June 18, 2025 • 23 mins
The healthcare landscape for children is changing dramatically, with families increasingly seeking solutions beyond medication for complex behavioral and developmental challenges. Melissa Smith, founder of NewView Integrative Pediatrics in Georgia, brings a revolutionary perspective as both a pediatric nurse practitioner and mental health specialist.
Melissa's journey began when she noticed alarming trends in children's health that conventional approaches weren't adequately addressing. Drawing from personal experience with her mother's cancer treatment and the power of nutrition, she developed a practice model that looks beyond symptoms to identify root causes of childhood behavioral issues. Her work challenges the growing reliance on diagnostic labels and medications for conditions like ADHD, anxiety, OCD, and autism spectrum disorders.
The conversation reveals a profound connection between gut health and mental wellbeing that many practitioners overlook. "I have seen autistic children get their speech back just from gut microbiome health and methylation support," Melissa shares, highlighting the transformative potential of addressing underlying imbalances. Her approach focuses on improving detoxification pathways, optimizing methylation, and restoring gut health - interventions that often allow children to reduce or eliminate psychotropic medications while seeing dramatic symptom improvement.
Many families arrive at NewView in crisis after being told repeatedly by conventional doctors that "nothing is wrong" despite obvious behavioral changes. Melissa validates these parental concerns by investigating what's actually happening physiologically rather than simply labeling symptoms. This comprehensive approach requires longer appointments and deeper investigation than the traditional 15-minute pediatric visit allows, creating challenges with insurance reimbursement and time management as demand grows.
Despite these challenges, Melissa's success demonstrates that when we address the body as an interconnected system rather than treating isolated symptoms, children experience improvements conventional medicine often considers impossible. For parents seeking alternatives to medication-focused treatment, this functional medicine approach offers renewed hope and practical pathways to helping children thrive.
- Guest Name: Melissa Smith, MSN, APRN, CPNP-PC, PMHS
- Business: NewView Integrative Pediatrics
- Title: Pediatric Nurse Practitioner & Pediatric Mental Health Specialist
- Location: Watkinsville, Georgia
- Clinic Address: 2053 Experiment Station Rd, Watkinsville, GA 30677
- Website: https://www.newviewpediatrics.com/
- Instagram: https://www.instagram.com/newview_integrativepediatrics
- Facebook (Clinic):https://www.facebook.com/profile.php?id=61557212357986
- LinkedIn: https://www.linkedin.com/in/melissa-smith-86622689/
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr Andrew Greenland (00:05):
Welcome back to Voices in Health and
Wellness.
This is the show where wespotlight the bold thinkers and
frontline leaders reshapinghealthcare from the ground up.
I'm your host, andrew Greenland, and today we're diving into a
powerful conversation around thefuture of small health clinics,
what's working, what's keepingclinic leaders up at night and
where we go from here.
So our guest today brings anincredible dual perspective to
the table.
She's both a certifiedpaediatric nurse practitioner
(00:27):
and a certified paediatricmental health specialist.
Melissa Smith is the founder ofNewView Integrative Paediatrics
in Watkinsville, georgia, whereshe's created a care model that
fuses medical and mental healthsupport for kids and families
under one roof.
In a time where many clinicsare stretched thin, melissa's
approach is a breath of freshair focused, compassionate,
deeply responsive to what modernfamilies need.
(00:49):
We're thrilled to have her onthe show and to unpack some of
the big trends and big decisionsshaping the future of community
based care.
So, melissa, thank you verymuch for your time this
afternoon and thank you verymuch for coming on to the show.
Melissa Smith (01:00):
Thank you so much for having me.
Dr Andrew Greenland (01:02):
So maybe we could start at the top.
Could you maybe share a littlebit about your role at NewView
and how your background in bothpediatric primary care and
mental health care plays out dayto day?
Melissa Smith (01:12):
Yes.
So I have been a nurse for 26years, got my NP in 2014 and
started to look at kind of thechanges I was seeing, especially
in pediatric mental health.
And my mom had got had canceraround the time and she was
working with a naturopath and itkind of dove into her treatment
(01:34):
and just the power of even dietalone with cancer and I started
to kind of question what wewere doing, especially in the
pediatric model.
So what we see a lot of now,because these children are
inundated with different toxins,is that they present with a lot
of behavior changes rangingfrom anywhere from, you know,
aggressive behavior to OCD, totics, to there's a range of them
(01:54):
, and so when I opened my clinic, I wanted to specialize in
especially PANS, which isPediatric Autoimmune
Neuropsychiatric Syndrome, andother autoimmune disorders,
especially in the pediatricworld, because it's a different
world we live in now than when Igrew up and my goal is to
provide functional, integrativehealth care that they can get to
(02:16):
the root cause of what'sdriving these changes that
you're seeing in kids.
Dr Andrew Greenland (02:20):
Amazing.
So what does a typical day looklike for you in your clinic?
At the moment, and I guessthere is no such thing as a
typical day, but how does itgenerally pan out for you?
Melissa Smith (02:29):
So we have, typically, I do, a combination
of also just traditional wellchecks and sick visits as well,
and then I do functionalmedicine.
So it kind of depends on whatthe visits are.
My functional medicine visitstend to be an hour a little bit
longer, and then the well checksand sick visits kind of fill
the spaces.
Right now I'm struggling alittle bit with being able to
get everybody seen.
I think this is definitely agrowing field.
(02:51):
People want this for sure.
I have patients that come fromout of state.
I have a lot of different,because they're looking for
someone who will look at theroot cause, and so my biggest
thing I'm trying to balanceright now is my schedule to be
able to have some downtime formyself but then to be able to
see everybody in a timelyfashion.
Dr Andrew Greenland (03:12):
And I guess you're quite unique in being
able to deliver sort offunctional medicine as well as
the mental health aspects.
And was that?
Did you see a gap for somethinglike this when you were kind of
thinking about what you do inNewView?
Melissa Smith (03:24):
So I think when you start to look at things
through a different lensspecifically, that really opened
my eyes.
I think, in mental health, whathappens, what I see a lot in
children is that they havelabels right.
They can have ADHD, they canhave autism, but what happens
when you get to the root causeis none of them are methylating
well, none of them are detoxingwell.
They have a lot of extra thingson board.
(03:46):
Their gut microbiome isn't in agood place and when you start
to balance things like that,these symptoms improve.
So it got me thinking.
You know, mental health is abig.
It's getting worse withchildren.
But my goal was to get to whatis driving this, what has
changed in our world from evenwhen I was younger, because we
didn't have the same amounts ofadhd and autism and all the
(04:07):
things that are rising as we didwhen I grew up.
So what's changing inenvironment, of course, is a big
player in all of this.
So my goal is to stare awayfrom labels and get to the root
cause, and the beautiful thingabout that is, once you do,
these kids get better.
I mean, I've seen autisticchildren get their speech back
right Just from gut microbiome,health and methylation support.
I've seen, you know, PANS.
(04:28):
Kids be able to return to theirnormal selves, where they're
not having anger outbursts andall of these these catastrophic
symptoms.
And these, these families thatcome in are in crisis.
I mean they're, they're livingin a crisis situation.
So when they come to me, it'slike you know what's wrong with
my child?
They've gone to all the regulardoctors and everyone said he's
fine, there's nothing wrong withthem.
But children, parents knowtheir children and they'll come
(04:51):
in and say, well, something'snot right, right.
And my response is always well,yeah, we need to look at, we
need to do the groundwork first.
Right, let's look at.
What does his gut microbiomelook like?
Dr Andrew Greenland (05:05):
Once you start to balance all of that,
it's amazing how well these kidsdo Amazing.
So I've had quite a fewconversations with practitioners
around the world and we've beenhearing a lot from small
clinics about the rising costs,more complex patient needs and
tech fatigue and what are youseeing any of these in your
world?
Or are you seeing any othershifts that sort of predominate
in your world?
Melissa Smith (05:22):
So cost is a big one.
And insurance, so in my clinicI don't take insurance.
The biggest reason is becausethere are different types of
appointments and so I and mostpeople, when they come for
functional medicine, they'rethey're more kind of prepared
for that because they want thetime.
But what I hear a lot of is,you know, insurance would cover
this, but the problem with thatis that the reimbursement on my
(05:45):
part isn't the time I put intothese appointments.
So that's where I struggle isfinding a balance between, um,
charging for your time and yourexpertise and then also being
cost effective, because Iobviously I mean that's a huge
part of this and I don't want tobe someone who's going to, you
know, price gouge people, peoplebut it is a balance, and so I
(06:05):
think that when you do this typeof medicine specifically, it's
very different.
Most people understand that.
Most people will say Iunderstand this isn't kind of
your routine.
I go and I have a sick visit, Iget an antibiotic right.
This is an hour appointment,digging into your whole history
and then addressing these rootcauses, and so most people
understand that.
Dr Andrew Greenland (06:27):
But that is always a concern for me is
trying to balance those costsAmazing.
And how do you balance the dualdemands of physical mental
health?
I mean, you mentioned PANS,which is a classical case of
there are physical and mentalhealth issues.
I'm just wondering how youmanaged to kind of package this
all up into a single visit.
Obviously, I know most patientshave more than one visit, but
how do you get the balance rightfor these kind of complicated
cases?
Melissa Smith (06:48):
So it's interesting because anything
mental so that could be anxiety,depression, ocd, I mean any of
them I have seen anecdotallythat it's 100% linked to the gut
microbiome.
So my conversation with parentsalways is let's go ahead and
kind of like, get this wholehistory, let's clear things.
Let's do ahead and kind of like, get this whole history, let's
clear things, let's do sometesting to dig into the root
(07:11):
cause and let's start to helpthe body do what it does.
Naturally, I always tell theparents it's like it can't put
out 12 fires.
It's trying but it can't, andso that's where you see symptoms
that happen, and I think it'svery reassuring and refreshing
for parents when they canunderstand the pathways.
So I will go through that withthem and show them this is what
your body is choosing to do andthis is why these symptoms occur
.
So I feel like any of these andmost people, at some point I'm
dealt with anxiety, depression,all the different things.
(07:33):
But there's a huge role intoxin burden in that.
There's a huge role inmethylation support in that, and
once you start to do that, thenI think you open a pathway.
So I think there's always aconnection there with mental
health, just because most of mykids have something ADHD is
another big one that I see a tonof and when you balance all of
that, those symptoms go away.
(07:53):
A lot of my children will comein on multiple medicines, which
is another big, you know, petpeeve of mine, because I'm
trying to kind of figure outthat.
That makes it a little moretricky right when they come in
with psychropic drugs beingtreated for different things
when they haven't done what Icall the groundwork, which is
always getting back to the rootcause, and the foundation, which
is always the gut microbiome.
So when you look at that, thenthey're able to come off these
(08:15):
medicines.
So there's kind of a balancethere.
But anything, any mentalconcerns, is 100% linked back to
the same thing.
Dr Andrew Greenland (08:25):
Interesting , I guess.
I don't know, but I'm guessingthat you probably see more child
and anxiety.
It certainly is becoming verypredominant in practice.
I just wondered how that'saffected demand for what you do.
There's this sort of epidemicof child anxiety and sort of
low-level mental health issuesand I just wondered how that
affects what comes through yourdoor.
Melissa Smith (08:46):
Yeah.
So that's a big reason why Ichose to start NewView, because
I couldn't change the lensanymore.
So I would have kids that wouldcome in, that would have severe
anxiety and the parents wouldwant them to go on different
medications.
And it's hard when you see whatyou can do on the other flip
side, which is diet, sleep right, all of the things that we
(09:07):
don't really address necessarilyin the traditional medicine
world because we have a15-minute appointment.
When you start to actually getto all of that, it's very
difficult to change that thoughtpattern.
So that's why I started NewViewand so I always tell parents
you know, yes, it's definitelysomething that we're going to
look at and we're looking at thewhole body, how the whole body
(09:30):
is working right.
What's driving this anxiety?
There's a lot to be said forovergrowth in the GI gut
microbiome that increasesdifferent neurotransmitter
levels and most of my childrenare high dopamine kids, right.
So they come in and they havevery high dopamine symptoms and
when you go into kind of clearall of that, it really does make
a huge difference.
So I think that's where my um,that's where I took a step back.
I wanted to start new thingsbecause I wanted to.
I couldn't see it through theother lens.
(09:51):
There's definitely a balancebetween, I always think,
functional medicine andtraditional medicine.
For sure, but I don't think intraditional medicine we do a
very good job of getting to thewhole thing, which is also diet,
sleep right, what's your stresslevel, are your cortisol levels
, and there's a lot to be saidfor all of that, and so what I
try to do is incorporate thatover, obviously, multiple visits
, because it can get to be a lotto try to balance that for them
(10:14):
.
Dr Andrew Greenland (10:15):
Amazing.
And tell me about your team.
Are you a one man person, a oneman band, or do you have a team
behind you?
How does it all work from ateam perspective at NewView?
Melissa Smith (10:29):
So it's just me as a primary practitioner right
now.
I do have a medical assistantand a receptionist, so it's kind
of a small practice right now.
We are growing, which is great.
So that's another thing.
I'm going to, as we continue togrow, have to kind of balance
it out because the demand isdefinitely increasing from my
time and so that's somethingthat talk about challenges with
small business practice.
That's a big challenge with mytime is balancing that out
between telehealth and alsomessages and you know all of the
(10:50):
different things.
So they do a great job ofhelping me with that and kind of
kind of helping to support mytime.
Dr Andrew Greenland (10:57):
Amazing and what's working particularly
well for you at the moment inyour practice Anything you can.
You're particularly proud ofanything that you kind of
champion in what you do.
Melissa Smith (11:06):
So I feel like I take a very different approach
to PANS.
Pandas, I think PANS is.
A lot of people get focused onthe antibody titers that can
drive these symptoms and my whatI look into I always go back to
gut health.
A big thing with PANS isantibiotic treatment, things
like that.
One of the things I steer awayfrom is that because, again, it
(11:29):
doesn't fix the root cause.
So I always said I kind of lookat PANS through a different lens
than most people do andanecdotally I can tell you it
works because I've seen it overthe years.
When I first started treatingit, I did it kind of like they
do right, they gave antibioticsand these patients get better,
but then I started to see thatthey didn't stay better and so
my question always was what'sgoing on right?
And so what was happening isyou lower dopamine levels for a
(11:52):
little bit with antibiotics, butit always comes back.
So that's why I'm proud of that, because I feel like I've kind
of come up with a really goodapproach now for PANS kids that
helps get to the root cause sothey don't have these recurrent
flares and you're not usingantibiotics and steroids and all
the things that really don'twork long term.
Dr Andrew Greenland (12:10):
Got it, and , on the flip side, is there
anything that you findparticularly frustrating or
challenging in what you do?
Melissa Smith (12:17):
I would say time management is probably my
hardest.
And what you do, I would saytime management is probably my
hardest, especially as we grow.
So when, when I have newpatients that come in, we do
functional medicine testing,there's always that follow up
that has to happen, and rightnow we're being pushed out
further and further.
So parents are getting a littlebit frustrated with that.
So I think that's a balance forme and I'm not.
We're kind of working throughthat that daily.
(12:39):
So what I try to do is when theycome in for that visit, always
get them on the schedule.
But if they're delayed insending off testing or whatever,
then they don't get on theschedule as quickly and then I
run into angry parents where thetest results come in and why
can't I get in to see me?
So I think time management ismy biggest challenge and but
having a team that helps me withthat is is huge.
That way it takes me kind ofout of that picture a little bit
(13:01):
.
So I'm not looking at theschedule and I'm not getting
overwhelmed, and that's a hugehelp, it's a release for me,
it's just a huge relief.
Dr Andrew Greenland (13:09):
So Got it and I mean you mentioned about
growth and you like wanting togrow and be able to offer your
services to more people.
So where would you like to bein sort of 12 months time?
Is it going to be sort of morepatients, more services, less
burnout?
Melissa Smith (13:22):
I'm not suggesting that you are burnt
out but a lot of practitionersare when do you want to go?
Yeah, I definitely think moregrowth and a balance.
So I do think burnout is a veryreal thing.
I think it's hard, especiallywhen you're dealing with very
emotionally charged cases.
A lot of my cases are verydifficult, they're very complex
and you have a lot of emotionswith the parents and the kids,
(13:44):
and so for me that I'm an empath, so I tend to absorb a lot of
that, so I do kind of I feellike I can be leaning towards
burnout quicker.
So my goal is to find a balancein this next year.
Right, I wanna help as manypeople with P as I can, because
I I know parents are looking forthat and it's a very real
diagnosis and it's somethingthat is can be treated.
(14:05):
But then on the flip side ismaking sure that I I can see the
patients I see and then I'mable to um also balance my home
life and my, my mental um, mymental health as well thank you.
Dr Andrew Greenland (14:19):
Um, so, in when you think about wanting to
grow and expand, have morepeople, what are the systems and
processes that are the hardestto scale from where you are to
where you want to be, do youthink?
Melissa Smith (14:36):
That's a very difficult question.
I don't know how to answer thatone.
I think most of my patientscome to me from word of mouth,
so I think that's where that'sbeing spread, that way kind of
word of mouth, and so I think Idon't even know how to really
answer that.
I think I just have to findthat balance as best I can, to
(14:56):
where I grow, but still becauseI don't want to grow to the
point where it's not it's notkind of personal right, then
they can get ahold of you andthat you are their doctor, that
you can.
So I don't want to grow into abig practice like that.
However, I know that the need ismuch growing and as people are
starting to look at changes inchildren's behaviors, they're
saying, okay, something else isgoing on here and, to be honest,
(15:17):
there are so many people, evenadults, walking around with
toxic issues, and so it's justone of those things that's going
to continue to grow and I thinkpeople are waking up.
Covid was a big game changerfor a lot of people and I think
that opened their eyes toalternative types of medicine
and like what's at the heart ofall of this.
So I think, keeping it personaland keeping it small, but then
again helping as many people asI can.
Dr Andrew Greenland (15:40):
So that's going to be a tricky balance to
find, completely understand.
And obviously functionalmedicine I mean, I'm in
functional medicine as well, soI completely understand what you
do and where you're coming fromStill regarded a little bit
alternative.
How are things in the US forthis?
I think functional medicine hasgot a bit of a better rap than
it has in the UK because it'sstill very small and very niche
over here and people haven'treally heard of it.
(16:00):
But do you see, is there anysort of a view taken by the
conventional medicalestablishment against things
like functional medicine in yourworld?
Melissa Smith (16:09):
Absolutely it's ignorance, I mean.
I just I think that theyhaven't well I know they haven't
done the research.
So parents are absolutelyasking more I think.
I think this demographic inpediatrics is different than
adults, because with kids,parents want to know what's
going on in their body, what'sbeing put into their children's
body right, what's at the heartof the treatment.
So this is very much a growingfield here very much, and I do
(16:33):
think COVID kind of put thatseed in people where they were
like okay, this vaccine seems alittle different.
This kind of got pushed through.
What about the other vaccines?
What about everything elsethat's happened?
What about what's in our food?
So it's very much growing here.
There are, we are receiving alot of pushback from traditional
medicine, especially when itcomes to vaccines in this
country, and so that is a bigdrive of what comes into to see
(16:54):
me because I don't.
I don't push vaccines, I don'tdo it because there's a it's not
a one size fits all, right.
So I always look at the biggerpicture and so I think that's a
big driver for a lot of parents.
But they're being dismissedfrom pediatric practices because
they don't follow their rulesright, and that's sad to me
because I think the research isdefinitely out there.
I think practitioners need toopen their minds a little bit
(17:14):
and look into it.
There's definitely research andso, anyway, I think it's more
ignorance and just not wantingto to learn more about what's in
the functional integrativemedicine world.
It's amazing when you do.
Dr Andrew Greenland (17:26):
Brilliant.
So on this sort of theme ofgrowth, because I'm very
interested in what you do andobviously very keen to see how
you expand and reach more people.
So if a genie handed you$100,000 grant tomorrow, how
would you invest it in yourpractice?
Melissa Smith (17:41):
handed you a hundred thousand dollar grant
tomorrow, how would you investit in your practice?
So one of the big things Ireally want to do is start to
train other professionals.
I feel like there is there's avery little research not really
research.
There's very little um on howto treat pants.
Most of the people that come tome they've done antibody titers
and that's it right.
So when they come to me we talkabout the much bigger picture.
(18:02):
I think there's a need in thecommunity for more practitioners
that are treating this for sure, and I would love to reach more
people to be able to say, hey,this is what I've seen through
the years.
That's worked.
This is a great way to start.
This is the testing that Irecommend.
You know, you kind of startwith and then people can start
(18:23):
to, because I think the burdenwould then be lifted off me a
little bit because people arelooking for that right.
So more getting moreinformation out there would be
probably how I would invest thatmoney, especially more into
traditional medicine doctors andlooking into this other side of
things and how it works.
Also doing research on my ownto what I see right and starting
to publish some things there tosay this is what I'm seeing in
the clinic, this is what'sworking, and just letting people
see, like what anecdotallyworks for in this type of
(18:44):
medicine.
Dr Andrew Greenland (18:47):
And are there any services or supports
you wish you could offer but youcan't do yet?
I know with growth it's allabout sort of trying to reach
out to more people.
Are there any things that you'dlike to be able to bring on
board as you kind of grow andexpand from your in your
practice?
Melissa Smith (19:00):
I would love to live to bring on, like
traditional or like Chinesemedicine or acupuncture or
different services, massageservices.
There's so many things that redlight, therapy, all the
different things to bring on andalso have as an adjunct with
that, because my practicefocuses on supplementation and
focuses on, you know, diet,support, sleep, but the other
(19:21):
part of that is so many thingsthat go beautifully with that
that I would love to offer forparents so that they can have it
all in one spot and havecomplimentary treatment as well.
Dr Andrew Greenland (19:31):
So true, true holistic care.
Melissa Smith (19:33):
Yes absolutely yes.
Dr Andrew Greenland (19:36):
And if I could get the same genie who's
also given you the $100,000grant to solve one big roadblock
or challenge?
What would that be?
Melissa Smith (19:46):
I think the biggest roadblock would probably
be understanding the differencebetween this type of medicine
and traditional.
And I say that because that isa common question I get from
parents why don't you takeinsurance?
Why don't you?
You know, why can't you get onboard with the insurance
companies?
And so I think, trying toexplain that this is a different
(20:06):
model and that this is adifferent approach, when they,
when they come and they see theapproach, it's a different, they
understand more.
But I think the phone calls Iget are always like well, she
doesn't take insurance, so I'mnot going to go to her, right,
and that's fine.
But I try to explain to peoplethis is the reason why I don't
take insurance.
So that's a big roadblock forme as far as getting people to
come and offer services.
(20:27):
And it hurt, hurts my heart alittle bit, because I've seen
people that haven't come becauseof that reason and I know that
I can help them.
And so that's where I kind ofgo back and forth, because I my
heart wants to help everybody.
I know I can't, but that'swhere the roadblock is with
insurance versus not takinginsurance.
Dr Andrew Greenland (20:46):
Amazing.
And finally, what do you?
Who do you look to forinspiration and guidance in this
space?
Is it other clinics, otherthought leaders, other mentors?
Who kind of gives you theinspiration to keep going and do
what you do?
Melissa Smith (20:57):
Yep.
So I did work under a physicianin the United States for a
little bit and got a lot of hismodels.
He was very inspirational forme.
Also, mosaic Diagnosticsthere's a lot of people through
them.
Dr Waller's one of them, drShaw.
All of those people that I goto for support and help because
some of my cases are verycomplex and that's also another
roadblock is findingpractitioners who understand the
(21:19):
testing I'm doing, can help mewith it because they are pretty
complex.
So those are my big supportpeople.
And then I'm always reading,always learning different types
of conferences and things likethat is just a huge inspiration.
Dr Andrew Greenland (21:33):
Brilliant.
So I think before we did therecording you were asking me
whether we have nursepractitioners in the UK, and we
do.
It's a much smaller thing.
Do you get any pushback frompeople coming to see you
expecting?
I don't know that.
We want to go and see a doctor.
Is there any pushback for nursepractitioners in the US or are
they very much a bedded in thing?
Melissa Smith (21:53):
So in different states it's different.
There's a lot of states wherewe don't practice under a
physician.
Georgia is one of the oneswhere we still do.
So the physician that I workunder though he's not on site,
he's actually in South Georgiaand so, yes, I do receive that
sometimes.
But when you sit down and talkto people and explain your role,
then that clears it up prettyquickly.
(22:15):
Most people, to be honest, ifyou ask them, would you rather
see a nurse practitioner ordoctor, they're going to tell
you a nurse practitioner becausethey are more holistic in their
care.
They tend to be more nurses.
So we just a little bitdifferent approach to things.
So most people are incrediblyreceptive to that and if there
is any of that kind of questions, I always sit down and say this
is kind of what our role is,what we do, and this is in
(22:38):
Georgia how this works right andpeople are very supportive of
that.
Dr Andrew Greenland (22:41):
Amazing.
Melissa, thank you so much foryour time this afternoon.
It's been a really interestingconversation, really interesting
to hear what you do.
The people that you serve andyou know from one functional
medicine practitioner to another, I mean really appreciate what
you do because we're definitelyon the same page.
I love your approach.
I love the fact that you'reable to integrate mental health
into what you do.
I think that's a really usefuland helpful case mix for the
(23:03):
patients that you treat.
But thank you so much for yourtime and talking to me this
afternoon.
Melissa Smith (23:07):
And thank you so much for having me.
I so enjoyed it.
Dr Andrew Greenland (23:09):
You're welcome.
Welcome back to Voices in Health and
Wellness.
This is the show where wespotlight the bold thinkers and
frontline leaders reshapinghealthcare from the ground up.
I'm your host, andrew Greenland, and today we're diving into a
powerful conversation around thefuture of small health clinics,
what's working, what's keepingclinic leaders up at night and
where we go from here.
So our guest today brings anincredible dual perspective to
the table.
She's both a certifiedpaediatric nurse practitioner
(00:27):
and a certified paediatricmental health specialist.
Melissa Smith is the founder ofNewView Integrative Paediatrics
in Watkinsville, georgia, whereshe's created a care model that
fuses medical and mental healthsupport for kids and families
under one roof.
In a time where many clinicsare stretched thin, melissa's
approach is a breath of freshair focused, compassionate,
deeply responsive to what modernfamilies need.
(00:49):
We're thrilled to have her onthe show and to unpack some of
the big trends and big decisionsshaping the future of community
based care.
So, melissa, thank you verymuch for your time this
afternoon and thank you verymuch for coming on to the show.
Melissa Smith (01:00):
Thank you so much for having me.
Dr Andrew Greenland (01:02):
So maybe we could start at the top.
Could you maybe share a littlebit about your role at NewView
and how your background in bothpediatric primary care and
mental health care plays out dayto day?
Melissa Smith (01:12):
Yes.
So I have been a nurse for 26years, got my NP in 2014 and
started to look at kind of thechanges I was seeing, especially
in pediatric mental health.
And my mom had got had canceraround the time and she was
working with a naturopath and itkind of dove into her treatment
(01:34):
and just the power of even dietalone with cancer and I started
to kind of question what wewere doing, especially in the
pediatric model.
So what we see a lot of now,because these children are
inundated with different toxins,is that they present with a lot
of behavior changes rangingfrom anywhere from, you know,
aggressive behavior to OCD, totics, to there's a range of them
(01:54):
, and so when I opened my clinic, I wanted to specialize in
especially PANS, which isPediatric Autoimmune
Neuropsychiatric Syndrome, andother autoimmune disorders,
especially in the pediatricworld, because it's a different
world we live in now than when Igrew up and my goal is to
provide functional, integrativehealth care that they can get to
(02:16):
the root cause of what'sdriving these changes that
you're seeing in kids.
Dr Andrew Greenland (02:20):
Amazing.
So what does a typical day looklike for you in your clinic?
At the moment, and I guessthere is no such thing as a
typical day, but how does itgenerally pan out for you?
Melissa Smith (02:29):
So we have, typically, I do, a combination
of also just traditional wellchecks and sick visits as well,
and then I do functionalmedicine.
So it kind of depends on whatthe visits are.
My functional medicine visitstend to be an hour a little bit
longer, and then the well checksand sick visits kind of fill
the spaces.
Right now I'm struggling alittle bit with being able to
get everybody seen.
I think this is definitely agrowing field.
(02:51):
People want this for sure.
I have patients that come fromout of state.
I have a lot of different,because they're looking for
someone who will look at theroot cause, and so my biggest
thing I'm trying to balanceright now is my schedule to be
able to have some downtime formyself but then to be able to
see everybody in a timelyfashion.
Dr Andrew Greenland (03:12):
And I guess you're quite unique in being
able to deliver sort offunctional medicine as well as
the mental health aspects.
And was that?
Did you see a gap for somethinglike this when you were kind of
thinking about what you do inNewView?
Melissa Smith (03:24):
So I think when you start to look at things
through a different lensspecifically, that really opened
my eyes.
I think, in mental health, whathappens, what I see a lot in
children is that they havelabels right.
They can have ADHD, they canhave autism, but what happens
when you get to the root causeis none of them are methylating
well, none of them are detoxingwell.
They have a lot of extra thingson board.
(03:46):
Their gut microbiome isn't in agood place and when you start
to balance things like that,these symptoms improve.
So it got me thinking.
You know, mental health is abig.
It's getting worse withchildren.
But my goal was to get to whatis driving this, what has
changed in our world from evenwhen I was younger, because we
didn't have the same amounts ofadhd and autism and all the
(04:07):
things that are rising as we didwhen I grew up.
So what's changing inenvironment, of course, is a big
player in all of this.
So my goal is to stare awayfrom labels and get to the root
cause, and the beautiful thingabout that is, once you do,
these kids get better.
I mean, I've seen autisticchildren get their speech back
right Just from gut microbiome,health and methylation support.
I've seen, you know, PANS.
(04:28):
Kids be able to return to theirnormal selves, where they're
not having anger outbursts andall of these these catastrophic
symptoms.
And these, these families thatcome in are in crisis.
I mean they're, they're livingin a crisis situation.
So when they come to me, it'slike you know what's wrong with
my child?
They've gone to all the regulardoctors and everyone said he's
fine, there's nothing wrong withthem.
But children, parents knowtheir children and they'll come
(04:51):
in and say, well, something'snot right, right.
And my response is always well,yeah, we need to look at, we
need to do the groundwork first.
Right, let's look at.
What does his gut microbiomelook like?
Dr Andrew Greenland (05:05):
Once you start to balance all of that,
it's amazing how well these kidsdo Amazing.
So I've had quite a fewconversations with practitioners
around the world and we've beenhearing a lot from small
clinics about the rising costs,more complex patient needs and
tech fatigue and what are youseeing any of these in your
world?
Or are you seeing any othershifts that sort of predominate
in your world?
Melissa Smith (05:22):
So cost is a big one.
And insurance, so in my clinicI don't take insurance.
The biggest reason is becausethere are different types of
appointments and so I and mostpeople, when they come for
functional medicine, they'rethey're more kind of prepared
for that because they want thetime.
But what I hear a lot of is,you know, insurance would cover
this, but the problem with thatis that the reimbursement on my
(05:45):
part isn't the time I put intothese appointments.
So that's where I struggle isfinding a balance between, um,
charging for your time and yourexpertise and then also being
cost effective, because Iobviously I mean that's a huge
part of this and I don't want tobe someone who's going to, you
know, price gouge people, peoplebut it is a balance, and so I
(06:05):
think that when you do this typeof medicine specifically, it's
very different.
Most people understand that.
Most people will say Iunderstand this isn't kind of
your routine.
I go and I have a sick visit, Iget an antibiotic right.
This is an hour appointment,digging into your whole history
and then addressing these rootcauses, and so most people
understand that.
Dr Andrew Greenland (06:27):
But that is always a concern for me is
trying to balance those costsAmazing.
And how do you balance the dualdemands of physical mental
health?
I mean, you mentioned PANS,which is a classical case of
there are physical and mentalhealth issues.
I'm just wondering how youmanaged to kind of package this
all up into a single visit.
Obviously, I know most patientshave more than one visit, but
how do you get the balance rightfor these kind of complicated
cases?
Melissa Smith (06:48):
So it's interesting because anything
mental so that could be anxiety,depression, ocd, I mean any of
them I have seen anecdotallythat it's 100% linked to the gut
microbiome.
So my conversation with parentsalways is let's go ahead and
kind of like, get this wholehistory, let's clear things.
Let's do ahead and kind of like, get this whole history, let's
clear things, let's do sometesting to dig into the root
(07:11):
cause and let's start to helpthe body do what it does.
Naturally, I always tell theparents it's like it can't put
out 12 fires.
It's trying but it can't, andso that's where you see symptoms
that happen, and I think it'svery reassuring and refreshing
for parents when they canunderstand the pathways.
So I will go through that withthem and show them this is what
your body is choosing to do andthis is why these symptoms occur
.
So I feel like any of these andmost people, at some point I'm
dealt with anxiety, depression,all the different things.
(07:33):
But there's a huge role intoxin burden in that.
There's a huge role inmethylation support in that, and
once you start to do that, thenI think you open a pathway.
So I think there's always aconnection there with mental
health, just because most of mykids have something ADHD is
another big one that I see a tonof and when you balance all of
that, those symptoms go away.
(07:53):
A lot of my children will comein on multiple medicines, which
is another big, you know, petpeeve of mine, because I'm
trying to kind of figure outthat.
That makes it a little moretricky right when they come in
with psychropic drugs beingtreated for different things
when they haven't done what Icall the groundwork, which is
always getting back to the rootcause, and the foundation, which
is always the gut microbiome.
So when you look at that, thenthey're able to come off these
(08:15):
medicines.
So there's kind of a balancethere.
But anything, any mentalconcerns, is 100% linked back to
the same thing.
Dr Andrew Greenland (08:25):
Interesting , I guess.
I don't know, but I'm guessingthat you probably see more child
and anxiety.
It certainly is becoming verypredominant in practice.
I just wondered how that'saffected demand for what you do.
There's this sort of epidemicof child anxiety and sort of
low-level mental health issuesand I just wondered how that
affects what comes through yourdoor.
Melissa Smith (08:46):
Yeah.
So that's a big reason why Ichose to start NewView, because
I couldn't change the lensanymore.
So I would have kids that wouldcome in, that would have severe
anxiety and the parents wouldwant them to go on different
medications.
And it's hard when you see whatyou can do on the other flip
side, which is diet, sleep right, all of the things that we
(09:07):
don't really address necessarilyin the traditional medicine
world because we have a15-minute appointment.
When you start to actually getto all of that, it's very
difficult to change that thoughtpattern.
So that's why I started NewViewand so I always tell parents
you know, yes, it's definitelysomething that we're going to
look at and we're looking at thewhole body, how the whole body
(09:30):
is working right.
What's driving this anxiety?
There's a lot to be said forovergrowth in the GI gut
microbiome that increasesdifferent neurotransmitter
levels and most of my childrenare high dopamine kids, right.
So they come in and they havevery high dopamine symptoms and
when you go into kind of clearall of that, it really does make
a huge difference.
So I think that's where my um,that's where I took a step back.
I wanted to start new thingsbecause I wanted to.
I couldn't see it through theother lens.
(09:51):
There's definitely a balancebetween, I always think,
functional medicine andtraditional medicine.
For sure, but I don't think intraditional medicine we do a
very good job of getting to thewhole thing, which is also diet,
sleep right, what's your stresslevel, are your cortisol levels
, and there's a lot to be saidfor all of that, and so what I
try to do is incorporate thatover, obviously, multiple visits
, because it can get to be a lotto try to balance that for them
(10:14):
.
Dr Andrew Greenland (10:15):
Amazing.
And tell me about your team.
Are you a one man person, a oneman band, or do you have a team
behind you?
How does it all work from ateam perspective at NewView?
Melissa Smith (10:29):
So it's just me as a primary practitioner right
now.
I do have a medical assistantand a receptionist, so it's kind
of a small practice right now.
We are growing, which is great.
So that's another thing.
I'm going to, as we continue togrow, have to kind of balance
it out because the demand isdefinitely increasing from my
time and so that's somethingthat talk about challenges with
small business practice.
That's a big challenge with mytime is balancing that out
between telehealth and alsomessages and you know all of the
(10:50):
different things.
So they do a great job ofhelping me with that and kind of
kind of helping to support mytime.
Dr Andrew Greenland (10:57):
Amazing and what's working particularly
well for you at the moment inyour practice Anything you can.
You're particularly proud ofanything that you kind of
champion in what you do.
Melissa Smith (11:06):
So I feel like I take a very different approach
to PANS.
Pandas, I think PANS is.
A lot of people get focused onthe antibody titers that can
drive these symptoms and my whatI look into I always go back to
gut health.
A big thing with PANS isantibiotic treatment, things
like that.
One of the things I steer awayfrom is that because, again, it
(11:29):
doesn't fix the root cause.
So I always said I kind of lookat PANS through a different lens
than most people do andanecdotally I can tell you it
works because I've seen it overthe years.
When I first started treatingit, I did it kind of like they
do right, they gave antibioticsand these patients get better,
but then I started to see thatthey didn't stay better and so
my question always was what'sgoing on right?
And so what was happening isyou lower dopamine levels for a
(11:52):
little bit with antibiotics, butit always comes back.
So that's why I'm proud of that, because I feel like I've kind
of come up with a really goodapproach now for PANS kids that
helps get to the root cause sothey don't have these recurrent
flares and you're not usingantibiotics and steroids and all
the things that really don'twork long term.
Dr Andrew Greenland (12:10):
Got it, and , on the flip side, is there
anything that you findparticularly frustrating or
challenging in what you do?
Melissa Smith (12:17):
I would say time management is probably my
hardest.
And what you do, I would saytime management is probably my
hardest, especially as we grow.
So when, when I have newpatients that come in, we do
functional medicine testing,there's always that follow up
that has to happen, and rightnow we're being pushed out
further and further.
So parents are getting a littlebit frustrated with that.
So I think that's a balance forme and I'm not.
We're kind of working throughthat that daily.
(12:39):
So what I try to do is when theycome in for that visit, always
get them on the schedule.
But if they're delayed insending off testing or whatever,
then they don't get on theschedule as quickly and then I
run into angry parents where thetest results come in and why
can't I get in to see me?
So I think time management ismy biggest challenge and but
having a team that helps me withthat is is huge.
That way it takes me kind ofout of that picture a little bit
(13:01):
.
So I'm not looking at theschedule and I'm not getting
overwhelmed, and that's a hugehelp, it's a release for me,
it's just a huge relief.
Dr Andrew Greenland (13:09):
So Got it and I mean you mentioned about
growth and you like wanting togrow and be able to offer your
services to more people.
So where would you like to bein sort of 12 months time?
Is it going to be sort of morepatients, more services, less
burnout?
Melissa Smith (13:22):
I'm not suggesting that you are burnt
out but a lot of practitionersare when do you want to go?
Yeah, I definitely think moregrowth and a balance.
So I do think burnout is a veryreal thing.
I think it's hard, especiallywhen you're dealing with very
emotionally charged cases.
A lot of my cases are verydifficult, they're very complex
and you have a lot of emotionswith the parents and the kids,
(13:44):
and so for me that I'm an empath, so I tend to absorb a lot of
that, so I do kind of I feellike I can be leaning towards
burnout quicker.
So my goal is to find a balancein this next year.
Right, I wanna help as manypeople with P as I can, because
I I know parents are looking forthat and it's a very real
diagnosis and it's somethingthat is can be treated.
(14:05):
But then on the flip side ismaking sure that I I can see the
patients I see and then I'mable to um also balance my home
life and my, my mental um, mymental health as well thank you.
Dr Andrew Greenland (14:19):
Um, so, in when you think about wanting to
grow and expand, have morepeople, what are the systems and
processes that are the hardestto scale from where you are to
where you want to be, do youthink?
Melissa Smith (14:36):
That's a very difficult question.
I don't know how to answer thatone.
I think most of my patientscome to me from word of mouth,
so I think that's where that'sbeing spread, that way kind of
word of mouth, and so I think Idon't even know how to really
answer that.
I think I just have to findthat balance as best I can, to
(14:56):
where I grow, but still becauseI don't want to grow to the
point where it's not it's notkind of personal right, then
they can get ahold of you andthat you are their doctor, that
you can.
So I don't want to grow into abig practice like that.
However, I know that the need ismuch growing and as people are
starting to look at changes inchildren's behaviors, they're
saying, okay, something else isgoing on here and, to be honest,
(15:17):
there are so many people, evenadults, walking around with
toxic issues, and so it's justone of those things that's going
to continue to grow and I thinkpeople are waking up.
Covid was a big game changerfor a lot of people and I think
that opened their eyes toalternative types of medicine
and like what's at the heart ofall of this.
So I think, keeping it personaland keeping it small, but then
again helping as many people asI can.
Dr Andrew Greenland (15:40):
So that's going to be a tricky balance to
find, completely understand.
And obviously functionalmedicine I mean, I'm in
functional medicine as well, soI completely understand what you
do and where you're coming fromStill regarded a little bit
alternative.
How are things in the US forthis?
I think functional medicine hasgot a bit of a better rap than
it has in the UK because it'sstill very small and very niche
over here and people haven'treally heard of it.
(16:00):
But do you see, is there anysort of a view taken by the
conventional medicalestablishment against things
like functional medicine in yourworld?
Melissa Smith (16:09):
Absolutely it's ignorance, I mean.
I just I think that theyhaven't well I know they haven't
done the research.
So parents are absolutelyasking more I think.
I think this demographic inpediatrics is different than
adults, because with kids,parents want to know what's
going on in their body, what'sbeing put into their children's
body right, what's at the heartof the treatment.
So this is very much a growingfield here very much, and I do
(16:33):
think COVID kind of put thatseed in people where they were
like okay, this vaccine seems alittle different.
This kind of got pushed through.
What about the other vaccines?
What about everything elsethat's happened?
What about what's in our food?
So it's very much growing here.
There are, we are receiving alot of pushback from traditional
medicine, especially when itcomes to vaccines in this
country, and so that is a bigdrive of what comes into to see
(16:54):
me because I don't.
I don't push vaccines, I don'tdo it because there's a it's not
a one size fits all, right.
So I always look at the biggerpicture and so I think that's a
big driver for a lot of parents.
But they're being dismissedfrom pediatric practices because
they don't follow their rulesright, and that's sad to me
because I think the research isdefinitely out there.
I think practitioners need toopen their minds a little bit
(17:14):
and look into it.
There's definitely research andso, anyway, I think it's more
ignorance and just not wantingto to learn more about what's in
the functional integrativemedicine world.
It's amazing when you do.
Dr Andrew Greenland (17:26):
Brilliant.
So on this sort of theme ofgrowth, because I'm very
interested in what you do andobviously very keen to see how
you expand and reach more people.
So if a genie handed you$100,000 grant tomorrow, how
would you invest it in yourpractice?
Melissa Smith (17:41):
handed you a hundred thousand dollar grant
tomorrow, how would you investit in your practice?
So one of the big things Ireally want to do is start to
train other professionals.
I feel like there is there's avery little research not really
research.
There's very little um on howto treat pants.
Most of the people that come tome they've done antibody titers
and that's it right.
So when they come to me we talkabout the much bigger picture.
(18:02):
I think there's a need in thecommunity for more practitioners
that are treating this for sure, and I would love to reach more
people to be able to say, hey,this is what I've seen through
the years.
That's worked.
This is a great way to start.
This is the testing that Irecommend.
You know, you kind of startwith and then people can start
(18:23):
to, because I think the burdenwould then be lifted off me a
little bit because people arelooking for that right.
So more getting moreinformation out there would be
probably how I would invest thatmoney, especially more into
traditional medicine doctors andlooking into this other side of
things and how it works.
Also doing research on my ownto what I see right and starting
to publish some things there tosay this is what I'm seeing in
the clinic, this is what'sworking, and just letting people
see, like what anecdotallyworks for in this type of
(18:44):
medicine.
Dr Andrew Greenland (18:47):
And are there any services or supports
you wish you could offer but youcan't do yet?
I know with growth it's allabout sort of trying to reach
out to more people.
Are there any things that you'dlike to be able to bring on
board as you kind of grow andexpand from your in your
practice?
Melissa Smith (19:00):
I would love to live to bring on, like
traditional or like Chinesemedicine or acupuncture or
different services, massageservices.
There's so many things that redlight, therapy, all the
different things to bring on andalso have as an adjunct with
that, because my practicefocuses on supplementation and
focuses on, you know, diet,support, sleep, but the other
(19:21):
part of that is so many thingsthat go beautifully with that
that I would love to offer forparents so that they can have it
all in one spot and havecomplimentary treatment as well.
Dr Andrew Greenland (19:31):
So true, true holistic care.
Melissa Smith (19:33):
Yes absolutely yes.
Dr Andrew Greenland (19:36):
And if I could get the same genie who's
also given you the $100,000grant to solve one big roadblock
or challenge?
What would that be?
Melissa Smith (19:46):
I think the biggest roadblock would probably
be understanding the differencebetween this type of medicine
and traditional.
And I say that because that isa common question I get from
parents why don't you takeinsurance?
Why don't you?
You know, why can't you get onboard with the insurance
companies?
And so I think, trying toexplain that this is a different
(20:06):
model and that this is adifferent approach, when they,
when they come and they see theapproach, it's a different, they
understand more.
But I think the phone calls Iget are always like well, she
doesn't take insurance, so I'mnot going to go to her, right,
and that's fine.
But I try to explain to peoplethis is the reason why I don't
take insurance.
So that's a big roadblock forme as far as getting people to
come and offer services.
(20:27):
And it hurt, hurts my heart alittle bit, because I've seen
people that haven't come becauseof that reason and I know that
I can help them.
And so that's where I kind ofgo back and forth, because I my
heart wants to help everybody.
I know I can't, but that'swhere the roadblock is with
insurance versus not takinginsurance.
Dr Andrew Greenland (20:46):
Amazing.
And finally, what do you?
Who do you look to forinspiration and guidance in this
space?
Is it other clinics, otherthought leaders, other mentors?
Who kind of gives you theinspiration to keep going and do
what you do?
Melissa Smith (20:57):
Yep.
So I did work under a physicianin the United States for a
little bit and got a lot of hismodels.
He was very inspirational forme.
Also, mosaic Diagnosticsthere's a lot of people through
them.
Dr Waller's one of them, drShaw.
All of those people that I goto for support and help because
some of my cases are verycomplex and that's also another
roadblock is findingpractitioners who understand the
(21:19):
testing I'm doing, can help mewith it because they are pretty
complex.
So those are my big supportpeople.
And then I'm always reading,always learning different types
of conferences and things likethat is just a huge inspiration.
Dr Andrew Greenland (21:33):
Brilliant.
So I think before we did therecording you were asking me
whether we have nursepractitioners in the UK, and we
do.
It's a much smaller thing.
Do you get any pushback frompeople coming to see you
expecting?
I don't know that.
We want to go and see a doctor.
Is there any pushback for nursepractitioners in the US or are
they very much a bedded in thing?
Melissa Smith (21:53):
So in different states it's different.
There's a lot of states wherewe don't practice under a
physician.
Georgia is one of the oneswhere we still do.
So the physician that I workunder though he's not on site,
he's actually in South Georgiaand so, yes, I do receive that
sometimes.
But when you sit down and talkto people and explain your role,
then that clears it up prettyquickly.
(22:15):
Most people, to be honest, ifyou ask them, would you rather
see a nurse practitioner ordoctor, they're going to tell
you a nurse practitioner becausethey are more holistic in their
care.
They tend to be more nurses.
So we just a little bitdifferent approach to things.
So most people are incrediblyreceptive to that and if there
is any of that kind of questions, I always sit down and say this
is kind of what our role is,what we do, and this is in
(22:38):
Georgia how this works right andpeople are very supportive of
that.
Dr Andrew Greenland (22:41):
Amazing.
Melissa, thank you so much foryour time this afternoon.
It's been a really interestingconversation, really interesting
to hear what you do.
The people that you serve andyou know from one functional
medicine practitioner to another, I mean really appreciate what
you do because we're definitelyon the same page.
I love your approach.
I love the fact that you'reable to integrate mental health
into what you do.
I think that's a really usefuland helpful case mix for the
(23:03):
patients that you treat.
But thank you so much for yourtime and talking to me this
afternoon.
Melissa Smith (23:07):
And thank you so much for having me.
I so enjoyed it.
Dr Andrew Greenland (23:09):
You're welcome.
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Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.
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If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.