Most mental health care is built for speed, not understanding and patients feel it. When appointments are short and the plan is mostly symptom management, even smart, motivated people can end up “stable” but nowhere near well. We sit down with psychiatrist and healthcare innovator Dr Sonia Diaz, founder and medical director of Wellmivia Medical, to talk about what changes when you stop treating diagnoses like destinations and start treating the whole person.
We dig into precision psychiatry and metabolic psychiatry, including why blood sugar swings can destabilise mood, how thyroid dysfunction can look like depression or anxiety, and why hormonal health such as testosterone may sit quietly behind fatigue, low drive, and poor sleep. Dr Diaz also explains how pharmacogenetics and pharmacogenomics can guide medication choices, not as a gimmick, but as a way to reduce trial-and-error and tailor treatment to real biology and real life.
You will also hear the practical side of building a modern practice: direct pay and concierge psychiatry, a 90-minute evaluation model, what patients actually value most (time, trust, and direct access), and why some premium telehealth platforms deliver slick experiences without better outcomes. We finish with a grounded look at AI in healthcare, where it helps, where it does not, and how smart documentation tools can restore human connection instead of replacing it.
If you care about better mental health outcomes, more personalised care, and the future of psychiatry, subscribe, share this with a colleague or friend, and leave us a review with your biggest takeaway.
Guest Biogrophy
Dr. Sonia Mia Diaz, MD is a psychiatrist, healthcare innovator, and founder of Welmivia Medical, a direct-pay precision psychiatry practice serving patients in Virginia and Florida.
Drawing on experience in academic medicine, community psychiatry, and healthcare innovation, Dr. Diaz takes a root-cause approach to mental health by integrating psychiatric care with metabolic, hormonal, and lifestyle factors. Her work focuses on helping high-performing professionals optimise both mental wellbeing and overall function.
Dr. Diaz has also worked as a physician expert in AI and is exploring how artificial intelligence can help clinicians deliver more personalised care while reducing administrative burden. Through Welmivia, she is building a modern model of psychiatry that combines technology, accessibility, and deeply individualised care.
Links
- Website: https://welmivia.com
- LinkedIn: https://www.linkedin.com/in/sonia-mia-diaz-md/
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Voices in Health and Wellness features conversations at the intersection of medicine, lifestyle, and human potential, with clinicians, scientists, and thinkers shaping the future of care.
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UK-based medical doctor and founder of Greenland Medical, specialising in Integrative and Functional Medicine. Trained in both conventional and root-cause approaches, Andrew helps people optimise health, performance, and longevity, with a focus on cognitive resilience and healthy ageing.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr Andrew Greenland (00:00):
So, welcome back to Voices in Health and
Wellness.
This is the podcast where wespeak with practitioners,
founders, and innovators who arereshaping the future of
healthcare.
Today I'm joined by Dr.
Sonia Diaz, founder and medicaldirector of Wellmvia Medical.
Sonia is a psychiatrist andhealthcare innovator who has
taken a very different path fromthe traditional model of mental
healthcare.
(00:20):
Through Whelmvia, she'sbuilding what she calls a
precision psychiatry practice,one that looks beyond symptom
management and considers thebroader metabolic, hormonal, and
lifestyle factors thatinfluence mental well-being.
So with that, Sonia, I'd loveto welcome you to the show and
thank you so much for joining ustoday.
Dr Sonia Diaz (00:36):
Yeah, thank you so much, Dr.
Greenland.
I'm uh I'm really excited justto share more and kind of talk
about uh how I view healthcareand how I'm trying to do my part
to address it.
Dr Andrew Greenland (00:46):
Fantastic.
So maybe we could start withyour story.
You've had experience withintraditional medicine and
academic environments beforelaunching Wellvia.
What ultimately led you to stepaway and build your own
practice?
Dr Sonia Diaz (00:58):
I think a big part of it was that throughout
all this practice, because likeyou said, I had worked at a
large academic medical center atstarts in my training, and I
did a lot of community work aswell throughout that training.
And I think what it was is Ikept on seeing kind of the same
patterns repeat themselves overand over and over again.
And one of them that I saw waskind of smart, really
(01:21):
high-functioning people.
They'd been through the system,you know, they had a prescriber
or multiple, they had atherapist, they had
prescriptions, um, but theystill just they still felt stuck
and they still weren't gettingwell.
And it wasn't because, youknow, their providers didn't
care, it wasn't because, youknow, that there was, you know,
(01:43):
something that somebody wasmissing.
It just was that thetraditional system that we have
built doesn't really allowpatients or providers the time
to really get to the bottom andreally look closely enough and
figure out, hey, what's going onhere?
So it uh was quite thedeparture, I guess, from what I
was hearing.
But I think that was the main,that was the main driver.
(02:05):
Um, just not having enough timeto really get the full picture
and really start treating likepatients, like holistically.
Dr Andrew Greenland (02:15):
Thank you.
Really helpful context.
Um, so we said that's somethingyou kind of picked up over your
career and realized that thingsweren't really aligned with
where you were thinking.
Was there a particular momentor patient experience that
really kind of triggered youinto making that leap?
Dr Sonia Diaz (02:29):
I think honestly, I think it was um right when I
had uh left my training program,and a couple of um my
colleagues had graduated.
And like I said, these people,you know, they were
psychiatrists.
So it's not like they wereunaware of healthcare.
Um, you know, they went totheir appointments, they had
their 15-minute med management,but a lot of them were just
(02:52):
dealing with so much that wasn'tbeing addressed.
And it again was talking to allof them, talking to my
colleagues, my peers, andsaying, like, what are you
dealing with?
And you know, you're fine,you're functioning, but you're
not really optimized.
And I think that's where itcame from.
Just looking around at mypeers.
Um, the similar I had a similarexperience with my partner who
(03:16):
was in a uh MBA program andlooking at his peers.
And it, like I said, that samepattern emerged not only with my
patients, but with my peers aswell.
And I think at that moment whenI was making the shift, it kind
of hit for me that um therereally is like a need here that
isn't really being addressed.
Dr Andrew Greenland (03:34):
Got it.
So, were there any fears orreservations that you had about
leaving a more conventionalpath?
Dr Sonia Diaz (03:41):
Um, completely.
I mean, I think everybody does,you know.
I didn't want people to thinkthat like I was a quack, right?
I'm a psychiatrist.
So it's easy, it's easy to makethe jump.
I didn't want people to thinkthat I was kind of um, you know,
being arrogant and saying,well, I'm gonna take over and do
this whole managed care.
Because that's not what I'mdoing either.
I am practicing psychiatry, butwith a bio-psychosocial model
(04:05):
that incorporates the entireperson.
And I think like once Iactually started building and
started kind of talking topeople and saying, hey, this is
what I want to do.
Does this seem what is this,you know, how does this sound?
Um, I kind of gained moreconfidence, you know.
It wasn't kind of out of thebox.
It wasn't something, you know,that is so, you know, out of
(04:29):
left field that people weregonna be scared of it, but it
was just innovative enough thatkind of made me pause.
And like I said, with talkingto people, I realized, you know,
this really shouldn't beinnovative.
This kind of should be thestandard.
Um, so I think that helped kindof just starting to build and
really seeing that this waspossible, that it wasn't
(04:49):
something that I had to wait 10,20 years to do and establish
myself, you know, in the fieldas some kind of voice.
Like I'm a physician, I havethis training and I know how to
help patients.
And once I grounded it inthere, I think a lot of the fear
like started falling away.
Dr Andrew Greenland (05:04):
Thank you.
So, what was it that you wantedto create that simply wasn't
possible within the traditionalmodel?
Dr Sonia Diaz (05:09):
And you really need to dive into the weeds here
and kind of pick out what wasYeah, I think what it comes down
to, like what I really wantedto create was I wanted to
actually give people patientsaccess, direct access to their
physician.
I wanted people to have directaccess to an expert that they
trusted to ask questions.
(05:30):
And I think like we see it allthe time with like, I mean,
there's two new studies comingout all the time about the
amount of misinformation onsocial media, especially
surrounding, you know, medicineand healthcare, and particularly
surrounding mental health careas well.
And I think a lot of that isdriven by people really not
having that trusted resource,you know, and even their doctors
that they have, you know, theytrust them to a certain degree,
(05:52):
but again, 15-minute medmanagement appointments, you
really can't cultivate thatrelationship where you really
can understand each other aspeople and kind of move forward
with their treatment in aholistic way.
So I think that's really one Iwant to provide people.
You know, it's very confusing,it's very scary when you have
something going on and you don'treally know.
I wanted to be able to be, hey,listen, I am a resource that
(06:14):
will be able to give you myundivided attention and all of
the skills that I have at mydisposal to try to figure out
what's going on.
Dr Andrew Greenland (06:21):
Amazing.
So you describe your approachas precision psychiatry.
So for people that hadn't heardthat term before, what does it
actually mean?
Give us a kind of a snapshot.
Dr Sonia Diaz (06:31):
So I think um it's not, I don't, it's it's not
as uh fancy as some people liketo think, but um it really is
instead of kind of narrowing inon, you know, one diagnosis, one
set of symptoms, and treatingthem and or masking them with
medication.
It's that the treat, it's theidea that treatment should be
(06:54):
built around the individual,never the diagnosis.
So two people can walk in, samedepressive symptoms, same pHQ
score, and still have completelydifferent interventions that
actually help them based ontheir genetics, their
metabolism, their lifestyle.
So it really is the idea thattreatment is not
diagnosis-focused, symptomfocused, it is person-focused.
Dr Andrew Greenland (07:20):
Thank you, really clear.
And I know you have a veryholistic approach to what you
do.
So, what role do metabolic orhormonal health as examples play
in mental well-being?
Dr Sonia Diaz (07:30):
So a huge role.
Um, one of the things that Ifound is that I mean, like just
pulling it back, just basically,if somebody isn't optimized
metabolically, if they're reallystruggling, they're having
issues, um medication managementmight not be like the best like
(07:52):
first course action becausethey might not even their bodies
might not even be processingthese medical interventions like
optimally.
Also, like there is a hugelevel of um metabolism that is
influenced by our genetics.
So, another thing that I liketo incorporate is
pharmacogenetics in that.
So that we're making sure thatthe medications that we do use
(08:15):
to treat are actually ones thatare the most likely to be
effective, um, based off, like Isaid, a hormonal profile,
metabolic profile, geneticprofile.
And they're not, I mean,they're not really separate
systems when you think about it.
Um, blood sugar dysregulation,for example, that can happen to
any of us at any given timedirectly affects mood stability,
thyroid dysfunction, um,testosterone deficiency,
(08:38):
especially in men.
So there's all these differentthings that have
neuropsychiatric symptoms thatwe're kind of just treating
separately in boxes.
And I'm saying, let's get tothe root cause of why you're so
anxious, the root cause of whyyou're having such trouble
sleeping, your mind is racing.
Let's treat that and then maybeavoid some unnecessary
(08:58):
medications or some unnecessaryinterventions and go after the
root cause.
Dr Andrew Greenland (09:04):
So it's obvious to you and me, because
we work in this field that thisis our world, but why are these
areas so overlooked?
Why is nobody else getting ontothis stuff?
Dr Sonia Diaz (09:13):
So I think I think it's kind of multifaceted.
I think um with thespecialization of medicine and
specialty training uh being soso in-depth and so
hyper-specific, people kind ofreally like kind of stay in
their boxes, stay in like a verydefined set of like this is
what I treat, this is what Imanage, these are interventions
(09:33):
I do.
And I think a lot of that isdriven too by our kind of
institutions that we're workingunder and the insurances that
we're billing to.
Um, it's a very narrow, veryspecific described set of
treatment.
And um, like I said, I thinkthat causes some of the
narrowing, you know.
Oh, I don't know how I can billfor this.
(09:54):
I'm not sure if my patient willactually have coverage for
this.
So it becomes kind of the gameof what can I can I do, not
really based off of training,not really based off of your
credentials, but based off ofyou know, billing
infrastructure.
So I think that's one of thereasons that people kind of
don't really branch out as much.
Um, I think another might justbe kind of like what I said at
(10:17):
the beginning about being scareduh to be viewed as a quack or
kind of as unserious as aphysician.
You know, you see so much aboutthere about you know, hormones
and TRT, peptides, GLP ones, anda lot of it is from this
cosmetic framework, this ideathat like people are seeking
these out from shady channels,possibly, and you know, they're
(10:39):
not really being open, they'reprobably doing damage to
themselves, and the idea thatit's never necessary.
And I think that's a little bitof an outdated look on how
really, like I said, thisbiopsychosocial model of
medicine really works, that allof these things do have an
interplay, and it's you know,we've learned a lot in the last
(11:00):
like few decades that you know,you don't always wait until
you're having severe symptoms totreat.
That might not always be thebest intervention, and sometimes
making sure that you'recompletely optimized where
you're supposed to be in all ofthese areas can lead to years
down the line of better health,it can lead to thousands of
dollars from previously likemissed work opportunities
(11:23):
because you're feeling better,you're able to perform better.
So I think the idea those twothings.
I think it's a lot of providerfear, and I think it's a lot of
being comfortable with thestatus quo that has kind of kept
people just staying very narrowin their scope.
Dr Andrew Greenland (11:41):
So you've very clearly set out your stool
and your approach.
But when patients come to you,what are they looking for that
they haven't found elsewhere?
Dr Sonia Diaz (11:49):
Um, I think it is the relationship.
I think it is having somebodythat they feel really has the
time to hear the entire picture,to hear the whole story.
Um, I think a big part of it ishaving somebody they do feel
comfortable with a professionalto say, hey, listen, I saw this
thing about peptides onInstagram and I'm really
(12:12):
interested and I want to gothrough with it, and having a
sounding board right there tolike be able to talk about.
Because I I think that was oneof the big things that I kind of
noticed when I was umpracticing in a group.
I had patients willing to kindof divulge certain things that
they would normally not divulgeto other providers, and you
know, they weren't necessarilynecessarily harmful all the
(12:35):
time, but they did make thingsmore complicated when you know
me as a provider didn't have thewhole picture.
So I think that is somethingthat patients kind of really um
are looking for more as funny asit seems, more kind of a
traditional healthcare system,not oh well, I don't see this
type of visit, this type ofvisit.
I'm a physician, I'm yourphysician, you are now hiring me
(12:58):
to help you get well.
You have all my tools now to dothat.
So I think it's just a lot moreof like the traditional like
provider-patient relationshipthat people are seeking.
Dr Andrew Greenland (13:09):
Thank you.
So tell us a little bit aboutWellmia, a practice, what it
looks like from a patient pointof view, from a typical patient
journey through your approachand what you've actually built
in terms of your practice.
Dr Sonia Diaz (13:22):
Yeah, of course.
So as of right now, Wellmiviais exclusively telehealth.
We operate um out of Virginiaand Florida, as of right now.
So if you were a Virginia or aFlorida patient, you could go to
the website and um kind of seeour services, anything like
that.
Everyone comes through thepractice, establishes with the
practice with a persistentpsychiatry evaluation.
(13:45):
It's a 90-minute evaluation,which seems like a long time to
a lot of people, but I mean, Icould probably go for a little
bit longer, even, and I have.
But really, it gives us thetime to really get, you know,
let me understand who you are,get to know your medical
history, your psychiatrichistory, really understand
what's going on, why you'recoming in, and what your goals
(14:06):
are.
Um, so I think that's a bigpart of when patients start with
mamibia, spend a decent amountof time kind of establishing
what are your goals, what areyour expectations for care, what
do you expect, you know, me toprovide you, and what do you
kind of expect as ourrelationships moves forward?
And I think people having thattype of certainty instead of
confusion helps a lot with theprocess.
Um, after that, patients cankind of choose like how much uh
(14:30):
how much involvement they want.
So we have three tiers, uh, onebeing a la carte, kind of just
paying for your follow-ups asneeded or based on the schedule
in 15-minute or 30-minutefollow-up blocks.
Um, and then our other optionsis a Womenfium member.
So there's a core and asignature option.
Each one comes with dedicatedaccess uh to messaging, it comes
(14:55):
with a kind of monthlymembership check-in calls, um,
multiple visits throughout themonth that you have access to,
um, along with other things, youknow, help with prioritization
if you want to bill for likemedications.
Uh, it comes with pharmaconsetic um test ordering as
well.
So, like just extra benefitsfor people who want more of like
(15:19):
a high touch and a moreconcierge like direct patient
experience.
And um, yeah, so that is how itruns.
Like I said, like I said, mybig my big goal was that
patients would have actualaccess to me, right?
If they needed a questionanswered, if they were confused
(15:40):
about their plan, I reallywanted them to be able to have
that access.
So that's built-in for thepatients.
And then um, each patientleaves their initial appointment
with a Wamivia blueprint.
So basically, it's acomprehensive plan that includes
their diagnosis, the plans wediscussed, um, neurooptimization
techniques, and uh dietaryrecommendations to help with
(16:01):
medication supplementrecommendations and kind of just
a full picture of theirtreatment plan and where we are
planning to go so that patientshave something to refer to and
they have, like I said, lessconfusion around the whole
process.
Dr Andrew Greenland (16:16):
Thank you.
So you're obviously talkingabout the concierge model, and
you've talked about many of theadvantages of doing that kind of
model.
What are the challenges thatcome with that decision, though?
You know, versus you know, theum direct pay sort of versus the
insurance route.
Dr Sonia Diaz (16:31):
Yeah, I think I think one of the challenges is
um kind of just the the lack ofawareness.
I think a lot of people don'treally understand that like you
can access healthcare this way,uh, that it doesn't have to be
through an insured model.
You can go out of network, youcan kind of just go down on your
own, find a physician and paythem directly.
(16:52):
I don't really think people oreveryone under has the awareness
that that's available to them.
Um obviously, I think access isof course one issue.
Not everybody also has like thefunds to be able to, you know,
afford direct pay physicians allthe time, or they believe that
it would be like a hugehardship.
(17:12):
Uh, I would say that kind oflike doing the math myself and
switching the to that care modelfor myself.
Um, you know, in in the US, wehave kind of different models.
One of the things that Iexperienced switching from
training was COBA insurance justfor coverage in between.
And that was thousands ofdollars a month.
And, you know, under like adirect care concierge model, you
(17:35):
have a whole year of mentalhealth care already covered that
I know is gonna happen for theprice of about a month and a
half or two months of insurancecoverage at that time.
So, you know, then when likethe need is immediate, it was
kind of a no-brainer.
Um, so I think that's one ofthe big challenges, just the
awareness of like how this worksand how accessible it is to
(17:56):
patients.
Um, another another factor justbeing um kind of yeah, the the
the difficulty that it takesjust to navigate healthcare for
a lot of people, um, I thinkcauses some of that, like uh
some of those difficulties withdirect pay, kind of
(18:17):
understanding and like educatingand figuring out, oh, wait a
minute, this is actually likethis is what goes on, this is
how I can, you know, getmedications or see a doctor or
things like that.
So I think the big thing isjust education and awareness.
Um uh I another big one justfrom the provider side is uh I
think guidance.
(18:38):
You know, when you're whenyou're first going out there and
kind of building what you wantto build and building the model,
there's some there's a lot ofother physicians that are really
helpful that kind of postonline, but I there really is no
one kind of like you know,Bible.
There is no no gold standard.
And so I think when you'recrafting things out yourself,
um, you kind of have to put onmultiple hats, you have to be
(18:59):
founder and physician ratherthan just a physician and do and
focus on your clinical duties.
Dr Andrew Greenland (19:06):
Thank you.
And on that point, um, weobviously are in a market where
many people have becomeaccustomed to insurance-based
care.
What is working in terms of thecommunication that you put out
to really communicate the valueof the model that you have?
Dr Sonia Diaz (19:21):
Um, I think as far as uh communication, a lot a
lot of the communication I Ihave um has been in person.
Uh so and I think the minute Isay, you know, I do precision
psychiatry or metabolicpsychiatry, people become very
interested that they're, ohwait, there's other forms,
(19:44):
there's other ways to look atthis.
Um, so I I'm very I'm verypassionate about it.
I do like to post you know onLinkedIn and I started posting
on Instagram a little bit.
Um, and I think that's kind ofwhat's hitting people, people
realizing that there is not oneway to to handle your mental
health care.
Um, there is not one way to tohandle like the effects that
(20:06):
you're having from your chronicillnesses.
Like there are there arealternatives and there are ways
to do it that um feel I thinkmore human.
And I think that's kind of whatpeople really respond to.
Dr Andrew Greenland (20:20):
Thank you.
Um, you mentioned previouslywhen we chatted that many
premium healthcare offeringsdon't necessarily produce better
outcomes.
Can you expand a bit on thatfor us?
Dr Sonia Diaz (20:30):
Yeah, so um I think we've all kind of seen the
the era of telehealth platformsexplode um in the last few
years.
And there has been a milliondifferent models, and some some
good ones, some not so goodones.
And I think with these thisexpansion, um, especially with
(20:50):
like a lot of these like VCbacked or private equity-backed
platforms, you're seeing like alot of really great like uh you
know, business uh models, reallygreat kind of like profit
margin plans and things likethat, but not really good
clinical care.
Um, that things start beingkind of streamlined and cut down
(21:13):
so that you know the mostprofit comes in, which almost
inevitably means that the careis affected.
Um, and even if you want tomake it as simple as you know,
reimbursement rates are prettylow and in cases like this.
I think you know, when aprovider is seeing multiple
people and they also might bethinking in the back of their
(21:35):
head, oh wait, is this gonna beenough to cover all of my
expenses?
It's very likely that thatcognitive load is going to
affect the care that theirpatients are getting.
Um, so I think within thesesystems, like I said, they're
they're very good at marketingluxury.
They're very good at providinguh what people think is like
(21:56):
really well managed care.
Um, but at the end of the day,You know, you sometimes have no
idea who the person you'reseeing is, where they're
located, what their credentialsare.
Um, and people aren't reallygetting the I think the health
education that comes with greatcare.
(22:16):
You know, they're moved througha model, they're made happy
with the very, very fancy, youknow, offerings, but they're not
really improving their care.
They're stabilized, but they'renot optimized.
So I think that's really likewhat we're seeing there.
And that's why I think thatluxury care doesn't necessarily
mean better care.
Dr Andrew Greenland (22:35):
Thank you.
So one of the things thatreally stood out from our
previous conversation was youruse of AI.
And there's a lot of fear andhype around AI right now,
particularly in healthcare.
How are you actually using AIwithin your practice today?
Dr Sonia Diaz (22:48):
So I think uh one of the big ways I use AI,
obviously, is for a lot of mylike um backend things, a lot of
my business management.
Um, so like I said, a big partof this and knowing that like I
wanted to work under my model, amodel that I created, was
having to put on like thefounder hat in addition to the
(23:08):
clinician hat.
So figuring out how to dothings like RCMs, um, you know,
pipelines to reach out topeople, things like that.
So I have been able to utilizeAI for a lot of the build work.
Um, I was able to build mywebsite, I was able to build
everything completely on my own.
I haven't had to hire anycontractors, engineers, anything
(23:29):
like that.
So that's been a huge help justas somebody who is a founder
trying to build and you know beas self-reliant as possible.
Secondly, um throughout kind oflearning and building just the
framework of the practice, I wasable to get a really good
understanding of how do thesetools work, right?
Like what can be done withthem.
Uh and I have been able tocreate my own like proprietary
(23:55):
system and based off myframeworks to aid in
documentation.
So it's not just a random ChatGPT bot or anything like that
telling me what to do, but it isuh my own frameworks that have
been trained on my tone ofvoice, on my previous notes,
things like that.
Um and that documentationpathway allows me to formulate
(24:20):
patient plans in like very umconcise, consistent ways so it's
not confusing for patients.
And it also allows for um thewell Nibia blueprint, like I
said, to be created based off oftheir own clinical data.
So it's not a copy and paste,you know, drink eight glasses of
(24:42):
water a day, get eight hours ofsleep.
They are personalizedrecommendations based off of my
frameworks and how I treatpatients for your exact symptoms
that you're coming in with.
So that's been really helpful.
Um, another thing that I'vebeen working on too is um uh
just a similar model uh to helpother psychiatrists, other
builders that would alsoincorporate a cognitive
(25:06):
assessment, uh, some cognitiveassessment questions and some
practice style questions forphysicians when they initially
uh start their profiles, so thatthe recommendation would not
only be geared towards thepatient, but also towards what
would like recommendations andkind of uh wording that makes
(25:26):
the physician feel comfortable,that sounds you know, like them,
that kind of would makedecisions like them.
So if you're more of aconservative, you know,
prescriber, or if you're moreaggressive, or if you like, you
know, using one medication forthis presentation, one for the
other, kind of learning those umlittle intrinsicities of each
(25:49):
provider and uh hopefully beingable to be consistent so that
they can use it as well, likedown the line.
That is the idea.
Fingers crossed.
Dr Andrew Greenland (25:57):
Amazing.
So I know many practitionersworry that AI could replace the
human connection.
What do you what's your take onthat?
Dr Sonia Diaz (26:05):
Um, I so I think as a psychiatrist as well, um,
it's for me, I think it it kindof has given back a little bit
of the human connection.
Um, I would like to be able tohave a conversation without
documenting.
And I would like, you know, tobe able not to be like, hey,
listen, I I am listening, butyou see me over here, I'm
(26:27):
typing.
Like, I think a lot of thosetake people out of the like
rapport building that you do andof the connection, you know,
especially in psychiatry, we'rediscussing kind of really
delicate personal things attimes.
And having somebody, you know,typing as you're talking to them
about potentially one of theworst things that's ever
(26:48):
happened to you doesn't alwaysfeel very human.
So I think with these tools andum especially, you know, with
the scribes and thedocumentation aid, it's kind of
helping bring back that humanconnection.
Uh, everything else is so faris kind of done still, you know,
by me.
Like I will scheduleappointments and do all I
respond messages.
(27:08):
So I don't think um I don'tthink it it will have a huge
impact on replacing humans, um,kind of unless we let them,
right?
So uh like I said, it's given,I think it's given a lot of the
human element uh back,especially in psychiatric care,
(27:30):
when implemented appropriately.
And I think that's the bigdeal.
Like that's the big, the bigfocus on where AI should be,
less so on the existence,because existence is a net
positive for a lot of us.
But the implementation, Ithink, is where we can kind of
get into trouble.
Dr Andrew Greenland (27:45):
Completely.
So you're obviously superadvanced with AI and you're
using it to build your businessand you're thinking about the
clinical applications of AI.
Where do you think otherclinicians are perhaps
underestimating AI's potentialin your experience?
Dr Sonia Diaz (27:59):
Um, I think I think one of the things that I I
saw a lot, like when I wastalking to other clinicians and
like kind of exploring at thebeginning of building, was that
kind of underutilizing like howhelpful it can be to manage um,
like I said, like kind of smalltasks like an RCM or building a
(28:21):
spreadsheet of clinical, youknow, to help you build a
spreadsheet to input clinicaldata to help build intake forms.
I I think it's it's been, Ithink it's widely accepted that
it's it could it's a good placeto go kind of for answers, you
know, if you want to kind oflike throw things back, chat
chat things out, but there's alot of like skills that I think
(28:44):
uh a lot of physicians aren'tutilizing.
Um, I've been able, you know,to like build my own apps uh and
and things like that.
Um and it's and I plan toexplore even more as time goes
on, but I think people are justunderutilizing how much of a
benefit it can be kind of justto organize your own thought
process and kind of get the theball rolling on projects you've
(29:08):
probably been, you know,eyeballing for years, but really
have never been able to getstarted.
Dr Andrew Greenland (29:15):
Thank you.
Now I know you've had anopportunity to work as a
physician expert in AI, and Ijust wanted to ask what did that
experience teach you aboutwhere the technology is heading?
Dr Sonia Diaz (29:24):
Um, I think it's it's really kind of showing us
that we are moving forwardtowards uh more understanding.
I think the technology is it'snot perfect, right?
Like people are concerned aboutplace humans because they're
not humans, right?
But I think we're gettingtowards a better understanding
(29:47):
of what the capabilities are andaren't in clinical medicine.
Um, you know, it's great foraiding a physician in
documentation.
It's amazing for, you know,aiding a physician with their
thought process and likenarrowing down a differential.
Um, it's not great fordiagnosing or creating
medication plans.
We know that that stillrequires, you know, a clinical
(30:10):
expert looking at the patientand understanding the real world
implications of those things.
So I think I think that's wherewe're headed.
I think we're headed towards amore defined role for AI in
clinic clinical medicine, ratherthan, you know, just
speculation and innovation kindof every other week.
(30:30):
I think we'll we'll get to aplace where we really understand
where where will this benefitus and where should we probably
leave it out for the benefit ofpatients.
Dr Andrew Greenland (30:39):
Thank you.
So you're building a verydifferent kind of healthcare
business, and you've talkedabout the success of the model
and what you're doing to buildit.
But what are the um the biggestchallenges or bottlenecks that
you face in doing what you doand the transition that you've
made in the business that you'rebuilding?
Dr Sonia Diaz (30:55):
Um, I mean, I think one of the big things was
kind of just uh turning my focuscompletely onto this, right?
Kind of shutting everythingoff.
Um one of the bottlenecks Ithink too uh is just patient
acquisition, the natural kind offlow and building up of a
panel.
Um I I will I will say I'mbeing very selective right now
(31:16):
as I get things started.
I want to make sure that likethe initial like founding panel
um is really receiving kind ofthe best care and I'm getting
the feedback uh necessary frommy patients to make sure that
like this is actually like whatthey want and what's needed.
Um so I think that's that's oneof the big bottlenecks, you
know, really like patientacquisition and getting a good
(31:37):
initial panel and feedback fromthat panel to understand how
kind of to move forward.
That's one of the big things, Ithink.
Dr Andrew Greenland (31:44):
And once you've kind of nailed that, and
if you had a sudden influx ofsudden influx of patients next
week, what would happen?
Would you have the capacity?
How is how is your kind ofsystem built for scale and
dealing with sort of surges?
Dr Sonia Diaz (31:58):
So I think uh I would probably be okay at first,
very excited, and then a littlebit overwhelmed.
Um because of like wediscussed, because I've
automated a lot of kind of likeoffice tasks through AI, um, I'd
be able to kind of likeschedule and like and actually
(32:18):
see the patient and documentvery quickly.
So much quicker than than Ihave in the past.
Um so I think that like that,uh having those infrastructures
in place now have been uh veryhelpful for the scalability
because you know, right now I dohave lots of time to sit there
(32:39):
and really like work on a noteand the wording and make sure
everything's there.
When there is a full panel andthere's you know five patients a
day, that time is gonnaseverely compress.
And I don't want my patients tohave to feel the pain of that
by waiting like days or weeksfor their note to be done for
the recommendations to be in.
(33:00):
You know, I don't want somebodyto have to wait two, three,
four days for me to have torefill a prescription.
Um, so I think, like I said,those infrastructure in place
for like patient messagetriaging and for documentation,
I think really have have me setup for future scalability to a
(33:21):
certain point, of course.
Dr Andrew Greenland (33:24):
Great.
So you're the founder, you wearall the hats, like you just
said.
So which of which of the thingsis draining your time most now?
Is it is it clinical becauseit's taking you away from the
build, or is it the operationalor the administrative, or is it
a kind of a mix of all three?
Dr Sonia Diaz (33:40):
So I think right now it is more the
administrative side.
I uh the regulation side, youknow, making sure like licenses
and insurance, billing, um, setjust setting up our payment
processing has been uh kind of awhole thing for a whole journey
for me because we work, youknow, we operate in a very
specific niche field, you know,we're direct pay, precision
(34:03):
psychiatry, we're telehealth.
Um, so there's a lot of likeregulatory things that come with
that.
There's a lot of laws that needto be followed.
So I think a lot of my timenow, is especially you know,
with the early build and as wewe are starting to stop launch,
has really been the regulatorybusiness administrative side,
just making sure that like allof our ducks in our in a row, we
(34:25):
have everything we're set tothat we can see patients with no
issue.
Um, that also might be my ownanxiety as well.
I don't ever want to make surethat like we're not in
compliance, but that does eat upquite a bit of time.
I mean, one of the things thatI think for me was like, oh
wait, I have to meet with anddiscuss and sign an agreement
(34:48):
with every lab and uh pharmacyand all of this, and things that
like kind of I never eventhought that I took advantage of
that.
I just sent, you know, ane-script and kind of walked
away.
So kind of those things havebeen taking quite a bit of time,
but I'm willing, you know, kindof try to get it out of the way
and hopefully as time moves on,that clinical, I mean that
administrative burden will godown as the clinical burden goes
(35:11):
up.
Dr Andrew Greenland (35:12):
And if I was to give you a magic wand and
you could fix one thing in thebusiness tomorrow, what would
that be at this point in time?
Dr Sonia Diaz (35:19):
Oh goodness.
Oh gosh.
Um so difficult.
I think there's so many littlethings I would go for.
Um I guess probably just Ithink probably um just uh
recognizability.
(35:40):
I think right now we're Ioperate on a very niche model,
and um that's not something thatpeople see and like immediately
recognize.
And I think that that thatwould be a huge thing.
If I can wave a magic wand andkind of have that
recognizability and have peopleknow, like, hey, this is what
we're offering, uh, I think thatwould be just huge just for the
(36:04):
field in general, not just mealone.
Dr Andrew Greenland (36:08):
Thank you.
And what would um success looklike for Wellm V over the next
12 months?
We take you 12 months ahead.
Where would you like to be withthe business?
Dr Sonia Diaz (36:17):
So in the next whole month, um, I think success
for me uh would be getting, youknow, a great initial patient
panel and making sure that likein 12 months they still want to
continue and continue havingsuccess.
Um it would also be I thinklaunching uh one of the things
(36:39):
that my partner and I have beendiscussing is launching a
specific um peri and prenataltract for walmivia.
So um a very uh structured planthat really addresses where the
risk factors lie in that entirepregnancy process and
post-birth as well for forwomen.
So I think in about a year,success would be a you know
(37:03):
robust patient panel and thelaunching of uh Walmivia met a
preenatal program.
Dr Andrew Greenland (37:10):
Fantastic.
Um, beyond 12 months andthinking more generally, where
would you where do you see sortof the excitement in mental
health care in say five to tenyears?
What would you like to see inthis field?
Dr Sonia Diaz (37:24):
I think um there's some like very exciting
things when it comes totreatment, obviously, always,
but I I think I'm really moreexcited for the assessment and
kind of diagnostic tools thatwe're seeing coming out.
Um, like I mentioned,pharmacogenomic testing is
something I'm very excitedabout.
Um, I think pharmacogenomictesting and um psychedelics as
(37:46):
well.
Um so I'm very excited aboutkind of having these more
precise diagnostic tools, moreprecise, you know, metabolic
genomic tools to pinpoint reallylike the the core root cause of
like someone's suffering, youknow, is this neurological, is
this physiological, kind ofbeing able to really, really
(38:09):
kind of hone in on what we'retreating and to get just kind of
you know to have person havethe most relief.
So I think that's what I'm I'mreally excited about, you know,
the focus on diagnosis, thefocus on assessment, um, so that
we really know what we'retargeting when we treat.
Dr Andrew Greenland (38:28):
With that, Sonia, I'd love to thank you so
much for joining me today.
It's been a really fascinatingconversation.
I think a lot of practitionerslistening will resonate with
your willingness to questiontraditional models, build
something more aligned withpatient outcomes and
professional fulfillment.
Thank you so much for sharingthe nitty gritty behind the
scenes of your business and themodel that you're building.
It's been a really fascinatingconversation, and I'm very
(38:49):
grateful for your time.
Thank you so much.
Dr Sonia Diaz (38:51):
Thank you.
So, welcome back to Voices in Health and
Wellness.
This is the podcast where wespeak with practitioners,
founders, and innovators who arereshaping the future of
healthcare.
Today I'm joined by Dr.
Sonia Diaz, founder and medicaldirector of Wellmvia Medical.
Sonia is a psychiatrist andhealthcare innovator who has
taken a very different path fromthe traditional model of mental
healthcare.
(00:20):
Through Whelmvia, she'sbuilding what she calls a
precision psychiatry practice,one that looks beyond symptom
management and considers thebroader metabolic, hormonal, and
lifestyle factors thatinfluence mental well-being.
So with that, Sonia, I'd loveto welcome you to the show and
thank you so much for joining ustoday.
Dr Sonia Diaz (00:36):
Yeah, thank you so much, Dr.
Greenland.
I'm uh I'm really excited justto share more and kind of talk
about uh how I view healthcareand how I'm trying to do my part
to address it.
Dr Andrew Greenland (00:46):
Fantastic.
So maybe we could start withyour story.
You've had experience withintraditional medicine and
academic environments beforelaunching Wellvia.
What ultimately led you to stepaway and build your own
practice?
Dr Sonia Diaz (00:58):
I think a big part of it was that throughout
all this practice, because likeyou said, I had worked at a
large academic medical center atstarts in my training, and I
did a lot of community work aswell throughout that training.
And I think what it was is Ikept on seeing kind of the same
patterns repeat themselves overand over and over again.
And one of them that I saw waskind of smart, really
(01:21):
high-functioning people.
They'd been through the system,you know, they had a prescriber
or multiple, they had atherapist, they had
prescriptions, um, but theystill just they still felt stuck
and they still weren't gettingwell.
And it wasn't because, youknow, their providers didn't
care, it wasn't because, youknow, that there was, you know,
(01:43):
something that somebody wasmissing.
It just was that thetraditional system that we have
built doesn't really allowpatients or providers the time
to really get to the bottom andreally look closely enough and
figure out, hey, what's going onhere?
So it uh was quite thedeparture, I guess, from what I
was hearing.
But I think that was the main,that was the main driver.
(02:05):
Um, just not having enough timeto really get the full picture
and really start treating likepatients, like holistically.
Dr Andrew Greenland (02:15):
Thank you.
Really helpful context.
Um, so we said that's somethingyou kind of picked up over your
career and realized that thingsweren't really aligned with
where you were thinking.
Was there a particular momentor patient experience that
really kind of triggered youinto making that leap?
Dr Sonia Diaz (02:29):
I think honestly, I think it was um right when I
had uh left my training program,and a couple of um my
colleagues had graduated.
And like I said, these people,you know, they were
psychiatrists.
So it's not like they wereunaware of healthcare.
Um, you know, they went totheir appointments, they had
their 15-minute med management,but a lot of them were just
(02:52):
dealing with so much that wasn'tbeing addressed.
And it again was talking to allof them, talking to my
colleagues, my peers, andsaying, like, what are you
dealing with?
And you know, you're fine,you're functioning, but you're
not really optimized.
And I think that's where itcame from.
Just looking around at mypeers.
Um, the similar I had a similarexperience with my partner who
(03:16):
was in a uh MBA program andlooking at his peers.
And it, like I said, that samepattern emerged not only with my
patients, but with my peers aswell.
And I think at that moment whenI was making the shift, it kind
of hit for me that um therereally is like a need here that
isn't really being addressed.
Dr Andrew Greenland (03:34):
Got it.
So, were there any fears orreservations that you had about
leaving a more conventionalpath?
Dr Sonia Diaz (03:41):
Um, completely.
I mean, I think everybody does,you know.
I didn't want people to thinkthat like I was a quack, right?
I'm a psychiatrist.
So it's easy, it's easy to makethe jump.
I didn't want people to thinkthat I was kind of um, you know,
being arrogant and saying,well, I'm gonna take over and do
this whole managed care.
Because that's not what I'mdoing either.
I am practicing psychiatry, butwith a bio-psychosocial model
(04:05):
that incorporates the entireperson.
And I think like once Iactually started building and
started kind of talking topeople and saying, hey, this is
what I want to do.
Does this seem what is this,you know, how does this sound?
Um, I kind of gained moreconfidence, you know.
It wasn't kind of out of thebox.
It wasn't something, you know,that is so, you know, out of
(04:29):
left field that people weregonna be scared of it, but it
was just innovative enough thatkind of made me pause.
And like I said, with talkingto people, I realized, you know,
this really shouldn't beinnovative.
This kind of should be thestandard.
Um, so I think that helped kindof just starting to build and
really seeing that this waspossible, that it wasn't
(04:49):
something that I had to wait 10,20 years to do and establish
myself, you know, in the fieldas some kind of voice.
Like I'm a physician, I havethis training and I know how to
help patients.
And once I grounded it inthere, I think a lot of the fear
like started falling away.
Dr Andrew Greenland (05:04):
Thank you.
So, what was it that you wantedto create that simply wasn't
possible within the traditionalmodel?
Dr Sonia Diaz (05:09):
And you really need to dive into the weeds here
and kind of pick out what wasYeah, I think what it comes down
to, like what I really wantedto create was I wanted to
actually give people patientsaccess, direct access to their
physician.
I wanted people to have directaccess to an expert that they
trusted to ask questions.
(05:30):
And I think like we see it allthe time with like, I mean,
there's two new studies comingout all the time about the
amount of misinformation onsocial media, especially
surrounding, you know, medicineand healthcare, and particularly
surrounding mental health careas well.
And I think a lot of that isdriven by people really not
having that trusted resource,you know, and even their doctors
that they have, you know, theytrust them to a certain degree,
(05:52):
but again, 15-minute medmanagement appointments, you
really can't cultivate thatrelationship where you really
can understand each other aspeople and kind of move forward
with their treatment in aholistic way.
So I think that's really one Iwant to provide people.
You know, it's very confusing,it's very scary when you have
something going on and you don'treally know.
I wanted to be able to be, hey,listen, I am a resource that
(06:14):
will be able to give you myundivided attention and all of
the skills that I have at mydisposal to try to figure out
what's going on.
Dr Andrew Greenland (06:21):
Amazing.
So you describe your approachas precision psychiatry.
So for people that hadn't heardthat term before, what does it
actually mean?
Give us a kind of a snapshot.
Dr Sonia Diaz (06:31):
So I think um it's not, I don't, it's it's not
as uh fancy as some people liketo think, but um it really is
instead of kind of narrowing inon, you know, one diagnosis, one
set of symptoms, and treatingthem and or masking them with
medication.
It's that the treat, it's theidea that treatment should be
(06:54):
built around the individual,never the diagnosis.
So two people can walk in, samedepressive symptoms, same pHQ
score, and still have completelydifferent interventions that
actually help them based ontheir genetics, their
metabolism, their lifestyle.
So it really is the idea thattreatment is not
diagnosis-focused, symptomfocused, it is person-focused.
Dr Andrew Greenland (07:20):
Thank you, really clear.
And I know you have a veryholistic approach to what you
do.
So, what role do metabolic orhormonal health as examples play
in mental well-being?
Dr Sonia Diaz (07:30):
So a huge role.
Um, one of the things that Ifound is that I mean, like just
pulling it back, just basically,if somebody isn't optimized
metabolically, if they're reallystruggling, they're having
issues, um medication managementmight not be like the best like
(07:52):
first course action becausethey might not even their bodies
might not even be processingthese medical interventions like
optimally.
Also, like there is a hugelevel of um metabolism that is
influenced by our genetics.
So, another thing that I liketo incorporate is
pharmacogenetics in that.
So that we're making sure thatthe medications that we do use
(08:15):
to treat are actually ones thatare the most likely to be
effective, um, based off, like Isaid, a hormonal profile,
metabolic profile, geneticprofile.
And they're not, I mean,they're not really separate
systems when you think about it.
Um, blood sugar dysregulation,for example, that can happen to
any of us at any given timedirectly affects mood stability,
thyroid dysfunction, um,testosterone deficiency,
(08:38):
especially in men.
So there's all these differentthings that have
neuropsychiatric symptoms thatwe're kind of just treating
separately in boxes.
And I'm saying, let's get tothe root cause of why you're so
anxious, the root cause of whyyou're having such trouble
sleeping, your mind is racing.
Let's treat that and then maybeavoid some unnecessary
(08:58):
medications or some unnecessaryinterventions and go after the
root cause.
Dr Andrew Greenland (09:04):
So it's obvious to you and me, because
we work in this field that thisis our world, but why are these
areas so overlooked?
Why is nobody else getting ontothis stuff?
Dr Sonia Diaz (09:13):
So I think I think it's kind of multifaceted.
I think um with thespecialization of medicine and
specialty training uh being soso in-depth and so
hyper-specific, people kind ofreally like kind of stay in
their boxes, stay in like a verydefined set of like this is
what I treat, this is what Imanage, these are interventions
(09:33):
I do.
And I think a lot of that isdriven too by our kind of
institutions that we're workingunder and the insurances that
we're billing to.
Um, it's a very narrow, veryspecific described set of
treatment.
And um, like I said, I thinkthat causes some of the
narrowing, you know.
Oh, I don't know how I can billfor this.
(09:54):
I'm not sure if my patient willactually have coverage for
this.
So it becomes kind of the gameof what can I can I do, not
really based off of training,not really based off of your
credentials, but based off ofyou know, billing
infrastructure.
So I think that's one of thereasons that people kind of
don't really branch out as much.
Um, I think another might justbe kind of like what I said at
(10:17):
the beginning about being scareduh to be viewed as a quack or
kind of as unserious as aphysician.
You know, you see so much aboutthere about you know, hormones
and TRT, peptides, GLP ones, anda lot of it is from this
cosmetic framework, this ideathat like people are seeking
these out from shady channels,possibly, and you know, they're
(10:39):
not really being open, they'reprobably doing damage to
themselves, and the idea thatit's never necessary.
And I think that's a little bitof an outdated look on how
really, like I said, thisbiopsychosocial model of
medicine really works, that allof these things do have an
interplay, and it's you know,we've learned a lot in the last
(11:00):
like few decades that you know,you don't always wait until
you're having severe symptoms totreat.
That might not always be thebest intervention, and sometimes
making sure that you'recompletely optimized where
you're supposed to be in all ofthese areas can lead to years
down the line of better health,it can lead to thousands of
dollars from previously likemissed work opportunities
(11:23):
because you're feeling better,you're able to perform better.
So I think the idea those twothings.
I think it's a lot of providerfear, and I think it's a lot of
being comfortable with thestatus quo that has kind of kept
people just staying very narrowin their scope.
Dr Andrew Greenland (11:41):
So you've very clearly set out your stool
and your approach.
But when patients come to you,what are they looking for that
they haven't found elsewhere?
Dr Sonia Diaz (11:49):
Um, I think it is the relationship.
I think it is having somebodythat they feel really has the
time to hear the entire picture,to hear the whole story.
Um, I think a big part of it ishaving somebody they do feel
comfortable with a professionalto say, hey, listen, I saw this
thing about peptides onInstagram and I'm really
(12:12):
interested and I want to gothrough with it, and having a
sounding board right there tolike be able to talk about.
Because I I think that was oneof the big things that I kind of
noticed when I was umpracticing in a group.
I had patients willing to kindof divulge certain things that
they would normally not divulgeto other providers, and you
know, they weren't necessarilynecessarily harmful all the
(12:35):
time, but they did make thingsmore complicated when you know
me as a provider didn't have thewhole picture.
So I think that is somethingthat patients kind of really um
are looking for more as funny asit seems, more kind of a
traditional healthcare system,not oh well, I don't see this
type of visit, this type ofvisit.
I'm a physician, I'm yourphysician, you are now hiring me
(12:58):
to help you get well.
You have all my tools now to dothat.
So I think it's just a lot moreof like the traditional like
provider-patient relationshipthat people are seeking.
Dr Andrew Greenland (13:09):
Thank you.
So tell us a little bit aboutWellmia, a practice, what it
looks like from a patient pointof view, from a typical patient
journey through your approachand what you've actually built
in terms of your practice.
Dr Sonia Diaz (13:22):
Yeah, of course.
So as of right now, Wellmiviais exclusively telehealth.
We operate um out of Virginiaand Florida, as of right now.
So if you were a Virginia or aFlorida patient, you could go to
the website and um kind of seeour services, anything like
that.
Everyone comes through thepractice, establishes with the
practice with a persistentpsychiatry evaluation.
(13:45):
It's a 90-minute evaluation,which seems like a long time to
a lot of people, but I mean, Icould probably go for a little
bit longer, even, and I have.
But really, it gives us thetime to really get, you know,
let me understand who you are,get to know your medical
history, your psychiatrichistory, really understand
what's going on, why you'recoming in, and what your goals
(14:06):
are.
Um, so I think that's a bigpart of when patients start with
mamibia, spend a decent amountof time kind of establishing
what are your goals, what areyour expectations for care, what
do you expect, you know, me toprovide you, and what do you
kind of expect as ourrelationships moves forward?
And I think people having thattype of certainty instead of
confusion helps a lot with theprocess.
Um, after that, patients cankind of choose like how much uh
(14:30):
how much involvement they want.
So we have three tiers, uh, onebeing a la carte, kind of just
paying for your follow-ups asneeded or based on the schedule
in 15-minute or 30-minutefollow-up blocks.
Um, and then our other optionsis a Womenfium member.
So there's a core and asignature option.
Each one comes with dedicatedaccess uh to messaging, it comes
(14:55):
with a kind of monthlymembership check-in calls, um,
multiple visits throughout themonth that you have access to,
um, along with other things, youknow, help with prioritization
if you want to bill for likemedications.
Uh, it comes with pharmaconsetic um test ordering as
well.
So, like just extra benefitsfor people who want more of like
(15:19):
a high touch and a moreconcierge like direct patient
experience.
And um, yeah, so that is how itruns.
Like I said, like I said, mybig my big goal was that
patients would have actualaccess to me, right?
If they needed a questionanswered, if they were confused
(15:40):
about their plan, I reallywanted them to be able to have
that access.
So that's built-in for thepatients.
And then um, each patientleaves their initial appointment
with a Wamivia blueprint.
So basically, it's acomprehensive plan that includes
their diagnosis, the plans wediscussed, um, neurooptimization
techniques, and uh dietaryrecommendations to help with
(16:01):
medication supplementrecommendations and kind of just
a full picture of theirtreatment plan and where we are
planning to go so that patientshave something to refer to and
they have, like I said, lessconfusion around the whole
process.
Dr Andrew Greenland (16:16):
Thank you.
So you're obviously talkingabout the concierge model, and
you've talked about many of theadvantages of doing that kind of
model.
What are the challenges thatcome with that decision, though?
You know, versus you know, theum direct pay sort of versus the
insurance route.
Dr Sonia Diaz (16:31):
Yeah, I think I think one of the challenges is
um kind of just the the lack ofawareness.
I think a lot of people don'treally understand that like you
can access healthcare this way,uh, that it doesn't have to be
through an insured model.
You can go out of network, youcan kind of just go down on your
own, find a physician and paythem directly.
(16:52):
I don't really think people oreveryone under has the awareness
that that's available to them.
Um obviously, I think access isof course one issue.
Not everybody also has like thefunds to be able to, you know,
afford direct pay physicians allthe time, or they believe that
it would be like a hugehardship.
(17:12):
Uh, I would say that kind oflike doing the math myself and
switching the to that care modelfor myself.
Um, you know, in in the US, wehave kind of different models.
One of the things that Iexperienced switching from
training was COBA insurance justfor coverage in between.
And that was thousands ofdollars a month.
And, you know, under like adirect care concierge model, you
(17:35):
have a whole year of mentalhealth care already covered that
I know is gonna happen for theprice of about a month and a
half or two months of insurancecoverage at that time.
So, you know, then when likethe need is immediate, it was
kind of a no-brainer.
Um, so I think that's one ofthe big challenges, just the
awareness of like how this worksand how accessible it is to
(17:56):
patients.
Um, another another factor justbeing um kind of yeah, the the
the difficulty that it takesjust to navigate healthcare for
a lot of people, um, I thinkcauses some of that, like uh
some of those difficulties withdirect pay, kind of
(18:17):
understanding and like educatingand figuring out, oh, wait a
minute, this is actually likethis is what goes on, this is
how I can, you know, getmedications or see a doctor or
things like that.
So I think the big thing isjust education and awareness.
Um uh I another big one justfrom the provider side is uh I
think guidance.
(18:38):
You know, when you're whenyou're first going out there and
kind of building what you wantto build and building the model,
there's some there's a lot ofother physicians that are really
helpful that kind of postonline, but I there really is no
one kind of like you know,Bible.
There is no no gold standard.
And so I think when you'recrafting things out yourself,
um, you kind of have to put onmultiple hats, you have to be
(18:59):
founder and physician ratherthan just a physician and do and
focus on your clinical duties.
Dr Andrew Greenland (19:06):
Thank you.
And on that point, um, weobviously are in a market where
many people have becomeaccustomed to insurance-based
care.
What is working in terms of thecommunication that you put out
to really communicate the valueof the model that you have?
Dr Sonia Diaz (19:21):
Um, I think as far as uh communication, a lot a
lot of the communication I Ihave um has been in person.
Uh so and I think the minute Isay, you know, I do precision
psychiatry or metabolicpsychiatry, people become very
interested that they're, ohwait, there's other forms,
(19:44):
there's other ways to look atthis.
Um, so I I'm very I'm verypassionate about it.
I do like to post you know onLinkedIn and I started posting
on Instagram a little bit.
Um, and I think that's kind ofwhat's hitting people, people
realizing that there is not oneway to to handle your mental
health care.
Um, there is not one way to tohandle like the effects that
(20:06):
you're having from your chronicillnesses.
Like there are there arealternatives and there are ways
to do it that um feel I thinkmore human.
And I think that's kind of whatpeople really respond to.
Dr Andrew Greenland (20:20):
Thank you.
Um, you mentioned previouslywhen we chatted that many
premium healthcare offeringsdon't necessarily produce better
outcomes.
Can you expand a bit on thatfor us?
Dr Sonia Diaz (20:30):
Yeah, so um I think we've all kind of seen the
the era of telehealth platformsexplode um in the last few
years.
And there has been a milliondifferent models, and some some
good ones, some not so goodones.
And I think with these thisexpansion, um, especially with
(20:50):
like a lot of these like VCbacked or private equity-backed
platforms, you're seeing like alot of really great like uh you
know, business uh models, reallygreat kind of like profit
margin plans and things likethat, but not really good
clinical care.
Um, that things start beingkind of streamlined and cut down
(21:13):
so that you know the mostprofit comes in, which almost
inevitably means that the careis affected.
Um, and even if you want tomake it as simple as you know,
reimbursement rates are prettylow and in cases like this.
I think you know, when aprovider is seeing multiple
people and they also might bethinking in the back of their
(21:35):
head, oh wait, is this gonna beenough to cover all of my
expenses?
It's very likely that thatcognitive load is going to
affect the care that theirpatients are getting.
Um, so I think within thesesystems, like I said, they're
they're very good at marketingluxury.
They're very good at providinguh what people think is like
(21:56):
really well managed care.
Um, but at the end of the day,You know, you sometimes have no
idea who the person you'reseeing is, where they're
located, what their credentialsare.
Um, and people aren't reallygetting the I think the health
education that comes with greatcare.
(22:16):
You know, they're moved througha model, they're made happy
with the very, very fancy, youknow, offerings, but they're not
really improving their care.
They're stabilized, but they'renot optimized.
So I think that's really likewhat we're seeing there.
And that's why I think thatluxury care doesn't necessarily
mean better care.
Dr Andrew Greenland (22:35):
Thank you.
So one of the things thatreally stood out from our
previous conversation was youruse of AI.
And there's a lot of fear andhype around AI right now,
particularly in healthcare.
How are you actually using AIwithin your practice today?
Dr Sonia Diaz (22:48):
So I think uh one of the big ways I use AI,
obviously, is for a lot of mylike um backend things, a lot of
my business management.
Um, so like I said, a big partof this and knowing that like I
wanted to work under my model, amodel that I created, was
having to put on like thefounder hat in addition to the
(23:08):
clinician hat.
So figuring out how to dothings like RCMs, um, you know,
pipelines to reach out topeople, things like that.
So I have been able to utilizeAI for a lot of the build work.
Um, I was able to build mywebsite, I was able to build
everything completely on my own.
I haven't had to hire anycontractors, engineers, anything
(23:29):
like that.
So that's been a huge help justas somebody who is a founder
trying to build and you know beas self-reliant as possible.
Secondly, um throughout kind oflearning and building just the
framework of the practice, I wasable to get a really good
understanding of how do thesetools work, right?
Like what can be done withthem.
Uh and I have been able tocreate my own like proprietary
(23:55):
system and based off myframeworks to aid in
documentation.
So it's not just a random ChatGPT bot or anything like that
telling me what to do, but it isuh my own frameworks that have
been trained on my tone ofvoice, on my previous notes,
things like that.
Um and that documentationpathway allows me to formulate
(24:20):
patient plans in like very umconcise, consistent ways so it's
not confusing for patients.
And it also allows for um thewell Nibia blueprint, like I
said, to be created based off oftheir own clinical data.
So it's not a copy and paste,you know, drink eight glasses of
(24:42):
water a day, get eight hours ofsleep.
They are personalizedrecommendations based off of my
frameworks and how I treatpatients for your exact symptoms
that you're coming in with.
So that's been really helpful.
Um, another thing that I'vebeen working on too is um uh
just a similar model uh to helpother psychiatrists, other
builders that would alsoincorporate a cognitive
(25:06):
assessment, uh, some cognitiveassessment questions and some
practice style questions forphysicians when they initially
uh start their profiles, so thatthe recommendation would not
only be geared towards thepatient, but also towards what
would like recommendations andkind of uh wording that makes
(25:26):
the physician feel comfortable,that sounds you know, like them,
that kind of would makedecisions like them.
So if you're more of aconservative, you know,
prescriber, or if you're moreaggressive, or if you like, you
know, using one medication forthis presentation, one for the
other, kind of learning those umlittle intrinsicities of each
(25:49):
provider and uh hopefully beingable to be consistent so that
they can use it as well, likedown the line.
That is the idea.
Fingers crossed.
Dr Andrew Greenland (25:57):
Amazing.
So I know many practitionersworry that AI could replace the
human connection.
What do you what's your take onthat?
Dr Sonia Diaz (26:05):
Um, I so I think as a psychiatrist as well, um,
it's for me, I think it it kindof has given back a little bit
of the human connection.
Um, I would like to be able tohave a conversation without
documenting.
And I would like, you know, tobe able not to be like, hey,
listen, I I am listening, butyou see me over here, I'm
(26:27):
typing.
Like, I think a lot of thosetake people out of the like
rapport building that you do andof the connection, you know,
especially in psychiatry, we'rediscussing kind of really
delicate personal things attimes.
And having somebody, you know,typing as you're talking to them
about potentially one of theworst things that's ever
(26:48):
happened to you doesn't alwaysfeel very human.
So I think with these tools andum especially, you know, with
the scribes and thedocumentation aid, it's kind of
helping bring back that humanconnection.
Uh, everything else is so faris kind of done still, you know,
by me.
Like I will scheduleappointments and do all I
respond messages.
(27:08):
So I don't think um I don'tthink it it will have a huge
impact on replacing humans, um,kind of unless we let them,
right?
So uh like I said, it's given,I think it's given a lot of the
human element uh back,especially in psychiatric care,
(27:30):
when implemented appropriately.
And I think that's the bigdeal.
Like that's the big, the bigfocus on where AI should be,
less so on the existence,because existence is a net
positive for a lot of us.
But the implementation, Ithink, is where we can kind of
get into trouble.
Dr Andrew Greenland (27:45):
Completely.
So you're obviously superadvanced with AI and you're
using it to build your businessand you're thinking about the
clinical applications of AI.
Where do you think otherclinicians are perhaps
underestimating AI's potentialin your experience?
Dr Sonia Diaz (27:59):
Um, I think I think one of the things that I I
saw a lot, like when I wastalking to other clinicians and
like kind of exploring at thebeginning of building, was that
kind of underutilizing like howhelpful it can be to manage um,
like I said, like kind of smalltasks like an RCM or building a
(28:21):
spreadsheet of clinical, youknow, to help you build a
spreadsheet to input clinicaldata to help build intake forms.
I I think it's it's been, Ithink it's widely accepted that
it's it could it's a good placeto go kind of for answers, you
know, if you want to kind oflike throw things back, chat
chat things out, but there's alot of like skills that I think
(28:44):
uh a lot of physicians aren'tutilizing.
Um, I've been able, you know,to like build my own apps uh and
and things like that.
Um and it's and I plan toexplore even more as time goes
on, but I think people are justunderutilizing how much of a
benefit it can be kind of justto organize your own thought
process and kind of get the theball rolling on projects you've
(29:08):
probably been, you know,eyeballing for years, but really
have never been able to getstarted.
Dr Andrew Greenland (29:15):
Thank you.
Now I know you've had anopportunity to work as a
physician expert in AI, and Ijust wanted to ask what did that
experience teach you aboutwhere the technology is heading?
Dr Sonia Diaz (29:24):
Um, I think it's it's really kind of showing us
that we are moving forwardtowards uh more understanding.
I think the technology is it'snot perfect, right?
Like people are concerned aboutplace humans because they're
not humans, right?
But I think we're gettingtowards a better understanding
(29:47):
of what the capabilities are andaren't in clinical medicine.
Um, you know, it's great foraiding a physician in
documentation.
It's amazing for, you know,aiding a physician with their
thought process and likenarrowing down a differential.
Um, it's not great fordiagnosing or creating
medication plans.
We know that that stillrequires, you know, a clinical
(30:10):
expert looking at the patientand understanding the real world
implications of those things.
So I think I think that's wherewe're headed.
I think we're headed towards amore defined role for AI in
clinic clinical medicine, ratherthan, you know, just
speculation and innovation kindof every other week.
(30:30):
I think we'll we'll get to aplace where we really understand
where where will this benefitus and where should we probably
leave it out for the benefit ofpatients.
Dr Andrew Greenland (30:39):
Thank you.
So you're building a verydifferent kind of healthcare
business, and you've talkedabout the success of the model
and what you're doing to buildit.
But what are the um the biggestchallenges or bottlenecks that
you face in doing what you doand the transition that you've
made in the business that you'rebuilding?
Dr Sonia Diaz (30:55):
Um, I mean, I think one of the big things was
kind of just uh turning my focuscompletely onto this, right?
Kind of shutting everythingoff.
Um one of the bottlenecks Ithink too uh is just patient
acquisition, the natural kind offlow and building up of a
panel.
Um I I will I will say I'mbeing very selective right now
(31:16):
as I get things started.
I want to make sure that likethe initial like founding panel
um is really receiving kind ofthe best care and I'm getting
the feedback uh necessary frommy patients to make sure that
like this is actually like whatthey want and what's needed.
Um so I think that's that's oneof the big bottlenecks, you
know, really like patientacquisition and getting a good
(31:37):
initial panel and feedback fromthat panel to understand how
kind of to move forward.
That's one of the big things, Ithink.
Dr Andrew Greenland (31:44):
And once you've kind of nailed that, and
if you had a sudden influx ofsudden influx of patients next
week, what would happen?
Would you have the capacity?
How is how is your kind ofsystem built for scale and
dealing with sort of surges?
Dr Sonia Diaz (31:58):
So I think uh I would probably be okay at first,
very excited, and then a littlebit overwhelmed.
Um because of like wediscussed, because I've
automated a lot of kind of likeoffice tasks through AI, um, I'd
be able to kind of likeschedule and like and actually
(32:18):
see the patient and documentvery quickly.
So much quicker than than Ihave in the past.
Um so I think that like that,uh having those infrastructures
in place now have been uh veryhelpful for the scalability
because you know, right now I dohave lots of time to sit there
(32:39):
and really like work on a noteand the wording and make sure
everything's there.
When there is a full panel andthere's you know five patients a
day, that time is gonnaseverely compress.
And I don't want my patients tohave to feel the pain of that
by waiting like days or weeksfor their note to be done for
the recommendations to be in.
(33:00):
You know, I don't want somebodyto have to wait two, three,
four days for me to have torefill a prescription.
Um, so I think, like I said,those infrastructure in place
for like patient messagetriaging and for documentation,
I think really have have me setup for future scalability to a
(33:21):
certain point, of course.
Dr Andrew Greenland (33:24):
Great.
So you're the founder, you wearall the hats, like you just
said.
So which of which of the thingsis draining your time most now?
Is it is it clinical becauseit's taking you away from the
build, or is it the operationalor the administrative, or is it
a kind of a mix of all three?
Dr Sonia Diaz (33:40):
So I think right now it is more the
administrative side.
I uh the regulation side, youknow, making sure like licenses
and insurance, billing, um, setjust setting up our payment
processing has been uh kind of awhole thing for a whole journey
for me because we work, youknow, we operate in a very
specific niche field, you know,we're direct pay, precision
(34:03):
psychiatry, we're telehealth.
Um, so there's a lot of likeregulatory things that come with
that.
There's a lot of laws that needto be followed.
So I think a lot of my timenow, is especially you know,
with the early build and as wewe are starting to stop launch,
has really been the regulatorybusiness administrative side,
just making sure that like allof our ducks in our in a row, we
(34:25):
have everything we're set tothat we can see patients with no
issue.
Um, that also might be my ownanxiety as well.
I don't ever want to make surethat like we're not in
compliance, but that does eat upquite a bit of time.
I mean, one of the things thatI think for me was like, oh
wait, I have to meet with anddiscuss and sign an agreement
(34:48):
with every lab and uh pharmacyand all of this, and things that
like kind of I never eventhought that I took advantage of
that.
I just sent, you know, ane-script and kind of walked
away.
So kind of those things havebeen taking quite a bit of time,
but I'm willing, you know, kindof try to get it out of the way
and hopefully as time moves on,that clinical, I mean that
administrative burden will godown as the clinical burden goes
(35:11):
up.
Dr Andrew Greenland (35:12):
And if I was to give you a magic wand and
you could fix one thing in thebusiness tomorrow, what would
that be at this point in time?
Dr Sonia Diaz (35:19):
Oh goodness.
Oh gosh.
Um so difficult.
I think there's so many littlethings I would go for.
Um I guess probably just Ithink probably um just uh
recognizability.
(35:40):
I think right now we're Ioperate on a very niche model,
and um that's not something thatpeople see and like immediately
recognize.
And I think that that thatwould be a huge thing.
If I can wave a magic wand andkind of have that
recognizability and have peopleknow, like, hey, this is what
we're offering, uh, I think thatwould be just huge just for the
(36:04):
field in general, not just mealone.
Dr Andrew Greenland (36:08):
Thank you.
And what would um success looklike for Wellm V over the next
12 months?
We take you 12 months ahead.
Where would you like to be withthe business?
Dr Sonia Diaz (36:17):
So in the next whole month, um, I think success
for me uh would be getting, youknow, a great initial patient
panel and making sure that likein 12 months they still want to
continue and continue havingsuccess.
Um it would also be I thinklaunching uh one of the things
(36:39):
that my partner and I have beendiscussing is launching a
specific um peri and prenataltract for walmivia.
So um a very uh structured planthat really addresses where the
risk factors lie in that entirepregnancy process and
post-birth as well for forwomen.
So I think in about a year,success would be a you know
(37:03):
robust patient panel and thelaunching of uh Walmivia met a
preenatal program.
Dr Andrew Greenland (37:10):
Fantastic.
Um, beyond 12 months andthinking more generally, where
would you where do you see sortof the excitement in mental
health care in say five to tenyears?
What would you like to see inthis field?
Dr Sonia Diaz (37:24):
I think um there's some like very exciting
things when it comes totreatment, obviously, always,
but I I think I'm really moreexcited for the assessment and
kind of diagnostic tools thatwe're seeing coming out.
Um, like I mentioned,pharmacogenomic testing is
something I'm very excitedabout.
Um, I think pharmacogenomictesting and um psychedelics as
(37:46):
well.
Um so I'm very excited aboutkind of having these more
precise diagnostic tools, moreprecise, you know, metabolic
genomic tools to pinpoint reallylike the the core root cause of
like someone's suffering, youknow, is this neurological, is
this physiological, kind ofbeing able to really, really
(38:09):
kind of hone in on what we'retreating and to get just kind of
you know to have person havethe most relief.
So I think that's what I'm I'mreally excited about, you know,
the focus on diagnosis, thefocus on assessment, um, so that
we really know what we'retargeting when we treat.
Dr Andrew Greenland (38:28):
With that, Sonia, I'd love to thank you so
much for joining me today.
It's been a really fascinatingconversation.
I think a lot of practitionerslistening will resonate with
your willingness to questiontraditional models, build
something more aligned withpatient outcomes and
professional fulfillment.
Thank you so much for sharingthe nitty gritty behind the
scenes of your business and themodel that you're building.
It's been a really fascinatingconversation, and I'm very
(38:49):
grateful for your time.
Thank you so much.
Dr Sonia Diaz (38:51):
Thank you.
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