Physician Coach

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Join host Tom Butler as he celebrates the success of the inaugural Cycling Over Sixty Annual Celebration of Cycling Later in Life and teases an exciting new collaboration bringing a special event next spring.

Tom then welcomes two remarkable guests who are helping to revolutionize healthcare: Dr. Audrey Falconi and Dr. Ayla Hopkins, co-founders of Physician Coach, an innovative medical clinic that places exercise at the very center of primary care.

In this inspiring conversation, discover how these forward-thinking physicians are transforming the traditional doctor-patient relationship by adopting an individualized approach to health that treats exercise as medicine. Learn about their unique treatment philosophy where doctors become coaches and patients—regardless of age—embrace their identity as athletes in training.

Whether you're over sixty or supporting someone who is, this episode offers valuable insights into a new model of healthcare that empowers people to take charge of their wellness through movement and personalized coaching. Tune in to explore how this innovative approach is creating stronger, more collaborative relationships between physicians and patients.

Perfect for cyclists, fitness enthusiasts, and anyone interested in aging actively and taking control of their health journey.

LINKS

Physician Coach Website: yourphysiciancoach.com

Cycling Over Sixty Tour de Cure Team: tour.diabetes.org/teams/CO60

Thanks for Joining Me!

Consider becoming a member of the Cycling Over Sixty Strava Club! www.strava.com/clubs/CyclingOverSixty

Cycling Over Sixty is also on Zwift. Look for our Zwift club!

Please send comments, questions and especially content suggestions to me at [e-mail]

Follow and comment on Cycling Over Sixty on Instagram: https://www.instagram.com/cyclingoversixty/

Show music is "Come On Out" by Dan Lebowitz. Find him here : lebomusic.com

Episode Transcript

Speaker 1 (00:04):
This is the Cycling Over 60 podcast, season three,
episode 37, physician Coach andI'm your host, tom Butler.
On Sunday, september 14th, welaunched the Cycling Over 60

(00:27):
Annual Celebration of Cycling.
This year the celebration wassimply a group ride.
I really liked how the ridecame together.
Unfortunately, I couldn't beaggressive at promoting the ride
because there ended up being aquestion about the route being
open.
We chose to do three routes andtwo of them went over a bridge
that I thought was going to beopen in August.
Construction problems meant thedelay of the project completion

(00:50):
.
I ended up getting confirmationthat the bridge was going to be
open on September 13th, but Ionly found that out a week
before.
They did end up opening thebridge earlier, but they had the
official ribbon cutting on the13th.
I am so happy that the bridgewas open because riders got to
experience the entire FoothillsTrail and the beautiful area it
goes through.
I know I'm biased, but I dobelieve the Foothills Trail is a

(01:13):
national treasure.
Even with the lack of promotionand the threat of rain, we had
around 40 people show up.
I somehow managed to pick therainiest day of the week and the
rainiest part of the day toschedule the ride.
It reminded me of when I wasgrowing up.
Our family always seemed to endup with the rainiest days on
our camping trips.
The truth is, the weather wasactually really tolerable.

(01:34):
We had light rain for a littlewhile, then it just was mostly
overcast.
Having a small group wasactually helpful.
I didn't need to get anypermits or worry about a huge
group on the trail and it waseasy to find a place to gather
afterwards.
We got together afterwards at acafe just across from the
trailhead and I had a fun timegetting to know people a little
more.

(01:55):
I did a drawing for a couple ofgift cards and some in-store
vouchers.
I want to give a huge shout outto Trek Tacoma North for
providing a bunch of $20in-store credit vouchers.
I accomplished the goals that Ihad for this first event.
We tested the routes and Ibelieve they are nearly perfect.
We had three routes a metriccentury, about 62 miles, a 40

(02:17):
mile route and a 30 mile route.
Now, based on some interactionsI had with people as I was
talking about the ride, I willadd a shorter route in future
events.
Having this first event wasreally important to start the
process, a dynamic annualcycling event.
I've begun to talk with a feworganizations about expanding
what we can offer for supportand for a fun post-ride event in

(02:40):
the future.
Of course, I will keep everyoneposted on anything we plan the
future.
Of course I will keep everyoneposted on anything we plan.
You can find information aboutCycling Over 60 events on the
Strava Club and I also will addany larger events to the website
.
I'm also currently building anemail list of people who want to
get information about CyclingOver 60 events in their inbox.
I won't be sending out a bunchof emails, just details about

(03:00):
upcoming events.
For now, events will mostly bein the Seattle area.
However, I want to see eventselsewhere as soon as it is
feasible.
The annual event has led towhat I think is a fantastic plan
for a spring Cycling Over 60event.
I do need to stay focused onthe fall event, so I don't see
managing all the details of aspring event.

(03:21):
However, I had a meeting withthe development manager at the
Pacific Northwest chapter of theAmerican Diabetes Association.
She asked if Cycling Over 60would put together a team for
Tour de Cure in Seattle.
If you listen to the podcast,you know that I'm struggling
with management blood glucose.
Cycling is vital for helping meto avoid the consequences of
diabetes.
So having the opportunity tocollaborate with the American

(03:45):
Diabetes Association Tour deCure ride, that was something I
was immediately interested in.
I did form a team for the Tourde Cure in Seattle.
If you are in the area, pleaseconsider joining the team and
riding with us on May 2nd ofnext year.
You can find the team attourdiabetesorg.
Forward slash teams.
Forward slash CO60.

(04:05):
I'll put that link in the shownotes.
I like the fact that there areTour de Cure rides in 12
locations across the US.
I would love it if the CyclingOver 60 team expanded to be
represented in other regions.
This is a very newcollaboration with Tour de Cure,
but I'm hoping to have thebiggest team in the Seattle ride
.
We only need 50 riders to showup to be the biggest team.

(04:28):
I think it would be absolutelyawesome to make a statement
about the value of cycling laterin life by having the largest
team in the Seattle event.
And of course, the AmericanDiabetes Association chapter
here understands the value ofcycling over 60 as well.
There's absolutely no questionthat activity has a massive
impact on preventing andmanaging diabetes.

(04:50):
Riding the Tour de Cure allowsthe cycling over 60 community to
have a huge positive impact aswe demonstrate the bicycle as a
great way to stay active and, asI like to think of it,
demonstrate the value of thebicycle as a medical device.
One of my big tasks in the nextcouple of months is to find
organizations that areinterested in helping support
the Cycling Over 60 Tour de Cureteam.

(05:11):
In order to participate in theride, each person needs to
secure $250 of donations.
My task is going to be figuringout how to get organizations
and individuals to adopt CyclingOver 60 team members to make it
easy to achieve $250 indonations.
So stay tuned for moreinformation on Cycling Over 60
and Tour de Cure.
Like I said, if you're inWestern Washington, please

(05:34):
consider registering with ourteam.
I'll end this update with astory of frustration and then
happiness and then acceptance.
After we got back from ridingthe Tour de Victoria, which I
still need to talk about here, Icouldn't find my bike computer.
I looked all over and wasreally frustrated because I
convinced myself that I left itin the hotel in Victoria, but

(05:56):
then I remembered that I'd beenthinking about replacing it with
a computer that had bettermapping.
So I got excited to shop for anew computer and then,
unfortunately, a couple dayslater I found my computer.
The computer had slipped out ofmy backpack and somehow got
kicked under a bookshelf, so fornow I'll still be writing with
a minimally viable mappingfeature, but just maybe I can

(06:20):
find a way to lose it morepermanently next time.
As I have thought about theconcept of exercise as medicine
and the bicycle as a medicaldevice, one thing in my mind has

(06:42):
been the thought that I wouldlike to see a different kind of
medical practice that reallyputs exercise at the heart of a
treatment plan.
I recently was on a ride aroundTacoma with a group touring
some of the most recentpedestrian and bicycle
infrastructure projects when abusiness caught my eye.
The name of the business isPhysician Coach.
I went over to the building andstarted looking to see if I
could figure out the nature ofthe business.

(07:02):
It looked like a medicalpractice that was inside a gym.
As soon as I got home, I pulledup the website
yourphysiciancoachcom to findout it was indeed the practice
concept that I had been thinkingabout.
I visited the clinic in personand asked if somebody would come
on the podcast to talk aboutPhysician Coach.
I'm so happy to say that DrAudrey Falcone and Dr Ayla

(07:26):
Hopkins said that they wouldcome on.
Here's our conversation.
I'm as excited about today'sconversation as I've ever been
on the podcast.
Thank you, dr Audrey Falconeand Dr Ayla Hopkins, for joining
me.

Speaker 2 (07:40):
Thank you for having us, Tom.

Speaker 1 (07:42):
Now, I recently rode by your clinic in Tacoma,
washington, called PhysicianCoach, and I instantly knew that
I had to get more informationon what you do, and I'm so glad
to have this conversation andespecially that listeners get to
hear from you guys.
So let's start out, dr Falcone,talk about your experience as a
family medicine physician.

(08:03):
How did that shape your viewabout the role of a physician?
And then how does yourexperience as a competitive
athlete inform how you approachhealth care?

Speaker 3 (08:14):
I ended up thinking family medicine as I was going
through my medical school andreally I think what I was drawn
to is the range that you getwith family medicines.
So I did spend a couple oftimes with some specialists and
realized pretty quickly that Ikind of enjoyed not being so
hyper-focused, having theability to help people kind of

(08:36):
as their first approach to themedical provider and that really
appealed to me with familymedicine.
As far as my competitiveathletics, I think that the
biggest thing that taught me wasthat how important exercise is
and how irreplaceable it is tomost health problems.
Within the first step, alwaysseeing.

(09:02):
But lifestyle would be thefirst step.
That's primary prevention,including exercise right, and
it's just, I think, kind of goneby the wayside in conventional
medicine.
It has been one of the biggestthings here that we focused on.

Speaker 1 (09:15):
What did you experience as far as the role of
the family in health decisions?
That seems paramount.
Would you agree with what yousaw as a family physician, that
family influence or having afamily that supports different
behavioral choices?

Speaker 3 (09:32):
Yeah, that's huge, Even for my clients.
Now, if the family isn't onboard with their lifestyle
change, especially when it comesto hey, maybe we need to remove
gluten or dairy.
We need you to start exercisingdaily and if it's not a
household commitment, it isreally, really hard to change a
habit.

Speaker 2 (09:50):
You know and I'm going to keep in there really
quickly I think another thingthat we're constantly trying to
reframe for people is this kindof adage of oh it's just my
genetics.
I think a lot of people holdthat true to any type of health
condition.
Oh, it's just my genetics.
I think a lot of people holdthat true to any type of health
condition.
And, yes, genetics do play apart.
But we truly believe thatlifestyle can greatly alter

(10:12):
genetic course of what you maybe predisposed to, so often
shifting that also, which thatkind of goes along with that
like family, what have you heard?
What have you grown up with?
What have you been inundatedwith?
Oh it's just my genetics, it'sjust going to happen, versus
realizing they may have a rolein being able to alter that
course.

Speaker 1 (10:28):
I already know you guys are going to say so many
interesting things that I justwant to take off on, so this is
awesome.
Now, Dr Hopkins, can you talkabout your medical education and
maybe help people understandwhat it means to attend Bastyr
University?
I think in the Northwest wekind of know a bit about Bastyr,

(10:48):
but can you talk about thatexperience?

Speaker 2 (10:51):
Yes, yes, so we are so lucky to have Bastyr
University kind of in ourbackyard and located in Kenmore,
washington.
It's one of the I think six orseven accredited naturopathic
medical schools and that'swithin the United States and
Canada.
It's kind of on the forefrontas far as being kind of
science-driven, which oftentimespeople sometimes equate natural

(11:11):
medicine with not beinganything science-based.
So really what it is is anaccredited medical school where
you're learning naturopathicmedicine.
You come out of that educationas a primary care physician.
That varies state by statedepending on where you end up
practicing, but after you passyour board, say in Washington
State, we are considered primarycare physicians.

(11:32):
So technically there may be nodifference.
If you decide to take insurance, you kind of get popped into
the system and some people maynot notice a difference between,
say, a conventional doctor anda naturopathic doctor.
That being said, our educationis we learn the kind of standard
of care right.
So we learn pharmaceuticals,diagnosis, minor surgery, you
know some of the primary careoffice type things.

(11:54):
But our main focus is reallylifestyle and natural
interventions and that typicallyis really focusing on exercise,
diet, sleep, stress management,community.
You know all of those.
Those quote unquote natural,natural things.
So really when we see a patientwe are making sure that all of

(12:16):
those what we call foundationsof health are in place if it's
safe to do so, right If apatient doesn't need a higher
intervention immediately reallyworking to either kind of
prevent or reverse any type ofdisease process.
So you know, that's anotherthing that I've seen just time
and time again where it's justtruth to me as many of these
chronic diseases being reversedwith the right protocol for

(12:38):
somebody and I think a lot oftimes that's something that you
know once somebody gets thediagnosis it almost becomes an
identity where it becomes hardto break free of that.
But there really is a lot ofhope and a lot of intervention
that can happen there.
So that's you know.
Bastyr University has a lot ofother incredible programs, but I
graduated from theirnaturopathic medicine program,

(12:58):
so I am a naturopathic physicianhere in Washington state here
in Washington state.

Speaker 1 (13:07):
One of the things that I think is interesting is
that I imagine that at Bastyryou're going to see research
being done that you wouldn'tfind at most medical schools.

Speaker 2 (13:14):
Yeah, so there's a big group of us that are
interested in research and maybego into that.
I think this conversation couldgo so deep because right now in
the United States and in thegeneral kind of conventional
medical system, we heavily relyon the placebo-blinded,
placebo-controlled double-blindstudy, which is great.
It gives us this kind ofcapsule in order to look at

(13:36):
something.
But what it doesn't allow us todo is realize the synergistic
effect of potentially 10different interventions that may
look different from patient Ato patient B.
So that's really difficult tostudy as far as naturopathic
medicine goes.
That being said, the amount ofresearch that has been done in

(13:57):
those types of trials on, say,select herbal medicines or
compounds in plants which, ifyou look at some of the top
prescribed medications, allactually derived from a plant
somewhere, right?
So it's, I think, naturopathicmedicine.
Often, if people aren't awareof our education and what we do,
there's that whole snake oilthing where we're doing some
crazy things and really it'sjust stuff that makes sense.

(14:20):
It's really, you know, veryintuitive, very, you know,
patient-focused type stuff.
So there's research there, butyeah, those are great comments
for sure.

Speaker 1 (14:32):
Can both of you share what caused you to want to
pursue careers in medicine?
Is that an interest that beganearly in life?

Speaker 3 (14:40):
Yeah, I would say for myself not so much.
I just kind of fell intomedical school application.
I was a chemistry major goingthrough my undergrad and my
first month, or sorry summer, ofresearch it was hours of very,
very tedious titrations in thelab and I quickly realized that

(15:01):
that was not the life for me.
And I quickly realized thatthat was not the life for me and
I had two friends that wereapplying to medical school my
junior year and they were like,hey, you should, you should
apply with us.
Like I had been taking bioclasses with my electives, I
just enjoyed them, really pairedwell with my chemistry
electives.
So that's kind of how I fellinto medicine.
I at that point had not evenconsidered it until my junior

(15:23):
year of college.

Speaker 2 (15:25):
And I'm going to pipe in there for you.
I feel like Audrey has such anacademic, intelligent background
and people often hear that asthe forefront.
But since getting to know hershe's just so extremely
empathetic and caring andintuitive with people that I'm
sure on some level that drew youto medicine too, or at least
made you a good bit.
That you never really say, butthat's been something really

(15:46):
special like blending thatintelligence and that science
kind of mind, but then also withthe ability to connect with the
person in front of you.
I think is a really importantquality.

Speaker 1 (15:56):
Awesome, I love it.
How about you, dr Hopkins?

Speaker 2 (15:59):
I grew up with.
So my grandfather was animmigrant here from Colombia.
He was the firstSpanish-speaking OBGYN in
Washington in the Tri-Citiesarea, and he just always was so
fun to hear his stories andeverything that he went through
in his life and I just greatlyadmired him that I just from the
jump, wanted to be a doctor.

(16:20):
During my undergrad I went toWestern Washington University
and I was majoring inkinesiology.
So fitness has always kind ofbeen an interest of mine.
But I was going pre-med and Iworked at a cardiovascular unit.
I got a really great job and Iwas super excited to get all
this experience for medicalschool.
I was caring for patientsstraight out of open heart

(16:41):
surgery.
Although the intervention isincredible, I'm so glad we have
the advances in surgery at thispoint for bypass surgery, but
what was happening was they weregetting out of this
life-altering surgery and theirfamily was bringing them a big
mac and fries as a celebration.
There was this really just bigdisconnect between either the
tools that they had in theirpocket for their health, the

(17:04):
incredible procedure they justwent to, and then what happens
after that, and so I actuallykind of put the brakes on
medical school and I was likewell, maybe nutrition, maybe you
know, I was trying to what canhave the most profound effect on
health for these people and Iended up just finding Bastyr.
I didn't even know aboutnaturopathic medicine and it was
just fit all the boxes that Iwas looking for, so that's kind

(17:26):
of how I went down that route.

Speaker 1 (17:27):
I was immediately struck by the name physician
coach, and so I'm really curiousabout how the practice was
formed, like the whole messageof physician coach, things like
that.

Speaker 3 (17:39):
At the time.
You know we've gone through somany evolutions of this business
and what we thought it wasgoing to be to what it is now,
and we both very much connectedon the fact that, yes, we were
doctors, but we really believedthat movement and exercise was
one of the main forms oftreatment and metabolic health,
or the inflammation caused bymetabolic health, was at the

(18:01):
root of most diseases.
And so really, I think pairingthose two together and basically
my pastime of you know when I'mnot doing medicine is coaching.
Like I fell in love withcoaching at a CrossFit gym and
took a bunch of, like,weightlifting and nutrition
classes, I just found that, like, helping people to heal was

(18:24):
what I wanted to do, andbringing those two names
together for us was a way oflike how we were going to blend
and present this business.

Speaker 2 (18:33):
You know, in a kind of conventional system, a doctor
is typically telling thepatient what to do, giving them
a prescription, and it's almostthis one-sided relationship Not
always, but it can present thatway and so with the word coach
in there, I feel like there's alittle bit more of hey, we're
partners in your health, we'regoing to give you our expertise,

(18:55):
we expect you to kind of comeback and show up for yourself,
your health, your community andbe a player in this game that
we're trying to get, whateverthat is longevity, wellness,
fixing your knee pain, whateverthat may be.
So I think that also is a partof it too.
We want exercise to be aprescription.
We want the doctors to startreally be holding that high in

(19:18):
how powerful that medicine is,but also for our patients to
want to be here, want to show up, want to like kind of put in
the hard work that it takessometimes to change habits and
really get to kind of the rootcause of whatever their ailment
or issue is and really work tokind of unpack all that.

Speaker 1 (19:34):
I think it's just an awesome name.
Again, walking by, I wasactually riding by, but riding
by and then stopping because youhave a great logo too, I mean I
I just like the whole presencethat you guys project from your
clinic there.
Is it right to call it a clinic?

Speaker 3 (19:55):
yeah, yeah, we tend to call it a clinic okay the
clinics, the space the gym.

Speaker 2 (20:00):
You know, we we have a lot of different names for it.

Speaker 1 (20:02):
Yeah, but there's such an energy and just stopping
.
And you know you got big glasswindows and you can see a bit
like you kind of know a bitabout what you're getting into.
You know just from lookingthrough your windows and I think
that's cool.
You know you can see thatthere's activity, you know it's
meant to be a really activeplace and I think that's so cool

(20:26):
to see.

Speaker 2 (20:28):
Thank you.
It's really nice to hear thatthat is at least caught your eye
and you definitely are somebodywho would be great in our
services.
So it's nice that it'sappealing to some people.
We do have an issue.
People, you know, will look inand they right, we have these
boxes, we have a medical clinicand then we have a gym and the
fact that they're blended ishard for people to kind of

(20:48):
comprehend.
So people peep in and they'relike either that's a gym or
physical therapy.
You know they don't realizethere's like actual physicians
practicing in the back.
We do have a physical therapist, who's fantastic, but it's not
just a physical therapy clinic.
So it's definitely a reframingfor a lot of people and what it
presents us.

Speaker 1 (21:05):
Yeah, I can totally see that I mean, and again
there's kind of a the way thatmy brain's been thinking about
my own health.
That I think was part of what Iwas seeing.
But again, I think you guys aredoing a great job of projecting
a message and I'm wondering, asit's formed and as it's grown

(21:25):
and maybe been shaped over time,what is the need that you feel,
physician coaches meeting in aunique way?

Speaker 3 (21:33):
Yeah, I think really what we're trying to do, or I
feel like what we've turned into, is medicine has gotten very
compartmentalized.
You know you have to see yourprimary care to get a referral
to see an orthosurgeon, but ifthe orthosurgeon's like, oh,
maybe it's the spine, now you'regoing to a neurologist, right.
So it's gotten socompartmentalized that things I

(21:56):
think are getting missed or thepossible pieces are not being
put together well, and so it hasallowed us one to have like a
more holistic approach tosomeone's pain or ailments or
disease.
And then, two, a lot of what Ifind is people may not
necessarily know how to exerciseor how to build muscle or how

(22:19):
to recover, and so having thosethings here or options for
people like that's easy toaccess or it's, you know, a
place that they trust, it allowsus to, I think, streamline a
lot of these parts of medicinethat people get very frustrated
with in the conventional systemHaving to, you know, wait months
for imaging to then finally seethe surgeon who said, oh, you

(22:40):
shouldn't have been sent to me,go back to your primary care and
get another referral.
You shouldn't have been sent tome, go back to your primary
care and get another referral.
You know, it's this kind ofcycle that like people just get
thrown in and can be in chronicpain for eight months before
they finally get to the rightperson.

Speaker 2 (22:52):
Yeah, and I think I'll add in there two things
that are kind of a little bitdifferent of topics.
There's a lot of overlap offolks who are members here at
the gym or patients here.
Whether they started at one orthe other they went back forth,
whatever that may be, but whathas happened is we're small and
we've developed this reallybeautiful community and I think

(23:15):
that a big piece of medicinethat nobody really talks about
is community and just watchingour members be there for each
other, show up for each other,often doing gluten elimination
together, who you are aroundmakes a huge difference and that
is often lost, say in like alarge primary care clinic,

(23:38):
potentially.
So the community piece I thinkis a really beautiful part that
we don't really ever talk aboutis being medicine as well.
But I also want to give a kindof like a little peep about
insurance.
So we are a cash pay clinic.
The beautiful side of that meansthat we don't have to abide by
appointment times really shortappointment times.
We are able to do whatevertreatment we want with folks,

(24:01):
don't have to worry about ifwhether it will be covered,
whether you know all of that.
We can address multiple thingsat one time, which is another
really amazing thing, because weare a holistic body and
everything is working together.
Not to say that, you know,there's so many folks that
really rely on insurance, and Ithink insurance is important for
a large group of people, butthe amount of times that we

(24:23):
actually see people saving moneyby coming to us to get
everything addressed potentiallyin one visit, versus the time
constraint and the billingconstraint that often insurance
can present so you know, I thinkthat's another piece is
unfortunately by not takinginsurance which a lot of people
find that to be a hindrancewe're actually able to fill this

(24:45):
need where we're able to do awhole lot more with people per
visit.

Speaker 1 (24:48):
I like both of those so much and especially the
community piece, both of thoseso much and especially the
community piece.
You know, I think you know, forme, you know, cycling over 60
is a community.
We actually just did our firstannual event to celebrate
cycling later on in life and itwas a great moment of community,

(25:09):
you know, coming together anddoing some rides together, then
hanging out afterwards andtalking about bike gears and
aches and pains when cycling andall kinds of things.
And I believe that some of thethings that need to happen to
stay healthy later in life,community is just so vital to it

(25:29):
and that's a commitment that Ihave building.
Cycling Over 60, is to buildthat community.
I'd like to talk more about theconcept of coach and I really
what you said really resonatedwith me.
That like there can be thisreally stereotypical
relationship between patient anddoctor and to think of it more

(25:51):
as a coaching session, I thinkis a fantastic reframe and I
consider it valuable to seemyself as an athlete in training
.
When I'm walking down the streetI don't think anybody's seeing
me as an athlete in training,but it's like a dedication that

(26:14):
comes with kind of having thatconcept in my mind that I need
right now to improve my health.
You know, there's just makingthe space to be active.
Sometimes it's just superdifficult.
Sometimes it's just superdifficult and it's one of the

(26:48):
reasons why, you know, for likeevery year for 30 years my
health kind of got a little bitworse, got a little bit worse,
got a little bit worse becauselife was not immediately
structured to be healthy.
That people immediatelyunderstand that like that coach
relationship.
Do they come in, seeking that?
Is that something that you kindof help them need to make?
That reframe?
How automatic is it that peoplecan get that, that reframe of
the physician coach?

Speaker 2 (27:06):
I'm actually going to start with this and then I
definitely want you to take overjust with a bit of a personal
anecdote.
I've been active my whole life,fairly focused on health, my
whole life really into fitness.
But really what that meant wasmaybe reading an article in a
magazine and maybe doing a repscheme.
You know that I read about a3x12 or something on a machine

(27:29):
going consistently right.
I loved to do my three-mile runand I would just continually do
that and I felt fit and thatwas very healthy for me and it
felt great.
I started CrossFit and I wasdoing that really consistently
and seeing results.
But because I never was acompetitive athlete as an adult,
I never in a million yearsconsidered myself an athlete.

(27:50):
No, not at all.
I would never even considerthat, nor would I think I should
enlist the help of a coach toget me better.
And then after I met Audrey andshe just inherently has that
mindset you know of like nomatter who you are, everybody's
an athlete and there's alwaysroom for improvement and if you
want to improve you have to havea plan and typically that

(28:13):
includes progressive overloadand all of that it totally
reshaped and it made me justwant to kind of spread that
message to everybody and anybodywho like, yeah, it's maybe bit
into fitness, but even if you'rejust starting, like getting on
a plan with the coach is such animportant piece that's just
going to, you know, help youhave better results.

(28:33):
So I just wanted to keep thatin, because I kind of started
from being like a lot of peopleof like I'm not an athlete, even
though I was probably prettyfit, you know.
But as far as actually beingconsidering an athlete and
having a goal, I just know thatwasn't on my on my radar.

Speaker 3 (28:48):
Yeah, and I think the mind shift definitely happens
as they come in and I think theyI tell a lot of people of, hey,
if you have someone that wantsto come see me, or we get a
phone call for a new patient.
I try to get people tounderstand that, like this is
going to be a mutualrelationship.
I am going to help and coachyou in any way I can, but the

(29:09):
work comes from you.
Like you have to be committedto change and committed to all
of the work that it takes toactually get to health with
primary preventions, which isexercise, nutrition, sleep.
You know as some of the cores,and so a lot of my appointments
are more based on, hey, theseare my nutrition guidelines, but

(29:31):
how can we get you there?
Like what can you change rightnow?
What sounds feasible to you?
So it's very much thisstep-by-step process and a lot
of that has come with, like meunderstanding how hard it is for
myself to change a habit,understanding that, like I may
want them to do 20 differentthings in their life, but I have
to pick one or two, becausethat's just reality, that's

(29:52):
human nature.
Like it's really hard to make asignificant change in your life
.
You know, all of a suddenintroducing exercise or all of a
sudden saying you can't havegluten is huge.
It's really, really difficultfor people.
That is a complete lifestylechange, not only for yourself
but for your family, who ishopefully on board.
Probably the majority of myencounters with people are

(30:13):
starting to involve coaching andhelping them get through life
and make these changes and makethem consistent changes right
that are going to be with themfor the long haul.

Speaker 2 (30:24):
And I'm going to peak Dr Peter Attia, which we really
appreciate what he's doing kindof for the field right now and
if you've heard of him or if youhaven't, definitely look him up
.
But he has this idea oftraining, for I think he calls
it the Centurion decathlon.
So you know, I think somepeople are like, well, what am I
going to train for?
Or health goal, Like what?

(30:44):
I don't know, I just want to behealthy.
Or I just want to be fitbecause I don't have a marathon,
or I don't have a CrossFitcompetition, right, they don't
have something they're trainingfor.
But to pick what?
How you want to live your lifeat age 80 or 90, what do you
want to be doing?
Do you want to be able to pickup your great grandchild?
Do you want to be able?
You know?
So giving yourself like littlegoals and what you want as far

(31:07):
as longevity goes, and almosttraining for that, you know it
doesn't necessarily have to betraining for a marathon, which
is where that word athlete getsin there, but the idea of being
coached and having a trainingprogram, whether that's in
fitness or in your health, Ithink is just such a great
reframe.
You know, like, dream big.

(31:27):
What do you want?
Let's try to get you there.

Speaker 1 (31:29):
Yeah, and I experienced that personally.
You know I started out.
I made a decision that at 60, Iwanted to ride Seattle to
Portland for the first time.
Now, the truth of the matter isI didn't think I was going to
make it, you know, but I thoughtit was going to be really great
to you know, if I made 75 milesor 50 miles, and I was really

(31:50):
fortunate because I had somepeople that were working with me
and encouraging me andeverything but.
But seeing those progressivelysmall wins you know, I went for
a 60 mile ride on my actual 60thbirthday, you know, and things
like that it's just thatprogressive thing.
But again, I think it's thatathlete mindset where you set a

(32:14):
goal and you say I want toachieve this thing and I'm then
seeing, you know, appreciatingthe small gains along the way
too.
On your website there's astatement and it says that, you
quote recognize that health is acomplex, nonlinear journey to
each person.

(32:34):
Health is a complex, nonlinearjourney to each person.
So this complex, nonlinearjourney to each person, can you
unpack that a bit?

Speaker 2 (32:41):
Yeah, you know, I think really what that boils
down to is personalized medicine, and really what that means is
oftentimes, through medicalschool, you often learn
algorithms, right?
A patient is this, you go thisway or this way.
If they're this, you go this orthis way, and you just kind of
get funneled into this algorithmof how to treat every single

(33:03):
person with, say, one disease.
So really what we're doing hereis trying to look at every
single person that walks throughthe door as a complex
individual who has their ownhistory, their own genetics,
their own diet and lifestyle,their own traumas, their own
whatever it may be, and figuringout what kind of led them to,

(33:23):
whatever disease state they'rein or whatever ailment they're
dealing with, and how to kind ofmediate some of those things to
reverse or cure or healwhatever they have going on, and
that is just can look sodifferent person to person.
And so I think really whatwe're getting at is just we're
really trying to look at eachperson holistically and as their

(33:46):
own person that may have atotally different treatment plan
than the next person, even ifthey have this come in with the
same exact diagnosis.

Speaker 1 (33:53):
Well, you talked earlier about time, about being
able to have time.
It seems like this is one ofthe biggest things in kind of a
traditional medicalreimbursement system.
It just seems like there's notthe space to have that kind of
discussion with people.
Is that a fair comment?

Speaker 3 (34:22):
Yes, that is a fair comment, I think a lot of times
the doctors are on the frontlines and they're getting blamed
, but what's happening, or whatmaybe people don't realize, is
when you are a physician workingin a large corporation, they
are looking at the numbers.
Basically, right, it's a numbersgame for the hospital to stay
productive and, in the net,positive.
And so what happens is and thisis I kind of experienced this

(34:43):
over in my residency was thateach year we went, we got
shortened down from 60 minutesto 40 minutes to 30 minutes to
eventually I was cut down to 20minute appointments, and it
didn't matter how complex thepatient was.
They needed me to see 20patients per day to be a viable
physician for the clinic.
And so when you're hitting thatto the point where, like you

(35:07):
know, sometimes your patientsare waiting an hour because you
got that far behind, because youhad a complex patient that
needed more time, it's like allof the systems that are built
inside are not made to besuccessful, right, and a lot of
it is boiling down to thehospital has to make money and
it's not a well-functioningsystem, in my opinion, and that

(35:28):
is what's causing that timeconstriction.
It's not that the physiciandoesn't want to spend time with
you, it's that they're not beingallowed to have that
opportunity.

Speaker 2 (35:37):
Yeah, and you know, it's, I think, a lot of things
that we state.
We're often comparing toconventional medicine, and I
just want to like be blatantlyclear like we have so much
respect for the medical system,for the doctors and the other
practitioners that are out theredoing this work, but there are
constraints, right, and it's notthat the practitioner doesn't
care, it's the box that they'refitting into in our medical

(35:58):
system today, and I think that'swhat we're really trying to do
is like really create a shift inthe medical system where we're
thinking about thingsdifferently, we're structuring
it differently so we can, youknow, achieve real results with
people and that we don't have todo any of the quick fixes which
really only fit into a shortertime period, or we do have that
time to talk through a diet planthat maybe, you know, a

(36:21):
traditional doctor doesn't.
So, yeah, I think that's animportant piece to just note.

Speaker 1 (36:27):
Given that activity is at the heart of physician
coach, I think that's fair tosay.
What do you think about theconcept of exercises medicine?

Speaker 3 (36:38):
Yeah, I think that's basically, you know, at the root
of why we started this practiceis like I've lived my life that
way that you know exercise iskeeping me healthy and the more
I treat people here and we cansee the effects that exercise
can have in reversing chronicdisease.
We just believe in reversingchronic disease.
We just believe in it more andmore.

Speaker 2 (36:57):
Yeah, we're huge proponents of that and I'm going
to get down a little bit morein the nitty gritty of that.
I feel like there's like thisaerial view of it and there's
also this very like minute viewof it.
And so the minute view is trulyon a cellular level.
Our mitochondria, which is ourpowerhouse of the cell, is so

(37:19):
fundamental to a healthy celland a healthy system, and
mitochondrial dysfunction isoften at the root of a lot of
chronic diseases.
I'm sure it could be tied backto nearly all of them.
One of the best ways to supportyour mitochondria with the most
effect is exercise, anddifferent types of exercise too
can really make a change there.

(37:39):
And so I think you know, ifpeople really understood, it's
not just movement is good, itgets your heart rate, it's
cardiovascular thing right.
We're like truly focusing onsome level on really trying to
support and optimize everybody'smitochondria for a healthier
system.
So that's kind of that piece ofit.
But then, like we alreadytouched on you know, exercise is

(38:05):
such a huge support to ourmental health and our
neurotransmitters and communityand breathing and taking a
stress relief.
You know it's just there's somany pieces of it that can be
considered medicine and a verypotent medicine.
That that's, you know, it'skind of what we live and breathe
now is yes, it is medicine.
It's kind of the front linethat we want to make sure that
people are hitting, you know.

Speaker 1 (38:24):
I believe if you buy into the concept of exercise as
medicine, then the bicycle is amedical device, is a medical
device.
I haven't approached myinsurance carrier about latching
onto that concept and payingfor my bike, but I, you know, I
do believe that bicycle is amedical device.
Do you guys think that's fair?

Speaker 2 (38:46):
Yes, very much so I'll sign off on that.

Speaker 3 (38:49):
Yeah, I think too there's been a shift to where a
gym membership is allowed to bea medical necessity.
So I think you know, hopefullywe're making a shift into the
right direction forunderstanding that, like that
should hopefully be somethingthat an insurance company would
be willing to pay for, in thefact that they will reduce
medical costs over the long term.

Speaker 2 (39:11):
Yeah, and Audrey, I may be putting you on the spot
with a statistic.
I'm sure you've seen we do alot of VO2 max from.
I think improving it maybe just25% in the lower profile or

(39:40):
something like that, has a hugebenefit in your longevity.
So even just you know peoplethink, oh, do I need to get to
the elite level of VO2 max?
No, it's just improving it froma low level to a moderately low
level has exponential benefitto your overall health.
So that is I always find thatto be just like a really

(40:00):
powerful thing that you knowanybody can start and it have a
really profound impact on ourhealth.

Speaker 1 (40:06):
If we had more time, I would love to just talk about
VO2 max for me.
So, to me there's this you knowelement I really believe that
in today's world, to beconsistently active, you almost

(40:28):
need to be countercultural.
You know there's a lot ofpeople within Cycling Over 60
that are cycling because they'reout of the workforce, they're
retired, and I experienced thismyself a lot.
To be active it really is aspecific choice to live a
different way.

(40:48):
I'll tell you a story that wasreally interesting for me.
I used to work in a health club,and that health club was part
of the International Health andRacquet Sports Club Association.
I don't know if thatorganization even exists anymore
, but they had a program thatwas focused on getting
compensation for gym memberships.

(41:10):
One of the gyms that had been aleader in that movement and
this is like, I'm thinking, 94or something like that.
Somewhere around that time theywere sending reports every week
to the insurance carrier thatwas compensating for these gym
memberships.

(41:30):
They met with the insurancecompany to talk to them about
the program and how they wereperceiving the program, and when

(41:54):
they came in to meet with theinsurance carrier, all the boxes
that they had sent them withreports had been stacked and
never opened.
They were not interested at allin actually who was using the
gym.
Their entire philosophy was thatif they were offering discounts
for gym membership, they wouldattract a population who was
more active, and that populationwould then be lower utilizers

(42:18):
of healthcare services, and Ijust thought that was really
fascinating that, you know, itwas just all about knowing that
people who would care abouthaving access to a gym were
lower utilizers of their otherservices, and I think that's one
thing that when you talk aboutinvestment and one thing for me

(42:42):
for sure is if someone comes toChristian Coach and makes that
investment in themselves, Iheavily believe that's going to
pay off for the rest of theirlife.
I'm sure that's something thatyou believe and something that
you've seen.

Speaker 3 (42:58):
Yeah, definitely, when they invest into their
health here, a lot of them arefeeling better, moving better,
pain is down, their labs areimproving.
They see those benefits and Ido think that I'm very grateful
for the shift that's happeningover social media right now,
especially towards older womenand really trying to explain to

(43:21):
them how important muscle is,because that is probably one of
the largest populations that wesee here is.
They're coming in here becausethey're like, hey, I'm hearing
from so-and-so that I need toget stronger because that's
going to help me live longer,and so that is helping us get
some of that initial buy-in thatwe need to then get them
feeling like, okay, I need toseek this out and they're

(43:43):
finding us and it's really greatfor, at least for me, I'm
grateful to see that and seethat shift in society and
hopefully that continues totrickle through all populations,
all ages.

Speaker 1 (43:56):
On the podcast I interviewed someone from the
Behavior Change for GoodInitiative at University of
Pennsylvania.
They're focused on how can theyunderstand behavior change.
Can they understand you knowbehavior change?
I'm wondering, as practitioners, do you feel like we know how
to get people motivated?

(44:16):
Do you feel like basicallysomebody has to come in
motivated or it's not going towork?
Do you feel like there's a lotthat we need to learn how to
help people make that transition, to really be motivated to do
the work that it takes to behealthy?

Speaker 3 (44:32):
Yeah, definitely.
It's not something that we gettaught.
You know, motivationaleducation it's really, really
difficult.
I think my first kind ofawareness was that was I took a
nutrition course that was calledPrecision Nutrition, and their
whole first module was basicallylike teaching you how to make
this attainable or change habitor create baby steps for these

(44:54):
people so that they're steppingtowards behavioral change.
And I think that was a bigshift for me as a physician too,
because a lot of times in whenI was initially trained, it'd be
like, hey, you need to exercisemore 150 minutes per week, like
check that box, and you're good.
That is so hard for someone tobreak down for themselves.
What does that mean?
Like, how do I spread that outthrough the week?

(45:16):
Like, what should every daylook like?
And a lot of people end updoing the same exact thing, you
know, multiple days a week for acouple months and then they
drop off, right.
So it's like understanding that.
Like one, my guidance can't betoo general.
And two, it has to be veryspecific.
And three, depending on theperson, how motivated they are
is kind of how I dictate howmany times I need to check in

(45:38):
with them, like if this is asuper motivated person.
It may be once every threemonths hey, let's just check in
and see how you're doing.
But other people it may be like, hey, I need to see you every
two weeks because I know you'regoing to run into roadblocks,
and it creates a way for them tohave somebody holding them
accountable, right?
They don't want to come totheir follow up appointment and
tell me they didn't do anythingthey were supposed to do, so it

(46:00):
helps get them to buy in.

Speaker 2 (46:01):
Yeah, yeah, you know, that's something I really
appreciated about mynaturopathic medical school was
we actually had a rotation withas counseling, so we learned
motivational interviewing,different basics of, you know,
cognitive behavioral therapy,because that is so integral to
the work that you do with apatient.

(46:21):
If there needs to be a referralto a trained therapist, yes, we
send that.
But I think part of what we cando in a longer appointment is
really get to the root of whysomebody is in the spot that
they're in.
You know everybody hasdifferent motivations, everybody
has different traumas,everybody has different things
that they're protectingthemselves from or they're.

(46:42):
You know there's, there's somuch there to unpack and luckily
we we have the time to be ableto sometimes get to that root
right.
We call it kind of the we'retrying to find the root cause of
whatever it is and so reallytrying to give people the tools
to one discover that and thenthat helps dictate treatment
plans.
Right, it's to kind of figureout that, like you said, that

(47:05):
determines kind of the dose, thefrequency, if you maybe need to
address something else beforeyou address the other, and I
just think that's a little bitlost, that actual kind of
therapeutic kind of discussion,when somebody is coming in with
a presenting complaint.

Speaker 1 (47:18):
You talked about treatment plans and what does
the treatment team look like?
What are the differentcomponents there and different
professions that you guys haveon board?

Speaker 3 (47:29):
Yeah.
So right now we have myself andDr Hopkins as the physicians.
Like she said, we brought on aphysical therapy who's just been
a huge advance to the clinic, Ithink, especially with all of
the regenerative injectiontreatments that I do and the
chronic pain that we're dealingwith Myself and the PT.

(47:50):
We both came from the militarywhere sports medicine was huge
Like that was 90% of thecomplaints that we were seeing,
and so just the experience thatcame with that has and bringing
that into the general population, I think it's there's a huge
gap between what people thinkrehab or recovering from an
injury should be and what itactually is when they come in

(48:14):
here.
It's a stark contrast and mostpeople are very, very surprised
by the treatment they get here.
The other component that wehave that when we started we
definitely had no intention ofstarting was the actual fitness
classes Because, like I said, itwas really really difficult to
help people realize what theyshould do to stay fit and

(48:35):
healthy and, you know, makingsure they get the right dose of
zone two training, the rightdose of strength training, the
right dose of tempo and highintensity and that bred.
Well, maybe we should start ourown classes where we can create
the programming that allows,like gives people a place where
they can just come in andthey're going to follow our
classes and they're going to gethealthier.

Speaker 2 (48:55):
Like she said, her and I, Dr Marlisa Overton, who's
the physical therapist, andthen a set of coaches who we
work really closely with, whichI think is part of the whole
physician coach kind of missionhere is really bridging that gap
.
You know, we find a coach inthe gym is so amazing to
somebody's health that theyshould be working with the

(49:16):
doctor to kind of bridge thatgap and get the best kind of
result for the patient.
So our coaches here are awesomeand often involved in a lot of
the things that we're doing tokind of create like a bit of an
integrative scenario.

Speaker 1 (49:28):
I would prefer to just bicycle.
Unfortunately, I got reached outto by a lot of people that have
convinced me that I need to doupper body workouts as well.
You know, it got to the pointwhere okay, I can't deny that,
you know.
So I reached a goal this yearof doing 25 weeks in a row of

(49:49):
two days a week of upper bodytraining, you know, and I wasn't
working with a coach and itwasn't even optimized, but it
was.
It was more about the habit, itwas more about training my body
to one, except that we weredoing this, but as a result,

(50:12):
except that we were doing this,but as a result, you know, I'm
62 years old and, as a result, Isaw this reshaping of my body
structure, you know, and it wasfantastic.
It was like so encouraging andI felt a real improvement in my
ability to function.
I'm thinking, if I'm 62 and I'mon the bike a lot, and yet I

(50:33):
still saw such improvement bydoing this upper body work, I'm
thinking that most sedentarypeople are going to experience
that kind of difference if theycommit to some consistent
program.

Speaker 3 (50:49):
Yeah, I think that really, the more sedentary you
are, the greater the effect willbe with consistency and it's an
exponential growth, right, if Ican just get someone in here to
work out a couple of days aweek.
Even if everything is modifiedbecause they're that unfit,
they're gonna see massive gainsbecause they have so much more

(51:10):
potential and it's almost easieror more rewarding to work with
that group of people becausethey see all those benefits so
fast and they feel so great.
It's almost harder, in myopinion, to work with more elite
athletes who are trying to getthat last one or two percent of
improvement.
It's like really has to bedialed in very scientific, like

(51:34):
you know everything, every partof their life is controlled.
It's so much more difficult, Ithink, when you're on the higher
end to see those improvementsand easier to say, well, what am
I doing this for?
But yeah, to you know, to whatyou experienced.
I think that's very, verycommon to what you experienced.
I think that's very, verycommon and I think if people
could just stay in long enoughto start to see the benefit,

(51:55):
they would grab onto it and wantto continue doing it.

Speaker 2 (51:58):
Tom, I just have to commend you.
I've known you for 45 minutesnow and you are just such a cool
dude.
You have kind of are justpreaching our mission out there
without even knowing it.
You're setting goals foryourself, you're kind of
initiating yourself, you're intomovement and learning more and
just thank you for who you are,because I think everything that
we're doing here and what you'redoing is like how we're going

(52:19):
to change kind of the system atlarge and the community at large
is really kind of these smaller, grassroot type things and
showing up and doing the workourselves.
So anyway, that's amazing and Ijust wanted to say thank you
for being you.
But also I wanted to highlight Ithink a lot of people almost
feel like there's this plateauafter 25 years old, right, like

(52:41):
you can really only get thesecertain gains in your twenties
and then that's, that's nolonger the case and that is just
so, so wrong.
As you experienced it as we seeall the time.
You know there could be somebarriers, but as you kind of get
somebody's nutrition, movement,whatever injuries may be
inhibiting them, their hormonesin check, like whatever it may

(53:02):
be, there's just so much roomfor gains in whatever that may
be upper body strength,cardiovascular, whatever that
may be, for any age, really anyage.

Speaker 1 (53:12):
I think that's probably the most important
message of cycling over 60 isthat you can get stronger later
on in life.
I was riding Sunday with awoman who started cycling when
she was 72.
And she talked about the gainsthat she made at 72,.
You know where she was climbingthese hills and she lives in

(53:34):
Tacoma and she was climbingthese hills, you know, after I
don't know.
You know some time on the bike,but all of a sudden she's
strong enough now, her legs arestrong enough now that she can
climb up these hills, that shejust could never imagine
climbing the hills, and so Ithink it's such an important

(53:56):
message and I needed to learn itmyself.
You know I thought it was toolate.
So, like when I was 50, Ithought it's too late for me to
do Seattle to Portland, and it'sbeen really valuable to have
that experience.
That it's not.
I do have a couple of conditionsthere at the core of my health
status, and you talked earlierabout metabolic functioning.

(54:16):
One is that it seems reallyobvious that my muscles are
insulin resistant.
I would love to be able to dosome kind of test that really
looked at that, and I wish wefully understood what happens
with insulin resistance and likethe role of things like glute

(54:37):
for transport and all that stuff.
But I think it's really obviousthat my muscles are insulin
resistant glucose tolerance andinsulin response test and that
seems to indicate that mypancreas is not pumping out as
much insulin as optimal or evengood.

(54:57):
But these conditions aren'trare in America.
I'm wondering, from theperspective of functional
medicine, how does that getthought of?
Is that a fair question to askor is it just too complex to
answer that?

Speaker 3 (55:15):
No, I think it's not too complex.
It is something that we'recommonly taking a look at and
trying to understand better.
We know now and I say we, butreally in functional medicine
and naturopathic medicine it isunderstood that, like insulin is
the primary indicator evenbefore prediabetes or diabetes

(55:36):
ever show up.
The other thing that weunderstand is the muscle is the
first organ to break down.
When we talk about insulinresistance, traditionally people
expect it to be the liver, andthen you know larger
complications like the land, theeyesight and the kidneys.
But if we can catch it whenit's starting in the muscle,
before it has even made it tothe liver, like we are going to

(55:57):
get way farther ahead.
Reversing it becomes difficultbecause you're trying to reteach
the muscles how to respond toinsulin and, like you mentioned,
the GLUT4 pathway is a wayaround that.
So there's some things that wecan use in functional medicine
as well as in conventionalmedicine that have allowed us to
start to reverse that process,as long as we can catch it

(56:19):
before the pancreas has bottomedout.
And even some of those signswill show up on a metabolic test
.
On a VO2 max test, I can seewhen someone is not processing
glucose or fat well and, morespecifically, it shows up on a
lactate test.
So there was a really greatpaper.
I don't know if you know AnigoSan Milan.
He is a scientist who has alsotrained a Tour de France winner

(56:43):
and mainly in light cancerresearch.
But he did this amazing paperwhere he compared a professional
cyclist kind of an amateurcyclist and a person with
metabolic disease, showing theirlactate curves, and how stark
that difference was for theperson in metabolic disease and
how you can kind of teach theirbody how to recover from that.

Speaker 2 (57:05):
Yeah, I don't know, tom, how much you've heard about
lactate, but we love talkingabout it here and it's something
that I wasn't really taughtmuch in medical school.
I think at that point I wastaught that lactate was what
caused your muscles to be sore.
Is that what they used to say?
Yeah, the lactic acid, yeah,but lactate is a fuel and
lactate also gives us a lot ofinformation about the metabolic

(57:28):
system.
And on the VO2 max test that wedo or the graded exercise test
that we do, traditionally, ifyou get that anywhere, they're
really only doing kind of thebreath analysis, where you're
looking at the exchange ofoxygen and CO2 and you're kind
of making inferences based oncarbohydrate or fat utilization,
crossover points, all thatstuff.
But what we do here is weactually pair it with a blood

(57:49):
lactate test throughout the testand that just gives us like an
additional, really interestinginsight into somebody's muscle
physiology, exercise kind ofphysiology itself.
So I really, really love thetopic of lactate.

Speaker 1 (58:04):
Well, so I'm going to come in and see you guys and I
like knew that the moment that Irode by your place.
You know this is just aformality to start the process,
but I'm going to come in and seeyou, and you know, for a couple
reasons.
One you told me I'm a cool dudeand you guys, I think, are

(58:27):
probably the coolest physiciansin the state of Washington,
maybe nationally.
So that felt good.
But the other thing is that Ijust I've not seen like this
practice concept anywhere, andmaybe it's just because I've not
been around to see it.
But but it's like exactly inline with the way that I think

(58:50):
about what I'm doing, about myhealth, I'm really interested in
coming in and I'm reallyinterested to be able to
communicate that process andeverything with listeners.
And I'm just going to remindlisteners that my body's unique,
the things I'm dealing with isunique.
So, as I'm reporting on whatI'm doing, that doesn't mean
it's advice for what you did youshould do, yeah, so I want to

(59:13):
come in and get the processstarted and everything.
How does that work?
What are the?
What are the steps look like towhen you start?
When?

Speaker 3 (59:24):
you bring a new patient in.
Yeah, kind of like we startedin the beginning.
Like medicine is individualized, so there is no linear path
that we follow here.
It's everybody's going to comein at a certain point in their
health, whether you know.
For me, a lot of times it'schronic pain bringing people in
to see me or something going onwith their labs, or just wanting

(59:46):
performance.
So, depending on what they arevery much interested in that
will start.
So it may start with a VO2 maxtest.
It may start with hey, we needto do a full lab panel and see
what's actually going on.
Or it may start with I can't doanything until my chronic pain
is gone.
So let's start there right.
So it's very muchindividualized to the person

(01:00:09):
what brings them in and,depending on how their health is
going, we may shift into theother things that we provide
here to eventually get them tothat state where they feel
healthy again and feel like theyhave their life back heard that

(01:00:32):
her PRP has really greatresults and they schedule
because they have knee issues.

Speaker 2 (01:00:34):
So they come in, they get their PRP, they kind of
realize what we're doing hereand they're like, hey, now that
I can move again and I'm healed,I'd love to start exercising.
So then maybe they go to ourfitness classes now that they
can move.
Or we have some people call andsay I don't know, my
cholesterol is out of whack, Ireally need some help with that.
They come in we maybe do moreof like a lab analysis.

(01:00:54):
That then maybe leads tosomething else.
So maybe you're not movingbecause you have an injury.
And that's when you know Audreywould potentially do a more
sportsman appointment, reallywants the VO2 max test and we
realize there's maybe somemetabolic dysfunction and then
that turns into a differentappointment.
So really it's.
You know, we try to guidepeople on kind of where to start
.
But that can often kind of movethrough a lot of pieces here as

(01:01:18):
it as people kind of progressas one issue gets taken care of
and then they can kind of focuson something else.
So yeah, it is.
It definitely isn't a nonlinearthing here, for sure.

Speaker 1 (01:01:33):
Well, it sounds wonderful and I look forward to
it for sure.
So you'll be seeing me there,you know, at some point in
person.
Let me finish with thisquestion what is your hope for
the future of healthcare in theUS?

Speaker 3 (01:01:44):
Yeah, I think my hope is that, like I said, when we I
think when medicine firststarted, it very much was rooted
in lifestyle intervention andmy hope is that, with this shift
that's happening, you know,people believing that exercise
and nutrition can truly heal it.
We're seeing and it may be justa bias to our clinic, but we're

(01:02:04):
starting to see people who arebelieving that they want to come
off of pharmaceuticals, theywant to live a healthy lifestyle
.
They're looking for alternativemedicine because they're so
frustrated with the healthcaresystem.
So my hope is that with enoughof us, you know, clinicians who
have the education needed topush that and be able to provide
that, and with enough of theselike really great podcasters out

(01:02:28):
there who are also spreadingthat mission of exercise as
medicine, movement as medicine,muscle as medicine, that with
those two things together we canhopefully change the way that
we approach medicine.
That's my hope.
It would probably be a verylong time from now.

Speaker 2 (01:02:46):
I think that my hope would be getting people to
realize that they are theirgreatest partner in their
kitchen, are right in their home, are right in their community,

(01:03:13):
so more and more peopleunderstanding that.
I think is just would be so, soincredible to kind of see that
shift in healthcare.
Audrey has this really horribleissue with curing so many
people's pain that they don'tbook again, which is a great
problem to have.
But as a clinic, trying to getoff the ground is also be kind

(01:03:34):
of difficult.
But we are very happy thatpeople are starting to kind of
learn these tools.
I think doctor came from theLatin word docere, which is to
teach.
So you know, also shifting thatas doctor as a role of really
teaching their patients how tolive.
We don't get taught how to eat,how to nourish, how to rest,
how to sleep and with all ofthese new things in our world

(01:03:56):
electronics and whatever elsemay be there's just a lot of
things that are working againstus.
But yeah, just really helpingpeople realize how much they
have in the process, how muchyou know they can do themselves.

Speaker 1 (01:04:09):
One thing I'm hearing that you say is something that
I think is really obvious, butthere's just not, again, a
system that really promotes it,and that's like we're kind of
used to.
You got a problem, you take amedication, the problem goes
away.
You stop taking the medication,or you know you have an
innovation intervention, youhave a surgery, whatever

(01:04:29):
medication.
Or you know you have aninnovation intervention, you
have a surgery, whatever.
And it's like this mindset ofyou do something and then you
stop, but to have that shiftwhere it's like no, it's a
process, and you get into thisprocess and continue that
process, yeah, that's just thatchange alone, I think would be
awesome.
This has been so awesome.

(01:04:51):
It's exactly what I was hopingit would be.
You guys are awesome and Iappreciate so much for you to
take the time I know you've gota busy clinic going there and to
take the time to get on andtalk to me so I can share that
with the listeners.
Thank you so much for doingthat.

Speaker 2 (01:05:08):
Thank you for having us.
Thank you for having us andjust your mission.
Like I said, thank you so muchfor having this podcast and then
also living the life thatyou're living, which I know kind
of rubs off on all of yourcommunities, so it's great to
see.

Speaker 1 (01:05:21):
Well, that's awesome to say, so I will talk to you
again sometime, for sure.

Speaker 2 (01:05:26):
We'll see you around.

Speaker 1 (01:05:27):
Yeah, all right, bye now.
I don't know how many otherclinics there are like Physician
Coach, but I do believe thereneeds to be many, many more.
At the core of what they do iscreating an individualized

(01:05:47):
program tailored to support eachperson's needs.
That is exactly what I'mlooking for, and the fact that
they are looking forcomprehensive solutions with
exercise at the heart of it thatgives me a lot of confidence in
their approach.
I look forward to sharing moreinformation about my journey as
I engage more with PhysicianCoach.
I'm very excited to see theresults.

(01:06:08):
I'm also excited because Ithink my interaction with
physician coach could open upsome great topics to explore in
the podcast.
The concept of functionalmedicine is fascinating to me,
and I'm intrigued by the thoughtthat Dr Falcone and Dr Hopkins
could be steering me to expertsthat can speak more about what
functional medicine offers forthose of us who want to remain
active later in life.

(01:06:28):
During the conversation, Imentioned the episode on
behavior change for good.
That was an interview with SeanEllis, phd, from the Behavior
Change for Good Initiative atthe University of Pennsylvania.
The episode was on March 21st2024.
I hope you all are experiencingthe awesome effects of cycling.
Maybe, like me, the bike is away to improve, or maybe you

(01:06:50):
don't need much improvement andyour riding is about maintaining
good health.
Either way, I hope your ridesare filled with joy, and
remember age is just a gearchange.