#would’ve solved several conflicts is all I’m saying. caused several more? most definitely. but that’s not the point

[thatsit-thatsthepost]

if i said Chino WSS was a repressed homosexual would you see the vision?

[flightfoot]

What's your favorite Rick Riordan series between Percy Jackson, The Kane Chronicles, Heroes of Olympus, Magnus Chase and Trials of Apollo? (or like, if you can't choose, what do you like about the series you've read?)

Trials of Apollo, no contest. 

I liked Percy Jackson a lot, it was VERY well done. Percy was hilarious and relatable, but also just super awesome, his dynamic with Annabeth was fun to read, along with his dynamic with Grover, the quests had a lot of entertaining encounters, and it had some well-executed themes that tied in with the overall conflict nicely, mostly about how parents’ and adults’ negligence and even abuse can harm their kids, the overall effects of that, and just... generally trying to get the parents to shape up, as well as the effects of not respecting others in general, like with how the minor gods and by extension, their children, are treated by the Olympians. It comes up with Percy’s relationships with both Gabe and Poseidon, and most of the campers’ relationships with their godly parents, and that’s a MAJOR cause behind the entire conflict, and one of the major things that Percy tries to make better at the end of the last book.

Kane Chronicles... it’s been awhile since I read it. I don’t remember it having as prevalent a theme as Percy Jackson did, though there was definitely social commentary on racism, with how Carter was sometimes treated, and with how people had trouble comprehending that Carter and Sadie were full siblings, since while both are mixed, Carter’s pretty dark-skinned, while Sadie looks White. It was more of a background thing though, not a major plot point. I liked the characters and the plot fine, they were entertaining, and it was good overall - but it’s not a series I’ve felt a pressing need to reread either. Only real complaint I have about it is the romances centering around Sadie. Her and Anubis were kinda cute, but it would’ve been a lot cuter if she was older than 12-13, and he wasn’t a 4000-year-old god who looked, acted, and was treated as a 16-year-old. And then the whole thing with making it a love triangle with Walt who’s ALSO 16 and Rick’s method of “solving” the love triangle... look honestly I just would’ve been a lot more ok with the romantic shenanigans there if Sadie wasn’t a middle-schooler throughout it. Overall still good though, I’d be down for an adaptation of it, but it’s one of the few cases where I hope something IS flat-out changed to make the romances more palatable.

Heroes of Olympus is where I originally fell off of the Riordanverse. There was just so long between books and I could barely remember what happened between them, and with most of the books being like parts of the same quest (especially books 3, 4, and 5), unless you were constantly refreshing your memory of them via fandom, they were hard to follow, especially with several main characters and different character dynamics to keep track of. When I went back and read the whole set of them though, getting back into the series, it was WAY better, since I could read them as a coherent whole. I could tell he was struggling to juggle all the characters, but I thought he did a fairly decent job of it for what it was. I ended up liking all the characters - ESPECIALLY Leo, I thought he was great and relatable and funny, but I also wanted to hug him - and while the quest could drag on a bit at times, there were some interesting parts there. And Percy and Annabeth’s journey through Tartarus was GREAT. 

The themes for Heroes Of Olympus overall were pretty much the same as with Percy Jackson, but with less emphasis I think. It was mostly just “the gods (mostly Zeus, really) are being crappy again, but this time we have enough support among ourselves to manage, except for when a god is technically required to defeat a Giant”. A lot more emphasis was placed on individual character arcs and circumstances, which I think was a good choice, since with so many main characters, they needed more concentrated character development in order to put them up to par with Percy and Annabeth. Plus it allowed Rick to still go into some different themes a bit, like racism with Hazel, trauma with Leo, insecurity with Frank, etc, in a way that felt natural and relevant. It helped that they were broken up into different books for their introductions, so not everything was dumped in at once.

The ending of Heroes of Olmypus... yeah the final battle with the GIants was lame as all hell, and honestly the quest ended up feeling a bit like busywork, but screw it, I did LOVE one part of the ending. The imagery of big, bad Gaia, who even Zeus is so scared of he just wants to hide away with his head in the ground, physically manifesting and being about to take everyone out, everyone losing hope... and then screaming as Festus appears and snatches her up into the sky as Leo gives a shit-eating grin and hurls fireballs at her while insulting her the whole time is just GREAT. I always giggle, and I honestly found it a lot more memorable than the Kronos fight, even if it was technically less epic. It seemed fitting for her to be taken out in such an embarrassing way, by the boy she’d personally taken the most from.

Magnus Chase... yeah that’s the only one I didn’t finish. Quick note: its been over a year since I tried it, so I’m operating off of memory here. I wanted to like it, and after reading through Heroes of Olympus (which i originally stopped reading after Mark of Athena) and Trials of Apollo, I was all hyped up for more Riordanverse... and was disappointed. The basic elements were there, and the writing itself wasn’t bad, but... well, I never really got attached to most of the characters this time, I didn’t find the quest very interesting, and... well, you see how I mentioned about the themes in the earlier reviews? I thought Rick bit off more than he could chew with Magnus Chase, at least with the first book. (I slogged through the first book, got a hundred pages into the second book to see whether Alex, who I’d heard a lot of hype about, could save it, thought Alex was only ok but not someone who saved the book, and called it quits). 

So in Magnus Chase, Rick went DEEP into the social commentary on a lot of disparate subjects, trying to really tackle homelessness, child abuse (because no duh, that’s pretty much a staple, I think the only of his series that DOESN’T have major themes around that is Kane Chronicles), Islamophobia, ableism, and... I’m having trouble thinking of the exact term for it, but Blitzen was heavily looked down upon and derided for wanting to make fashionable armor and just being into fashion in general, so... I think it’s supposed to commentary on making fun of people for having interests that are generally seen as feminine? I guess? I dunno, it was definitely social commentary on SOMETHING, but I think the dwarves having their own particular culture here hurt whatever Rick was trying to say, since social commentary is very much tied to the culture it’s in, and we only have a small taste of dwarven culture, at least in the first book. 

In any case, all these things are fine to do social commentary on, but when you’re trying to go in-depth and really address them, it helps if they’re more tied in with the overall conflict in the book, and if each issue has room to breathe. As it was, it kinda felt to me like the characters were being paraded from location to location to confront some different social issue. I just thought it was too much, too crammed into one book, and the overall conflict had pretty much nothing to do with that. Like, at the end of the book Rick tried to tie it together with some sort of “we’re a band of misfits” message, and... well, a message based on NOT fitting in with society, isn’t one that’s very satisfying or cohesive. And the individual issues, while there’s certainly cross-sectionality between, aren’t intrinsically linked, so... they just don’t mesh together very well. Not so many, all mashed into one book. Plus I just didn’t care for any of the gods, and the only characters I liked were Magnus and Sam. Blitz and Hearthstone... they were just sort of “there” for me.

I can see why people like Magnus Chase, and it’s not BAD by any means, but it just wasn’t for me. Maybe I’ll take another crack at it at some point, but I’m not super optimistic about it. As it was, I just ended up looking up the parts where Magnus met with Annabeth and read those.

Trials of Apollo though, I ADORE. Apollo was hilarious (along with the books in general), it had a pretty focused message about child abuse and abuse in general, along with how a privileged position can blind you from the travesties that are going on around you, or that you yourself cause, and I just thought the themes worked very well. Rick went more in-depth this time on the exact consequences of child abuse and the ways that a parent could abuse and manipulate their child, something that wasn’t covered as much in his earlier series, as those were more based around neglect. I’m a sucker for a good redemption arc, and I was really impressed with how it was kinda slipped in with Apollo. Like, he didn’t even know he NEEDED one, and the good guys weren’t especially pressing him on that point, it’s a realization he slowly came to over the course of several books. And you can clearly tell that he’s conceited and has issues, but isn’t actually malicious... and slowly the reader comes to the realization that he has hidden depths, that not even HE knew he had. It’s really interesting how he did some pretty bad things (or DIDN’T do, a lot of it has to do with inaction and just being uncaring), but he never comes off as being like, evil. He comes off as being an arrogant, narcissistic person at first, but then slowly finding out that beneath that is a lot of pain and trauma, and part of that persona he’s built up has been to deal with this. Watching him slowly change and grow and discover himself during the series, in a way he never had before... it’s just amazing to read. Also puts a nice cap on the Greco-Roman saga, in that the past two series had a heavy emphasis on how the gods didn’t care enough and had to have their hands forced a lot, and Apollo sort of acting as a stand-in for those other gods, showing that yes, they CAN change for the better - something that most of the gods, and even other immortals, didn’t think was possible, even as they did it.

Well that was super long. But yeah, I have strong feelings on the Riordanverse, and Trials of Apollo is far and away my favorite.

[embidoesdreaming]

[ May 30, 2020 --- I ended up sleeping the second half of the day away ]

Series Involved: Boku no Hero Academia Theme(s): aliens; post-apocalyptic; sci-fi

I had an alien invasion-esque AU of an dream where there were these aliens that I want to say looked a little like Xenomorphs but also more anthropod-like in general, and they acted like a hivemind. The aliens were shapeshifters---any person that they saw, they could change their appearance into---and they all came from another planet from probably some other galaxy through this portal they made in order to claim Earth as their new home.

I was Deku, trying to find everyone amidst all the chaos happening when the invasion had begun and was at its worst, though mainly looking for Inko. The details are hazy/blurred together as to how exactly the chaos looked while I was going around the city, but I eventually stumbled upon some machine at some person's house --- my guts tell me that this person was a scientist, part of an organization that dabbled in this kind of sci-fi stuff, so I'm pretty sure the machine held some kind of importance that now evades me. That aside, I must've entered this house either under some kind of belief that Inko was there or for just some other significant purpose/reason that I can no longer tell, but soon after I found thks machine, something happened that cause the whole earth to shake.

The building collapsed, burying me underneath it, which brings us to a timeskip of 3 years later. How I managed to remain preserved alive is beyond me -- perhaps it was some unforeseen force; maybe the machine had something to do with it; it could just also be dream logic, but that's beside the point.

Waking up, I found that my legs were crushed. It took some work to pull myself out from all the debris, but what laid before me when I did was a post-apocalyptic setting where the aliens now roamed the Earth, desolate of the human race, along with some new alien wildlife settling into the remains of urban settlement. The hazy sky was a foreboding greenish hue, I remember seeing a couple of War of the World-esque tripod-looking aliens going around looking for gods know what in the distance --- it was real jarring to say in the least. I spent a solid minute or two at a complete loss and all confused, trying to get a grip of what's happened, when suddenly a portal like the aliens' opened up near me. I saw people coming out of it armed with guns and other protective/military(?) gear. They were survivors either looking for supplies/other survivors, or going on an expedition to investigate more on the alien invaders.

Ochako was one of them. She freaked out when she saw me, Deku. Everyone immediately went on guard -- for all they knew, I was another one of the aliens shapeshifting to look like Deku. It wasn't until they soon started to shoot and I used OFA to dodge did Ochako immediately realize I was the real thing and made everyone stop. Apparently, from what I was told later on, the aliens don't actually copy one's Quirk unless it's displayed. Basically, if they can see it, they can implement it into their system and replicate it, so everyone was eventually advised not to use their Quirks in front of an alien under any circumstances. I'm not sure how Ochako knew it was me -- I can only assume that it's because the aliens never did anything that showed they could replicate OFA for the past 3 years since I was MiA, so it was impossible for them to suddenly use OFA now.

It took some convincing before the others finally listened. It was decided that they'd taoe me back to home base, which was beyond the portal, under the condition that I was placed inside this weird container thingy so I couldn't suddenly attack. Going through the portal brought us to the aliens' home planet (which sort of looked like a jungle, at least where we came out of), except they no longer lived there because they've all migrated to Earth. Survivors have made a home base there, and have been working on reclaiming Earth back from the aliens using their technology and making it their own. The details on how they dealt with me are hazy around here, but they eventually let me out to meet all the survivors and also be brought to the infirmary.

All of Class 1-A had survived, including several important adult figures like Aizawa, All Might and so on. I also learned that not many others made it out, and that included a lot of the students' parents. Inko was.. not among the survivors, either, but in any case, all the classmates were quite shook to see that I was actually alive, stuck between relieved and on edge (which is honestly quite understandable) before eventually just being generally glad.

I saw Kacchan. He had this.. very weird look on his face. Definitely in shocm, definitely in disbelief, but also conflicted, and.. torn over something? I can't quite explain it, but he was definitely in distraught. Rather than letting Kaminari and the others convince him to go greet me, he just.. swiftly turned away and left with a bit of haste. It was confusing, but I had to go back to the infirmary, so after I did and got my legs in casts, I went looking for Kacchan.

I found him in this huge training room, doing that training exercise with those battle ropes thingies. I know I was in a wheelchair and all, but, I guess being the Deku that I was, I threw myself off of it and dragged myself towards Kacchan. At first, it's like he didn't want to notice me no matter how many times I called out to him, but soon enough he stopped and.. well, I wouldn't say ensued a fist fight, but he sure did acted very rash. He pushed me aside, or grabbed me by the shirt and threw me back, etc. We argued for some reason, and I was saying how I was already set on joining the expedition crew as soon as I could so that I could find Mom and also basically be the protagonist that I was with the big idea of solving this mess for humanity. Kacchan wasn't having none of it, belittling me and saying not to even try, especially since my legs were crushed, that I couldn't possibly recover from that. I think he might've even said that I would've been better off dead, but I'm not too sure, but the arguments continued to escalate until eventually he just.. broke down where he stood.

Turns out, his parents also didn't survive, and it was assumed that I was dead was well, so he was convinced that he had lost everyone who were really, really important to him and supported him from the beginning regardless of how he was. The pain hurt so much that he ended up detaching himself from his emotions, distancing himself from everyone and repelling them with his rude behavior, and overall closing himself completely off just so that he couldn't hurt anymore, so that he could just focus solely on killing off the aliens and exacting revenge like a cold machine.

And yet, after 3 years of detaching himself from reality, I suddenly come out of nowhere, brought back hurt but alive. It left him in a whirlwind of conflicted emotions, like: Deku was alive? How is that possible? What about his parents? Is it only Deku? Why couldn't it also be my parents? Why only Deku? Why is this happening? What kind of sick joke was this? Why now? Kacchan didn't want to care anymore, so he ‘turned himself off’, but now...

I let him vent everything out and just listened, let him recollect himself and gather his emotions, fragile as they were now, and eventually had a moment of silence together, with him sitting there eventually picking up the battle ropes if just to busy his hands with the exercise. Eventually, people from the infirmary arrived to bring me back to the infirmary and keep me there for proper treatment, because this whole time I was too scattered and stubborn and wanted to get a grip of everything first and also too hasty to find Kacchan to sit still. Kacchan had them give us 5 more minutes since I wanted to keep him company a little longer. We talked a little, about what I can't remember, but eventually he dismissed me saying to go get treated already.

Kacchan gave me the most genuine, soft, thankful smile then. I'd never seen him with such a relieved face without any sign of him holding back or attempting to cover it up with an irritated behavior or whathaveyou. A genuinely blessed smile. He was just so, so glad that he hadn't actually lost everything.

He still insisted that I don't join the expeditions back to Earth later on as I adjusted to the new life. I wasn't in any condition for it, probably might not ever be. Of course, being the Deku that I am, I was too stubborn to agree, and wanted to prove that I could. A montage/timeskip full of recovery and physical therapy later, and I reached a point where I was finally able to stand without help (save for the bars for me to hold onto just in case), then stand and slowly shuffle forward just a little without help.

There are probably bits here and there that I glossed over in this timeframe, which were just snippets of me adjusting to the new life at the base; talking to Class 1-A, to Ochako, to other survivors; learning what happened during the time I'd gone unconscious for 3 years, how people managed to get a hold of the aliens' technology and use their portal to make a base on their home planet, and what they've all been doing with this current situation. Basically one big open world-esque lore drop.

It was around the time when Deku was working on walking on his own when I separated myself from his character, now seeing him continue his physical therapy in the background while I learn more about this dream world. Apparently, this part of the dream from then on wasn't significant enough for me to remember much of it, I guess, and soon enough, I woke up.

[unfortunate-stranger-losers]

Ik why Nick is questioning his parents’ love. It’s Olaf that piece of rat shit. He’s the one who said stuff like “if your parents really loved u they’d tell you about their secrets”. Isosisk im so sorry but I can’t wait for you to kill that scum in your fic

Nick knows a lot more than he lets on, in regards to the mysteries about VFD, their parents, and even Count Olaf and the troupe. He hasn’t shared these answers for several reasons - one, while he is reasonably sure the information the Quagmires and Ol*f had were accurate, he does still have that nagging hope of “maybe if I don’t acknowledge it, it’ll turn out to not be true.” We all kinda do that every now and again- if we pretend it doesn’t exist, it’ll go away, right? 

Two, a lot of these answers are either directly emotionally conflicting for him and/or were given to him while he was enduring massive trauma, so talking about them just makes his post-traumatic stress much much worse, as seen at the end of Chapter 31 when he has a near-breakdown while simply trying to tell his siblings what he knows about VFD, and in the fact most of the answers he does hand over come out in bursts of emotion- like when he tells Klaus that their parents “fucked up” or when he asks Olivia if she knows what Olaf did to him. 

Thirdly, he knows full well that a lot of these answers will cause a shitton of emotional turmoil for his siblings. While their mental state isn’t too compromised by knowledge of VFD’s existence or the occasional namedrop, a lot of these secrets will definitely fuck with them, ie a lot of information on their parents’ involvement in VFD, how fucked up VFD is as an organization, and, of course, the whole Lemony Snicket thing. That last one, at least, he knows he has to tell Lilac at some point- she has a right to know- but she also has a right to keep it to herself if she wants, which is why he wants to tell her alone. 

Lastly, Nick’s never been good at letting people know when he was actually upset. He’s always had a bit of a hero complex, thinking he can solve anything, and he doesn’t like to admit when he’s failed. I’m not saying his siblings would’ve fared better with the trauma he went through, just that he probably was the one who could’ve been hit the hardest by it, and he definitely was. He was kidnapped and traumatized in virtually every way, with no way to save himself or his friends who were with him (who endured less pain due to the fact they knew when to keep their heads low and not antagonize their captors, but it doesn’t mean they got off scot-free) and knowing full-well that the fact he was captured meant his siblings had gone from “kidnap targets” to “brutal murder targets” and he could do nothing about it. Not to mention that he doesn’t want to burden his siblings with the knowledge of what he went through, cause he knows they’d feel guilty about it, and he doesn’t feel like he deserves pity, as seen when he tries to hide his injuries from Klaus in Chapter 21. 

So, yeah. Nick would very much like to talk about what he learned and what’s happened to him... but it’s going to take a very long time. 

[digimonadventuretimelines]

[03 - After The Re:encounter]

He opened the door of his dad’s office room after everyone had left the house, holding a few packages and juice boxes so he could feed the other two. It was like dealing with pets except said pets can eat human food.

Ulforce was still sleeping in the couch, with Natsu in her digimon form on his back. A very adorable scene, except that Daichi had to wake them up.

“Uh, good morning?”

The digimon duo opened their eyes slowly, sitting one next to the other on the couch.

“Man, I’ve been sleepin’ on the cold solid ground of a cave so this whole royal treatment is so good!” Ulforce chirped, smiling “Huh? What’s this? Food?”

“Uh, yeah… I couldn’t cook something without my mom and Kiyoko asking me about the quantity of food so… I brought some snacks and juice.”

“Oh, I miss eating those!!” Natsu cried “It brings me so many good memories…”

“Y-you’ve eaten those before, digi-girl?!” the blue digimon exclaimed.

“Daisuke and I had known each other for years…! I’m an honorary partner digimon of his.”

“That I didn’t know” Daichi seemed happier today “My dad always talked about you being an old friend of his and friends.”

“Mimi and Wallace were okay, but Vee was so jealous of me!”

“Is Vee my father’s partner digimon?” the boy asked “I thought he was just an employee from my dad’s restaurant…”

“Your dad’s partner is Vee, and he can be a little meanie compared to my loyalty to Daisuke.”

She wasn’t fine talking about another digimon, especially the one who didn’t like her at the beginning…

“You kiddin’?! He’s a legend!” Ulforce protested “He beat Chimeramon, Cherubimon Vice, Belial Vamdemon, Boltmon and Pukumon, and Diablomon’s highest form!”

“W-wow, this means… my father were in those stories?!” you can feel Daichi’s joy to hear his father had been a hero in the past.

“Not only him, but also other cool ‘mons too!” the draconian digi-child grinned, “All the Twelve are legendaries! You seem surprised, didn’t you hear about them?! They’re in the books and lore about our worlds as the ones who connected humans and digimons!”

“Um… My parents never had told me that. Actually, I didn’t even know the DigiWorld’s Ambassador was one of those most known heroes too… I’m not sure if I can tell Taisuke about that...”

“They had children” Natsu said vaguely “and they decided to not let anyone else know their identities and keep their children safe.”

That made sense, at least to Daichi.

“When the first kids of the Twelve had born, a lot of discussion between what to do and how to keep them safe happened. Then, Taichi and Daisuke decided they had to keep their identities as a secret and… Requested Homeostasis to do a soft reboot on the worlds. Their digimon kept being known, but the human partners of them got all data and memories deleted from most of the people and digimon’s heads.”

“So… No one knows the identity of the Twelve? But how can my father be controlled by the bad guys right now…?”

“I didn’t say ‘everyone’ but ‘most of them’ had their memories rebooted” she pouted “Some digimon and the Worldwide Chosen Children know their identities. Also them all had their memories untouched.”

“Man, that thing about reboots is annoyin’!!” Ulforce crossed his arms “Lots of stories got taken away! Not just that, but some don’t even believe they existed!”

“Thinking about that… That possibly happened with the first human children who fought for the DigiWorld…”

“So, my dad and ambassador Yagami weren’t the first…?”

She looked down.

“No, Taichi’s from the second generation and Daisuke from the third. The story of the first gen. is a bit of unknown… All we know is that four of their partners evolved into the Holy Beasts to fight the Four Dark Masters.”

“ENOUGH OF STORIES I WANT TO EAT!!” Ulforce roared nervously “I want those there! and that too! Aaah, human food! I’ve dreamed with this day!!”

------------------------------------------------------------------------

“Ugh, he’s spending more and more time inside without even taking a break to play with me!”

Kiyoko was not okay again, venting all of her frustrations to Taisuke and Eiji, the ones who she sees as her best friends. Despite of Eiji’s height, he’s twelve like Kiyoko, and only Taisuke is the youngest of the trio, being eleven years old.

“I don’t understand!”

“Have you tried to ask what’s bugging him?” Eiji mused “Sometimes asking is better than jumping to conclusions… I hope that’s not a little intrusive.”

“I tried!” she responded with some annoyance. She was upset with Daichi though, “Today mom left to work and then he just said ‘go play with your friends I have to study’ and… And…!!”

“He’s a meanie!” Taisuke interrupted her “Locking themselves in the office and not even coming to play with us at the park…!”

“Yeah, that!”

Though Eiji realized Taisuke wasn’t talking about Daichi only, but about someone else too…

“Who do they think they are?!” the youngest clenched his fist “They have no time for us, we’re like nothing to them?! I hate it!!”

“Yeah-- Uh, ‘they’ you mean…”

“Sigh, his father” Eiji answered “The ambassador is too busy lately and Taisuke spends more time at my house with my sister and me.”

“Oh… Yeah, I’ve heard the news” she frowned “There’s something big happening, some guys causing a fuss because of the digimon and some digimon causing a fuss because of us.”

“My dad is also busy…” he added “We barely see him these days.”

“I’m mad…!” Taisuke growled.

“At least you two aren’t hearing weird theories that my dad is dead and no one can admit that, like Daichi’s doing on a daily basis every time we talk...”

“We don’t relate to that issue but we feel sorry, Kiyoko.”

“Thanks Eiji…”

“I’d have said it’s okay to spend time studying, but honestly Daichi’s case is somehow unhealthy. Does he skip meals or pull all nighters?”

“Huh, not that I know… If he weren’t going to school I’d have said he has turned into a complete shut-in.”

“That’s a problem then… He needs to exercise at least once per day…”

“Why care about him,” Taisuke rolled his eyes “He chose that path. Let him face the consequences.”

“I don’t want to let Daichi’s health get bad…” she kept voicing her concerns “He’s definitely suffering the most with that anxiety about dad. Maybe we can do something?”

“... ‘we’ like, me and Eiji?!”

Eiji glanced at her and then started thinking of something. ------------------------------------------------------------------------

After the digimon finished their breakfast, them and Daichi started examining the mysterious D-TimeRune device given by Skuld. The boy explained then that the digivice’s design reminded him one of the several retro phones his best friend had collected.

But that made no sense to the blue digimon, since he never had seen said phone before and Daichi’s description of that sounded like a digivice to him while Natsu kept in silence. Daichi sighed, then changed the entire subject.

“I… I tried talking to mom about what we know but…”

“ ‘But’ …?”

“I lost courage,” he sighed.

“But you HAVE to tell her and Taichi!” Natsu wasn’t happy with that answer.

“I know, I know! But seems they’re too busy to hear me out!” he babbled “I can try to send him an e-mail or a voicemail… And try to talk with mom when she’s home from work tonight!”

“At this pace better you take me back to the DigiWorld so I can beat that--” Ulforce was threatened by Natsu’s deathly glare “--that m-man and then bring it back home f-for you, kid!”

“... mrs. Skuld said I can… Do something about that.”

He looked at the digivice.

“What if I use this power to prevent my dad from being captured?”

“H-Hold on, Daichi” the pink digimon gasped “You shouldn’t mess with space-time! Awful things happen to those who defy the laws of Space-Time.”

“How do you know that?” both Ulforce and Daichi frowned.

“... Feminine intuition.”

“But we can try… I won’t mess things enough to change the entire course of story!”

“Ryou, Taichi and Daisuke never messed with time, just traveled through parallel worlds. You messing with time might be worse than anything. You can end up destroying this world’s timeline or…”

“... Making me to not exist anymore?”

“Yes.”

“Whoa, wait can all of those happen?!” that V-mon definitely felt concerned with that idea.

“Natsu,” Daichi glared at her “If you had this power to save my father, would’ve you taken the chance to change his fate… Or would’ve you let him suffer and be seen as a traitor?”

“H-how do you know about that part… About him being accused of--”

“If he’s a hero and is working for the evil, then they will treat him as a traitor until proven otherwise. It’s logical. I don’t know if mom and ambassador Yagami think he’s innocent, but you do! We do!”

“Except Ulforce, though”

“I didn’t know he’s the kid’s father COME ON!!”

“But…” she looked at the boy with some concern in her face “I think it’s better to let the adults solve it. Have faith in your parents and Taichi, they will solve it--”

“I know my father is friends with Ambassador Yagami, but now that he’s on an important role, he will ignore boundaries and do what’s right for the digimon. He won’t go easy on dad, and might… Might do something wrong.”

“And why do you think that…?”

“Because as I remember, this is a threat to the human world and it might force Ambassador Yagami to put an end on this, by killing my dad.”

“... I think he wouldn’t--”

“No, he would. He’s a responsible adult, not a leader from a children’s group.”

“Hey, kid’s right” Ulforce added “If he let his mom and this Yagami-dude know about Lupinmon they gotta ground kid and do the wrong thing!”

Natsu felt conflicted. Especially because she knows Daisuke would’ve preferred her to keep Daichi and Kiyoko away from him to avoid misfortune, but on the other hand Daichi is the only one able to do something and save Daisuke.

“Please, Natsu!” Daichi begged her.

“I don’t know!!” she cried “Daisuke’s very important to me, but his children is also important! I can’t let you do something risky-- I...”

“My father would’ve done the same for me! I know it!”

Natsu’s imagination worked all again, her imagining Daisuke in front of her smiling and approving the idea of Daichi becoming a hero like him. It made her eyes shine and she nodded her head many times that the boy and blue digimon felt scared.

“LET’S GO!” she yelled “To save your father and the worlds!”

“But kid needs a partner digimon first, doesn’t he?” Ulforce looked at the digivice and then to Daichi, “This means he needs to… Return there.”

“Let’s go,” the boy nodded “If I get partnered with a digimon, I can save my father.”

“... I can’t be your partner” Natsu looked away “I can’t, sorry.”

“Who’s sayin’ it will be you!?” Ulforce pouted “Also why would he pick you!?”

“I understand” Daichi smiled “You don’t want to fight my father, is it?”

“... Let’s say it's that.”

“Then, you won’t be forced to! Now let’s go to the Digital World, I will find a digimon who’s willing to fight alongside me and then save my father and the the world.”

[paleorecipecookbook]

RHR: A Three-Step Plan to Fix Conventional Healthcare

In this episode we discuss:

The patient case that inspired the book

Who is this book for?

The mismatch between our medical paradigm and chronic disease

Drug companies and conflicts of interest

How clinicians can help create a new paradigm

The three core problems and how to solve them

What this new paradigm looks like

How do we pay for this? Is it scalable?

How allied providers are the key

Show notes:

Unconventional Medicine by Chris Kresser

Special offer for RHR podcast listeners - get the audiobook free if you buy the book by November 12th.

NaturalForce.com - use coupon “unconventional” and get $10 plus free shipping

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Chris Kresser: Hey, everybody, Chris Kresser here. Welcome to another episode of Revolution Health Radio. Today we’re going to do something a little different. I am bringing on a guest host, Tony Federico, he’s the VP of marketing for Natural Force Nutrition, a physiology editor for the Journal of Evolution and Health, and a longtime contributor to Paleo Magazine, and also at Paleo f(x), which is where I met Tony, I think, originally, and I have interacted with him the most. And he’s moderated several panels that I’ve been on and I’ve always been impressed with the way he’s done that, the intelligent questions that he asks and just his balanced perspective on ancestral health and Functional Medicine, and this movement overall. Today is the day that my new book, Unconventional Medicine, comes out. It’s now available on Amazon, and I wanted to ask Tony to come take over the podcast and talk with me about the book because I know he’s really interested in all these topics and he’s read quite a bit of the book himself, and I thought it would be more interesting to have a conversation about it than for me to just sit here and do a monologue. So Tony welcome to the show and thanks for being here. Tony Federico:  Yeah, thanks for inviting me on, Chris. It’s always fun, when we’ve had the chance to chat, as you said. Whether in person or on podcast, I’m always happy to jump in and dish on health with you. Chris:  Fantastic. So, you have read a little bit of the book and we chatted a little bit about it via email, so let’s dive in. Let’s talk a little bit about this book. And for me it was really, it felt like the most important next step that I could take in order to get this message out about ending chronic disease. Tony:  Yeah, I got my copy of Unconventional Medicine a couple days ago. I just so happened to have some time off yesterday, and the next thing I knew I was 80 pages in. Chris:  Nice. Tony:  So, I have to say that, as somebody who’s been in the trenches, I worked as a personal trainer for 10 years, I could really relate to a lot of the things that you were saying in the book, and we’ll get into why a little bit later on in the interview. But you know I just am really impressed with what you put together here, Chris. So let's just, let's get into it, and the first thing that I actually wanted you to maybe tell me a little bit about was how you open the book, which I think is a really great story about a patient named Leo. So I wanted to talk a little bit about Leo and his story and kind of how that inspired you to go down this particular path of unconventional medicine.

The patient case that inspired the book

Chris:  Sure, yeah. So, Leo was an eight-year-old boy that I treated in my clinic a few years back, and I wanted to start with his story because it's, unfortunately, a typical story, much more common than, of course, we would like. And it was powerful for me, it was a powerful experience. It's what actually led to me writing this book. So, like way too many other kids of his age, he was suffering from a number of behavioral issues. He was initially diagnosed on the autism spectrum. Eventually they settled on OCD and sensory processing disorder. He would throw these just crazy tantrums where he'd end up crying or screaming inconsolably, writhing on the floor, and this would happen for seemingly the simplest of reasons. Like trying to get his shoes tied as they were going out the door, not cutting the crust off his sandwich in just the right way or getting a stain on his favorite T-shirt. And he was really rigid around his behavior and its environment, everything had to be just right, just the way he wanted it to be, or else he would fly off the handle.

Is a new healthcare paradigm affordable? Scalable? You bet.

His diet was extremely limited, he only ate a handful of foods, pretty much all of which were processed and refined. So crackers, bread, toaster waffles, that sort of thing, and this is part of the kind of OCD-like tendencies. And any time his parents would try to introduce new food, he would go totally ballistic. And they were worried about nutrient deficiency, but they didn't feel like they ... they were just worn down. Any parent who has a kid like this will understand that. It's just they didn’t feel like they had the resources to battle him at every meal. And they took him to a bunch of doctors locally, and that’s where they got those diagnoses. Initially they were kind of relieved to have those, but then after a while they realized that they were just simply labels for symptoms. And when they asked what the treatment was, you can probably guess the answer: medication. Tony:  Something to do with drugs. Chris:  Something to do with drugs. Yeah. And when they asked how long he would be on that treatment, you can probably also guess the answer. Tony:  The rest of your life. Chris:  Yeah. Shrug of the shoulders, indefinitely, maybe he'll grow out of it, that sort of thing. And they weren't excited about the idea of of medicating their son, but they were also aware of how much he was suffering, and they were suffering, frankly, too. They decided to give them a try, starting with Adderall, and then they progressed to Ritalin and then antidepressants. And certainly the drugs did seem to help with at least some of the symptoms, but there were a couple issues. Number one, they also caused some very intractable side effects like headache, abdominal pain, irritability, and most significantly, severe sleep disruption. And they had a couple of other kids that were younger than Leo. So they were not happy about the sleep disruption. Nobody was because it was brutal for them and also brutal for Leo. Kids need a lot of sleep, and if they’re waking up throughout the night, that’s going to make ... So that was in some ways worse than the original symptoms they were trying to treat. And then Leo's mom had done quite a bit of research on the effects of these medications and she was scared. Particularly for children and adolescents, some of these drugs have some pretty scary side effects and long-term risks. So what really stood out to me, and I mentioned this in the book, is that not once during this entire process of seeing all these different doctors, primary care provider, psychiatrist, eventually behavioral disorder specialists, did anybody even hint at the possibility that something in Leo's diet or some other underlying issue like a gut problem or nutrient deficiency or heavy metal toxicity or something like that could be contributing to his symptoms. It wasn't even broached as a possibility at any time. Fortunately, Leo's mom, one of her friends followed my work and sent her a couple of articles from my blog. One was on the gut–brain–axis, and I think the other one was on the underlying root causes of behavioral disorders. And so that's what led them to bring Leo to see me, and long story short, we were able to ... we did a bunch of testing, found issues that you might guess at. So, disrupted gut microbiome, SIBO, fungal overgrowth, gluten intolerance, but also intolerance of soy and corn and rice and buckwheat, which were major ingredients in a lot of the processed and refined food products that he ate, and arsenic toxicity because rice milk was the only other beverage he would drink aside from water. And we know that rice products can be high in arsenic. So, we, over several months, it definitely wasn't easy to address these problems because of his OCD-like tendencies and his picky eating habits. But after several months he was like a different kid. His teacher even called home and was like, “What have you done with Leo and who’s this kid that you’re sending in?” Because it was a big issue for her. They often had to come to school and pick him up early because of the behavioral problems. And his diet expanded; he was eating foods he would've thrown against the wall just months before, he was more tolerant of disorder, more relaxed in his environment. They were able to travel for the first time in a long time because he wasn't so anxious in unfamiliar environments. His physical symptoms had improved significantly. So they were just over the moon. They couldn't believe it, and toward the end of our treatment together, she said something that really struck me, which was there’s so many kids out there that are like Leo and they’re suffering, they’re not finding help in the conventional system. Tony:  Sure. Chris:  And their doctors and parents are not even thinking about this stuff. Like it’s not even in most people’s consciousness that if a kid has a behavioral disorder that you should look at these physiological issues. It’s not, for 99 percent of people they don't even go there because they don't know. Tony:  Yeah, I mean I think that that was—reading about Leo and reading about a story and certainly there's people that I've known, myself included, who have had very similar experiences—I think it's great to have a narrative like this that you can really connect to because then when you tease it apart, all the pieces really make sense. It makes sense why having doctors treat symptoms has failed, it makes sense why a lack of communication between the health provider network that was supposed to be serving Leo failed. It makes sense why it didn't work when you actually start to tease it out. But then we’re still all, well not all, but most of us are still going down this path and it's an exercise in futility, really. You have an eight-year-old kid who's on powerful stimulant medications, he’s on antidepressants, and it was bad enough for his parents to reach out and to seek those interventions as solutions, and then the side effects are even worse. And that’s just something that just gets you right in the heart. And like you said, he’s not the only one, he’s not the only kid. His parents are not the only parents. And frankly, his doctors are not the only doctors because I can guarantee you that that probably doesn’t really feel good for the practitioner, for the healthcare provider to not get results as well. And they’re working with what they’ve got. Chris:  Absolutely. Tony:  And trying to use the tools they have. Chris:  Yeah, I mean, let’s be clear about this. Everybody is doing the best they can in this situation. The parents are doing the best they can, in the vast majority of situations, parents just love their kids and do everything possible that they can to help their kids thrive. I’m a parent, I know that that’s how I relate to my kid. I know that every parent I know, that’s how they relate to their kids. And I would even, I would say that’s true for doctors too. The vast majority of them are trying to do the best they can with the tools that they have and in the system that they’re working within. And that’s the rub. Tony:  Right. Chris:   It’s like most doctors I’ve seen have been caring and they’ve wanted to do the right thing, but the question is, can they do the right thing in the conventional medical system as it exists today? And, of course, that’s largely what the book is about.

Who is this book for?

Tony:  Yeah, so let’s kind of speak to that specifically. And we’re talking about doctors, we’re talking about medical professionals, we’re talking about patients, and then we didn’t mention it, but where I fit into this formula or potential formula as an allied healthcare provider, as a personal trainer/health coach, is that your audience for this book, do you really see that kind of triad is who you're speaking to here? Chris:  Yeah, definitely. I think if you look at the cover of the book, the subtitle is “join the revolution to reverse chronic disease, reinvent healthcare, and create a practice you love.” So that last bit would suggest that it's mostly for practitioners, but that's not true. It is really for anybody that is interested in the ideas of reinventing healthcare and reversing chronic disease. And, in fact, I would argue that that change is going to be initiated by people, primarily by people that are not practitioners. So it's like a grassroots, bottom-up approach, where a good example is with my training program, my ADAPT training program, now that we've been training practitioners in this approach for the last couple years, we always ask people how they learned about my work or how they learned about the training program. And in a surprising number of cases, the answer is from their patients. So these doctors or other practitioners, their patient brings an article in that I wrote or brings something in, tells them about me, and to their credit they’re open-minded enough to go and check it out. And then they like what they see and they end up taking the next step. So people even who have no intention of ever becoming a healthcare practitioner, I think would really benefit from this book if they're interested in these ideas. And then certainly, as you mentioned, licensed healthcare providers like medical doctors or nurse practitioners or physician assistants that are currently working within the conventional paradigm but have already seen its limitations and want to do something different but don't yet know what that might look like. And then people who are outside of the conventional paradigm but are already practitioners, so acupuncturists, chiropractors, naturopathic physicians, etc., in many cases they’re already well aware of the limitations of conventional medicine, which is why they chose to go down a different path. But speaking personally as an acupuncturist myself, I also saw some limitations in the traditional Chinese medicine approach, or at least some differences in the way that I wanted to practice it. I was looking for something that could incorporate modern diagnostic testing and create a more systematic approach that included ancestral diet and lifestyle and some of the other things we talk about in the book. So, I think many of those practitioners can benefit from the book from that perspective. And then you have the growing and already large number of people like yourself who are personal trainers, health coaches, nutritionists, etc., who I really think are going to play an increasingly important role in this revolution to reinvent healthcare. Tony:  Yeah, it so important now for people to really, for patients to be their own advocate, and I don't think we’re living in a time where I remember with my grandparents—if your doctor said something, it was basically gospel and you didn’t question it and you didn't think about it. Now, the first thing people do when they experience a symptom, it's Dr. Google first. So it's super important to equip and arm patients with good information, which I think this book does. Here's a path, here's a path forward for you as a patient. But then it's respectful of the role of doctors, and you highlight many situations where conventional medicine is great. If you break your arm or get in a car accident or have a heart attack or whatever the case may be, yeah, you need a doctor, and you need to go to an emergency room and you need those types of interventions. But it's really in this kind of gray area, it’s really not gray, it’s actually quite clear. And we could probably specify a little bit more, but there’s this middle zone where somebody’s not acutely injured, they’re not acutely in a disease state. They’re in a chronic disease state, or they’re just unwell. And it’s hard for a system that is all about pharmacological interventions, surgical interventions, to deal with a more subtle approach. And that’s where that whole middle ground and acupuncturists and massage therapists and everybody who's in that middle zone. I had clients constantly when I was actively training, constantly asking me questions where I was like, you know what? This is really something they maybe should be taking to their doctor. But guess what? The doctor only has 15 minutes under pressure to see as many patients as they can. I had a friend who was a physician in France. And he was telling me about their medical model, and he would spend tons of time with his patients. And it was actually incentivized for prevention. And here we see some maybe misplaced incentives, and perhaps you can speak a little bit more about that.

The mismatch between our medical paradigm and chronic disease

Chris:  Yeah, so, going back to your original comments, I think that the most important thing for people to understand is that our medical model, when it comes to our medical paradigm, is that it evolved during a time when acute problems were the biggest issues. So in 1900, the top three causes of death were all infectious diseases, tuberculosis, typhoid, and pneumonia. And the other reasons people would see the doctor were among those you mentioned, like a broken bone or a gallbladder attack or appendicitis. Tony:  War. Chris:  Right, injuries, trauma, etc. And so the treatment for that's pretty straightforward. It wasn't always successful, of course, but it was straightforward. You know, if the bone was broken, you set it in a cast. If the gallbladder was swelling, you would take it out. If someone was having appendicitis, you’d remove the appendix. So that's pretty ... it's one problem, one doctor, one treatment. Pretty straightforward. But you fast-forward to today, it's a totally different healthcare landscape. Seven of the top 10 causes of death are chronic disease rather than acute problems now, and 86 percent of the healthcare dollars we spend go toward treating chronic disease. And unlike acute problems, chronic diseases are expensive, difficult to manage and usually last for a lifetime. They don't lend themselves to that one doctor, one problem, one treatment kind of approach. The average chronic disease patient requires multiple doctors, usually one for every different part of the body in our system, and is taking ... Tony:  Specialists. Chris:  Right, specialists, they’re taking multiple medications in many cases, and they're going to be taking those medications for the rest of their life. So far, it's really, our conventional medical system is amazing for these acute problems. But it's the wrong tool for the job for chronic problems. So that's one issue, and it’s really important to point that out, because we just went through the whole healthcare debate again with the Affordable Care Act and the current administration’s proposal for a replacement, which has not come to fruition. But throughout that entire discussion, it really bothered me that there was an elephant in the room. All the discussion was around insurance. Like, who gets insurance and who doesn’t. And that’s important, it’s important to talk about that. But we have to recognize that health insurance is not the same thing as healthcare. Tony:  Yeah. Chris:  Health insurance is a method of paying for healthcare. And that’s really crucial to get that difference. Because my argument in the book is that there is no method of paying for healthcare, whether it’s the government, corporations, or individuals, that will be adequate and will be sustainable under the pressure of growing prevalence of chronic disease. It will bankrupt all of us. Government, the corporations, individuals, whoever is responsible for paying for the care will not be able to do it unless we can actually prevent and reverse chronic disease instead of just slapping Band-Aids on it. Tony:  I think the analogy you gave in the book was rearranging the deck chairs on the Titanic. “Making a few small tweaks to our current system and expecting that to work is like rearranging the deck furniture on the Titanic as it inexorably sinks into the ocean. Too little, too late.”  Chris:  Yeah, exactly. That’s the argument about insurance. As the whole ship goes under, sinks under. The other problems you mentioned are very real also. So we have a misalignment of incentives, like the insurance industry, for example, doesn't benefit when the cost of care shrinks because they only make more money when the overall expenditures rise. So it's actually not in their best interest necessarily to seek out the most cost-effective solutions.

Drug companies and conflicts of interest

Chris: And then of course, we have drug companies. People are pretty well aware of the conflicts of interest there. It’s in their interest to sell drugs, and even when that’s not in the interests of the general public or the patients or the doctors. In many cases, it’s not in their interest either. So the best example of this is a recent one. We’re in the midst of an opioid crisis, the worst we’ve ever seen by far, and the DEA has been wanting to create new regulations that restrict a pharmacy’s ability to sell opioids in ways that will protect people. So, for example, there was a pharmacy in West Virginia in a town that was tiny. It had like 30,000 people in this town, and they had ordered something like nine million opioid pills in the last year. It was clearly a front, like there’s clearly something shady going on there. There's no way that 30,000 people in that town needed nine million opioid pills, and yet there are no regulations to actually prevent that from happening. And so, the DEA had proposed some regulations to just safely protect people from that kind of thing. And the Big Pharma lobby basically shut that down and they played a big role in writing a law that limits the DEA's ability to do that kind of regulation in the midst of the worse opioid crisis ever. And to put this in perspective, we hear a lot about the gun lobbies and their control. They spend about $10.5 million lobbying Congress, I think, per year. And Big Pharma, they spent $250 million. Tony:  Wow. Chris:  Twenty-five-fold higher. Tony:  It's really tragic. I actually, I don’t think we’ve ever talked about this, but I grew up in South Florida, which was kind of ground zero for the opioid epidemic. And I remember in high school down in Miami and West Palm Beach, and kids would get a hold of a contact or whatever, somebody that had a prescription and basically would end up being a de facto drug dealer vis-à-vis a pill mill, etc. The kid across the street from me died, multiple kids in my high school died, multiple kids went into in-treatment programs, some of them battled addictions for decades. Some of them got out of it. Very few got out of it. Some of them didn't and have continued to be plagued with either switching from pharmaceuticals to street drugs like heroin, etc., and then we can see what's happening there. And that's just one example. If we look at drug consumption in the United States, is it that Americans are just that much sicker and we’re in that much more pain than people in other countries? Because we’re consuming far and away more painkillers than any other country on the planet. And I would venture to guess that you could say the same about antidepressants or ADD medication. It's very much a case of misaligned incentives. And incentives are working in the sense of the pharmaceutical companies are doing very well. Chris:  Yeah. Who are they working for is the question. Tony:  Exactly. Chris:  We’re the only country aside from New Zealand that allows direct-to-consumer drug advertising, and I think that's a big part of the problem. But it's not just Big Pharma. We also have conflicts in medical research that, of course, are related to Big Pharma because they pay for two-thirds of all medical research. We have broken payment models, where there's no real incentive or reward for good performance, and in fact, you could argue it's the other way around because doctors are compensated for, usually based on the number of procedures they order and the number of patients they see. So to your point about the doctor in France who is actually incentivized to prevent, rather than just treat disease, we don't have that at all, it's the opposite. And so there are a lot of deeply entrenched issues that we certainly need to address, and that's not essentially what this book is about. There are other books that cover that material really well, and frankly many of those issues are outside of our individual control as clinicians or practitioners.

How clinicians can help create a new paradigm

Chris: We can work toward addressing them, and I think we should, but the good news is that I think that the bigger changes that we need to focus on individually and collectively are addressing the medical paradigm which we’ve talked about, creating a medical paradigm that’s better suited to tackle chronic disease. Addressing the mismatch between our modern diet and lifestyle, and our genes and our biology, which we've, of course, talked a lot about on the show before. And then creating a new way of delivering healthcare that actually supports this new medical paradigm and this more preventative approach. Because those things are all within our control as clinicians. Tony:  Yeah. I like how you posed the question, and it was kind of a cool little, I think it was, not Hiroshi, but the person who is in charge of cooking at a Buddhist monastery. And basically a young monk comes up to this older man. He’s like, why are you doing the grunt work, basically washing rice out in the courtyard? And he says, it was like, what was it? “If not me, who? And if not now, when?” And I think that that’s really kind of the core of setting all this stuff up. Talking about the problem is really in the service of pivoting to the solution, and I’m a big believer in thinking globally, thinking big, but acting locally, hyper-locally, like yourself. Chris:  Yeah. Tony:  And then the people around you and who you can touch and impact. That’s ultimately where the power comes from. So let’s talk about that. What is in people’s power. And you started to describe some of those pillars of a new model. And you describe it as the ADAPT framework. And I don’t know how much you get into this on your regular podcast episodes, but to just kind of lay it out, ADAPT from a big-picture perspective. How does that actually address some of these systemic issues from an individually empowered stance? Chris:  Yeah, great question, and before I even go into that, I just want to say I agree that I think the change is going to happen on different levels. So, because a lot ... we’ve talked about this stuff at conferences or even some people who’ve already read the book. They say, oh, this is fantastic. I’m so excited. But how are we going to deal with Big Pharma and the insurance industry and these misaligned incentives and all of that? And can we ever deal with that? The answer is we’re not going to deal with that overnight and it’s going to take a while to unwind those things. Tony:  It’s the chronic disease, is what you call... Chris:  Exactly, exactly. And I use that analogy in the book. But the good news is that changes can happen very quickly on an individual and local level. And there’s already a lot of evidence of that happening. So my own clinic, CCFM, tripled in size in the last three years alone. We have Cleveland Clinic Center for Functional Medicine, launched by Dr. Mark Hyman, has just blown up like crazy. I mean they started in this tiny space. Now their 17,000-square-foot space, it takes up the whole second floor of the Glickman Tower at Cleveland Clinic. They've got a waitlist of 2,500 patients from nine countries around the world. This is really exciting! The Cleveland Clinic is always on the forefront of the newest trends in medicine, and the fact that they've invested that much money in this speaks volumes. Then we have groups like Iora Health, an organization based in the Rocky Mountain area that’s reversing diabetes using health coaches. So there are lots of really interesting produced concepts, and there's going to be more and more of these. Like we’re doing a pilot program with the Berkeley Fire Department where we’re working with their new recruits to help, we’re implementing a wellness program. Tony:  That’s awesome. Chris:  To reduce injuries and help with recovery and optimize their performance. And if that goes well, there’s been interest from the wider fire department and in the city of Berkeley as a whole. Robb Wolf’s done some incredible work with Reno that we’ve talked about before. So I think the change is going to happen more quickly on this local grassroots level, and then that's going to start to get the attention of people on a state and federal level. And then it will start to get really interesting.

The three core problems and how to solve them

To answer your question, in my book I basically lay out three core fundamental problems with the healthcare system in the US. And these, I argue, go even deeper than the misaligned incentives and Big Pharma and all of that stuff, although they’re, of course, connected. The first is that there is a profound mismatch between our genes and our biology and our modern diet and lifestyle. And I'm not going to say more about that now because almost everyone listening to this podcast knows exactly what I mean. The second problem is the mismatch between our medical paradigm and chronic disease, which we just talked about. We need a new medical paradigm that is better suited for chronic disease. And then the third is that the way we deliver care in this country is also, it's not set up to support the most important interventions. And we’ve touched on that too, where the average visit with the primary care provider is just actually eight to 12 minutes. Tony, you were talking about 15 minutes. That’s luxurious in our current model. The average amount of time a patient gets to speak before they’re interrupted by the doctor is 12 seconds. Tony:  Wow. Chris:  So I think it’s pretty clear that if a patient has multiple chronic diseases, which one in four Americans now do, one in two has one chronic disease, and they show up to the doctor’s office and they're on multiple medications, and they had been presenting with a whole set of new symptoms, there’s absolutely no way to provide high-quality care in a 10-minute visit. So we have to change our, not only the paradigm, but also the way that care is delivered. So that was my premise. So it follows then that my solution would address, I would hope at least those three points, right? Each of those three deficiencies. So the ADAPT framework combines an ancestral diet and lifestyle, which addresses that mismatch between our genes and biology in our modern diet and lifestyle. And then Functional Medicine is the new paradigm of medicine that is based on addressing the root cause of health problems, so we can prevent and reverse them instead of just suppressing symptoms. And then the third component is what I call a collaborative practice model, which links licensed providers like medical doctors, nurse practitioners, with what I call allied providers, which include folks like yourself, Tony, health coaches, nutritionists, personal trainers, etc., to provide a much, much higher level of care than what doctors are able to provide on their own. So, again, we're not trying to replace doctors in any, or even conventional medicine. We need people to do colonoscopies and remove cancerous tumors and use all of the incredible amount of training and expertise and skill that they’ve acquired over a lifetime of practice and study. We absolutely want that, but we need to add stuff to that that's not available now. Tony:  What that really says to me is, emphasize the importance of community, of connection, of collaboration. We’re social creatures, we’re tribal by nature. That’s another kind of Paleo/ancestral health part of the puzzle. And it would be foolish to think that we can dissect out and silo out all these different aspects of our lives without consequence. I really like this idea of bringing everybody into the fold, and it’s not saying that you can go to just the naturopath, or you can go to just the health coach. Because like I mentioned already, I certainly would’ve been ill-equipped to handle plenty of issues that a client would’ve brought to mind or brought up in conversation during a training session. But it would’ve been really great to say, ah, here's the Functional Medicine practitioner that I recommend you speak with, and to have a good relationship with that person and to be able to, as a health coach, help my clients better by getting them in touch with the right person. And that’s having this network that can really support people throughout their health journey whether it’s just feeling better and more energy, or addressing something like diabetes or hypertension. Which certainly there’s a place for all the players in that kind of scenario.

What this new paradigm looks like

Chris:  Absolutely. And let’s use an example just to bring this to life for people. So, imagine you go to the doctor and they do some blood testing for your annual physical. And they find that your fasting blood sugar is 96 or 97. Your hemoglobin A1c is 5.5, and you’ve got triglycerides that are 110, 120, maybe 130. Currently, what would happen is nothing, usually. Tony:  You’re not sick enough yet. Chris:  Yeah, all of your markers are within the lab range, they say, and that means you’re normal, and so you might get some vague advice about make sure to exercise and follow a good diet. And thank you very much, that’s it. Certainly there are exceptions to the rule, of course. There’s some practitioners who can get a lot more proactive about that. But I can’t tell you how many people, patients I’ve had that have been given that basic line with those kinds of lab results. What could happen is this. The doctor says, “Well, you know, if we think of blood sugar disorders on a spectrum, on the left you’ve got perfect blood sugar. On the right you’ve got full-fledged type 2 diabetes. You’re not on the right yet, you don’t have type 2 diabetes or even technically prediabetes, but you’re progressing along that spectrum. And what we know from a lot of research is that if we don’t intervene now, that you’re going to continue progressing. And in fact, we have studies that show that the average patient who has prediabetes, will progress to full-fledged type 2 diabetes in just five years if it’s not addressed.” So what we want to do is be proactive here. We want to intervene now because it’s much easier to prevent a disease before it occurs than it is to treat it after it’s already occurred. So here’s what we’re going to do. We’re going to set you up with our staff health coach, and they’re going to give you all the support you need to adopt a better diet. They’re actually even going to take you shopping, they’re going to come to your house and clean out your pantry with you, and they're going to give you recipes and meal plans and give you ... totally hold your hand and do everything that they need to to get you on this diet. Because we know that information is not enough. We’ve got lots of studies. I can tell you as a doctor, go eat a healthy diet, and hey, we know that that’s probably not going to happen. Most people know what they should be doing, but they’re not doing it, and it’s not because of lack of information. It’s because they need support, and we’re here to support you. We’ve got this health coach. Furthermore, we've got this great personal trainer named Tony. We’re going to set you up with him and we’re also going to set you up with a gym membership. And the good news is, your insurance is going to pay for all this. They’re going to pay for the health coach, they’re going to pay for the gym membership, they’re going to pay for your sessions with Tony. And in six months’ time, you’re going to come back here and we’re going to retest your blood markers and I can almost guarantee that if you stick with the program, you’re going to have normal blood sugar by that time. And throughout that period you’re going to have weekly check-ins with a health coach, you’re going to have training sessions. And not only will your blood sugar be normal, you’re going to lose weight, your energy levels are going to go up, your sleep’s going to get better, you’re going to feel more confident and empowered because you’re making these changes, and you’re going to feel like a different person. Now that’s totally possible.

How do we pay for this? Is it scalable?

Chris: I can hear some people saying, “Oh, how are we going to pay for that? That’s ridiculous.” Tony:  Is it scalable? Chris:  The question we should be asking is, is treating type 2 diabetes scalable? Because I mentioned this in the book, it costs $14,000 a year to treat a single patient with type 2 diabetes. So let’s imagine that this patient progresses. We don’t intervene, five years later they have type 2 diabetes. All of a sudden the healthcare system is spending $14,000 a year paying for that person’s care. And let’s say that that person gets diagnosed at age 40, which is still reasonable these days. The age of diagnosis is dropping more and more, and then let’s say that they live until they’re 85 years old, which is also possible because of our heroic medical interventions that keep people alive a lot longer than they might have been otherwise. So 45 years living with type 2 diabetes, that’s a cost of almost $650,000 for one patient to the healthcare system. Tony:  And that doesn’t even touch on the lost wages, cost to employers, when someone’s on leave, loss of productivity. And then the cost to the family members. Chris:  Absolutely. Tony:  People that are actually, are helping the patient, their health is going to be going down too. Chris:  Yeah. Nor does it touch on the qualitative aspects. Being immobilized, not being able to play with your grandkids, all of that stuff. But let’s just even forget about that for a second—$650,000, okay? And then the CDC recently came out with statistics saying that 100 million Americans have either prediabetes or diabetes, and 88 percent of people with prediabetes don’t even know that they have it. Which means they're almost certainly going to progress, right? If you do the math and you multiply 100 million people times even $14,000 for one year, you get a number that’s so large, I don’t even know what it is. It’s like a google something. It’s like, it has so many zeros after it, I don’t even know how to characterize it. But then if you multiply 100 million times like 20 or 30 years, it’s more money than there is in the world. It's like it's not going to happen. Tony:  Not sustainable, not scalable. Chris:  Not sustainable, not scalable. So let’s say in our example that we ... the healthcare system spends $10,000, which is way more than would be necessary, but let’s even say we buy the person’s groceries for three months. And their gym membership and their trainer, and their health coach, and those weekly, let’s say we spend $10,000. We’re just super generous and we spend $10,000 for that six-month period. Again, the research and my clinical experience indicates with near certainty that if the person is at that stage of not even prediabetic and we intervene, there’s like almost no chance that it’s not going to, we’re not going to be able to normalize that person’s blood sugar. And if they do that and they stick with it and they are able to do that because they now have support rather than just information, we’ve just saved the healthcare system $640,000 over the course of that patient’s lifetime. And that’s a conservative estimate, as you say. We're not including even the indirect costs. Tony:  Right, right. Chris:  I think that this is not only possible, it's going to become necessary. And whether we get there with a proactive approach where we decide to move in this direction and we make these changes or whether we get there because we absolutely have no choice, we’re going to get there. Tony:  Yeah. I mean it really sounds like we can’t afford to not do this. Chris:  Exactly. Tony:  And if we get to that point where we continue down the reactive path and we wait until there’s a total collapse, it might be too late, just to put it frankly. And it’s going to come out at a huge, not just financial cost, a huge human cost. Chris:  Yeah, it’s going to be, we can use the chronic disease metaphor again, it’s a lot easier to prevent a problem or reverse it at an earlier stage than it is to wait until the patient is essentially on life support or the healthcare system is on life support. It’s harder to reverse it at that time. And that’s of course why I’m writing the book now because I want to get this message out as far and wide as I can. Tony:  Yeah. If not now, when? If not you, who? Go right back to there.

How allied providers are the key

Chris:  Exactly. And one more thing about that is the amazing thing, the beauty of this is that it takes about eight years and hundreds of thousands of dollars to train a doctor. And it takes a certain kind of personality and a certain kind of comfort level with science, and a lot of prerequisites. It’s not for everybody. And there’s a ... already we have a shortage of doctors, and that’s predicted to get worse. I’ve seen estimates that suggest by 2025 we’ll have a shortage of 52,000 primary care physicians. So that’s a big deal. [insert image] So we already don’t have enough doctors, it’s already going to get worse, but if you think of healthcare as like a ... I have something in the book called the healthcare population pyramid. And you were referring to it earlier, Tony, where at the very top of that pyramid you’ve got 5 percent of people who are in really acute situations. So they’re in the hospital or they’re in an intensive outpatient care setting. They need the conventional medicine paradigm as it exists, and it’s fantastic for those situations. Then you’ve got another 25 percent of people in that kind of high middle of the pyramid who are dealing with some pretty serious chronic health challenges. So they require more regular care, but they’re not sick enough to be in the hospital or in any kind of ... they’re living their lives, but they’re struggling a lot. A Functional Medicine practitioner/clinician usually working in concert possibly with the conventional specialist of some kind is a really great option for that 25 percent of the pyramid. But then you’ve got the 70 percent at the bottom. So these are people who do, may have health issues, but they’re more minor, so they might have skin problems, or a little bit of brain fog, some difficulties sleeping, some GI issues. And these can be definitely debilitating and total pain, but they’re not at the level of that 25 percent. My argument is that in many cases these people could be very well served by a health coach or nutritionist with good training. And possibly seeing a Functional Medicine provider once or twice a year, or something like that. And the thing is, we can train people in a year or two without an extensive science background to be very, very objective in this role. Because they’re mostly working with patients on changing their behavior. If you think about it, most of the risk factors for chronic disease come down to the wrong behaviors. Eating the wrong diet, not getting enough sleep, not exercising, or exercising too much, or any number of things that come down to choices that we’re making. And so if a skilled health coach who’s trained in things like motivational interviewing and coaching to strengths and other evidence-based principles of facilitating behavior change which we have a ton of research on, they can be incredibly effective for that 70 percent of the population. That's the majority of the population. So we’re totally underutilizing these practitioners, and my argument is that they’re going to play a huge role in this future of medicine. And that's of course one reason why we're launching an ADAPT Health Coach Training Program next year to complement the practitioner training program that we've been doing. Because I want to create this ecosystem we've been talking about where you have all of these different types of practitioners working to the maximum of their training and ability and scope of practice and supporting each other and therefore providing the highest level of care to patients. Tony:  That certainly kind of perks my ears up hearing about the ADAPT health coach option and something that I’m personally interested in. So who knows? Maybe I can get in on that. We can talk about it again in the future. Chris:  Yeah, for sure. For sure. Tony:  So, for this particular book, for Unconventional Medicine, people are fired up, they’re hearing about it, they’re like, “Okay, this resonates with me. I’m a practitioner, I’m an allied health provider, I’m a patient, I’m ready. Now’s the time. This is it. We’re going to do this.” What’s the best way for people to get their hands on this thing? Chris:  Well not surprisingly, Amazon. They have the best way to get your hands on anything. So it’s available in paperback, Kindle, and audiobook. We’re hoping [the audiobook] is going to be out today, the day this podcast is released. But it might be another two or three days. They’re just taking their sweet time to approve it. I narrated the audiobook myself. So you podcast listeners, I figured you might be into that, since you like to listen. Tony:  They know your voice. Chris:  Yeah, and just listening to something instead of reading it perhaps. So to that end, we have a special offer for podcast listeners, because I appreciate your support and I know many of you are already part of this movement, and some are wanting to get involved. So if you buy that paperback or Kindle version between now and Sunday night, you’ll get some really cool bonuses. The first is a free copy of the audiobook. So again, we wanted to include that for podcast listeners, since we figured you guys and gals are probably interested in audio. But there are two other things that are really, I think, fantastic. And one, they’re both tools to help you be more confident and persuasive and factual when you share your passion for Functional Medicine and an ancestral diet and lifestyle. Because we’ve had a lot of questions from people, both practitioners and non-practitioners alike. They say, “Oh, how do I talk about this stuff to my sister at Thanksgiving?” Tony:  “Isn’t that that caveman diet?” Chris:  Yeah, exactly. All of our ancestors died when they were 30, so why should we even care? How do you respond to those arguments? Or if you start talking about Functional Medicine and maybe one of your conventional medicine colleagues says, “Oh, that’s just, I saw something on Science-based Medicine that said that was all just hooey. There’s nothing to it. How do you respond to that?” So what we wanted to do is give people the ammunition they needed in a respectful way. You know, this isn’t about getting the better of somebody. It’s about responding in a factual and convincing but respectful way. So we’ve got two different, we’re calling these the Power Packs. And one is for practitioners, so clinicians, health coaches, nutritionists, trainers, etc., and these are facts, research that you can reference and persuasive reasons for your clients or patients or colleagues to consider this Functional Medicine and ancestral diet and lifestyle approach. And then we have one for non-practitioners called the Supporter Power Pack. And these are smart answers and compelling comebacks, again respectful, for those common objections that you hear when you start talking about this stuff with your friends and family. So these bonuses are available until Sunday night [November 12, 2017] at 11:59 p.m. Pacific Time. So you’ve got a few days to act on that, and you can go to ... we set up a special link for you to get these and that’s Kresser.co/bonus. That’s Kresser.co/bonus. So head over there to get your Power Packs and your free audiobook, and that’s after you purchase either the paperback or Kindle. There’ll be a place where you enter your order number and we ask for some information just to verify, and I hope you enjoy those and get a lot out of them. Because they were actually really fun to put together. Tony:  Yeah, I think the audiobook is huge. I like to listen to audiobooks when I’m driving around town or outside getting some exercise. Chris:  Yeah. Tony:  So, no excuses when you make it that easy. Chris:  Yeah, yeah. So, Tony, thanks so much for doing this. This has been really fun to talk to you, as it always is. And I appreciate it. Tony:  Actually, I wanted to throw in one extra little special thing, as we mentioned, at the top of the show. I spent 10 years as a personal trainer in the trenches, I was involved with Paleo Magazine for many, many years, going to all the events, and for me kind of an evolution in my professional life was, how do I impact more people? How do I help more people? And at first I was working one on one, and then it was as a facility manager helping other trainers and coaches get better. And then I was able to scale it up that way. And last year I had an opportunity to join the team over at Natural Force, which is all-natural, nutritional products, and I basically said, “You know what? I’m going to go all in on this because if I can touch a million people through really good, high-quality nutrition, that’s me maximizing my impact and really kind of living my purpose.” So one of the things I wanted to do today is put it out there for anyone listening who maybe uses collagen or MCT oil or whey protein. We really bend over backwards to source the best ingredients in the world, no additives, all that stuff. Everything is as clean as we can possibly make it. It takes a lot of work, working with manufacturers. Kind of like what you were saying, how patients have to know how to talk to their doctor. I don’t think people really realize, and I didn’t realize until I got on the inside, how much work it is for a brand to work with their manufacturers to convince them to get outside of the conventional mold. So it’s the kind of unconventional nutrition is really what we’re pushing here. So I set up a discount code for any Revolution Health listeners. Go to NaturalForce.com, use coupon code “unconventional” and get $10 off plus free shipping on your order. So I just want to put that out there as just a little extra bonus for anybody, and I would certainly love to help in that way and really get some good, high-quality nutrition into people’s hands. Chris:  Awesome. Yeah, and there’s so many ways people can help, and I ... at Paleo f(x) we’ve see the growth of companies that are serving this space, and it's amazing. Like the products that are available now. I had breakfast this morning, I had some eggs and kale and parsley and a little bit of bacon in a couple of cassava flour tortillas. Breakfast burritos. Whoever thought I’d be having a breakfast burrito again? Tortillas are made from completely cassava flour. They’re autoimmune friendly and they’re grain-free tortillas. It’s incredible. Tony:  I think I might have some of those in my fridge as well. Chris:  Yeah. I mean there’s so many things. And these people, they’re serving this movement with that kind of work. So it’s great to see. Tony:  It takes a village, man. Chris:  It does. Thanks again, Tony. I really appreciate it. Thank you, everybody. So again, Kresser.co/bonus to pick up your free audiobook and the other bonuses, and I hope you can all join me in this revolution to reinvent healthcare. We need you, whatever your background and goals. Take care, everybody.

Source: http://chriskresser.com November 08, 2017 at 04:12PM

[oumakokichi]

Because you were talking about Juzo, I'm curious, why was Kirigiri one of your favorites as well? I feel her character development was minimalistic at best and was dropped after the first game, especially in the dr3 anime

Although Ouma is definitely myfavorite ndrv3 character, I’ve been joking a lot lately that Saihara is the one Iactually relate to the most—because I too am an anxious depressed mess, feelsocially awkward at all times, and am a huge Kirigiri fan.

While Kirigiri is certainly nota character to demonstrate her emotions very noticeably outward, I wouldn’t saythat her development is minimalistic in the first game. If anything, Kirigiriis one of the characters whose growth and development is followed the most bythe first game, after Naegi.

The thing is, her developmentstarts from a different position than Naegi’s. Rather than starting from astandpoint of being naïve and overly optimistic or trusting, Kirigiri startsout rather like Ouma, actually. She’s rather cynical at heart, especially indr1, something many people tend to forget about her character. As a detective,she accepts what neither Saihara nor Jin Kirigiri want to accept about theirjob: that people have to be doubted, suspected, and questioned.

Dr3 certainly does drop theball on her character development, but, well—it did that for everyone’scharacter development, pretty much. Future Arc started strong, showed lots ofpromise, and then sadly ruined all the potential it had with weak writing. Bydelegating Kirigiri to the role of “damsel in distress” and “beautiful self-sacrificingcinnamon roll” all at once, dr3 did a really bad job at remembering whyKirigiri became so popular in the first place, because she never used to fitinto those character tropes typically reserved for female characters in the DRseries.

While I’m glad she lived (Seiko’santidote bottle was something I noticed right away when her “death” episodefirst aired, so the foreshadowing was definitely there), I don’t feel dr3 didher justice by any means. She was forced to take a backseat role; just as Chisawas used as nothing more than an object for Munakata’s character arc, Kirigiriwas forced to parallel her by being used as an object for Naegi’s arc. And thatwas a pretty huge insult to her character, in my opinion. Had the switch beenthe other way around, with Naegi sacrificing himself (in a wonderful throwbackto dr1 Chapter 5) and Kirigiri taking an unexpected protagonist role, I would’vebeen a lot more satisfied.

But unlike other DR characters,there are plenty of other materials besides just dr3 to give us insight intoKirigiri. The Kirigiri light novels, for one, as well as the new visual novel,Kirigiri Sou. Kirigiri’s continued popularity is a testament to what sherepresents to the DR series, from a mystery perspective. Just as Junko isiconic for her role as an antagonist, Kirigiri is iconic because of her role asnot only a detective, but thedetective. All the insight she provides Naegi and the player in dr1 about whatsolving a mystery entails, about how to reflect on the mindset of both victimsand culprits, as well as what exposing the truth really means, are themes thathave come up not only in dr1 but in every other DR installment to date,including ndrv3.

Kirigiri is perhaps thecharacter whose advice and teachings have lasted the longest. She instinctivelyunderstands, and helps the player understand, what a real mystery is all about.Where ndrv3 leads the player into a false sense of security before lampshadinghow ridiculous and utterly dangerous it is to trust people blindly, Kirigiriwarns Naegi of the dangers of blind trust and extreme paranoia as early asChapter 1 in dr1. While she’s certainly aloof and uninterested in socializing,especially at first, she’s someone who grasps what the “heart” of a mystery isall about, and helps guide Naegi and the player into understanding it too. Andunderstanding the “heart” is the first step to understanding any mystery presentedin the future, too.

Kirigiri starts dr1 as someonewho is level-headed, reasonable, and extremelysecretive (excessively so, sometimes). She’s smart, calm, and collected, butcertainly not infallible; having replayed dr1 quite recently myself, I’venoticed several instances in which her failure to take action as quickly as shecould’ve causes her to be surprised and blindsided when murders take placeelsewhere. Like Ouma, she often prioritizes her own objectives in: 1.)exploring the school and exposing the mastermind behind the whole game, and 2.)finding out the truth about her own memories, backstory, and talent, so smallerhurdles and culprits among the group can and often do throw her off guard.

Most importantly to note, she’snot a team player, especially not at first. Kirigiri’s cynicism and paranoiamakes it difficult for her to trust others besides herself, though notimpossible. The one major difference between her and Ouma is that Kirigiribelieved in the necessity of trust after doubting others first. Her bond oftrust with Naegi is something gradually developed throughout the course of dr1,slowly and steadily. It’s not something she would have developed with justanyone, but rather something she and Naegi both developed specifically becauseof their shared experiences with one another.

But she certainly didn’t careto explain her motivations or objectives to the rest of the group, nor did shebelieve in telling even Naegi about what she knew on anything more than a “need-to-know”basis. She’s extremely sensitive about people butting in on her personal life. Inher FTEs she says point-blank that she feels emotions just the same as otherpeople, but that she intentionally hides them behind a mask of composure—becauseshe has nothing to gain by tipping other people off as to what she’s feeling orthinking at the moment. In this sense, she’s also quite similar to Ouma. Butwhere Ouma’s mask is all about feigning every emotion, usually in a veryexaggerated fashion, Kirigiri’s is a mask of stoicism.

When others in the group wantto know where she’s been or what she’s been doing, she doesn’t feel any need totell them. Even when it clearly begins putting the group in a more disorganizedstate and things begin reaching a boiling point in Chapters 4 and 5, sheremains extremely closed-off and secretive, and it’s clear that there’s no onein the group she would trust with any of her personal information besidesNaegi. And even Naegi, she never tells the whole story to.

Naegi had to make a consciousdecision to cover for Kirigiri’s lie in Chapter 5—it wasn’t something sheprepared him for, and she knew there was a chance she might actually be sendinghim to his death, if Alter Ego failed to kick in. Still, it was a sacrifice shewas willing to make if need be, and that’s something incredibly cold andpragmatic and that I love to see in characters who are all about “the endsjustify the means.”

Just like Ouma, she wasabsolutely dead set on investigating things to the end. She couldn’t let thingsend with her death, which is why she refused to sacrifice herself in Chapter 5,just as Ouma initially refuses to let himself die in ndrv3 Chapter 4. Hertunnel vision towards stopping the mastermind and figuring out what happened toJin Kirigiri and how far he was involved with the killing game means that shedoesn’t want other people sticking their nose into her business.

Her feelings towards Jin arethe main proof of the fact that Kirigiri can also be driven by personalvendettas, pettiness, and unresolved anger and frustration. As someone who canperfectly understand the resentment towards an absent father figure, I alwaysappreciated that Kirigiri’s conflicted feelings about Jin were handled quitewell in dr1. The narrative ultimately focuses on the fact that yes, Jin lovedhis daughter and was a caring father, but he was also careless, overlytrusting, and thoughtless about how his actions would influence others.Kirigiri was allowed to be angry at Jinwhile also still caring about him, and that was a deeply realistic and humanreaction.

I appreciate the fact thatKirigiri, especially in dr1, was a character never played for fanservice, andnever used as an object of male character development or waifu-baiting. Therewas little to no forced romance between Naegi and Kirigiri in the first gamewhich is what led me to enjoying naegiri quite a lot on my own—when thenarrative isn’t trying to push it in a romantic connotation, I tend to warm upto these sorts of ships a lot faster. Dr1 was very emphatic about appreciatingtheir dynamic as friends first, withanything more than that being a matter of personal interpretation.

The fact that she’s extremelyintelligent, capable, and arguably a protagonist in her own right thanks tospinoffs like DR: Kirigiri and Kirigiri Sou now is a large part of the reasonwhy she’s still #2 on my overall DR ranking. Before Ouma came along, she wasactually #1 and I didn’t think anyone would ever shake her position. I stillreally enjoy her every time I do a reread; if anything, Ouma’s character hasmade me appreciate Kirigiri even more, given the noticeable similaritiesbetween them.

Anyway, these are just my personalthoughts on the subject! I’ve always appreciated that Kirigiri was a characterwho both embraces and embodies the role of a detective, but who alsounderstands the full meaning of “the truth,” and isn’t afraid to lie, cheat, orrely on other cold and calculating tactics in order to achieve her objectives. She’san extremely compelling female character in my opinion, and I’ll always have abig soft spot for her. Thanks for asking, anon!

[shapesnnsizes]

RHR: A Three-Step Plan to Fix Conventional Healthcare

In this episode we discuss:

The patient case that inspired the book

Who is this book for?

The mismatch between our medical paradigm and chronic disease

Drug companies and conflicts of interest

How clinicians can help create a new paradigm

The three core problems and how to solve them

What this new paradigm looks like

How do we pay for this? Is it scalable?

How allied providers are the key

Show notes:

Unconventional Medicine by Chris Kresser

Special offer for RHR podcast listeners - get the audiobook free if you buy the book by November 12th.

NaturalForce.com - use coupon “unconventional” and get $10 plus free shipping

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Chris Kresser: Hey, everybody, Chris Kresser here. Welcome to another episode of Revolution Health Radio. Today we’re going to do something a little different. I am bringing on a guest host, Tony Federico, he’s the VP of marketing for Natural Force Nutrition, a physiology editor for the Journal of Evolution and Health, and a longtime contributor to Paleo Magazine, and also at Paleo f(x), which is where I met Tony, I think, originally, and I have interacted with him the most. And he’s moderated several panels that I’ve been on and I’ve always been impressed with the way he’s done that, the intelligent questions that he asks and just his balanced perspective on ancestral health and Functional Medicine, and this movement overall. Today is the day that my new book, Unconventional Medicine, comes out. It’s now available on Amazon, and I wanted to ask Tony to come take over the podcast and talk with me about the book because I know he’s really interested in all these topics and he’s read quite a bit of the book himself, and I thought it would be more interesting to have a conversation about it than for me to just sit here and do a monologue. So Tony welcome to the show and thanks for being here. Tony Federico:  Yeah, thanks for inviting me on, Chris. It’s always fun, when we’ve had the chance to chat, as you said. Whether in person or on podcast, I’m always happy to jump in and dish on health with you. Chris:  Fantastic. So, you have read a little bit of the book and we chatted a little bit about it via email, so let’s dive in. Let’s talk a little bit about this book. And for me it was really, it felt like the most important next step that I could take in order to get this message out about ending chronic disease. Tony:  Yeah, I got my copy of Unconventional Medicine a couple days ago. I just so happened to have some time off yesterday, and the next thing I knew I was 80 pages in. Chris:  Nice. Tony:  So, I have to say that, as somebody who’s been in the trenches, I worked as a personal trainer for 10 years, I could really relate to a lot of the things that you were saying in the book, and we’ll get into why a little bit later on in the interview. But you know I just am really impressed with what you put together here, Chris. So let's just, let's get into it, and the first thing that I actually wanted you to maybe tell me a little bit about was how you open the book, which I think is a really great story about a patient named Leo. So I wanted to talk a little bit about Leo and his story and kind of how that inspired you to go down this particular path of unconventional medicine.

The patient case that inspired the book

Chris:  Sure, yeah. So, Leo was an eight-year-old boy that I treated in my clinic a few years back, and I wanted to start with his story because it's, unfortunately, a typical story, much more common than, of course, we would like. And it was powerful for me, it was a powerful experience. It's what actually led to me writing this book. So, like way too many other kids of his age, he was suffering from a number of behavioral issues. He was initially diagnosed on the autism spectrum. Eventually they settled on OCD and sensory processing disorder. He would throw these just crazy tantrums where he'd end up crying or screaming inconsolably, writhing on the floor, and this would happen for seemingly the simplest of reasons. Like trying to get his shoes tied as they were going out the door, not cutting the crust off his sandwich in just the right way or getting a stain on his favorite T-shirt. And he was really rigid around his behavior and its environment, everything had to be just right, just the way he wanted it to be, or else he would fly off the handle.

Is a new healthcare paradigm affordable? Scalable? You bet.

His diet was extremely limited, he only ate a handful of foods, pretty much all of which were processed and refined. So crackers, bread, toaster waffles, that sort of thing, and this is part of the kind of OCD-like tendencies. And any time his parents would try to introduce new food, he would go totally ballistic. And they were worried about nutrient deficiency, but they didn't feel like they ... they were just worn down. Any parent who has a kid like this will understand that. It's just they didn’t feel like they had the resources to battle him at every meal. And they took him to a bunch of doctors locally, and that’s where they got those diagnoses. Initially they were kind of relieved to have those, but then after a while they realized that they were just simply labels for symptoms. And when they asked what the treatment was, you can probably guess the answer: medication. Tony:  Something to do with drugs. Chris:  Something to do with drugs. Yeah. And when they asked how long he would be on that treatment, you can probably also guess the answer. Tony:  The rest of your life. Chris:  Yeah. Shrug of the shoulders, indefinitely, maybe he'll grow out of it, that sort of thing. And they weren't excited about the idea of of medicating their son, but they were also aware of how much he was suffering, and they were suffering, frankly, too. They decided to give them a try, starting with Adderall, and then they progressed to Ritalin and then antidepressants. And certainly the drugs did seem to help with at least some of the symptoms, but there were a couple issues. Number one, they also caused some very intractable side effects like headache, abdominal pain, irritability, and most significantly, severe sleep disruption. And they had a couple of other kids that were younger than Leo. So they were not happy about the sleep disruption. Nobody was because it was brutal for them and also brutal for Leo. Kids need a lot of sleep, and if they’re waking up throughout the night, that’s going to make ... So that was in some ways worse than the original symptoms they were trying to treat. And then Leo's mom had done quite a bit of research on the effects of these medications and she was scared. Particularly for children and adolescents, some of these drugs have some pretty scary side effects and long-term risks. So what really stood out to me, and I mentioned this in the book, is that not once during this entire process of seeing all these different doctors, primary care provider, psychiatrist, eventually behavioral disorder specialists, did anybody even hint at the possibility that something in Leo's diet or some other underlying issue like a gut problem or nutrient deficiency or heavy metal toxicity or something like that could be contributing to his symptoms. It wasn't even broached as a possibility at any time. Fortunately, Leo's mom, one of her friends followed my work and sent her a couple of articles from my blog. One was on the gut–brain–axis, and I think the other one was on the underlying root causes of behavioral disorders. And so that's what led them to bring Leo to see me, and long story short, we were able to ... we did a bunch of testing, found issues that you might guess at. So, disrupted gut microbiome, SIBO, fungal overgrowth, gluten intolerance, but also intolerance of soy and corn and rice and buckwheat, which were major ingredients in a lot of the processed and refined food products that he ate, and arsenic toxicity because rice milk was the only other beverage he would drink aside from water. And we know that rice products can be high in arsenic. So, we, over several months, it definitely wasn't easy to address these problems because of his OCD-like tendencies and his picky eating habits. But after several months he was like a different kid. His teacher even called home and was like, “What have you done with Leo and who’s this kid that you’re sending in?” Because it was a big issue for her. They often had to come to school and pick him up early because of the behavioral problems. And his diet expanded; he was eating foods he would've thrown against the wall just months before, he was more tolerant of disorder, more relaxed in his environment. They were able to travel for the first time in a long time because he wasn't so anxious in unfamiliar environments. His physical symptoms had improved significantly. So they were just over the moon. They couldn't believe it, and toward the end of our treatment together, she said something that really struck me, which was there’s so many kids out there that are like Leo and they’re suffering, they’re not finding help in the conventional system. Tony:  Sure. Chris:  And their doctors and parents are not even thinking about this stuff. Like it’s not even in most people’s consciousness that if a kid has a behavioral disorder that you should look at these physiological issues. It’s not, for 99 percent of people they don't even go there because they don't know. Tony:  Yeah, I mean I think that that was—reading about Leo and reading about a story and certainly there's people that I've known, myself included, who have had very similar experiences—I think it's great to have a narrative like this that you can really connect to because then when you tease it apart, all the pieces really make sense. It makes sense why having doctors treat symptoms has failed, it makes sense why a lack of communication between the health provider network that was supposed to be serving Leo failed. It makes sense why it didn't work when you actually start to tease it out. But then we’re still all, well not all, but most of us are still going down this path and it's an exercise in futility, really. You have an eight-year-old kid who's on powerful stimulant medications, he’s on antidepressants, and it was bad enough for his parents to reach out and to seek those interventions as solutions, and then the side effects are even worse. And that’s just something that just gets you right in the heart. And like you said, he’s not the only one, he’s not the only kid. His parents are not the only parents. And frankly, his doctors are not the only doctors because I can guarantee you that that probably doesn’t really feel good for the practitioner, for the healthcare provider to not get results as well. And they’re working with what they’ve got. Chris:  Absolutely. Tony:  And trying to use the tools they have. Chris:  Yeah, I mean, let’s be clear about this. Everybody is doing the best they can in this situation. The parents are doing the best they can, in the vast majority of situations, parents just love their kids and do everything possible that they can to help their kids thrive. I’m a parent, I know that that’s how I relate to my kid. I know that every parent I know, that’s how they relate to their kids. And I would even, I would say that’s true for doctors too. The vast majority of them are trying to do the best they can with the tools that they have and in the system that they’re working within. And that’s the rub. Tony:  Right. Chris:   It’s like most doctors I’ve seen have been caring and they’ve wanted to do the right thing, but the question is, can they do the right thing in the conventional medical system as it exists today? And, of course, that’s largely what the book is about.

Who is this book for?

Tony:  Yeah, so let’s kind of speak to that specifically. And we’re talking about doctors, we’re talking about medical professionals, we’re talking about patients, and then we didn’t mention it, but where I fit into this formula or potential formula as an allied healthcare provider, as a personal trainer/health coach, is that your audience for this book, do you really see that kind of triad is who you're speaking to here? Chris:  Yeah, definitely. I think if you look at the cover of the book, the subtitle is “join the revolution to reverse chronic disease, reinvent healthcare, and create a practice you love.” So that last bit would suggest that it's mostly for practitioners, but that's not true. It is really for anybody that is interested in the ideas of reinventing healthcare and reversing chronic disease. And, in fact, I would argue that that change is going to be initiated by people, primarily by people that are not practitioners. So it's like a grassroots, bottom-up approach, where a good example is with my training program, my ADAPT training program, now that we've been training practitioners in this approach for the last couple years, we always ask people how they learned about my work or how they learned about the training program. And in a surprising number of cases, the answer is from their patients. So these doctors or other practitioners, their patient brings an article in that I wrote or brings something in, tells them about me, and to their credit they’re open-minded enough to go and check it out. And then they like what they see and they end up taking the next step. So people even who have no intention of ever becoming a healthcare practitioner, I think would really benefit from this book if they're interested in these ideas. And then certainly, as you mentioned, licensed healthcare providers like medical doctors or nurse practitioners or physician assistants that are currently working within the conventional paradigm but have already seen its limitations and want to do something different but don't yet know what that might look like. And then people who are outside of the conventional paradigm but are already practitioners, so acupuncturists, chiropractors, naturopathic physicians, etc., in many cases they’re already well aware of the limitations of conventional medicine, which is why they chose to go down a different path. But speaking personally as an acupuncturist myself, I also saw some limitations in the traditional Chinese medicine approach, or at least some differences in the way that I wanted to practice it. I was looking for something that could incorporate modern diagnostic testing and create a more systematic approach that included ancestral diet and lifestyle and some of the other things we talk about in the book. So, I think many of those practitioners can benefit from the book from that perspective. And then you have the growing and already large number of people like yourself who are personal trainers, health coaches, nutritionists, etc., who I really think are going to play an increasingly important role in this revolution to reinvent healthcare. Tony:  Yeah, it so important now for people to really, for patients to be their own advocate, and I don't think we’re living in a time where I remember with my grandparents—if your doctor said something, it was basically gospel and you didn’t question it and you didn't think about it. Now, the first thing people do when they experience a symptom, it's Dr. Google first. So it's super important to equip and arm patients with good information, which I think this book does. Here's a path, here's a path forward for you as a patient. But then it's respectful of the role of doctors, and you highlight many situations where conventional medicine is great. If you break your arm or get in a car accident or have a heart attack or whatever the case may be, yeah, you need a doctor, and you need to go to an emergency room and you need those types of interventions. But it's really in this kind of gray area, it’s really not gray, it’s actually quite clear. And we could probably specify a little bit more, but there’s this middle zone where somebody’s not acutely injured, they’re not acutely in a disease state. They’re in a chronic disease state, or they’re just unwell. And it’s hard for a system that is all about pharmacological interventions, surgical interventions, to deal with a more subtle approach. And that’s where that whole middle ground and acupuncturists and massage therapists and everybody who's in that middle zone. I had clients constantly when I was actively training, constantly asking me questions where I was like, you know what? This is really something they maybe should be taking to their doctor. But guess what? The doctor only has 15 minutes under pressure to see as many patients as they can. I had a friend who was a physician in France. And he was telling me about their medical model, and he would spend tons of time with his patients. And it was actually incentivized for prevention. And here we see some maybe misplaced incentives, and perhaps you can speak a little bit more about that.

The mismatch between our medical paradigm and chronic disease

Chris:  Yeah, so, going back to your original comments, I think that the most important thing for people to understand is that our medical model, when it comes to our medical paradigm, is that it evolved during a time when acute problems were the biggest issues. So in 1900, the top three causes of death were all infectious diseases, tuberculosis, typhoid, and pneumonia. And the other reasons people would see the doctor were among those you mentioned, like a broken bone or a gallbladder attack or appendicitis. Tony:  War. Chris:  Right, injuries, trauma, etc. And so the treatment for that's pretty straightforward. It wasn't always successful, of course, but it was straightforward. You know, if the bone was broken, you set it in a cast. If the gallbladder was swelling, you would take it out. If someone was having appendicitis, you’d remove the appendix. So that's pretty ... it's one problem, one doctor, one treatment. Pretty straightforward. But you fast-forward to today, it's a totally different healthcare landscape. Seven of the top 10 causes of death are chronic disease rather than acute problems now, and 86 percent of the healthcare dollars we spend go toward treating chronic disease. And unlike acute problems, chronic diseases are expensive, difficult to manage and usually last for a lifetime. They don't lend themselves to that one doctor, one problem, one treatment kind of approach. The average chronic disease patient requires multiple doctors, usually one for every different part of the body in our system, and is taking ... Tony:  Specialists. Chris:  Right, specialists, they’re taking multiple medications in many cases, and they're going to be taking those medications for the rest of their life. So far, it's really, our conventional medical system is amazing for these acute problems. But it's the wrong tool for the job for chronic problems. So that's one issue, and it’s really important to point that out, because we just went through the whole healthcare debate again with the Affordable Care Act and the current administration’s proposal for a replacement, which has not come to fruition. But throughout that entire discussion, it really bothered me that there was an elephant in the room. All the discussion was around insurance. Like, who gets insurance and who doesn’t. And that’s important, it’s important to talk about that. But we have to recognize that health insurance is not the same thing as healthcare. Tony:  Yeah. Chris:  Health insurance is a method of paying for healthcare. And that’s really crucial to get that difference. Because my argument in the book is that there is no method of paying for healthcare, whether it’s the government, corporations, or individuals, that will be adequate and will be sustainable under the pressure of growing prevalence of chronic disease. It will bankrupt all of us. Government, the corporations, individuals, whoever is responsible for paying for the care will not be able to do it unless we can actually prevent and reverse chronic disease instead of just slapping Band-Aids on it. Tony:  I think the analogy you gave in the book was rearranging the deck chairs on the Titanic. “Making a few small tweaks to our current system and expecting that to work is like rearranging the deck furniture on the Titanic as it inexorably sinks into the ocean. Too little, too late.”  Chris:  Yeah, exactly. That’s the argument about insurance. As the whole ship goes under, sinks under. The other problems you mentioned are very real also. So we have a misalignment of incentives, like the insurance industry, for example, doesn't benefit when the cost of care shrinks because they only make more money when the overall expenditures rise. So it's actually not in their best interest necessarily to seek out the most cost-effective solutions.

Drug companies and conflicts of interest

Chris: And then of course, we have drug companies. People are pretty well aware of the conflicts of interest there. It’s in their interest to sell drugs, and even when that’s not in the interests of the general public or the patients or the doctors. In many cases, it’s not in their interest either. So the best example of this is a recent one. We’re in the midst of an opioid crisis, the worst we’ve ever seen by far, and the DEA has been wanting to create new regulations that restrict a pharmacy’s ability to sell opioids in ways that will protect people. So, for example, there was a pharmacy in West Virginia in a town that was tiny. It had like 30,000 people in this town, and they had ordered something like nine million opioid pills in the last year. It was clearly a front, like there’s clearly something shady going on there. There's no way that 30,000 people in that town needed nine million opioid pills, and yet there are no regulations to actually prevent that from happening. And so, the DEA had proposed some regulations to just safely protect people from that kind of thing. And the Big Pharma lobby basically shut that down and they played a big role in writing a law that limits the DEA's ability to do that kind of regulation in the midst of the worse opioid crisis ever. And to put this in perspective, we hear a lot about the gun lobbies and their control. They spend about $10.5 million lobbying Congress, I think, per year. And Big Pharma, they spent $250 million. Tony:  Wow. Chris:  Twenty-five-fold higher. Tony:  It's really tragic. I actually, I don’t think we’ve ever talked about this, but I grew up in South Florida, which was kind of ground zero for the opioid epidemic. And I remember in high school down in Miami and West Palm Beach, and kids would get a hold of a contact or whatever, somebody that had a prescription and basically would end up being a de facto drug dealer vis-à-vis a pill mill, etc. The kid across the street from me died, multiple kids in my high school died, multiple kids went into in-treatment programs, some of them battled addictions for decades. Some of them got out of it. Very few got out of it. Some of them didn't and have continued to be plagued with either switching from pharmaceuticals to street drugs like heroin, etc., and then we can see what's happening there. And that's just one example. If we look at drug consumption in the United States, is it that Americans are just that much sicker and we’re in that much more pain than people in other countries? Because we’re consuming far and away more painkillers than any other country on the planet. And I would venture to guess that you could say the same about antidepressants or ADD medication. It's very much a case of misaligned incentives. And incentives are working in the sense of the pharmaceutical companies are doing very well. Chris:  Yeah. Who are they working for is the question. Tony:  Exactly. Chris:  We’re the only country aside from New Zealand that allows direct-to-consumer drug advertising, and I think that's a big part of the problem. But it's not just Big Pharma. We also have conflicts in medical research that, of course, are related to Big Pharma because they pay for two-thirds of all medical research. We have broken payment models, where there's no real incentive or reward for good performance, and in fact, you could argue it's the other way around because doctors are compensated for, usually based on the number of procedures they order and the number of patients they see. So to your point about the doctor in France who is actually incentivized to prevent, rather than just treat disease, we don't have that at all, it's the opposite. And so there are a lot of deeply entrenched issues that we certainly need to address, and that's not essentially what this book is about. There are other books that cover that material really well, and frankly many of those issues are outside of our individual control as clinicians or practitioners.

How clinicians can help create a new paradigm

Chris: We can work toward addressing them, and I think we should, but the good news is that I think that the bigger changes that we need to focus on individually and collectively are addressing the medical paradigm which we’ve talked about, creating a medical paradigm that’s better suited to tackle chronic disease. Addressing the mismatch between our modern diet and lifestyle, and our genes and our biology, which we've, of course, talked a lot about on the show before. And then creating a new way of delivering healthcare that actually supports this new medical paradigm and this more preventative approach. Because those things are all within our control as clinicians. Tony:  Yeah. I like how you posed the question, and it was kind of a cool little, I think it was, not Hiroshi, but the person who is in charge of cooking at a Buddhist monastery. And basically a young monk comes up to this older man. He’s like, why are you doing the grunt work, basically washing rice out in the courtyard? And he says, it was like, what was it? “If not me, who? And if not now, when?” And I think that that’s really kind of the core of setting all this stuff up. Talking about the problem is really in the service of pivoting to the solution, and I’m a big believer in thinking globally, thinking big, but acting locally, hyper-locally, like yourself. Chris:  Yeah. Tony:  And then the people around you and who you can touch and impact. That’s ultimately where the power comes from. So let’s talk about that. What is in people’s power. And you started to describe some of those pillars of a new model. And you describe it as the ADAPT framework. And I don’t know how much you get into this on your regular podcast episodes, but to just kind of lay it out, ADAPT from a big-picture perspective. How does that actually address some of these systemic issues from an individually empowered stance? Chris:  Yeah, great question, and before I even go into that, I just want to say I agree that I think the change is going to happen on different levels. So, because a lot ... we’ve talked about this stuff at conferences or even some people who’ve already read the book. They say, oh, this is fantastic. I’m so excited. But how are we going to deal with Big Pharma and the insurance industry and these misaligned incentives and all of that? And can we ever deal with that? The answer is we’re not going to deal with that overnight and it’s going to take a while to unwind those things. Tony:  It’s the chronic disease, is what you call... Chris:  Exactly, exactly. And I use that analogy in the book. But the good news is that changes can happen very quickly on an individual and local level. And there’s already a lot of evidence of that happening. So my own clinic, CCFM, tripled in size in the last three years alone. We have Cleveland Clinic Center for Functional Medicine, launched by Dr. Mark Hyman, has just blown up like crazy. I mean they started in this tiny space. Now their 17,000-square-foot space, it takes up the whole second floor of the Glickman Tower at Cleveland Clinic. They've got a waitlist of 2,500 patients from nine countries around the world. This is really exciting! The Cleveland Clinic is always on the forefront of the newest trends in medicine, and the fact that they've invested that much money in this speaks volumes. Then we have groups like Iora Health, an organization based in the Rocky Mountain area that’s reversing diabetes using health coaches. So there are lots of really interesting produced concepts, and there's going to be more and more of these. Like we’re doing a pilot program with the Berkeley Fire Department where we’re working with their new recruits to help, we’re implementing a wellness program. Tony:  That’s awesome. Chris:  To reduce injuries and help with recovery and optimize their performance. And if that goes well, there’s been interest from the wider fire department and in the city of Berkeley as a whole. Robb Wolf’s done some incredible work with Reno that we’ve talked about before. So I think the change is going to happen more quickly on this local grassroots level, and then that's going to start to get the attention of people on a state and federal level. And then it will start to get really interesting.

The three core problems and how to solve them

To answer your question, in my book I basically lay out three core fundamental problems with the healthcare system in the US. And these, I argue, go even deeper than the misaligned incentives and Big Pharma and all of that stuff, although they’re, of course, connected. The first is that there is a profound mismatch between our genes and our biology and our modern diet and lifestyle. And I'm not going to say more about that now because almost everyone listening to this podcast knows exactly what I mean. The second problem is the mismatch between our medical paradigm and chronic disease, which we just talked about. We need a new medical paradigm that is better suited for chronic disease. And then the third is that the way we deliver care in this country is also, it's not set up to support the most important interventions. And we’ve touched on that too, where the average visit with the primary care provider is just actually eight to 12 minutes. Tony, you were talking about 15 minutes. That’s luxurious in our current model. The average amount of time a patient gets to speak before they’re interrupted by the doctor is 12 seconds. Tony:  Wow. Chris:  So I think it’s pretty clear that if a patient has multiple chronic diseases, which one in four Americans now do, one in two has one chronic disease, and they show up to the doctor’s office and they're on multiple medications, and they had been presenting with a whole set of new symptoms, there’s absolutely no way to provide high-quality care in a 10-minute visit. So we have to change our, not only the paradigm, but also the way that care is delivered. So that was my premise. So it follows then that my solution would address, I would hope at least those three points, right? Each of those three deficiencies. So the ADAPT framework combines an ancestral diet and lifestyle, which addresses that mismatch between our genes and biology in our modern diet and lifestyle. And then Functional Medicine is the new paradigm of medicine that is based on addressing the root cause of health problems, so we can prevent and reverse them instead of just suppressing symptoms. And then the third component is what I call a collaborative practice model, which links licensed providers like medical doctors, nurse practitioners, with what I call allied providers, which include folks like yourself, Tony, health coaches, nutritionists, personal trainers, etc., to provide a much, much higher level of care than what doctors are able to provide on their own. So, again, we're not trying to replace doctors in any, or even conventional medicine. We need people to do colonoscopies and remove cancerous tumors and use all of the incredible amount of training and expertise and skill that they’ve acquired over a lifetime of practice and study. We absolutely want that, but we need to add stuff to that that's not available now. Tony:  What that really says to me is, emphasize the importance of community, of connection, of collaboration. We’re social creatures, we’re tribal by nature. That’s another kind of Paleo/ancestral health part of the puzzle. And it would be foolish to think that we can dissect out and silo out all these different aspects of our lives without consequence. I really like this idea of bringing everybody into the fold, and it’s not saying that you can go to just the naturopath, or you can go to just the health coach. Because like I mentioned already, I certainly would’ve been ill-equipped to handle plenty of issues that a client would’ve brought to mind or brought up in conversation during a training session. But it would’ve been really great to say, ah, here's the Functional Medicine practitioner that I recommend you speak with, and to have a good relationship with that person and to be able to, as a health coach, help my clients better by getting them in touch with the right person. And that’s having this network that can really support people throughout their health journey whether it’s just feeling better and more energy, or addressing something like diabetes or hypertension. Which certainly there’s a place for all the players in that kind of scenario.

What this new paradigm looks like

Chris:  Absolutely. And let’s use an example just to bring this to life for people. So, imagine you go to the doctor and they do some blood testing for your annual physical. And they find that your fasting blood sugar is 96 or 97. Your hemoglobin A1c is 5.5, and you’ve got triglycerides that are 110, 120, maybe 130. Currently, what would happen is nothing, usually. Tony:  You’re not sick enough yet. Chris:  Yeah, all of your markers are within the lab range, they say, and that means you’re normal, and so you might get some vague advice about make sure to exercise and follow a good diet. And thank you very much, that’s it. Certainly there are exceptions to the rule, of course. There’s some practitioners who can get a lot more proactive about that. But I can’t tell you how many people, patients I’ve had that have been given that basic line with those kinds of lab results. What could happen is this. The doctor says, “Well, you know, if we think of blood sugar disorders on a spectrum, on the left you’ve got perfect blood sugar. On the right you’ve got full-fledged type 2 diabetes. You’re not on the right yet, you don’t have type 2 diabetes or even technically prediabetes, but you’re progressing along that spectrum. And what we know from a lot of research is that if we don’t intervene now, that you’re going to continue progressing. And in fact, we have studies that show that the average patient who has prediabetes, will progress to full-fledged type 2 diabetes in just five years if it’s not addressed.” So what we want to do is be proactive here. We want to intervene now because it’s much easier to prevent a disease before it occurs than it is to treat it after it’s already occurred. So here’s what we’re going to do. We’re going to set you up with our staff health coach, and they’re going to give you all the support you need to adopt a better diet. They’re actually even going to take you shopping, they’re going to come to your house and clean out your pantry with you, and they're going to give you recipes and meal plans and give you ... totally hold your hand and do everything that they need to to get you on this diet. Because we know that information is not enough. We’ve got lots of studies. I can tell you as a doctor, go eat a healthy diet, and hey, we know that that’s probably not going to happen. Most people know what they should be doing, but they’re not doing it, and it’s not because of lack of information. It’s because they need support, and we’re here to support you. We’ve got this health coach. Furthermore, we've got this great personal trainer named Tony. We’re going to set you up with him and we’re also going to set you up with a gym membership. And the good news is, your insurance is going to pay for all this. They’re going to pay for the health coach, they’re going to pay for the gym membership, they’re going to pay for your sessions with Tony. And in six months’ time, you’re going to come back here and we’re going to retest your blood markers and I can almost guarantee that if you stick with the program, you’re going to have normal blood sugar by that time. And throughout that period you’re going to have weekly check-ins with a health coach, you’re going to have training sessions. And not only will your blood sugar be normal, you’re going to lose weight, your energy levels are going to go up, your sleep’s going to get better, you’re going to feel more confident and empowered because you’re making these changes, and you’re going to feel like a different person. Now that’s totally possible.

How do we pay for this? Is it scalable?

Chris: I can hear some people saying, “Oh, how are we going to pay for that? That’s ridiculous.” Tony:  Is it scalable? Chris:  The question we should be asking is, is treating type 2 diabetes scalable? Because I mentioned this in the book, it costs $14,000 a year to treat a single patient with type 2 diabetes. So let’s imagine that this patient progresses. We don’t intervene, five years later they have type 2 diabetes. All of a sudden the healthcare system is spending $14,000 a year paying for that person’s care. And let’s say that that person gets diagnosed at age 40, which is still reasonable these days. The age of diagnosis is dropping more and more, and then let’s say that they live until they’re 85 years old, which is also possible because of our heroic medical interventions that keep people alive a lot longer than they might have been otherwise. So 45 years living with type 2 diabetes, that’s a cost of almost $650,000 for one patient to the healthcare system. Tony:  And that doesn’t even touch on the lost wages, cost to employers, when someone’s on leave, loss of productivity. And then the cost to the family members. Chris:  Absolutely. Tony:  People that are actually, are helping the patient, their health is going to be going down too. Chris:  Yeah. Nor does it touch on the qualitative aspects. Being immobilized, not being able to play with your grandkids, all of that stuff. But let’s just even forget about that for a second—$650,000, okay? And then the CDC recently came out with statistics saying that 100 million Americans have either prediabetes or diabetes, and 88 percent of people with prediabetes don’t even know that they have it. Which means they're almost certainly going to progress, right? If you do the math and you multiply 100 million people times even $14,000 for one year, you get a number that’s so large, I don’t even know what it is. It’s like a google something. It’s like, it has so many zeros after it, I don’t even know how to characterize it. But then if you multiply 100 million times like 20 or 30 years, it’s more money than there is in the world. It's like it's not going to happen. Tony:  Not sustainable, not scalable. Chris:  Not sustainable, not scalable. So let’s say in our example that we ... the healthcare system spends $10,000, which is way more than would be necessary, but let’s even say we buy the person’s groceries for three months. And their gym membership and their trainer, and their health coach, and those weekly, let’s say we spend $10,000. We’re just super generous and we spend $10,000 for that six-month period. Again, the research and my clinical experience indicates with near certainty that if the person is at that stage of not even prediabetic and we intervene, there’s like almost no chance that it’s not going to, we’re not going to be able to normalize that person’s blood sugar. And if they do that and they stick with it and they are able to do that because they now have support rather than just information, we’ve just saved the healthcare system $640,000 over the course of that patient’s lifetime. And that’s a conservative estimate, as you say. We're not including even the indirect costs. Tony:  Right, right. Chris:  I think that this is not only possible, it's going to become necessary. And whether we get there with a proactive approach where we decide to move in this direction and we make these changes or whether we get there because we absolutely have no choice, we’re going to get there. Tony:  Yeah. I mean it really sounds like we can’t afford to not do this. Chris:  Exactly. Tony:  And if we get to that point where we continue down the reactive path and we wait until there’s a total collapse, it might be too late, just to put it frankly. And it’s going to come out at a huge, not just financial cost, a huge human cost. Chris:  Yeah, it’s going to be, we can use the chronic disease metaphor again, it’s a lot easier to prevent a problem or reverse it at an earlier stage than it is to wait until the patient is essentially on life support or the healthcare system is on life support. It’s harder to reverse it at that time. And that’s of course why I’m writing the book now because I want to get this message out as far and wide as I can. Tony:  Yeah. If not now, when? If not you, who? Go right back to there.

How allied providers are the key

Chris:  Exactly. And one more thing about that is the amazing thing, the beauty of this is that it takes about eight years and hundreds of thousands of dollars to train a doctor. And it takes a certain kind of personality and a certain kind of comfort level with science, and a lot of prerequisites. It’s not for everybody. And there’s a ... already we have a shortage of doctors, and that’s predicted to get worse. I’ve seen estimates that suggest by 2025 we’ll have a shortage of 52,000 primary care physicians. So that’s a big deal. [insert image] So we already don’t have enough doctors, it’s already going to get worse, but if you think of healthcare as like a ... I have something in the book called the healthcare population pyramid. And you were referring to it earlier, Tony, where at the very top of that pyramid you’ve got 5 percent of people who are in really acute situations. So they’re in the hospital or they’re in an intensive outpatient care setting. They need the conventional medicine paradigm as it exists, and it’s fantastic for those situations. Then you’ve got another 25 percent of people in that kind of high middle of the pyramid who are dealing with some pretty serious chronic health challenges. So they require more regular care, but they’re not sick enough to be in the hospital or in any kind of ... they’re living their lives, but they’re struggling a lot. A Functional Medicine practitioner/clinician usually working in concert possibly with the conventional specialist of some kind is a really great option for that 25 percent of the pyramid. But then you’ve got the 70 percent at the bottom. So these are people who do, may have health issues, but they’re more minor, so they might have skin problems, or a little bit of brain fog, some difficulties sleeping, some GI issues. And these can be definitely debilitating and total pain, but they’re not at the level of that 25 percent. My argument is that in many cases these people could be very well served by a health coach or nutritionist with good training. And possibly seeing a Functional Medicine provider once or twice a year, or something like that. And the thing is, we can train people in a year or two without an extensive science background to be very, very objective in this role. Because they’re mostly working with patients on changing their behavior. If you think about it, most of the risk factors for chronic disease come down to the wrong behaviors. Eating the wrong diet, not getting enough sleep, not exercising, or exercising too much, or any number of things that come down to choices that we’re making. And so if a skilled health coach who’s trained in things like motivational interviewing and coaching to strengths and other evidence-based principles of facilitating behavior change which we have a ton of research on, they can be incredibly effective for that 70 percent of the population. That's the majority of the population. So we’re totally underutilizing these practitioners, and my argument is that they’re going to play a huge role in this future of medicine. And that's of course one reason why we're launching an ADAPT Health Coach Training Program next year to complement the practitioner training program that we've been doing. Because I want to create this ecosystem we've been talking about where you have all of these different types of practitioners working to the maximum of their training and ability and scope of practice and supporting each other and therefore providing the highest level of care to patients. Tony:  That certainly kind of perks my ears up hearing about the ADAPT health coach option and something that I’m personally interested in. So who knows? Maybe I can get in on that. We can talk about it again in the future. Chris:  Yeah, for sure. For sure. Tony:  So, for this particular book, for Unconventional Medicine, people are fired up, they’re hearing about it, they’re like, “Okay, this resonates with me. I’m a practitioner, I’m an allied health provider, I’m a patient, I’m ready. Now’s the time. This is it. We’re going to do this.” What’s the best way for people to get their hands on this thing? Chris:  Well not surprisingly, Amazon. They have the best way to get your hands on anything. So it’s available in paperback, Kindle, and audiobook. We’re hoping [the audiobook] is going to be out today, the day this podcast is released. But it might be another two or three days. They’re just taking their sweet time to approve it. I narrated the audiobook myself. So you podcast listeners, I figured you might be into that, since you like to listen. Tony:  They know your voice. Chris:  Yeah, and just listening to something instead of reading it perhaps. So to that end, we have a special offer for podcast listeners, because I appreciate your support and I know many of you are already part of this movement, and some are wanting to get involved. So if you buy that paperback or Kindle version between now and Sunday night, you’ll get some really cool bonuses. The first is a free copy of the audiobook. So again, we wanted to include that for podcast listeners, since we figured you guys and gals are probably interested in audio. But there are two other things that are really, I think, fantastic. And one, they’re both tools to help you be more confident and persuasive and factual when you share your passion for Functional Medicine and an ancestral diet and lifestyle. Because we’ve had a lot of questions from people, both practitioners and non-practitioners alike. They say, “Oh, how do I talk about this stuff to my sister at Thanksgiving?” Tony:  “Isn’t that that caveman diet?” Chris:  Yeah, exactly. All of our ancestors died when they were 30, so why should we even care? How do you respond to those arguments? Or if you start talking about Functional Medicine and maybe one of your conventional medicine colleagues says, “Oh, that’s just, I saw something on Science-based Medicine that said that was all just hooey. There’s nothing to it. How do you respond to that?” So what we wanted to do is give people the ammunition they needed in a respectful way. You know, this isn’t about getting the better of somebody. It’s about responding in a factual and convincing but respectful way. So we’ve got two different, we’re calling these the Power Packs. And one is for practitioners, so clinicians, health coaches, nutritionists, trainers, etc., and these are facts, research that you can reference and persuasive reasons for your clients or patients or colleagues to consider this Functional Medicine and ancestral diet and lifestyle approach. And then we have one for non-practitioners called the Supporter Power Pack. And these are smart answers and compelling comebacks, again respectful, for those common objections that you hear when you start talking about this stuff with your friends and family. So these bonuses are available until Sunday night [November 12, 2017] at 11:59 p.m. Pacific Time. So you’ve got a few days to act on that, and you can go to ... we set up a special link for you to get these and that’s Kresser.co/bonus. That’s Kresser.co/bonus. So head over there to get your Power Packs and your free audiobook, and that’s after you purchase either the paperback or Kindle. There’ll be a place where you enter your order number and we ask for some information just to verify, and I hope you enjoy those and get a lot out of them. Because they were actually really fun to put together. Tony:  Yeah, I think the audiobook is huge. I like to listen to audiobooks when I’m driving around town or outside getting some exercise. Chris:  Yeah. Tony:  So, no excuses when you make it that easy. Chris:  Yeah, yeah. So, Tony, thanks so much for doing this. This has been really fun to talk to you, as it always is. And I appreciate it. Tony:  Actually, I wanted to throw in one extra little special thing, as we mentioned, at the top of the show. I spent 10 years as a personal trainer in the trenches, I was involved with Paleo Magazine for many, many years, going to all the events, and for me kind of an evolution in my professional life was, how do I impact more people? How do I help more people? And at first I was working one on one, and then it was as a facility manager helping other trainers and coaches get better. And then I was able to scale it up that way. And last year I had an opportunity to join the team over at Natural Force, which is all-natural, nutritional products, and I basically said, “You know what? I’m going to go all in on this because if I can touch a million people through really good, high-quality nutrition, that’s me maximizing my impact and really kind of living my purpose.” So one of the things I wanted to do today is put it out there for anyone listening who maybe uses collagen or MCT oil or whey protein. We really bend over backwards to source the best ingredients in the world, no additives, all that stuff. Everything is as clean as we can possibly make it. It takes a lot of work, working with manufacturers. Kind of like what you were saying, how patients have to know how to talk to their doctor. I don’t think people really realize, and I didn’t realize until I got on the inside, how much work it is for a brand to work with their manufacturers to convince them to get outside of the conventional mold. So it’s the kind of unconventional nutrition is really what we’re pushing here. So I set up a discount code for any Revolution Health listeners. Go to NaturalForce.com, use coupon code “unconventional” and get $10 off plus free shipping on your order. So I just want to put that out there as just a little extra bonus for anybody, and I would certainly love to help in that way and really get some good, high-quality nutrition into people’s hands. Chris:  Awesome. Yeah, and there’s so many ways people can help, and I ... at Paleo f(x) we’ve see the growth of companies that are serving this space, and it's amazing. Like the products that are available now. I had breakfast this morning, I had some eggs and kale and parsley and a little bit of bacon in a couple of cassava flour tortillas. Breakfast burritos. Whoever thought I’d be having a breakfast burrito again? Tortillas are made from completely cassava flour. They’re autoimmune friendly and they’re grain-free tortillas. It’s incredible. Tony:  I think I might have some of those in my fridge as well. Chris:  Yeah. I mean there’s so many things. And these people, they’re serving this movement with that kind of work. So it’s great to see. Tony:  It takes a village, man. Chris:  It does. Thanks again, Tony. I really appreciate it. Thank you, everybody. So again, Kresser.co/bonus to pick up your free audiobook and the other bonuses, and I hope you can all join me in this revolution to reinvent healthcare. We need you, whatever your background and goals. Take care, everybody.

[denisalvney]

RHR: A Three-Step Plan to Fix Conventional Healthcare

In this episode we discuss:

The patient case that inspired the book

Who is this book for?

The mismatch between our medical paradigm and chronic disease

Drug companies and conflicts of interest

How clinicians can help create a new paradigm

The three core problems and how to solve them

What this new paradigm looks like

How do we pay for this? Is it scalable?

How allied providers are the key

Show notes:

Unconventional Medicine by Chris Kresser

Special offer for RHR podcast listeners - get the audiobook free if you buy the book by November 12th.

NaturalForce.com - use coupon “unconventional” and get $10 plus free shipping

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Chris Kresser: Hey, everybody, Chris Kresser here. Welcome to another episode of Revolution Health Radio. Today we’re going to do something a little different. I am bringing on a guest host, Tony Federico, he’s the VP of marketing for Natural Force Nutrition, a physiology editor for the Journal of Evolution and Health, and a longtime contributor to Paleo Magazine, and also at Paleo f(x), which is where I met Tony, I think, originally, and I have interacted with him the most. And he’s moderated several panels that I’ve been on and I’ve always been impressed with the way he’s done that, the intelligent questions that he asks and just his balanced perspective on ancestral health and Functional Medicine, and this movement overall. Today is the day that my new book, Unconventional Medicine, comes out. It’s now available on Amazon, and I wanted to ask Tony to come take over the podcast and talk with me about the book because I know he’s really interested in all these topics and he’s read quite a bit of the book himself, and I thought it would be more interesting to have a conversation about it than for me to just sit here and do a monologue. So Tony welcome to the show and thanks for being here. Tony Federico:  Yeah, thanks for inviting me on, Chris. It’s always fun, when we’ve had the chance to chat, as you said. Whether in person or on podcast, I’m always happy to jump in and dish on health with you. Chris:  Fantastic. So, you have read a little bit of the book and we chatted a little bit about it via email, so let’s dive in. Let’s talk a little bit about this book. And for me it was really, it felt like the most important next step that I could take in order to get this message out about ending chronic disease. Tony:  Yeah, I got my copy of Unconventional Medicine a couple days ago. I just so happened to have some time off yesterday, and the next thing I knew I was 80 pages in. Chris:  Nice. Tony:  So, I have to say that, as somebody who’s been in the trenches, I worked as a personal trainer for 10 years, I could really relate to a lot of the things that you were saying in the book, and we’ll get into why a little bit later on in the interview. But you know I just am really impressed with what you put together here, Chris. So let's just, let's get into it, and the first thing that I actually wanted you to maybe tell me a little bit about was how you open the book, which I think is a really great story about a patient named Leo. So I wanted to talk a little bit about Leo and his story and kind of how that inspired you to go down this particular path of unconventional medicine.

The patient case that inspired the book

Chris:  Sure, yeah. So, Leo was an eight-year-old boy that I treated in my clinic a few years back, and I wanted to start with his story because it's, unfortunately, a typical story, much more common than, of course, we would like. And it was powerful for me, it was a powerful experience. It's what actually led to me writing this book. So, like way too many other kids of his age, he was suffering from a number of behavioral issues. He was initially diagnosed on the autism spectrum. Eventually they settled on OCD and sensory processing disorder. He would throw these just crazy tantrums where he'd end up crying or screaming inconsolably, writhing on the floor, and this would happen for seemingly the simplest of reasons. Like trying to get his shoes tied as they were going out the door, not cutting the crust off his sandwich in just the right way or getting a stain on his favorite T-shirt. And he was really rigid around his behavior and its environment, everything had to be just right, just the way he wanted it to be, or else he would fly off the handle.

Is a new healthcare paradigm affordable? Scalable? You bet.

His diet was extremely limited, he only ate a handful of foods, pretty much all of which were processed and refined. So crackers, bread, toaster waffles, that sort of thing, and this is part of the kind of OCD-like tendencies. And any time his parents would try to introduce new food, he would go totally ballistic. And they were worried about nutrient deficiency, but they didn't feel like they ... they were just worn down. Any parent who has a kid like this will understand that. It's just they didn’t feel like they had the resources to battle him at every meal. And they took him to a bunch of doctors locally, and that’s where they got those diagnoses. Initially they were kind of relieved to have those, but then after a while they realized that they were just simply labels for symptoms. And when they asked what the treatment was, you can probably guess the answer: medication. Tony:  Something to do with drugs. Chris:  Something to do with drugs. Yeah. And when they asked how long he would be on that treatment, you can probably also guess the answer. Tony:  The rest of your life. Chris:  Yeah. Shrug of the shoulders, indefinitely, maybe he'll grow out of it, that sort of thing. And they weren't excited about the idea of of medicating their son, but they were also aware of how much he was suffering, and they were suffering, frankly, too. They decided to give them a try, starting with Adderall, and then they progressed to Ritalin and then antidepressants. And certainly the drugs did seem to help with at least some of the symptoms, but there were a couple issues. Number one, they also caused some very intractable side effects like headache, abdominal pain, irritability, and most significantly, severe sleep disruption. And they had a couple of other kids that were younger than Leo. So they were not happy about the sleep disruption. Nobody was because it was brutal for them and also brutal for Leo. Kids need a lot of sleep, and if they’re waking up throughout the night, that’s going to make ... So that was in some ways worse than the original symptoms they were trying to treat. And then Leo's mom had done quite a bit of research on the effects of these medications and she was scared. Particularly for children and adolescents, some of these drugs have some pretty scary side effects and long-term risks. So what really stood out to me, and I mentioned this in the book, is that not once during this entire process of seeing all these different doctors, primary care provider, psychiatrist, eventually behavioral disorder specialists, did anybody even hint at the possibility that something in Leo's diet or some other underlying issue like a gut problem or nutrient deficiency or heavy metal toxicity or something like that could be contributing to his symptoms. It wasn't even broached as a possibility at any time. Fortunately, Leo's mom, one of her friends followed my work and sent her a couple of articles from my blog. One was on the gut–brain–axis, and I think the other one was on the underlying root causes of behavioral disorders. And so that's what led them to bring Leo to see me, and long story short, we were able to ... we did a bunch of testing, found issues that you might guess at. So, disrupted gut microbiome, SIBO, fungal overgrowth, gluten intolerance, but also intolerance of soy and corn and rice and buckwheat, which were major ingredients in a lot of the processed and refined food products that he ate, and arsenic toxicity because rice milk was the only other beverage he would drink aside from water. And we know that rice products can be high in arsenic. So, we, over several months, it definitely wasn't easy to address these problems because of his OCD-like tendencies and his picky eating habits. But after several months he was like a different kid. His teacher even called home and was like, “What have you done with Leo and who’s this kid that you’re sending in?” Because it was a big issue for her. They often had to come to school and pick him up early because of the behavioral problems. And his diet expanded; he was eating foods he would've thrown against the wall just months before, he was more tolerant of disorder, more relaxed in his environment. They were able to travel for the first time in a long time because he wasn't so anxious in unfamiliar environments. His physical symptoms had improved significantly. So they were just over the moon. They couldn't believe it, and toward the end of our treatment together, she said something that really struck me, which was there’s so many kids out there that are like Leo and they’re suffering, they’re not finding help in the conventional system. Tony:  Sure. Chris:  And their doctors and parents are not even thinking about this stuff. Like it’s not even in most people’s consciousness that if a kid has a behavioral disorder that you should look at these physiological issues. It’s not, for 99 percent of people they don't even go there because they don't know. Tony:  Yeah, I mean I think that that was—reading about Leo and reading about a story and certainly there's people that I've known, myself included, who have had very similar experiences—I think it's great to have a narrative like this that you can really connect to because then when you tease it apart, all the pieces really make sense. It makes sense why having doctors treat symptoms has failed, it makes sense why a lack of communication between the health provider network that was supposed to be serving Leo failed. It makes sense why it didn't work when you actually start to tease it out. But then we’re still all, well not all, but most of us are still going down this path and it's an exercise in futility, really. You have an eight-year-old kid who's on powerful stimulant medications, he’s on antidepressants, and it was bad enough for his parents to reach out and to seek those interventions as solutions, and then the side effects are even worse. And that’s just something that just gets you right in the heart. And like you said, he’s not the only one, he’s not the only kid. His parents are not the only parents. And frankly, his doctors are not the only doctors because I can guarantee you that that probably doesn’t really feel good for the practitioner, for the healthcare provider to not get results as well. And they’re working with what they’ve got. Chris:  Absolutely. Tony:  And trying to use the tools they have. Chris:  Yeah, I mean, let’s be clear about this. Everybody is doing the best they can in this situation. The parents are doing the best they can, in the vast majority of situations, parents just love their kids and do everything possible that they can to help their kids thrive. I’m a parent, I know that that’s how I relate to my kid. I know that every parent I know, that’s how they relate to their kids. And I would even, I would say that’s true for doctors too. The vast majority of them are trying to do the best they can with the tools that they have and in the system that they’re working within. And that’s the rub. Tony:  Right. Chris:   It’s like most doctors I’ve seen have been caring and they’ve wanted to do the right thing, but the question is, can they do the right thing in the conventional medical system as it exists today? And, of course, that’s largely what the book is about.

Who is this book for?

Tony:  Yeah, so let’s kind of speak to that specifically. And we’re talking about doctors, we’re talking about medical professionals, we’re talking about patients, and then we didn’t mention it, but where I fit into this formula or potential formula as an allied healthcare provider, as a personal trainer/health coach, is that your audience for this book, do you really see that kind of triad is who you're speaking to here? Chris:  Yeah, definitely. I think if you look at the cover of the book, the subtitle is “join the revolution to reverse chronic disease, reinvent healthcare, and create a practice you love.” So that last bit would suggest that it's mostly for practitioners, but that's not true. It is really for anybody that is interested in the ideas of reinventing healthcare and reversing chronic disease. And, in fact, I would argue that that change is going to be initiated by people, primarily by people that are not practitioners. So it's like a grassroots, bottom-up approach, where a good example is with my training program, my ADAPT training program, now that we've been training practitioners in this approach for the last couple years, we always ask people how they learned about my work or how they learned about the training program. And in a surprising number of cases, the answer is from their patients. So these doctors or other practitioners, their patient brings an article in that I wrote or brings something in, tells them about me, and to their credit they’re open-minded enough to go and check it out. And then they like what they see and they end up taking the next step. So people even who have no intention of ever becoming a healthcare practitioner, I think would really benefit from this book if they're interested in these ideas. And then certainly, as you mentioned, licensed healthcare providers like medical doctors or nurse practitioners or physician assistants that are currently working within the conventional paradigm but have already seen its limitations and want to do something different but don't yet know what that might look like. And then people who are outside of the conventional paradigm but are already practitioners, so acupuncturists, chiropractors, naturopathic physicians, etc., in many cases they’re already well aware of the limitations of conventional medicine, which is why they chose to go down a different path. But speaking personally as an acupuncturist myself, I also saw some limitations in the traditional Chinese medicine approach, or at least some differences in the way that I wanted to practice it. I was looking for something that could incorporate modern diagnostic testing and create a more systematic approach that included ancestral diet and lifestyle and some of the other things we talk about in the book. So, I think many of those practitioners can benefit from the book from that perspective. And then you have the growing and already large number of people like yourself who are personal trainers, health coaches, nutritionists, etc., who I really think are going to play an increasingly important role in this revolution to reinvent healthcare. Tony:  Yeah, it so important now for people to really, for patients to be their own advocate, and I don't think we’re living in a time where I remember with my grandparents—if your doctor said something, it was basically gospel and you didn’t question it and you didn't think about it. Now, the first thing people do when they experience a symptom, it's Dr. Google first. So it's super important to equip and arm patients with good information, which I think this book does. Here's a path, here's a path forward for you as a patient. But then it's respectful of the role of doctors, and you highlight many situations where conventional medicine is great. If you break your arm or get in a car accident or have a heart attack or whatever the case may be, yeah, you need a doctor, and you need to go to an emergency room and you need those types of interventions. But it's really in this kind of gray area, it’s really not gray, it’s actually quite clear. And we could probably specify a little bit more, but there’s this middle zone where somebody’s not acutely injured, they’re not acutely in a disease state. They’re in a chronic disease state, or they’re just unwell. And it’s hard for a system that is all about pharmacological interventions, surgical interventions, to deal with a more subtle approach. And that’s where that whole middle ground and acupuncturists and massage therapists and everybody who's in that middle zone. I had clients constantly when I was actively training, constantly asking me questions where I was like, you know what? This is really something they maybe should be taking to their doctor. But guess what? The doctor only has 15 minutes under pressure to see as many patients as they can. I had a friend who was a physician in France. And he was telling me about their medical model, and he would spend tons of time with his patients. And it was actually incentivized for prevention. And here we see some maybe misplaced incentives, and perhaps you can speak a little bit more about that.

The mismatch between our medical paradigm and chronic disease

Chris:  Yeah, so, going back to your original comments, I think that the most important thing for people to understand is that our medical model, when it comes to our medical paradigm, is that it evolved during a time when acute problems were the biggest issues. So in 1900, the top three causes of death were all infectious diseases, tuberculosis, typhoid, and pneumonia. And the other reasons people would see the doctor were among those you mentioned, like a broken bone or a gallbladder attack or appendicitis. Tony:  War. Chris:  Right, injuries, trauma, etc. And so the treatment for that's pretty straightforward. It wasn't always successful, of course, but it was straightforward. You know, if the bone was broken, you set it in a cast. If the gallbladder was swelling, you would take it out. If someone was having appendicitis, you’d remove the appendix. So that's pretty ... it's one problem, one doctor, one treatment. Pretty straightforward. But you fast-forward to today, it's a totally different healthcare landscape. Seven of the top 10 causes of death are chronic disease rather than acute problems now, and 86 percent of the healthcare dollars we spend go toward treating chronic disease. And unlike acute problems, chronic diseases are expensive, difficult to manage and usually last for a lifetime. They don't lend themselves to that one doctor, one problem, one treatment kind of approach. The average chronic disease patient requires multiple doctors, usually one for every different part of the body in our system, and is taking ... Tony:  Specialists. Chris:  Right, specialists, they’re taking multiple medications in many cases, and they're going to be taking those medications for the rest of their life. So far, it's really, our conventional medical system is amazing for these acute problems. But it's the wrong tool for the job for chronic problems. So that's one issue, and it’s really important to point that out, because we just went through the whole healthcare debate again with the Affordable Care Act and the current administration’s proposal for a replacement, which has not come to fruition. But throughout that entire discussion, it really bothered me that there was an elephant in the room. All the discussion was around insurance. Like, who gets insurance and who doesn’t. And that’s important, it’s important to talk about that. But we have to recognize that health insurance is not the same thing as healthcare. Tony:  Yeah. Chris:  Health insurance is a method of paying for healthcare. And that’s really crucial to get that difference. Because my argument in the book is that there is no method of paying for healthcare, whether it’s the government, corporations, or individuals, that will be adequate and will be sustainable under the pressure of growing prevalence of chronic disease. It will bankrupt all of us. Government, the corporations, individuals, whoever is responsible for paying for the care will not be able to do it unless we can actually prevent and reverse chronic disease instead of just slapping Band-Aids on it. Tony:  I think the analogy you gave in the book was rearranging the deck chairs on the Titanic. “Making a few small tweaks to our current system and expecting that to work is like rearranging the deck furniture on the Titanic as it inexorably sinks into the ocean. Too little, too late.”  Chris:  Yeah, exactly. That’s the argument about insurance. As the whole ship goes under, sinks under. The other problems you mentioned are very real also. So we have a misalignment of incentives, like the insurance industry, for example, doesn't benefit when the cost of care shrinks because they only make more money when the overall expenditures rise. So it's actually not in their best interest necessarily to seek out the most cost-effective solutions.

Drug companies and conflicts of interest

Chris: And then of course, we have drug companies. People are pretty well aware of the conflicts of interest there. It’s in their interest to sell drugs, and even when that’s not in the interests of the general public or the patients or the doctors. In many cases, it’s not in their interest either. So the best example of this is a recent one. We’re in the midst of an opioid crisis, the worst we’ve ever seen by far, and the DEA has been wanting to create new regulations that restrict a pharmacy’s ability to sell opioids in ways that will protect people. So, for example, there was a pharmacy in West Virginia in a town that was tiny. It had like 30,000 people in this town, and they had ordered something like nine million opioid pills in the last year. It was clearly a front, like there’s clearly something shady going on there. There's no way that 30,000 people in that town needed nine million opioid pills, and yet there are no regulations to actually prevent that from happening. And so, the DEA had proposed some regulations to just safely protect people from that kind of thing. And the Big Pharma lobby basically shut that down and they played a big role in writing a law that limits the DEA's ability to do that kind of regulation in the midst of the worse opioid crisis ever. And to put this in perspective, we hear a lot about the gun lobbies and their control. They spend about $10.5 million lobbying Congress, I think, per year. And Big Pharma, they spent $250 million. Tony:  Wow. Chris:  Twenty-five-fold higher. Tony:  It's really tragic. I actually, I don’t think we’ve ever talked about this, but I grew up in South Florida, which was kind of ground zero for the opioid epidemic. And I remember in high school down in Miami and West Palm Beach, and kids would get a hold of a contact or whatever, somebody that had a prescription and basically would end up being a de facto drug dealer vis-à-vis a pill mill, etc. The kid across the street from me died, multiple kids in my high school died, multiple kids went into in-treatment programs, some of them battled addictions for decades. Some of them got out of it. Very few got out of it. Some of them didn't and have continued to be plagued with either switching from pharmaceuticals to street drugs like heroin, etc., and then we can see what's happening there. And that's just one example. If we look at drug consumption in the United States, is it that Americans are just that much sicker and we’re in that much more pain than people in other countries? Because we’re consuming far and away more painkillers than any other country on the planet. And I would venture to guess that you could say the same about antidepressants or ADD medication. It's very much a case of misaligned incentives. And incentives are working in the sense of the pharmaceutical companies are doing very well. Chris:  Yeah. Who are they working for is the question. Tony:  Exactly. Chris:  We’re the only country aside from New Zealand that allows direct-to-consumer drug advertising, and I think that's a big part of the problem. But it's not just Big Pharma. We also have conflicts in medical research that, of course, are related to Big Pharma because they pay for two-thirds of all medical research. We have broken payment models, where there's no real incentive or reward for good performance, and in fact, you could argue it's the other way around because doctors are compensated for, usually based on the number of procedures they order and the number of patients they see. So to your point about the doctor in France who is actually incentivized to prevent, rather than just treat disease, we don't have that at all, it's the opposite. And so there are a lot of deeply entrenched issues that we certainly need to address, and that's not essentially what this book is about. There are other books that cover that material really well, and frankly many of those issues are outside of our individual control as clinicians or practitioners.

How clinicians can help create a new paradigm

Chris: We can work toward addressing them, and I think we should, but the good news is that I think that the bigger changes that we need to focus on individually and collectively are addressing the medical paradigm which we’ve talked about, creating a medical paradigm that’s better suited to tackle chronic disease. Addressing the mismatch between our modern diet and lifestyle, and our genes and our biology, which we've, of course, talked a lot about on the show before. And then creating a new way of delivering healthcare that actually supports this new medical paradigm and this more preventative approach. Because those things are all within our control as clinicians. Tony:  Yeah. I like how you posed the question, and it was kind of a cool little, I think it was, not Hiroshi, but the person who is in charge of cooking at a Buddhist monastery. And basically a young monk comes up to this older man. He’s like, why are you doing the grunt work, basically washing rice out in the courtyard? And he says, it was like, what was it? “If not me, who? And if not now, when?” And I think that that’s really kind of the core of setting all this stuff up. Talking about the problem is really in the service of pivoting to the solution, and I’m a big believer in thinking globally, thinking big, but acting locally, hyper-locally, like yourself. Chris:  Yeah. Tony:  And then the people around you and who you can touch and impact. That’s ultimately where the power comes from. So let’s talk about that. What is in people’s power. And you started to describe some of those pillars of a new model. And you describe it as the ADAPT framework. And I don’t know how much you get into this on your regular podcast episodes, but to just kind of lay it out, ADAPT from a big-picture perspective. How does that actually address some of these systemic issues from an individually empowered stance? Chris:  Yeah, great question, and before I even go into that, I just want to say I agree that I think the change is going to happen on different levels. So, because a lot ... we’ve talked about this stuff at conferences or even some people who’ve already read the book. They say, oh, this is fantastic. I’m so excited. But how are we going to deal with Big Pharma and the insurance industry and these misaligned incentives and all of that? And can we ever deal with that? The answer is we’re not going to deal with that overnight and it’s going to take a while to unwind those things. Tony:  It’s the chronic disease, is what you call... Chris:  Exactly, exactly. And I use that analogy in the book. But the good news is that changes can happen very quickly on an individual and local level. And there’s already a lot of evidence of that happening. So my own clinic, CCFM, tripled in size in the last three years alone. We have Cleveland Clinic Center for Functional Medicine, launched by Dr. Mark Hyman, has just blown up like crazy. I mean they started in this tiny space. Now their 17,000-square-foot space, it takes up the whole second floor of the Glickman Tower at Cleveland Clinic. They've got a waitlist of 2,500 patients from nine countries around the world. This is really exciting! The Cleveland Clinic is always on the forefront of the newest trends in medicine, and the fact that they've invested that much money in this speaks volumes. Then we have groups like Iora Health, an organization based in the Rocky Mountain area that’s reversing diabetes using health coaches. So there are lots of really interesting produced concepts, and there's going to be more and more of these. Like we’re doing a pilot program with the Berkeley Fire Department where we’re working with their new recruits to help, we’re implementing a wellness program. Tony:  That’s awesome. Chris:  To reduce injuries and help with recovery and optimize their performance. And if that goes well, there’s been interest from the wider fire department and in the city of Berkeley as a whole. Robb Wolf’s done some incredible work with Reno that we’ve talked about before. So I think the change is going to happen more quickly on this local grassroots level, and then that's going to start to get the attention of people on a state and federal level. And then it will start to get really interesting.

The three core problems and how to solve them

To answer your question, in my book I basically lay out three core fundamental problems with the healthcare system in the US. And these, I argue, go even deeper than the misaligned incentives and Big Pharma and all of that stuff, although they’re, of course, connected. The first is that there is a profound mismatch between our genes and our biology and our modern diet and lifestyle. And I'm not going to say more about that now because almost everyone listening to this podcast knows exactly what I mean. The second problem is the mismatch between our medical paradigm and chronic disease, which we just talked about. We need a new medical paradigm that is better suited for chronic disease. And then the third is that the way we deliver care in this country is also, it's not set up to support the most important interventions. And we’ve touched on that too, where the average visit with the primary care provider is just actually eight to 12 minutes. Tony, you were talking about 15 minutes. That’s luxurious in our current model. The average amount of time a patient gets to speak before they’re interrupted by the doctor is 12 seconds. Tony:  Wow. Chris:  So I think it’s pretty clear that if a patient has multiple chronic diseases, which one in four Americans now do, one in two has one chronic disease, and they show up to the doctor’s office and they're on multiple medications, and they had been presenting with a whole set of new symptoms, there’s absolutely no way to provide high-quality care in a 10-minute visit. So we have to change our, not only the paradigm, but also the way that care is delivered. So that was my premise. So it follows then that my solution would address, I would hope at least those three points, right? Each of those three deficiencies. So the ADAPT framework combines an ancestral diet and lifestyle, which addresses that mismatch between our genes and biology in our modern diet and lifestyle. And then Functional Medicine is the new paradigm of medicine that is based on addressing the root cause of health problems, so we can prevent and reverse them instead of just suppressing symptoms. And then the third component is what I call a collaborative practice model, which links licensed providers like medical doctors, nurse practitioners, with what I call allied providers, which include folks like yourself, Tony, health coaches, nutritionists, personal trainers, etc., to provide a much, much higher level of care than what doctors are able to provide on their own. So, again, we're not trying to replace doctors in any, or even conventional medicine. We need people to do colonoscopies and remove cancerous tumors and use all of the incredible amount of training and expertise and skill that they’ve acquired over a lifetime of practice and study. We absolutely want that, but we need to add stuff to that that's not available now. Tony:  What that really says to me is, emphasize the importance of community, of connection, of collaboration. We’re social creatures, we’re tribal by nature. That’s another kind of Paleo/ancestral health part of the puzzle. And it would be foolish to think that we can dissect out and silo out all these different aspects of our lives without consequence. I really like this idea of bringing everybody into the fold, and it’s not saying that you can go to just the naturopath, or you can go to just the health coach. Because like I mentioned already, I certainly would’ve been ill-equipped to handle plenty of issues that a client would’ve brought to mind or brought up in conversation during a training session. But it would’ve been really great to say, ah, here's the Functional Medicine practitioner that I recommend you speak with, and to have a good relationship with that person and to be able to, as a health coach, help my clients better by getting them in touch with the right person. And that’s having this network that can really support people throughout their health journey whether it’s just feeling better and more energy, or addressing something like diabetes or hypertension. Which certainly there’s a place for all the players in that kind of scenario.

What this new paradigm looks like

Chris:  Absolutely. And let’s use an example just to bring this to life for people. So, imagine you go to the doctor and they do some blood testing for your annual physical. And they find that your fasting blood sugar is 96 or 97. Your hemoglobin A1c is 5.5, and you’ve got triglycerides that are 110, 120, maybe 130. Currently, what would happen is nothing, usually. Tony:  You’re not sick enough yet. Chris:  Yeah, all of your markers are within the lab range, they say, and that means you’re normal, and so you might get some vague advice about make sure to exercise and follow a good diet. And thank you very much, that’s it. Certainly there are exceptions to the rule, of course. There’s some practitioners who can get a lot more proactive about that. But I can’t tell you how many people, patients I’ve had that have been given that basic line with those kinds of lab results. What could happen is this. The doctor says, “Well, you know, if we think of blood sugar disorders on a spectrum, on the left you’ve got perfect blood sugar. On the right you’ve got full-fledged type 2 diabetes. You’re not on the right yet, you don’t have type 2 diabetes or even technically prediabetes, but you’re progressing along that spectrum. And what we know from a lot of research is that if we don’t intervene now, that you’re going to continue progressing. And in fact, we have studies that show that the average patient who has prediabetes, will progress to full-fledged type 2 diabetes in just five years if it’s not addressed.” So what we want to do is be proactive here. We want to intervene now because it’s much easier to prevent a disease before it occurs than it is to treat it after it’s already occurred. So here’s what we’re going to do. We’re going to set you up with our staff health coach, and they’re going to give you all the support you need to adopt a better diet. They’re actually even going to take you shopping, they’re going to come to your house and clean out your pantry with you, and they're going to give you recipes and meal plans and give you ... totally hold your hand and do everything that they need to to get you on this diet. Because we know that information is not enough. We’ve got lots of studies. I can tell you as a doctor, go eat a healthy diet, and hey, we know that that’s probably not going to happen. Most people know what they should be doing, but they’re not doing it, and it’s not because of lack of information. It’s because they need support, and we’re here to support you. We’ve got this health coach. Furthermore, we've got this great personal trainer named Tony. We’re going to set you up with him and we’re also going to set you up with a gym membership. And the good news is, your insurance is going to pay for all this. They’re going to pay for the health coach, they’re going to pay for the gym membership, they’re going to pay for your sessions with Tony. And in six months’ time, you’re going to come back here and we’re going to retest your blood markers and I can almost guarantee that if you stick with the program, you’re going to have normal blood sugar by that time. And throughout that period you’re going to have weekly check-ins with a health coach, you’re going to have training sessions. And not only will your blood sugar be normal, you’re going to lose weight, your energy levels are going to go up, your sleep’s going to get better, you’re going to feel more confident and empowered because you’re making these changes, and you’re going to feel like a different person. Now that’s totally possible.

How do we pay for this? Is it scalable?

Chris: I can hear some people saying, “Oh, how are we going to pay for that? That’s ridiculous.” Tony:  Is it scalable? Chris:  The question we should be asking is, is treating type 2 diabetes scalable? Because I mentioned this in the book, it costs $14,000 a year to treat a single patient with type 2 diabetes. So let’s imagine that this patient progresses. We don’t intervene, five years later they have type 2 diabetes. All of a sudden the healthcare system is spending $14,000 a year paying for that person’s care. And let’s say that that person gets diagnosed at age 40, which is still reasonable these days. The age of diagnosis is dropping more and more, and then let’s say that they live until they’re 85 years old, which is also possible because of our heroic medical interventions that keep people alive a lot longer than they might have been otherwise. So 45 years living with type 2 diabetes, that’s a cost of almost $650,000 for one patient to the healthcare system. Tony:  And that doesn’t even touch on the lost wages, cost to employers, when someone’s on leave, loss of productivity. And then the cost to the family members. Chris:  Absolutely. Tony:  People that are actually, are helping the patient, their health is going to be going down too. Chris:  Yeah. Nor does it touch on the qualitative aspects. Being immobilized, not being able to play with your grandkids, all of that stuff. But let’s just even forget about that for a second—$650,000, okay? And then the CDC recently came out with statistics saying that 100 million Americans have either prediabetes or diabetes, and 88 percent of people with prediabetes don’t even know that they have it. Which means they're almost certainly going to progress, right? If you do the math and you multiply 100 million people times even $14,000 for one year, you get a number that’s so large, I don’t even know what it is. It’s like a google something. It’s like, it has so many zeros after it, I don’t even know how to characterize it. But then if you multiply 100 million times like 20 or 30 years, it’s more money than there is in the world. It's like it's not going to happen. Tony:  Not sustainable, not scalable. Chris:  Not sustainable, not scalable. So let’s say in our example that we ... the healthcare system spends $10,000, which is way more than would be necessary, but let’s even say we buy the person’s groceries for three months. And their gym membership and their trainer, and their health coach, and those weekly, let’s say we spend $10,000. We’re just super generous and we spend $10,000 for that six-month period. Again, the research and my clinical experience indicates with near certainty that if the person is at that stage of not even prediabetic and we intervene, there’s like almost no chance that it’s not going to, we’re not going to be able to normalize that person’s blood sugar. And if they do that and they stick with it and they are able to do that because they now have support rather than just information, we’ve just saved the healthcare system $640,000 over the course of that patient’s lifetime. And that’s a conservative estimate, as you say. We're not including even the indirect costs. Tony:  Right, right. Chris:  I think that this is not only possible, it's going to become necessary. And whether we get there with a proactive approach where we decide to move in this direction and we make these changes or whether we get there because we absolutely have no choice, we’re going to get there. Tony:  Yeah. I mean it really sounds like we can’t afford to not do this. Chris:  Exactly. Tony:  And if we get to that point where we continue down the reactive path and we wait until there’s a total collapse, it might be too late, just to put it frankly. And it’s going to come out at a huge, not just financial cost, a huge human cost. Chris:  Yeah, it’s going to be, we can use the chronic disease metaphor again, it’s a lot easier to prevent a problem or reverse it at an earlier stage than it is to wait until the patient is essentially on life support or the healthcare system is on life support. It’s harder to reverse it at that time. And that’s of course why I’m writing the book now because I want to get this message out as far and wide as I can. Tony:  Yeah. If not now, when? If not you, who? Go right back to there.

How allied providers are the key

Chris:  Exactly. And one more thing about that is the amazing thing, the beauty of this is that it takes about eight years and hundreds of thousands of dollars to train a doctor. And it takes a certain kind of personality and a certain kind of comfort level with science, and a lot of prerequisites. It’s not for everybody. And there’s a ... already we have a shortage of doctors, and that’s predicted to get worse. I’ve seen estimates that suggest by 2025 we’ll have a shortage of 52,000 primary care physicians. So that’s a big deal. [insert image] So we already don’t have enough doctors, it’s already going to get worse, but if you think of healthcare as like a ... I have something in the book called the healthcare population pyramid. And you were referring to it earlier, Tony, where at the very top of that pyramid you’ve got 5 percent of people who are in really acute situations. So they’re in the hospital or they’re in an intensive outpatient care setting. They need the conventional medicine paradigm as it exists, and it’s fantastic for those situations. Then you’ve got another 25 percent of people in that kind of high middle of the pyramid who are dealing with some pretty serious chronic health challenges. So they require more regular care, but they’re not sick enough to be in the hospital or in any kind of ... they’re living their lives, but they’re struggling a lot. A Functional Medicine practitioner/clinician usually working in concert possibly with the conventional specialist of some kind is a really great option for that 25 percent of the pyramid. But then you’ve got the 70 percent at the bottom. So these are people who do, may have health issues, but they’re more minor, so they might have skin problems, or a little bit of brain fog, some difficulties sleeping, some GI issues. And these can be definitely debilitating and total pain, but they’re not at the level of that 25 percent. My argument is that in many cases these people could be very well served by a health coach or nutritionist with good training. And possibly seeing a Functional Medicine provider once or twice a year, or something like that. And the thing is, we can train people in a year or two without an extensive science background to be very, very objective in this role. Because they’re mostly working with patients on changing their behavior. If you think about it, most of the risk factors for chronic disease come down to the wrong behaviors. Eating the wrong diet, not getting enough sleep, not exercising, or exercising too much, or any number of things that come down to choices that we’re making. And so if a skilled health coach who’s trained in things like motivational interviewing and coaching to strengths and other evidence-based principles of facilitating behavior change which we have a ton of research on, they can be incredibly effective for that 70 percent of the population. That's the majority of the population. So we’re totally underutilizing these practitioners, and my argument is that they’re going to play a huge role in this future of medicine. And that's of course one reason why we're launching an ADAPT Health Coach Training Program next year to complement the practitioner training program that we've been doing. Because I want to create this ecosystem we've been talking about where you have all of these different types of practitioners working to the maximum of their training and ability and scope of practice and supporting each other and therefore providing the highest level of care to patients. Tony:  That certainly kind of perks my ears up hearing about the ADAPT health coach option and something that I’m personally interested in. So who knows? Maybe I can get in on that. We can talk about it again in the future. Chris:  Yeah, for sure. For sure. Tony:  So, for this particular book, for Unconventional Medicine, people are fired up, they’re hearing about it, they’re like, “Okay, this resonates with me. I’m a practitioner, I’m an allied health provider, I’m a patient, I’m ready. Now’s the time. This is it. We’re going to do this.” What’s the best way for people to get their hands on this thing? Chris:  Well not surprisingly, Amazon. They have the best way to get your hands on anything. So it’s available in paperback, Kindle, and audiobook. We’re hoping [the audiobook] is going to be out today, the day this podcast is released. But it might be another two or three days. They’re just taking their sweet time to approve it. I narrated the audiobook myself. So you podcast listeners, I figured you might be into that, since you like to listen. Tony:  They know your voice. Chris:  Yeah, and just listening to something instead of reading it perhaps. So to that end, we have a special offer for podcast listeners, because I appreciate your support and I know many of you are already part of this movement, and some are wanting to get involved. So if you buy that paperback or Kindle version between now and Sunday night, you’ll get some really cool bonuses. The first is a free copy of the audiobook. So again, we wanted to include that for podcast listeners, since we figured you guys and gals are probably interested in audio. But there are two other things that are really, I think, fantastic. And one, they’re both tools to help you be more confident and persuasive and factual when you share your passion for Functional Medicine and an ancestral diet and lifestyle. Because we’ve had a lot of questions from people, both practitioners and non-practitioners alike. They say, “Oh, how do I talk about this stuff to my sister at Thanksgiving?” Tony:  “Isn’t that that caveman diet?” Chris:  Yeah, exactly. All of our ancestors died when they were 30, so why should we even care? How do you respond to those arguments? Or if you start talking about Functional Medicine and maybe one of your conventional medicine colleagues says, “Oh, that’s just, I saw something on Science-based Medicine that said that was all just hooey. There’s nothing to it. How do you respond to that?” So what we wanted to do is give people the ammunition they needed in a respectful way. You know, this isn’t about getting the better of somebody. It’s about responding in a factual and convincing but respectful way. So we’ve got two different, we’re calling these the Power Packs. And one is for practitioners, so clinicians, health coaches, nutritionists, trainers, etc., and these are facts, research that you can reference and persuasive reasons for your clients or patients or colleagues to consider this Functional Medicine and ancestral diet and lifestyle approach. And then we have one for non-practitioners called the Supporter Power Pack. And these are smart answers and compelling comebacks, again respectful, for those common objections that you hear when you start talking about this stuff with your friends and family. So these bonuses are available until Sunday night [November 12, 2017] at 11:59 p.m. Pacific Time. So you’ve got a few days to act on that, and you can go to ... we set up a special link for you to get these and that’s Kresser.co/bonus. That’s Kresser.co/bonus. So head over there to get your Power Packs and your free audiobook, and that’s after you purchase either the paperback or Kindle. There’ll be a place where you enter your order number and we ask for some information just to verify, and I hope you enjoy those and get a lot out of them. Because they were actually really fun to put together. Tony:  Yeah, I think the audiobook is huge. I like to listen to audiobooks when I’m driving around town or outside getting some exercise. Chris:  Yeah. Tony:  So, no excuses when you make it that easy. Chris:  Yeah, yeah. So, Tony, thanks so much for doing this. This has been really fun to talk to you, as it always is. And I appreciate it. Tony:  Actually, I wanted to throw in one extra little special thing, as we mentioned, at the top of the show. I spent 10 years as a personal trainer in the trenches, I was involved with Paleo Magazine for many, many years, going to all the events, and for me kind of an evolution in my professional life was, how do I impact more people? How do I help more people? And at first I was working one on one, and then it was as a facility manager helping other trainers and coaches get better. And then I was able to scale it up that way. And last year I had an opportunity to join the team over at Natural Force, which is all-natural, nutritional products, and I basically said, “You know what? I’m going to go all in on this because if I can touch a million people through really good, high-quality nutrition, that’s me maximizing my impact and really kind of living my purpose.” So one of the things I wanted to do today is put it out there for anyone listening who maybe uses collagen or MCT oil or whey protein. We really bend over backwards to source the best ingredients in the world, no additives, all that stuff. Everything is as clean as we can possibly make it. It takes a lot of work, working with manufacturers. Kind of like what you were saying, how patients have to know how to talk to their doctor. I don’t think people really realize, and I didn’t realize until I got on the inside, how much work it is for a brand to work with their manufacturers to convince them to get outside of the conventional mold. So it’s the kind of unconventional nutrition is really what we’re pushing here. So I set up a discount code for any Revolution Health listeners. Go to NaturalForce.com, use coupon code “unconventional” and get $10 off plus free shipping on your order. So I just want to put that out there as just a little extra bonus for anybody, and I would certainly love to help in that way and really get some good, high-quality nutrition into people’s hands. Chris:  Awesome. Yeah, and there’s so many ways people can help, and I ... at Paleo f(x) we’ve see the growth of companies that are serving this space, and it's amazing. Like the products that are available now. I had breakfast this morning, I had some eggs and kale and parsley and a little bit of bacon in a couple of cassava flour tortillas. Breakfast burritos. Whoever thought I’d be having a breakfast burrito again? Tortillas are made from completely cassava flour. They’re autoimmune friendly and they’re grain-free tortillas. It’s incredible. Tony:  I think I might have some of those in my fridge as well. Chris:  Yeah. I mean there’s so many things. And these people, they’re serving this movement with that kind of work. So it’s great to see. Tony:  It takes a village, man. Chris:  It does. Thanks again, Tony. I really appreciate it. Thank you, everybody. So again, Kresser.co/bonus to pick up your free audiobook and the other bonuses, and I hope you can all join me in this revolution to reinvent healthcare. We need you, whatever your background and goals. Take care, everybody. RHR: A Three-Step Plan to Fix Conventional Healthcare published first on https://chriskresser.com