial Peace University or have a financial advisor locally available to consult with patients who are considering functional medicine. So you are supporting them within their financial world to deliberately spend money, to go in the direction they want to go, which is healing their root causes.

Dr. Nathan Morris: (19:10)

That’s correct. Yep. That is really what we’re after. And as you say, if you don’t have that platform in place, fortunately, you are just excellent at what you did with the financial piece. But the Dave Ramsey program is just extraordinary. And I would really recommend people who have a health coach actually understand some of these principles. It may be transformative in their own personal life, but it will definitely be transformative in the patient’s life as well.

Kara Ware: (19:38)

That’s a great point because I went through that Dave Ramsey, and it transformed me and how I spent money. I thought I was doing well but even learned more. And so I had that language, that understanding of how to work with patients. And so if you are a health coach listening, and you are working with a provider or want to work with a provider, I would consider going through that Financial Peace University because it will be basically your training of how to add this new modifiable lifestyle factor into a patient’s comprehensive plan without being a financial advisor.

Dr. Nathan Morris: (20:10)

The thing to realize if you’re listening as a provider, as a health coach that actually working within a patient’s financial limitations can actually benefit them and actually will make you a better provider, believe it or not. It’s so important that we have this piece because it actually is the secret sauce in a lot of ways.

Kara Ware: (20:32)

Yeah. Nathan, trying to do too much, too soon, really gives patients a wrong idea, to be honest, is that we’re going to do all this and it’s going to be over. And that’s far from the truth. And also I love how you talk about how we’re not the healing powers of the body when we’re trying to do too much, too soon, without covering the basics and doing these small incremental steps and building on competence and confidence. Tell us a little bit… I love how you tell your patients that the healing powers of the body are tremendous, more than anything we can think that we’re going to do.

Dr. Nathan Morris: (21:06)

I learned that because I used to… I’ve been humbled by the human body. Let me just say, the more I’ve been in functional medicine, the more I’ve been humbled by it. And all this knowledge that I’ve gained through functional medicine is fantastic. But what I found to be the most powerful aspect is not knowing all these minutia details, but understanding what role is their diet playing? What role is stress playing? What role is their airway playing? An really going back and understanding, how am I going to address these big factors?

Dr. Nathan Morris: (21:41)

And then what amazingly happened, Kara, and like I say, it humbled me, as I found out that if I gave them the right nutrition if I got the right sleep, if I did all these things, that it seems so basic and seems like, oh, you know, they came to see me a functional medicine doctor, I’m supposed to do all these fancy things, sometimes with them leaving 3,000 and $4,000 in debt, not necessarily my practice because I don’t like that a lot, but a lot of patients had that story.

Dr. Nathan Morris: (22:08)

I actually could do, because of financial limitations, I would focus on these basic things. And lo and behold, they got better, and they kept coming back to see me because they really saw the benefit. But because we had these financial limitations, I thought it was a godsend because quite honestly, they were able to heal. Their body has this innate wisdom to heal. If we just give them time, if we can take three or four thorns they have out of their feet and take the time to do that and not create unrealistic expectations.

Dr. Nathan Morris: (22:43)

Because when we charge a lot of money, expectations go way up. And they should. Somebody’s walking out, out of the doctor’s office, 3,000 and $4,000 later, hell yeah they’re going to be having some high expectations. I would. I’m not [inaudible 00:23:01].

Dr. Nathan Morris: (23:01)

So yeah, we have to consider that. So that’s why financial limitations to me are actually a really good thing to have because it makes us think as providers. We really have to think about the basics and really make sure our patients are doing those things because those things don’t cost near as much as all these fancy labs and all these fancy supplements and other things. So I think that’s really important.

Kara Ware: (23:28)

And you placing priority on the basics will help the patients place a priority on the basics.

Dr. Nathan Morris: (23:33)

That’s right.

Kara Ware: (23:34)

Patients usually want to skip over the basics.

Dr. Nathan Morris: (23:36)

Yeah. It’s common… because they’re like, “That seems too basic. That’s not going to help me.”

Kara Ware: (23:43)

Right, right. And with so much information today, I really feel for patients and parents of patients in today’s world, because as functional medicine and healing root cause resolution becomes more prevalent and well-known, there is so much information, and there are so many people saying, “Do this, and do that, and do this.” And I watch patients and I watch parents of patients try to do everything and it’s like they’re in a race, and they have a checklist, and they’re just doing as much as they can. And they’re causing everyone to go crazy and really more harm than good because they’re not allowing time for that healing, that innate healing power to kick in because we’re going slow and incremental. I was forced to learn to go slow. If I was trying to recover my son today from autism, I would be one of those parents that were just forcing and driving and doing everything and doing too much. I would totally be that overachiever parent.

Dr. Nathan Morris: (24:40)

Doing everything and accomplishing nothing.

Kara Ware: (24:43)

Yes. But I, 15 years ago, when I was on dial-up internet, and I had a flip phone that didn’t even text message at the time, there was no information. And here I was trying to solve, well, what’s causing his pain. To me, autism looked like he was in an unbearable amount of pain. And I wanted to know, well what’s causing his pain. And I was forced to go slow. For two years, all that I knew to do was cranial sacral therapy and the vitamins, minerals, and omega-3s, to be honest. That’s what I was supplementing and removing all the high allergens and taking a look at our lifestyle and cleaning up my cookware and our water and just small things. And I trusted if I just did all these small things well that over time they would accumulate into big change.

Kara Ware: (25:29)

And it wasn’t until two years down the road that we added in chelation. But his body was ready for that. Like looking back, I probably would’ve killed him had I got to that too soon. And so you placing priority on the basics will allow the patient to place a priority on the basics and slow everything down. This isn’t going to happen overnight. We can actually cause harm by doing too much too soon and cause a financial crisis.

Dr. Nathan Morris: (25:55)

I so agree, Kara. I think that was my a-ha moment. As we’ve talked about this, it’s just like, hey, this is a good thing. This is a good thing that we, as providers have to go back and say, “What can we do, not all at once, but over time?” And I really think this financial, this modifiable lifestyle factor that you’ve identified, that you’ve been talking to me about it for years. Just want to make sure you get credit. This is one we need to be talking about. And the patient needs to be given that, hey, this is a good thing that won’t add 2,000, $3,000 to spend right away. This is a good thing. It’ll help. We’ll take the steps you can take. So I mean, we need to make it a positive and not a negative.

Kara Ware: (26:42)

Yeah. And you know, the drivers of change are making sure that patients have their intrinsic motivators, what’s important to them. Why do they even want to approach this? And that really stems from their values and their needs and their beliefs. And by helping them to take a look at finances as a currency that will drive the ability to achieve or to experience their symptoms being placed into remission is really powerful. They actually have a lot of resources that we just need to reevaluate and maybe redirect.

Kara Ware: (27:11)

So it’s not maybe that we don’t have it. It’s just realigning where we’re putting our finances. And I know that’s really powerful for me, and it’s been a powerful conversation to have with patients.

Kara Ware: (27:25)

All right, Nathan. So the new modifiable lifestyle factor finances, one of our favorite topics, and we’re so happy to be bringing this to a broader audience. And hopefully, you too now feel compelled to figure out how you can add this very sensitive conversation as part of a patient’s comprehensive plan because we know that finances are an initiator of illness. And so we need to address it along with nutrition and lifestyle and stress and the movement and all the other modifiable lifestyle factors.

Kara Ware: (28:00)

So remember that we do have the functional medicine care planner that you can purchase and make available for your patients so that you have a tool that kind of takes the responsibility off you, the provider, you the health coach, to lead the patient through their planning. They actually have a tool to be ready to co-create with you to be sure their plan is reasonable and livable and within their financial threshold.

Dr. Nathan Morris: (28:24)

And we need to acknowledge functional medicine is expensive, and it can prevent patients from joining the practice and sticking around long enough to get better. We just have to admit that.

Kara Ware: (28:35)

Yep, exactly. And finances, affect all the other modifiable lifestyle factors. Think about how it affects stress and nutrition, like how we heard Nancy. She was directing $700 to nutrition that was causing more inflammation. And so how wonderful that they became aware of that and then changed as a result forevermore. That was so powerful for their family. I love that we worked collaboratively on that tremendous case.

Kara Ware: (29:02)

And actually, I’m going to post a video that you can see.

Dr. Nathan Morris: (29:05)

Oh, that’s great.

Kara Ware: (29:07)

Yeah, Nancy and her son’s transformation when they went through this group coaching event. And then they started working with Nathan. It’s an 18-month timeline. And so you can see how much progress can happen in 18 months by just focusing on the basics.

Dr. Nathan Morris: (29:23)

This episode discusses what a functional medicine practice can do. And I think that’s really important, that our providers out there know that we need to take a more active role and help patients understand how to work collaboratively with functional medicine to make it more affordable and sustainable in the future.

Kara Ware: (29:45)

Yeah. So the patient feels comfortable with this financial conversation because it can be ashamed almost, definitely an embarrassing conversation. We can almost be ashamed of the conversation, but we’re changing that. We’re changing that perspective.

Kara Ware: (29:57)

Next week, we’re going to hear from Leanne Webster, from the National Board Credentialing of Health and Wellness coaches. And this is the episode that we’ve been building up to. So if you are convinced, if we’ve made a strong case and you are ready to integrate a health coach in clinical practice, whether it’s in the salary approach or 1099 as we discussed in earlier episodes. But if you’re ready, this is the episode to really hear the nuts and bolts of how to hire and onboard and train and manage and optimize a health coach in clinical practice. So remember to go to karawarecoaching.com/podcast. That’s K-A-R-A-W-A-R-E coaching.com/podcast. And please, while you’re there, will you wait and review and subscribe and tell a friend because we are closely re-imagining the functional medicine journey to make it more approachable, affordable, and sustainable, and open up to our broader audience right when the masses need us the most.

Kara Ware: (31:02)

So thanks to everyone who makes this podcast possible. Pure Encapsulations, Douglas Laboratories, Genestra Brands, and LivingMatrix, and to our writing team, Kelsey Stafstrom and Paul Larkin. And our sound engineer Isadore Nieva.

Dr. Nathan Morris: (31:19)

Thanks, Kara. I can’t wait for next week.