Rethinking Men's Healthcare with Dr. Alejandro Miquel of Men's Only Medical | Ep 98

Have you ever wondered why your doctor seems rushed during appointments? Dr. Alex Miquel pulls back the curtain on how healthcare has transformed from patient-focused care to productivity-driven protocols, creating frustrated physicians and dissatisfied patients alike.

Dr. Miquel shares his journey from disillusioned family physician to founder of Men's Only Medical, a revolutionary concierge practice in West Palm Beach dedicated exclusively to men's health. As a third-generation physician, he witnessed the "glory days" of medicine through his father's practice before experiencing firsthand how insurance companies and administrative burdens have fundamentally changed the doctor-patient relationship. The consequences are stark: physicians seeing 30-40 patients daily, spending more time on documentation than patient care, and following cookie-cutter protocols rather than providing personalized treatment.

The concierge model offers a compelling alternative. By charging an annual membership fee, Dr. Miquel can spend 30-60 minutes with each patient, order comprehensive testing beyond what insurance typically covers, and develop individualized treatment plans addressing root causes rather than just symptoms. This approach proves especially valuable for common conditions like hypertension, diabetes, and hormonal imbalances, where lifestyle modifications and targeted interventions often prove more effective than medication alone. The practice combines primary care with specialized services including hormone replacement, weight loss, aesthetics, and hair restoration—all designed specifically for men who traditionally underutilize healthcare.

Most fascinating is Dr. Miquel's discussion of disconnects in modern medicine: elevated cholesterol doesn't always predict heart disease, imaging abnormalities don't necessarily explain pain, and protocols don't always serve patients. His refreshing approach emphasizes treating the person, not just test results—considering environmental factors, diet quality, and individual circumstances before reflexively prescribing medications that may create cascading side effects.

Ready to experience healthcare that puts you first? Visit mensonlymedical.com or call 561-725-0206 to learn how concierge medicine could transform your health journey through personalized, comprehensive care that addresses root causes instead of just managing symptoms.

Episode Transcript

Speaker 1 (00:00):
If you're a driven, active person who wants to reach
and pursue a higher qualitylife with some ambition, then
guess what this podcast is foryou.
This is the driven athletepodcast.
What's up y'all man?
Dr Kyle, welcome back to thedriven athlete podcast.
We got a really special guestwith us, dr Alex McHale from

(00:21):
Men's-only medical here in WestPalm Beach.
So I know you're busy guys.
So thank you for coming in andsharing some insights of what
you all do.

Speaker 2 (00:27):
Yeah, thanks for inviting me, so tell people
where you're at and what you do.
Yeah, so I just opened a place.
Men's Only Medical had ourgrand opening in June.
We're in downtown West PalmBeach, on Dixie, between Banning
and Clematis.
It's 116 North Dixie Highwayway.
We just created a kind ofcombination all-in-one men's

(00:48):
health facility where we doconcierge medicine and provide
primary care to members who paya yearly membership and on top
of that we have a wellnesscenter.
We provide aesthetics for men,from Botox to laser treatments.
We do hair solutions, from hairtransplants to hair restoration
with PRP injections.
We do IV fluids, hormonereplacement, weight loss

(01:09):
peptides.
You know we try to incorporatemany, if not everything that a
man would need all under oneroof.

Speaker 1 (01:18):
That's awesome.
Yeah, so family practice,that's your main education
background?

Speaker 2 (01:23):
Yeah, that's by training.
I'm a family physician.
Yeah, what'd you do with that?
Versus like orthopedics orcardio, or?
Yeah, I'm a third generationphysician.
My grandfather was a surgeon inCuba and then my father came
when he was in his early teens,grew up in Miami after that and
then went off to medical schoolhimself and became a family
physician.

(01:43):
So growing up I just watched myold man do what he did and I
like to kind of consider thosethe glory days of medicine, and
I would go to the office all thetime and just spend time with
him at the office, watch himtreat his patients and see the
relationship he would establishwith his patients, and I just
thought it was so cool.
You know, not only did I get tosee so many people come and

(02:07):
just appreciate the service thatthey were he was providing for
them, but but he, the servicesthat he was providing, helped
improve their quality of life.
You know, it either made themhealthier or kept them healthy
longer.
And as a kid, that's all I couldever remember that I wanted to
do, and it wasn't just going tomedicine, it was I wanted all I
could ever remember that Iwanted to do, and it wasn't just
going to medicine.
It was I wanted to be a familyphysician.

(02:27):
I wanted to treat the wholefamily.
I wanted to treat kids andadults, and what do they call?
Family physicians were like thejack of all trades, the bastard
of none, kind of thing.
So I didn't have to limit my,my training to one particular
field.
I got to learn about everydifferent organ system, every
different body part, uh, anddabble in everything from

(02:48):
surgery to OBGYN, to pediatrics,adult care, uh, it was just so
all encompassing that that'sjust what.
What really intrigued me as ayoung kid.

Speaker 1 (02:57):
Yeah, yeah, that's awesome.
Um, that quote Jack, of alltrades master of none is still
better than a master of one,right?
That's the thing I was like.
See, okay, yeah, I like that,you know, cause I've been called
that too, like some stuff.
Um, so, and?
And then what led you to pursue, like, opening your own
practice in a concierge setting?

Speaker 2 (03:15):
Yeah, this is um where we were previously, you
know, I think, uh, going back towhen I used to watch my dad
practice medicine back in the80s and 90s, that seemed to me
like a great situation where hehad his own private practice.

(03:36):
So he was a physician but asmall business owner.
He got to establish a rapportwith the patients, find out what
was wrong with them and thenwork with them to achieve their
goals.
And you know, if he felt thatthere was a certain medication
he needed to prescribe, he couldprescribe it.
If he felt that there was acertain study that needed to be
done, he could order it.
And then, as the years went on,things started changing.
When they started getting intothis managed care, they started

(03:58):
shifting all the risk onto thephysician and away from the
system and away from thepatients.
And then they started cuttingreimbursements and they really
made it difficult for physiciansto practice independently.
The insurance companies thesedays are really kind of pushing

(04:19):
their protocols and basicallydictating what they want you to
do for all your patients and itstarted to get frustrating what
they want you to do for all yourpatients and it started to get
frustrating.
Then I graduated, did myresidency and got out and
realized really quickly that itwas going to be virtually
impossible for me to have my ownprivate practice, like my old
man did, because I would have tosee 30, something 40 patients a
day in order to keep the lightson and make a decent living.

(04:42):
And when you're doing that,you're not providing the patient
enough time to even learn aboutthem, establish the rapport,
earn their trust and find outwhat's wrong with them, and or
deliver the care that they needor deliver the care that they
need, that's not dictated by athird party.

Speaker 1 (04:55):
Correct, you know, and no, we're going to go this
direction, right?
I don't think they need.
On the denied.

Speaker 2 (05:00):
It's like what do we do?
Automatic denials you know for,for imaging studies, certain
medications, and then you haveto just go through this gauntlet
of phone calls and peer to peercalls to try to convince them
that your patient needs what youfelt they needed all along, and
that's for one patient.
And that's for one patientTimes 30 a day.
It's ridiculous.
It's ridiculous and, um, youknow, I, I I've known for a long

(05:24):
time that it wasn't sustainablefor me.
I don't know how sustainable itis as a profession, because I'm
seeing a lot more physiciansjust being discouraged with how
the system has changed care andgoing into concierge, because it
empowers you to be able to kindof practice that old school

(05:46):
medicine again, where you canjust sit down and talk to your
patients.
You don't have to rush them inand out in 10 minutes.
You can provide them 30 minutes, 45 minutes an hour if you want
to.
You really can find out whattheir goals are.
Not everybody wants to bereflexively put on prescription
medications, you know, and Ifeel like the healthcare system
these days, and even thoughfamily medicine focuses on
preventative medicine, we'repracticing a very reflexive type

(06:08):
of medicine where we're justtreating a disease process as
opposed to trying to reallyfocus on the reason that these
disease processes are going on,with the underlying cause.
Yeah, the underlying causeexactly.
So you know, for me it wasprobably 10 years later than I

(06:29):
would have liked to have madethe conversion, because
concierge medicine has beenaround for a while but they
don't teach you much businesswhen you're going through
medical school and stuff andit's a scary venture to go into
opening your own business,whatever it is if it's a
healthcare or anything else,opening your own business
whatever it is if it's inhealthcare or anything else.
So there was probably a littlefear in there and a lot of just
not knowing how to do it.

(06:50):
But at the end of the day Ijust knew that the world of
concierge medicine allowed me topractice medicine the way I
felt like I wanted to practiceit and not just following these
protocols and these metrics thatthe insurances are are kind of
pushing out and forcing you tofollow.

Speaker 1 (07:07):
When was that shift in healthcare system where
insurances you know they'restrong arming everything?

Speaker 2 (07:14):
It started in the early to mid nineties.
Managed care really startedtaking off in the early nineties
93, 92, 93, 94 on there.
What led to that?
I think it was cost control.
I think there was probably somedecent reasoning behind it and

(07:34):
then it just kind of went waytoo far.
Yeah, so I think they wanted tocontrol the cost of healthcare,
lots of healthcare, and, and tobe honest and it's just my
opinion I felt like there was somuch money in healthcare that
everybody wanted to put theirhands in the in the honeypot.
You know one thing I tell peopleall the time is when my dad
passed away in 1996, he was 50years old had a heart attack,

(07:56):
unfortunately.
Wow, when he passed away in1996 as a family physician, he
was making more in 96 than mywife and I were making when we
moved back to West Palm Beach in2012, both being physicians
she's a pathologist and I'm afamily physician and our two
salaries combined was less thanwhat my dad was making back in

(08:16):
1996.
So I just don't know any otherprofession off the top of my
head where all these decadeshave passed and people are are
doing worse financially and thisthe stress increases because
now you don't even own yourpractice, so you always have
management and some officemanager or somebody medical

(08:36):
director who's on your backabout seeing more patients,
pushing productivity, pushingproductivity and pushing certain
products, you know, and it'sjust frustrating Wow.

Speaker 1 (08:46):
So y'all are just like.
I mean, those docs are just,they're just pawns, like they're
just being they're puppets.

Speaker 2 (08:53):
They're puppets.
Yeah, I mean, I would jokearound all the time, you know,
when I was practicing directpatient facing care, that if
this is how it's going to be, Icould put my son in here and
just give him a paper and tellhim this is what you have to do
for this patient.
You know, and it you know.
I I think there's we can go.

(09:14):
We could probably talk forhours about all the things I
think are wrong with healthcare,but for me it was the right
move.
Going to the concierge and I'lltell you what ever since we
opened this place up, I havethis newfound, just, passion for
medicine.
Again, I was waking up everyday miserable and just not
wanting to go to work, knowingit was going to be a stressful
day.
Uh, what I've said before is Ikind of equate it to like since

(09:38):
I've always wanted to be adoctor, since I was a kid, I
finally got there and kind ofgot like hit in the face with
all these changes anddisillusioned with the system,
and I equate it to like you havelike your idol, you know if
it's an athlete or an actor orwhatever it is, and you finally
meet them and you find out.
They're a dick, you know it'sjust like, or they're like a

(10:00):
jerk, you know that's.
That's what happened to me with, with health care.
So going back into I mean goinginto concierge medicine now has
me waking up every day, justhappy to go to work, excited,
yeah, just smiling all the time,just just happy.

Speaker 1 (10:13):
It's so interesting because, like very similar to
the same story that I had, likeit's the same kind of thing.
I mean just like in a, becausephysical therapy, you know ortho
, ortho, outpatient sports,whatever, it's all the same kind
.
It's just dictated by insuranceand stuff and you're just a
puppet trying to get theproductivity for whoever owns
the practice or the business orwhatever like that, and then

(10:34):
just to funnel patients and justsee more, do more units.
Why did you only do these units?
We need more units.
It's like I don't understand howI can possibly give and at the
end of the day, so dodocumentation.
Oh, yeah, yeah, it sucks.
So like you're just totally,you're drowning all the time.
Oh, it's miserable.
So, anyway, I did the samething, you know, six and a half
years ago and, um, I was likeit's the same thing.

(10:54):
I tell people I getreinvigorated.
My passion for like, like thisis I can puzzle, piece things
together and like problem solveand like work with people, talk
to them one-on-one for an hourevery time, work about
progressions and like anyway,just get excited about, um,
using talents, knowledge andskills straight to my ability,

(11:15):
versus just like I don't know,just surviving the day and then
drowning Right, you know itsucks and ultimately drowning.

Speaker 2 (11:21):
Yeah, that's what you get and at the end of the day,
the more time you spend withyour patient, the more trust you
can earn, yeah, and the betteroutcomes you have.
Oh for sure, you know, becausenow they, they really trust you,
they really feel like you knowwhat you're talking about.
They're.
You're developing arelationship I don't know if you
want to call it friendships ornot, you know with patients and
stuff, but you're establishingrelationships where they want to
come back for their follow-ups,they want to listen to your

(11:44):
advice, and if you're justshoveling people in and out,
they're leaving frustrated too.

Speaker 1 (11:49):
And I'm like I'm not going to take this stupid.
Yeah, the only people that gethurt are just the patients and
then the providers that aregetting deflated, like you were
saying, like you know, drowningand stuff.
We had a patient that she's aphysician in the area too and
she's in the area too and she'sin the in network like hospital
type of a system, drowning she'slike, she goes home, she has
like her, she spends her wholeweekend having to finish her
documentation to start on mondayagain.

(12:10):
We're like they, they had notime and they're just like
pumping out the communicationwith administration and like the
other team docs and whatever.
It's just really poor.
So patient continuity orpatients gets dished off or
dissed over or whatever.

Speaker 2 (12:25):
Like anyway, she just doesn't like it yeah, you know,
you know, and we, we bear thethe brunt of a lot of the of the
discontent from the patientsbecause they almost blame us for
it.
Yeah, right, and what theydon't realize is that we're as
frustrated as they are.
You know, I I felt it when Iwas a patient in the hospital.
I went in, for I don't rememberwhat it was.
When was the last time I was inthe hospital?

(12:49):
It was years ago, but Iremember laying in the hospital
bed.
Oh, I had a surgery on myAchilles and I had a lot of pain
over the night.
You had an Achilles repair.
I blew my Achilles out being aweekend warrior Playing softball
.
Solid, as it's said.
I blew my Achilles out being aweekend warrior playing softball
.
That's all I was going to say.
A buddy of mine had a tournamentgoing on at work and they
allowed them to bring one or twoguys that weren't related to

(13:11):
the company.
He invited me to play Hit theball.
Thought it was a home run.
So I'm doing my home run, trotrounding first, and I look up
and I see it hit off the top ofthe fence.
So I went from a trot to asprint and as soon as I planted
that left leg I felt the pop.
Wow, yeah, I was miserable.

(13:31):
But after the surgery I was in alot of pain and I remember
asking the nurse to get me ananti-inflammatory because they
had prescribed morphine orsomething for pain and it just
wasn't working and I didn't wantit anymore.
I wanted the anti-inflammatory.
And about an hour passed andshe walked by again and I'm like
did you ever hear back from thedoc?
And she's like I haven't evenhad time to call them because I
had to do my documentation.
If they don't finish theirdocumentation before a certain

(13:52):
time, they get dinged.
So now patients in the hospitalaren't getting the care they
need from their nursing staff,from their physicians, all
because of this documentation.
And it was supposed tostreamline things and make
information sharing better Right, but all it does is occupy the,
the healthcare professionals,time more, and none of these

(14:15):
EHRs really communicate, sothey're all independent systems.
So so the data sharing is isreally the same as it was before
, when you had handwrittencharts, that you still have to
fax it or email to somebody youknow it's.
So that's another thing that Ithink kind of backfired in
healthcare too, I believe it.

Speaker 1 (14:32):
That's a bummer.
So now you're doing it's men'sonly medical and you're seeing
men from 18 years old and up, 18and up.
Yeah, what led you to want todo men?
It's like, hey, I want to domen only.

Speaker 2 (14:47):
Yeah, no, that's a great question, you know, and it
kind of goes against the grainbecause men are the ones that
access healthcare less thanwomen.
We're just, you know, we're tooproud or, you know, or even
embarrassed to to talk aboutwhat's going on with us.
Yeah, so I think we got toproject toughness, right, yeah.
Yeah, we have to be a guy.

(15:07):
Yeah, we're providers, you know, and to an extent, you know, I
kind of buy into that.
But at the same time, we do itto our own detriment sometimes,
and so the easiest thing wouldhave been to do either a family
concierge, a man myself.
I just felt like man if therewas like a cool place where guys

(15:29):
could go feel comfortable, have, you know, manly colors on the
wall, leather couches, you knowjust a certain vibe, and feel to
it that men would come.
It's kind of like feel thedreams If you build it, they
will come.
So we kind of threw costume tothe wind, my business partner
and I, who's one of my bestfriends from Cardinal Newman
High School I'm a local guy here, his name is Chris Lazara and

(15:53):
we went into this venturetogether and when we were
talking about it we're like whatcould we do to kind of
differentiate ourselves from thetraditional concierge practice
and we're like let's do men.
You know, I'm very passionateabout it.
Almost sounds weird to say I'mpassionate about men or men's
health, men's health yeah.
But you know it, to me it's,it's a calling, because I live

(16:15):
through all these things thatguys are going through.
You know, if it's, if it's thedecrease in hormone and energy
levels, if it's issues with yourlibido, if it's issues with
confidence, if it's hair loss,whatever, it is.

Speaker 1 (16:32):
I'm also going through it.
So I just felt, like you know,it's good that it adds
credibility and like a trustfactor.
Right, Like I know you're goingthrough.

Speaker 2 (16:36):
Yeah, I've been through this, yeah, you know,
and I think it makes it easierfor me to treat the patient and
I think it's easier for thepatient to go on that ride with
somebody who they can relate to.
So we just decided, hey, let'sdo an all-encompassing men's
health facility, let's build itand they'll come.
And we've been open now forjust a few months and things

(16:59):
have started off, as mostbusinesses do, slow, but they're
really picking up now and nowwe have a good couple dozen
concierge members and peoplethat come in for all different
services, if it's IV fluids, ifit's skin treatments, if it's
hair treatments.
But for me it was just aboutstepping out of the box and

(17:19):
building something that Ihaven't seen out there,
something totally different,kind of pioneering this new path
of men's health.
Because, like I said, I feellike there's new path of men's
health.
Because, like I said, I feellike there's a lot of places
women can go to.
If it's a med spa, if it's afemale doctor, you know, if it's
whatever it is a wellnesscenter, a lot of these things
cater to women and we justdidn't have a place for men.

(17:41):
So I said let's, let's, let'sget it going.

Speaker 1 (17:43):
Is there anything else you'd be open to sharing?
You had your Achilles rupture.

Speaker 2 (17:47):
Let's, let's get it going.
Is there anything else you'd beopen to sharing?
You had your Achilles rupture.
I had my Achilles rupture, uh,in high school when I was
playing football.
I had a complex dislocation ofthe metacarpophalangeal joint,
uh, and what that is is theknuckle that attaches your
finger to your, to your hand uh,and tore all my tendons.
So I had to have surgery to fixall the tendons and to put the

(18:11):
bone back in place.
And at that time the handsurgeon that operated was a
really reputable guy.
He had known nationwide for hishand surgery, wrote it up in
the journal because it was onlythe fifth reported case in
history of that injury to thatparticular finger.
Interesting, wow, yeah.
And besides that, no othersurgeries or bodily Interesting,
wow, um, and besides that, um,no other surgeries or bodily
injury.

(18:31):
Well, I guess I did fall out ofa tree and broke my wrist when
I was little on Thanksgiving day, so that really made my parents
happy, Um, but besides that,you know just the typical stuff.
You know, I'm completelytransparent with everything I do
.
I did my blood work the otherday and my testosterone was low,
so, and it was low, I mean, itwas low to the point where the
lab was like excuse me, ma'am,um, I think you need some help

(18:53):
here.
And I'm like, uh, so yeah, so weuh.
So I got started on that and Ifeel so much better.
I've been on it for about amonth.
Energy levels are up, I'msleeping better.
Um, you know, I feel youthfulagain and for me it made all the
difference in the world, and alot of times we don't even know
how bad we're feeling until yousupplement what's missing.

(19:15):
You know we'll go through lifethinking that this is the norm,
but then, when you do a deeperdive and you start finding
little things and fixing them,you realize crap, obviously, the
difference it makes.

Speaker 1 (19:25):
I didn't realize I was living like this what do you
guys crap.
I don't see the difference itmakes.
I didn't realize I was livinglike this.
What do you guys?
What do you see most Like?
What kind of pathologies andissues and things that patients
ask you the most?

Speaker 2 (19:34):
Yeah, I think right now, since we we're doing a lot
of like more integrativemedicine function, you know,
functional type medicine.
So most of the guys that comein are about maintaining health
or just feeling better On theconcierge side with the primary
care.
The bread and butter of allprimary care, as far as

(19:55):
pathology goes or diseases go,is hypertension, high blood
pressure, diabetes, overweight.
Weight's a huge issue in theUnited States.
Yeah, totally.
Um, overweight, you knowweight's a huge issue in the
United States.
You know, I have conversationswith people all the time and
it's like this ongoing kind ofjoke in the world that if you
travel abroad you can tell whothe Americans are because
they're the big people that arewalking around.

Speaker 1 (20:15):
I hope we were talking with somebody recently.
They they were in Europe andthen they came back and they
were like I was eating more andum, enjoying like my trip and I
felt better than when I'm hereand I eat less and I'm like
trying and like I just feelbloated and like lethargic and
stuff like that.
Yeah, it's great, I'veexperienced it myself.

Speaker 2 (20:34):
So what is that it's?
You know it's this whole,regardless of what people want
to say and align themselves with.
And what do you want to call it?
You know they're calling it theMaha.
You know, make America healthyagain.
This movement here, um, you know, pushing the fast food, making,
you know, the bad food easierto get than than the healthy

(21:12):
food, and so the fact thatthey're focusing on that, I
think is is great.
So the like processed food,processed food, everything that
you can put in like a microwaveand anything you can pick up
through a drive-through windowand you know the amount of salt
and and and preservatives theyput in it.
It's just not good for you.
So that leads to chronic,chronic illness.

(21:32):
So everything starts with yourweight.
You know a lot of people, whenthey start gaining weight,
that's when all these problemsstart happening.
Your blood pressure goes up,your sugars start to go up
because you startdown-regulating your insulin
receptors, because you're kindof abusing them with all the
carbohydrates and sugars thatyou're consuming.
It puts stress on your jointsand that, you know, kind of

(21:54):
speaks to your world.
A lot of people that areoverweight have low back
problems, you know, knees andhips and ankle problems, and so
you know we're just an unhealthyand very inactive society,
although I'll tell you that I'venoticed a tremendous shift in
the last couple of years.

Speaker 1 (22:11):
I feel like I have too Focusing, yeah, on their
health, awareness of that andlike, wait a second, you know,
what should we focus on?
Yeah, it's great.
One of what you mentioned toois like where do you?
Okay then, where do you go forthings that's not processed?
Okay then, where do you go forthings that's not processed?
I'm always searching for ideasand stuff like that, because it
gets more challenging and pickyof where you can go to get that

(22:33):
stuff.
But I've had other people thatare really into that world and
stuff and they're like farmer'smarkets, direct-to-farmer meat,
and then produce similar kind ofthing or they grow their own
stuff.
You know, and I love that idea.
I love that idea.
There's no way do we have threekids right now, like there's no
chance.
We have no time.

Speaker 2 (22:52):
No, I mean, and it's still you know, and where do you
have the space for you know?
And they do have these indoorthings.
They're getting pretty creativeand innovative with some of
these like kind of growingsystems that you can do, um,
hydroponics in your house andstuff like that.
Um, but most people, yeah,don't have the room to like farm
, you know.
And so even when you go to thesupermarket, you know you have
options, you know you can getthe organic stuff or you can get

(23:13):
the other stuff, but then theprice difference is a real
problem for people.

Speaker 1 (23:17):
Yeah, I also heard something from a guy that's from
a Brian Johnson.
He's the guy that does thedon't die.
Yeah, he sounds.
Yeah, from Brian Johnson.
He's the guy that does thedon't die.
Yeah, he sounds.
Yeah, yeah, yeah, he's like 47.
He looks like he's like 18.
But anyway, his goal is to agethe slowest possible, yeah, so I
think it's just interesting.
I'm like, all right, I'm goingto take what I can't like see
what I can hear from this guyand see what he may have to say

(23:38):
with some things.
But anyway, I heard they weredescribing a, a study of like
where, what meat from whatsources has the most
microplastics.
So, like, what's going to bethe best for you and it's a lot
of, it's the packaging that it'sjust like put in, not aside
from, like the GMOs and you knowall this stuff that they the
farm, the, the, the produce thatthey're eating, like the cows

(24:00):
are eating, or whatever theenvironments the chickens are
raised and all the environmentaltoxins, even just that aside.
But then they're packaging itin plastic, then they're
shipping it around.
But one of the highest densitymicroplastics they're finding in
organic meat was from WholeFoods, really, and I was like,
oh my gosh, that's supposed tobe the place where everything's
fresh and organic.

(24:21):
That's a safe space.
Finally, even the air in here iscleaner.
This meat's got to be good.
Yeah, that's yeah.
Finally, even the air in hereis cleaner.
This meat's got to be good.
Yeah, that's what if?
Anyway, I don't know, I mean,that's just what I had heard.
Please, people, do your ownresearch and investigate that.
I'm always open to ideas andstuff and suggestions, but, like
I was like okay, so then wheredo we go?
You know?

Speaker 2 (24:37):
it's, it's, it's, it's frustrating, you know,
because you don't have to go toofar.
I mean, you know, because I, Idid.
I traveled to, to spain a fewtimes.
That's where my dad went tomedical school.
So we've gone to visit a fewtimes and I'll eat, you know,
normal, or I'll go out and have,you know, a nice steak dinner
and I never feel bloatedafterwards.
I never feel you feel likewalking and going around and

(24:59):
sightseeing after you eat.
You know you go out to a bigdinner here and you just want to
go home.
You want to lay down, get out,just let a truck run you over.
It's just not.
You don't feel good, that's not.
Yeah, it's not ideal, no, butto your point with the
supermarkets, you know like whenin the world has you know fruit
been able to last like two orthree weeks on your counter?
Like, that's not, it's notnormal.

(25:19):
Yeah it's not what's supposed tobuy it and eat it.
You know not just have thingsstay, but they do it on purpose
so that it lasts longer.
Yeah, it makes it moreconvenient.

Speaker 1 (25:29):
Yeah, so corporations are diving into like how can we
make things cheaper and moreprofitable on our end, right and
last longer and it'll looknicer?
Just the look.
Yeah.
To make things fluffy likebread or just fruit look
brighter, yeah.

Speaker 2 (25:43):
With wax over it or whatever.

Speaker 1 (25:51):
Yeah, yeah, with wax over it or whatever.
Like, yeah, you gotta spraysome wax on it.
Yeah, on the apples.
But I had heard that I forgetwhat the label was, but like
there was.
I had seen this.
So an article someone wasdescribing like if you scrape
the skin of the apple, you canget the way.
You can see like, oh, there's abunch of wax on here.
I saw a video about that.
Yeah, yeah, and I was like, ohman.
But I looked at apples we'regetting unfortunately, you know,
we're getting like the organicones from Costco is what we
usually go.
We live at Costco oh my gosh,for our family, and they're good
.
They're not the waxy ones.

Speaker 2 (26:10):
We have three kids.
It's a good place to go to getbang for your buck.

Speaker 1 (26:16):
Exactly, oh yeah, so the other one would be
environmental toxins that I'veheard a lot too of, just like,
as an example, farmingpesticides in the air and then
golf courses in the area, andpesticides in the air just for
maintaining the irrigation.

Speaker 2 (26:30):
Yeah, yeah, no, it's bad.
You know, and there's been alot, uh, there's been a lot of
focus on that lately.
You know, and um, one of ourbiggest kind of agricultural
businesses here is the sugarindustry.
You know, and um, a lot ofpeople try to kind of pin, you
know, some farming practices onthe algae that's growing into

(26:54):
the rivers and the feedersystems that go out into the St
Lucie, whatever it's called, thebay up there or whatever and
into the intercoastal, and Idon't know that it's coming from
them or from where it's comingfrom.
But there's definitely somethingto be said about the pesticides
and stuff, and you don't haveto look much further than listen
.
You can have every intention ofeating healthy and people will

(27:15):
focus their diet on fish, andthen you come to find out that
you have these elevated mercurylevels from eating something
that you're supposed to beeating, something that's healthy
for you and it's doing you harm.
So it's almost like you know,even when you try your best, you
can kind of shoot yourself inthe foot, so hypertension seems
to be one of the most commonpathologies.

Speaker 1 (27:38):
And it starts with just being overweight.

Speaker 2 (27:39):
A lot of it comes from being overweight.
You know, everything inhealthcare is very
multifactorial.
There's genetic components toit and then there's
environmental components to it.
There's not much you can do tochange your genetics, but
there's usually this like twohit kind of model where you have

(28:00):
the genetic predisposition forsomething, but something
environmental triggers it so sonow it's expressed.
So then it expresses, it comesout and it rears its ugly face
and then you just got to dealwith it, and a lot of times with
high blood pressure.
Now don't get me wrong.
You're going to find peoplethat are in shape and skinny
that have high blood pressure.
People that are in shape andskinny that have high

(28:20):
cholesterol.
That's kind of out of theircontrol.
But the grand majority ofpeople it's just lack of
physical activity and lack of agood diet Interesting, yeah, I
had.

Speaker 1 (28:32):
I had my blood work done recently and my LDL was
higher than I mean what would beideal, you know.
And I'm like man, it'sinteresting Cause I feel like I
eat.
I mean I definitely have cheatmeals, but you know, the
weekends usually I let a littlebit lower loose, um, or snacking
, if my kids happen to get tobed early enough and I'm like I
have like 45 minutes before Ineed to get to bed.
Like this is insane, like Iwant to have a snack.

(28:53):
That would be the only times,you know.
But anyway, I'm like what do Ido?
It had been like this actuallyfor like probably 10 years,
cause I yeah, when I firststarted my like, when I
graduated grad school 10 yearsago, I had my physician's
appointment with my previous jobthis is in Texas and they're
like, yeah, your LDL is likeelevated and I was like how you

(29:13):
know, right, but anyway, thesuggestion was like it's a
combination of like just thenutrition.
It's nutrition, maybe someenvironmental, but mostly
nutrition and then examininglike what things in the let's
talk about your diet, right,right, and then what of those
things might trigger maybe anldl type of elevated thing and,
uh, cheese seems to be one ofthose things for me.

(29:35):
Oh yeah, I love his dairy.
I don't really have that muchdairy to begin with, but anyway,
the cheese.
And I was like interesting, Ididn't even want to thought of
that because, like I have, Ihave a whole three eggs in the
morning every day, and then, um,like a, either a tortilla like
or a bagel, or like a croissantor something like a little bread
, all right, um, and then, uh, Iput cheese on the eggs, yeah,

(29:55):
and then at nighttime I'll havelike, if we have my wife will
make healthy dinners and stuff.
I'll put cheese on quinoa, orlike cheese on something else.
I'm like having cheese morefrequently.
I was like I didn't realizethat.

Speaker 2 (30:04):
Yeah, you know, and so one of the things that's
really interesting aboutcholesterol in particular is,
you know, in in in the medicalfield, it was all about
cholesterol back in the day andlow fat diets and and and lower
your cholesterol.
But then we we've seen time andtime again where people with
normal cholesterol levels aredying of heart attacks and

(30:25):
atherosclerotic plaque andpeople with elevated cholesterol
have zero cardiovasculardisease.
So there's something more to it.

Speaker 1 (30:33):
So there's a disconnect between just the
elevated LDLs Correct and thencardiovascular disease 100%
Interesting and what we found isthat.

Speaker 2 (30:41):
So one of the things we do at Men's Only Medical too,
for our concierge members is wedo their first blood work.
We do it on us.
We pay for it because theinsurance won't pay for they
deem it unnecessary.
Because we check uh,inflammatory markers, heavy
metals, autoimmune markers, likea full panel.
Full panel hormones, and notjust your testosterone.
We're checking your fsh, yourlh, your estrogen levels, your

(31:02):
prolactin level.
We we do everything and one ofthe things we do is we do this
fractionated kind of cholesterolpanel.
So we don't just get your LDL,your HDL, your triglycerides.
We get what type of LDL you have, the size of your LDL, the size
of your HDL, your applelipoprotein B.
We check the full, deep diveinto the cholesterol because

(31:24):
there are certain types andshapes of LDL that are more kind
of atherogenic, where it cancause atherosclerosis in your
arteries, and others that arevery low risk.
So you can have a very elevatedLDL and if you have the good
type of LDL you're really not atthat much risk for heart

(31:47):
disease.
Plus, your HDL, when it'selevated, becomes cardio
protective, so you can offsetsome of that elevated LDL with a
higher HDL.
How do you do that?
Just changing your diet,changing the types of oils you
cook with, you know, eatinghealthy nuts and stuff like that
, just kind of eating cleanerfats, yeah, you know.

(32:08):
And the other thing isinflammation.
Inflammation is a huge thingand it's not just for joints
anymore, you know, and we foundthat also people who develop
heart disease have a lot ofinflammation in their inside of
their arteries, which allows forthe plaque and everything to
stick to the walls easier andthen contributes to the blockage

(32:29):
that'll cause heart attacks andstrokes and stuff like that.

Speaker 1 (32:31):
Yeah, yeah, interesting.
So the good fats, likepolyunsaturated fats,
monounsaturated fats, where nutswould be an option, yeah, and I
would imagine like this is alsotoo like I mean a different
specialty of like what type ofnuts and like what we could for
them.
So you see, all right.
So I would imagine highcholesterol, hypertension and

(32:54):
then inflammatory markers on theblood work, common things, that
you and someone's overweight,they're feeling lethargic, they
don't they low libido Ifsomething other things hurt,
like their back and their kneesand stuff like that.
That's a common profile, commonprofile.

Speaker 2 (33:09):
You know, and the frustrating thing to me is that
when you go to your traditionalPCP, your primary care physician
, they're going to tell you yourcholesterol is high, your blood
pressure is high, you need tolose weight, you need to eat
better, and that's the end of it, and then take these statins.
And then, yeah, here's yourstatins, yeah, here's your
medications.
And then you're kind of left tofend for yourself where, if you

(33:31):
had better guidance andinstruction on how to lose the
weight and how to eat healthierand what type of activities you
can do to start getting some ofthat weight off, you would have
a good chance of losing theweight, dropping your blood
pressure, normalizing yourcholesterol, without even having
to be on the medications.
And that's what the approach wetake at Men's Only Medical.

(33:51):
We don't just reflexivelyprescribe medications to people.
We're not there to ignore theirhealthcare issues and their
medical issues, but we want toaddress the root cause.
We want to get down to whythese things are elevated.
Now don't get me wrong If wegive it the old college try and
we give them the guidance thatwe need to give them, and we'll
come up with a two or three pageprotocol with all sorts of

(34:16):
things that they can do, fromdifferent supplements to the
type of nutrition they shouldintake, to the type of exercises
, to even biohackingrecommendations like cold
plunges and infrared lights anddifferent things that you could
do.
And we do that and you'resticking to that and you come
back and you've lost the weight,but your cholesterol is still
high and your blood pressure isstill high.
Then we're going to have anhonest conversation about

(34:37):
starting medications.
But a lot of times you start amedication and it leads to side
effects, and then you have totake a medication to cover the
side effect that the firstmedication caused, and now
you're just a cocktail of meds.

Speaker 1 (34:49):
Yeah, you just slide down that slope 100 and we've
obviously we've all heard casesof that where like someone's
like 14 things, you know, justto counteract the other meds, so
bad the bummer, you know it'shorrible.
Um and the uh with the medic.
So medication stuff right withstatins.
Another thing I've heard a lotof was like well, joint pain is

(35:10):
a common thing with that one.
Yep muscle pain, joint pain yeah, it's the number one reason
people stop taking it but atthat point, what were the other
suggestions, like imagine, likean allopath, like a western
insurance base?
What do they do then?

Speaker 2 (35:24):
so you, what you would have to do is start on one
statin, find out they have aside effect, change them to a
different statin.
This is what the kind ofprotocol is in traditional
medicine and if they have a sideeffect to that, all that has to
be documented.
There are other medications now, like Repatha and other things
that are injectable that willlower your cholesterol.
That is not a statin.

(35:46):
That it's not a statin.
And we also have other kind ofnon-traditional treatments like
plasmapheresis.
So people are doing what'scalled therapeutic plasma
exchange, where you getconnected to a machine.
It'll take your blood out, runit through the machine and then
put it back in into your otherarm.
After it filters out all of thecertain substances it'll filter

(36:08):
out your heavy metals, it'llfilter out inflammatory
components and it'll also filterout cholesterol and
triglycerides.
So with people with significantissues with elevated
cholesterol and triglycerides,it's actually a medical
treatment.
But you have to jump throughall the hoops before you can get
there because it's a veryexpensive procedure.
It'll cost like $10,000 andinsurance isn't going to pay for

(36:28):
that?

Speaker 1 (36:29):
Yeah, of course, and you mentioned type two diabetes.
That's what you meant.
Type two, yes, um, from myunderstanding, that's reversible
.

Speaker 2 (36:37):
It's uh.
Most of the time with type twodiabetes it it is attributed to
lifestyle.
So if you can lose the weightwe usually see the kind of
typical and it's not everybodybut the typical type two
diabetic is overweight, has notvery healthy eating habits and
is very stationary.

(36:59):
So if you can get people movingand eating well and losing
weight, you can bring thatpatient's sugars down to a level
where they wouldn't have to beon medications.
Now it depends how deep theyare into it.
Some people they can be doingall the right things, but it's
gotten past a certain point andthey're always going to have to
be on some type of medication.

Speaker 1 (37:18):
Yeah, yeah, gotcha, but there is hope.
At least there's absolute hope.
It'd only be a benefit to trythat route.

Speaker 2 (37:24):
1,000%, it's part of the protocol.
A thousand percent it's part ofthe protocol and you should do
it, regardless if you're onmedications or not.
But to your point, yeah, type 1diabetes is.
Unfortunately, it's an issuewith production of insulin, so
you have to introduce theinsulin to the body, since
you're not making it yourself.
Yeah, yeah, have you seen a lotmore incidents of type 2

(37:45):
diabetes.
You know, in my career I'vebeen in health care now for
20-something years and I wouldsay it's just always been a big
problem.
It's just always been a bigproblem.
So have I seen an uptick in it?
A slight uptick, but I thinkit's only because when I got
into healthcare it was already ahuge problem to begin with.

Speaker 1 (38:04):
Interesting.
Is there something you've seenover the last several years?

Speaker 2 (38:11):
that's like this has, like this, has increased a lot
of of incidences.
Um, that's a great question.
Um, something that I've seen alot and I and I get to
experience it more secondhandbecause of my wife is cancer,
not any particular type of typeof cancer, but just cancer in
general, and I can't help butthink that it's got to be
related to a lot of these toxinsthat are either in our food,

(38:35):
you know, in our environment, inour surroundings, and we're
just seeing and my wife sees itshe'd tell you if she was here
it's crazy how many more peopleare getting cancer these days
and how many more women aregetting breast cancer younger.
It's almost a weekly thing thatshe gets biopsies of a 30

(38:57):
something year old woman withwith breast cancer.
Wow, and I would say that youknow 20, 30, 40 years ago, and I
don't have the data to back itup, but I, I would strongly
suggest people look it up, causeI, I firmly believe it and I
would be extremely shocked tofind out that the data to back
it up.
But I, I would strongly suggestpeople look it up because I, I
firmly believe it and I would beextremely shocked to find out
that the data suggests somethingotherwise, but more people have

(39:17):
cancer these days and peopleare getting them younger wow,
yeah, I uh.

Speaker 1 (39:23):
I mean fortunately I don't have any first-hand
experience with that, you know,and not my field, and what we
see, but I I could believe thatyou know, I know that, um,
something recent, like I feellike a type one diabetes has
been more prevalent over thelast couple of decades, for the
same kind of arguments that I'veheard, and uh, that seems

(39:44):
that's just interesting to me,you know, and of course parents
would feel extremely guiltyright Of like, oh, I did, I'm
feeding them this stuff and howwould I have known otherwise,
you know, or whatever, um, allthe, just the, the, the dietary,
you know, intakes of notknowing how processed everything
was, just not knowing otherwise, but um, anyway, I think like

(40:04):
that's been more prevalent.

Speaker 2 (40:07):
Yeah, uh, you know, I just think um, you, you know,
and the thing is, when you getinto family medicine, you tend
to live in the world of internalmedicine, because the
traditional family physiciansees kids of all ages, from
birth to death.
You know we're all encompassing, but because there's so many

(40:27):
pediatricians and so manyoptions, people typically take
their kids to the pediatricianand then the adults will come
and see their family physicianand type 1 diabetes is a lot
more common in kids.
Obviously, those kids go on tobe adults, but we do see it a
lot in kids and I would say thatthe pediatricians would
probably tell you that they'reseeing a lot more type 1

(40:49):
diabetics these days than theydid in the past.
It's terrible.

Speaker 1 (40:53):
I mean, we'd love to hopefully make a change with
that, you know, with just moreawareness and recognition and
stuff like that.
Yeah, what do you feel like isgoing to be the next?
Like what do you think theshift that we're seeing in
medicine, health care, overallhealth and wellness, and from
your end, from like a like whatdo you think is going to be the
next?
What direction are we going?

(41:14):
Like what's going to be reallygroundbreaking for?

Speaker 2 (41:15):
people.
I think it's it's all thenon-traditional stuff, you know.
I think it's like the.
It's really the wellnesscomponent of medicine.
It's it's really digging intopreventative medicine and not in
the not in the way that we'vealways talked about it which is
screening tests and and vaccinesand all that kind of stuff.

(41:36):
It's making sure that we areconsuming safe products, that
we're not experimenting withunsafe products, that we're
moving more and exercising, andif we do that and we can get our
population to shrink, not inthe number of people but in the
size of the people, then we'regoing to have a lot less disease

(41:59):
moving forward.
Oh, like, body mass index isshrinking, yeah, bmi, if we can
continue to go in that direction.
Childhood obesity right now Iwas reading some really
disturbing studies.
I mean it's something like onein three kids or something is
overweight or obese.
It's just, it's kind ofsickening, you know, and with
the advent of gaming and thesepersonal devices and iPads and

(42:24):
cell phones and kids don't getout as much as they used to and
then, if it starts as a kid, youjust end up being an unhealthy
adult.

Speaker 1 (42:33):
That lifestyle, that's the habit, the normal,
that's the new norm.
I totally agree.
We've heard from a lot ofdifferent parents and stuff,
family members and my nephewsand nieces and stuff like that,
but they're like, althoughfurther along we are with our
kids ages, and they were like,yeah, we're not getting our kids

(42:55):
a phone, that what I had heardfrom an expert was, when you're
ready for your kid to have umanxiety and self insecurity and
depression, then get them socialmedia and a phone.
Yeah, like well, I'm not readyfor that, I would never be ready
for that.

Speaker 2 (43:09):
I'm never ready for it.
We get in fights.
I have an 11 and a 13-year-old.
Two boys, oh, okay, my olderson has a phone now he's getting
a lot.
He's about to start high schoolnext year and it's more like we
want to be able to communicatewith him when he's out, friends
and stuff.
And the 11 year old just likewhen's my phone coming?
And we're just like you're notgetting a phone yet.

(43:30):
Yeah, you're not, you know, butbut my brother got one when he
was this age and I'm like, well,you know, you're not your
brother and for now you don'tget one, because we know, once
we get it to him, you kind oflose a kid and they start going
down the rabbit hole and try toget them out as much as possible
.
It's just harder, uh, these days, because kids are, you know,
into different things.

(43:51):
You know we they had to call usinto the house when we were
little.
Yeah, it's time for dinner,come in here.
Yeah, it was just dark out andyou're, your parents are full of
dirt, yeah parents are drivingaround like where were you?

Speaker 1 (44:01):
yeah, you know, we have dinner at six, right?
It's like I forgot to try time.
Yeah, I'm sorry, I wasn't, I'dwatch.

Speaker 2 (44:07):
I don't have a cell phone, yeah so we started
playing manhunt.
It was like dark, now perfectyeah, I mean, but those you know
, those are the good days and,uh, I think if we can get kids
active again and excited aboutbeing outside, it would go a
long way in in helping them whenthey become adults.

Speaker 1 (44:22):
Yeah, for that continuous lifestyle, yeah, um,
what about musculoskeletal stuff?

Speaker 2 (44:26):
and you'll see some of that yeah, I mean, you know I
see a lot of wear and tearstuff.
You know when, when I startseeing men as as adults already,
uh, a lot of them are formerathletes.
You know a lot of them.
If they're overweight, um, soyou know, it's a lot of low back
pain, um, a lot of knees, a lotof people with uh, with pain in
their knees.

(44:47):
And again, I think you know theway that we've started looking
at medicine and treating thesethings has gotten, I would say,
healthier as well, becausebefore it just used to be, hey,
we'll give you a cortisone shot,and that's great.
It's a really goodanti-inflammatory and it's going
to decrease your pain andinflammation for the time being,
but it's going to come back.

(45:08):
You can only do it so manytimes before you start causing
more damage to the joint thanhelping it, not to mention that
those cortisone shots increaseyour blood sugars.
It just that's what it does.
So we're actually contributingto more problems than helping
the person when we go that routethese days, with peptides and
PRP injections and stem cellsand exosomes you know so many

(45:32):
different things out there thatyou can use that help people's
bodies regenerate themselves andkind of heal naturally, as
opposed to introducing, you know, anti-inflammatories and or
prednisone, which is also ananti-inflammatory, but a
different type ofanti-inflammatory, I think is
going to be really helpful andbeneficial for people.
So yeah, knees, backs, ankles, alot of Achilles.

(45:55):
I know I was talking about itearlier how I blew out my
Achilles.
I just personally, friend-wise,I know a bunch of guys who, oh,
every day I play tennis, I wakeup the next morning and I can
barely walk because my Achillesis painful and it's bothering me
and stuff like that, and youknow a lot of those things
become chronic issues becausenobody gives themselves enough

(46:18):
time to rest and to get theinflammation down.
So they're dealing with it forweeks, if not months.
It lingers, yeah.

Speaker 1 (46:23):
Tendonitis, like lingers, oh yeah, but because we
see it a lot, you know stufflike that.
But, uh, cause we see that alot, you know stuff like that,
um, the uh for for that kind ofstuff.
And I was gonna ask about the,uh, the cortisone injections Um,
what is it that?
Like, how many?
When would you advocate for acortisone injection first, like
when it's like, yeah, that's youknow, I think it's a good time.

Speaker 2 (46:44):
Yeah, I think if somebody has, you know, kind of
more of an acute pain and it'snothing, that seems that it was
from like a significant injuryyou know, I'm not worried about
a significant tear and it's justinflammation, maybe some mild
swelling.
It's a quick fix, you know, andit's still a really good
medicine, it's a really goodtreatment.

(47:04):
Everybody that I've given letme say not everybody, most
people I give cortisone shots toin a joint tell me within a few
days I don't have the painanymore.

Speaker 1 (47:15):
So so it's a good just like quickly bringing down
a lot of heightened inflammatorypain.

Speaker 2 (47:19):
Correct that they're debilitated and it's like all
right, now we've got it likesettled Now let's do some stuff
for it, and that's what I likeand and you know very well a lot
of stuff, even like the knee,for example.
People deal with the knee ifit's mild osteoarthritis or if

(47:39):
it's some type of inflammationof the soft tissue, meniscus or
whatever it is.
You know, a people don't givethemselves, they don't afford
themselves the time that theyneed to let it heal or to rest
or anything.
People want to be active butthey're kind of re-aggravating
the injury.
So if we can calm that paindown and then start
strengthening the muscles aroundthe joint to give that joint
more support, you can actuallyhelp prevent it from recurring.

(48:02):
And again, instead of givingthe cortisone shot, which is an
anti-inflammatory to reduce theswelling once it's there, after
you've done that, let's go intothe world of PRP or exosomes or
the peptides, where it can nowuse, helps your body naturally

(48:25):
calm that inflammation down,repair the tissue that maybe
have micro tears and stuff in itso that you don't have it
recurring down the road.
So it's a good kind of fireextinguisher, the cortisone, but
it's not going to fix theproblem.

Speaker 1 (48:35):
That's a good one.
Fire extinguisher yeah, yeah,totally.
What peptides do you usuallyrecommend for that?

Speaker 2 (48:43):
There's a couple different ones.
God, why is it just escaping mymind right now?
Another common one is the BPC.
Yeah, that's one, the BPC.
Yeah, bpc-157 is the one we use, because I was just thinking we
just started talking to someguy.
He got some other stuff, someAOD and some CJC and ipamorelin,
but those are more kind of tohelp kind of build muscle.

(49:04):
Yeah, the growth hormoneanalogs and stuff like that.
But yeah, the BPC, that's theone that we use for all the
joints and soft tissueinflammation and pain.

Speaker 1 (49:13):
It's interesting you were mentioning the wear and
tear, joint pain stuff, likethat breakdown Similar to the
LDL, where it's like well, somepeople have elevated LDLs and
they have no cardiovascularissues and then some people have
low LDLs and highcardiovascular.
So there's a disconnect betweenjust like LDL and
cardiovascular right.
Similarly, what we've beenexposed to and what we talk with

(49:35):
a lot of our patients is wecan't change anything with the
bone right, the cartilagedegenerative changes, whatever.
We're not surgeons so we don'tgo and fix your labrum, whatever
.
But a lot of the research doesshow there's a huge disconnect
between abnormalities found onimaging with labral tears,
cartilage defects orchondromalacia breakdown,

(49:56):
osteoarthritis, whatever,herniated discs, facet
arthropathy, nerve issues orwhatever that cause sciatica
type symptoms, right referredpain.
And then the imaging wherethere's people that have like
pretty good looking knee MRI orx-ray and they have like a lot
of knee pain and swelling.
And then there's people thathave like that looks kind of bad
, you know, like a lot of boneon bone or like narrowing of the
joint space in the hip or likenarrowing of the disc space in

(50:20):
their lumbar spine.
We're like I feel pretty good.
What do you mean?
They're like moving around andthey're super limber.
I was like there's a hugedisconnect then between what the
imaging is showing and whethertheir functionality, prognosis
and pain.
So people and it's very commonlypeople will come in um, not as
common as you would think,actually, because the type of
people that we see are, um, youknow they're, they're very
motivated and like enthusiastic.

(50:40):
They're like I don't want, Idon't want to do that, I want to
fix this thing, like and I'mgoing to take the low, the slow
route, like I, I want to do whatI need to do, you know, yeah,
but anyway, yeah, there arestill occasionally people that
are like, but I have a herniateddisc and I'm like everybody
does.
You know we can't change that.
Anyway, everybody has aherniated disc.
It's pretty ubiquitous, but hey, like, 75% of people over the

(51:02):
age of 43 have some kind ofabnormality found on the spine
in an image, but you don't see75% of people hobbling around in
severe back pain and referredneurological pain.
So, like there's this hey, thisis supposed to be encouraging
and hopeful.
There's a disconnect betweenwhat they're finding.
So you had no pain six monthsago, but now you have like
debilitating back, like yourback's hurting a lot and you're

(51:24):
having some referred pain.
The imaging doesn't change thatquickly.
So five years ago a year agoyou had no pain, but now you do.
Your back didn't change thatmuch in a year of the image and
MRI where it looked identical,so that means you can get back
to a pain-free state withoutchanging the internal structure.
So it's supposed to beencouraging right.

Speaker 2 (51:42):
Yeah, it's really interesting that and you make
such a great point because oneof the things that everybody
should do, and you make such agreat point because one of the
things that everybody should do,and what I pride myself on, is
treating the person, not aresult, and that's why I don't

(52:03):
reflexively prescribe a statinfor everybody whose cholesterol
is elevated, because everybody'sdifferent and really
individualizing the care,because if you just do a certain
study and get a result and thenreflexively treat it, it may
not be a problem for that person, you know, but now you're
introducing a treatment modalitythat they may not need, um.
So really personalizing thecare, um, and and treating the

(52:24):
patient, not a result.
You know, I think it was thatmovie patch adams, robin
Williams.
Oh yeah, Good movie, yeah, andhe just says at the end you know
, you treat the person, not thedisease, you treat the person.
You need more compassion.
You're going to win, you know.
And so you can't just alwaysbase it on a result and you
can't just haphazardly justorder tests because you're going

(52:48):
to find something.
Yeah, you know, and there'sthis big trend now of people
doing these full body scans,like as a preventative type
thing.
Oh, just get me in the in theCAT scan machine and just do a
full body scan.
On one hand yeah, what are yourthoughts on that?
You know, on one hand, you knowknowledge is power, you know,

(53:12):
and if there's something reallybad and you catch it, but nine
times out of ten you're going tofind something and it's going
to lead you down a rabbit hole.
You're going to find some typeof benign nodule or cyst on some
type of organ.
That's going to lead to furthertesting, non-invasive or
invasive, only to find out thatit was nothing anyway.
So now you've increased yourcosts, you've increased the
stress of your body exposure tosomething.
Yeah, the radiation from a catscan or anesthesia from a biopsy

(53:35):
, the full body MRI, like samekind of same thought.
Yeah, I mean the full body MRIis different because it doesn't
expose you to radiation, butagain, it can still lead you
down the same rabbit hole.

Speaker 1 (53:47):
So your suggestion would be like all right, if
you're going to do that, just goin with the right mental
expectation, Correct, and thennot like jump off a cliff.
It's like oh, I have a smalllittle thing.

Speaker 2 (53:56):
Right, you know you have to.
That's why I think it'simportant you have to be on the
journey with your patient.
You can't just let your patientgo off on their own and try to
figure things out on their own.
You know you, really, if you'rea good physician, you're going
to walk that path with your,with your patient.
You're going to becommunicating with them, you're

(54:16):
going to be reassuring them, um,and, ideally, doing what's best
for them and what they need.
You know you can't just youcan't just do the same thing for
every patient that walks inthrough your door.
It's just not.
Again, that's kind of goingback to this whole protocol
driven insurance metrics thatthey're pushing.
You have to individualize andpersonalize the care and not

(54:39):
everybody's going to need a fullbody scan.
Not everybody's going to need,you know, peptides or hormone
replacement, or to be on astatin, regardless of what their
cholesterol is, or be on thisblood pressure medication versus
another one.
You know you have to really beon that journey with them and
care, and that's why, going backto our earlier conversation, I
love the concierge model becauseit allows me the time and the

(55:01):
ability to learn about thepatient, educate the patient and
then go down the journey withthem.

Speaker 1 (55:08):
One more question about the cortisone injections.
Injections.
I haven't heard differentthoughts on this.
How many would you say like,like, let's say hey, like a knee
or back, whatever, and they'regoing to inject it?
How many injections could thatindividual joint tolerate, or is
it a systemic three?

Speaker 2 (55:25):
three injections in any joint is the max you should
ever do.
You do more than three, thenthat cortisone is actually going
to start wearing away at thejoint, breaking out the
cartilage right, that's whatI've heard.

Speaker 1 (55:34):
Yeah, interesting.
So three, you got like two freetokens.

Speaker 2 (55:38):
Third, one's pushing it and what we find is you get
the first one that alleviatesthe pain and inflammation.
Three months later it's back.
You do a second one.
One month later it's back.
So it becomes decaf.
So it starts they start needingthem more frequently and that's
why I'm saying it's going toit's going to put the fire out,

(56:01):
but it's not going to fix theissue.

Speaker 1 (56:02):
I had a patient that this this person was a younger
person chronic back issues.
They were young, like theyweren't, they were mids, but
chronic back issues and triedmultiple routes of some things.
I think had at least twosurgeries on it and probably had
, at this point that I met thispatient, 20 injections in their

(56:25):
lumbar spine.
I was like do you think I'mokay?
I'm like, oh my gosh, it's beenbothering me a little bit again
.
I think I might go back foranother one.
I'm like, and they're like doyou think I'm okay?
And I'm like, oh my gosh,they're like, it's been
bothering me a little bit again.
I think I might go back foranother one.
I'm like stop immediately.
It was my opinion.
I can't tell you not to do that.
I'm just saying like, in myopinion, I would say I would
wait, but I'm like who's doingthis for you?

Speaker 2 (56:52):
You know, like handing out, like candy, you
know, hey, it's your medicalprofessional trust them, you
know.

Speaker 1 (56:54):
But you know, to a certain extent it's also a
business, hopefully.
Yeah, right, exactly that's theethics that come in.
It's like well, and with recentevents and again we're not
going to get political like thatbut just always question over
the last decade were some thingspushed for?
There's some kind of financialincentives or conflict by any
means?
But again, this, again, thispatient too, like patients are,
as we know, they don't alwaysknow exactly what the doc is

(57:16):
doing, you know.
So they might have beencommunicating exactly what they
were.
So hopefully it could have beenmistaken that it was cortisone
every time.
I don't know, it could havebeen something else.
Yeah, I guess we don't know.
But, they were pretty educatedand they were pretty.
They're a googler, you knowthey would google it and they
would research everything theywould.
So they were pretty on it and Iwas like, oh man, regardless
you know, you know.

Speaker 2 (57:35):
And the thing I'd say is you know, yeah, it's a lot.
So I would say, hey, you know,um, after I don't know 10, you
know and you keep having thesame problem.
Maybe it's time anotherdirection different, you know
yeah and something else might be.

Speaker 1 (57:48):
You don't need to get to 20 before you say, hey, well
, maybe something else and theywere like it was like I think 21
is going to be it, like I thinkI feel a little bit of stuff
and I was like, oh my God.

Speaker 2 (57:57):
Yeah, no, this is the last one, I swear.

Speaker 1 (57:59):
Yeah, oh man, until the next one If only we would
have was like man, if we couldhave just talked I could have
jumped to talk to off this cliff.
Way, different trajectory.
That's something I'd like withum team members that we bring on

(58:21):
, and like patients we talkabout, and like what patients we
bring in, I'm always like thestakes are high because, like
when somebody calls us and theyhave back pain or neck pain or
shoulder pain or whatever, welove helping people, by no means
that we can guarantee anything.
We've had good outcomes withthe right individuals and we're
confident that this recipe thatwe're able to present is helpful

(58:44):
.
If they don't come in to see us, then what are the other
options?
It's usually that other routeright where they descend into
like more meds, injection,surgery, whatever.
They're just despondentlyliving through pain that
nothing's getting better, I'mlike.
So the stakes are high becauseit's a way different life
trajectory, whereas, like otherpeople have success stories

(59:06):
where they were going there,where they weren't sure what
route to go.
Um, fortunately, we were ablehelp those people, which we're
not always a fit for everybody.
I totally understand that we'renot guaranteeing anything.
I'm just saying that we've hadgood success with some people
and the people that we did.
They were on the fence a waydifferent trajectory.
Now they're exercising, theyfeel really good, they listened,
they did the homework thatwe're supposed to be doing and
now they're able to work out andexercise and other than the

(59:29):
opposite, which would be like away different trajectory.

Speaker 2 (59:31):
Yeah, you know, I think it's one of those things
where you really need to educatethe pop not you or I, but in
general there has to be aneducation you know, so that
people know what their optionsare.
Yeah, because even that thatpatient probably thought he was
doing the right thing, you know,cause he didn't know any better
.
Yeah, and he's like this iswhat I'm supposed to be doing.

Speaker 1 (59:50):
Being misguided, misguided, you know, and then
it's like but what rationale?
I don't know.
I'm not making allegations onanybody.

Speaker 2 (59:59):
No, no, I don't know the situation at all, but at the
end of the day, there was sometype of lack of education or of
alternative options that thisperson just didn't have.

Speaker 1 (01:00:13):
You know that, and I think that's one thing, um, and
we can land the plane here.
But, like with social media andum, the connectivity of
information, at least that is anavenue where people are getting
a little bit more exposed toalternatives and different
things.
Yeah, double-edged sword,double-edged sword.
They're just like okay, withinreason and moderate, you know.

Speaker 2 (01:00:31):
And then guidance with the younger individuals and
stuff like that, yeah, becauseyou got to take it a step
further.
You know it's.
You see something, some people,just those people that believe
everything they see, you know,and you see it on social media
and it's the new, best thing youknow.
Next thing, you know you'reeating, like you know, ground up
tortoise feet and you're likethis is supposed to help me?

Speaker 1 (01:00:49):
yeah, exactly because , like one influencer said that,
yeah, oh my gosh, relax, allright.
Um well, that will, uh, we'llend it here.
We'll have to get you in again,like we can dive into other
stuff yeah, next time great yeahbut tell people where you're,
like, how they can best reachyou and like get in contact with
you yeah, men's only medical.

Speaker 2 (01:01:06):
Uh, we have a website .
It's men's only medicalcom.
We're, uh, downtown Palm Beach,116 North Dixie Highway on
Dixie, between Banyan andClematis in downtown West Palm.
Our phone number is561-725-0206.
I invite anybody and everybodyto come by and check it out.
There's obviously no commitment.
You get to come in and meet andhang out with one of the

(01:01:29):
coolest doctors you'll ever meetand one of the nicest
environments that you'll you'llwalk into as a doctor's office
and, at the very least, you knowyou, you get.
You get the, not just cause I'msaying you get to meet me.
But I don't think anything badcomes from having conversations,
you know, and there's nocommitment for you to just come

(01:01:49):
in and check the place out, havea conversation and see if it's
going to work for you or not,you know.
But, um, we're really excitedabout it and it's really one of
a kind kind of place.
There's nothing else like itthat I've seen.
That's just for men.
Cool, that's awesome man.

Speaker 1 (01:02:02):
Well, thanks again for coming in.
I appreciate your insights andstuff, um, and if y'all ever
have any questions, comments,questions concerns, conflicting
opinions, like, please alwaysreach out.
We're always open to differentideas and conversations and
stuff.
And, um, if you're battling anylike pain that you feel like is
limiting you with like anactive lifestyle, we'd love to
help.
We can at least chat on thephone, um, and talk more about
what you have going on, if we'rea good fit for you too, and

(01:02:23):
maybe what direction to least toguide you and um, and if they
can say if you have anyquestions, please don't.