WEBVTT 00:00:30.429 --> 00:00:32.670 Is it true though, Natalie, that blondes have 00:00:32.670 --> 00:01:09.420 more fun? What's up, guys? Welcome to Hormones 00:01:09.420 --> 00:01:12.400 Happen. I'm your neighborhood NP, Jeremiah, and 00:01:12.400 --> 00:01:15.959 I'll tell you what. We've been lied to, tricked, 00:01:16.260 --> 00:01:19.280 and brainwashed to be reactive with our health 00:01:19.280 --> 00:01:22.359 instead of proactive. There's no such thing as 00:01:22.359 --> 00:01:26.040 normal, and no one knows you better than, well, 00:01:26.040 --> 00:01:29.540 you. Stick around, and we'll talk about hormones, 00:01:29.879 --> 00:01:33.939 peptides, and other amazing advancements in proactive 00:01:33.939 --> 00:01:37.040 medicine. I won't sit here and say I know everything, 00:01:37.180 --> 00:01:41.180 but like they say, knowledge is power, and I'm 00:01:41.180 --> 00:01:44.359 trying to become more powerful every day, just 00:01:44.359 --> 00:01:48.180 like you. Let's get optimized together and become 00:01:48.180 --> 00:02:00.920 the heroes of our own stories. Welcome back, 00:02:00.959 --> 00:02:03.420 guys, to another episode of Hormones Happen. 00:02:03.680 --> 00:02:06.379 I have a very special guest with us today. She's 00:02:06.379 --> 00:02:09.080 a board -certified nurse practitioner with an 00:02:09.080 --> 00:02:11.500 extensive background in emergency and primary 00:02:11.500 --> 00:02:15.780 care, and now the owner and operator of E &O 00:02:15.780 --> 00:02:18.460 Wellness. Natalie, thank you for being with us. 00:02:18.639 --> 00:02:20.560 Of course. Thank you so much for having me today. 00:02:20.800 --> 00:02:23.639 Natalie, I have a question. What inspired you 00:02:23.639 --> 00:02:26.840 to start a DPC practice? instead of a traditional 00:02:26.840 --> 00:02:29.199 insurance one. Kind of a long story. So kind 00:02:29.199 --> 00:02:32.500 of how I decided to go off on my own was I was 00:02:32.500 --> 00:02:35.759 in a provider meeting with my corporate job and 00:02:35.759 --> 00:02:37.719 they had told us that our hours were going to 00:02:37.719 --> 00:02:40.639 change. And I had come from another corporate 00:02:40.639 --> 00:02:43.259 position and I just kind of sat there for a little 00:02:43.259 --> 00:02:45.080 bit and I was like, I just don't think I'm ever 00:02:45.080 --> 00:02:47.400 going to get what I really want out of corporate. 00:02:47.740 --> 00:02:50.080 And so I went home to my husband and I was like, 00:02:50.139 --> 00:02:52.599 I think that I want to go off on my own. And 00:02:52.599 --> 00:02:56.659 he was like. do it. So I quit my job in May. 00:02:56.780 --> 00:03:00.819 I spent the entire summer transitioning into 00:03:00.819 --> 00:03:03.240 my own practice, figuring out what I wanted to 00:03:03.240 --> 00:03:05.740 do. And I worked with a company, Oma Health, 00:03:05.960 --> 00:03:08.479 to help get my business up from the ground up. 00:03:08.599 --> 00:03:11.319 And they have been amazing to work with and taking 00:03:11.319 --> 00:03:13.539 care of everything on the back end. That is so 00:03:13.539 --> 00:03:18.000 over my head. So what led me to open a DPC versus 00:03:18.000 --> 00:03:22.860 a traditional primary care. was I got denied 00:03:22.860 --> 00:03:28.199 by insurances. Sure. I submitted all my applications 00:03:28.199 --> 00:03:32.460 and I came back and I was sitting and just kind 00:03:32.460 --> 00:03:34.479 of waiting around, didn't really hear anything. 00:03:34.620 --> 00:03:37.580 And right when I was like getting ready to move 00:03:37.580 --> 00:03:40.680 into my suite, I got noticed that three out of 00:03:40.680 --> 00:03:42.900 like the six insurances that I applied for denied 00:03:42.900 --> 00:03:46.319 me. And I was like. Okay, well, I have to start 00:03:46.319 --> 00:03:50.539 and I'm maybe kind of biased. I see a DPC, my 00:03:50.539 --> 00:03:53.139 kids and I do, and I absolutely love it. And 00:03:53.139 --> 00:03:56.360 so I connected with my doctor, you know, kind 00:03:56.360 --> 00:03:58.740 of got, you know, a little bit of information 00:03:58.740 --> 00:04:02.000 about how she structures her practice. And I 00:04:02.000 --> 00:04:05.560 just, and I just kind of went with it. I haven't 00:04:05.560 --> 00:04:07.439 looked back since. Isn't it funny how sometimes 00:04:07.439 --> 00:04:09.500 life just has a way of telling us where we need 00:04:09.500 --> 00:04:11.199 to go, even though that's not where we intended 00:04:11.199 --> 00:04:14.580 to? 100%. Yeah. I didn't expect to hit those 00:04:14.580 --> 00:04:17.420 kinds of roadblocks. I had every intention of, 00:04:17.420 --> 00:04:20.379 you know, kind of doing like still kind of incorporating 00:04:20.379 --> 00:04:23.699 like the DPC route. Like I still wanted every 00:04:23.699 --> 00:04:26.480 single appointment to be like at least 60 minutes 00:04:26.480 --> 00:04:30.519 with my patients to ensure that I covered everything. 00:04:30.779 --> 00:04:32.860 That's why I opened my own. I don't want to. 00:04:33.269 --> 00:04:36.470 20 minute appointments anymore where, you know, 00:04:36.470 --> 00:04:38.930 like, oh, by the way, like something else came 00:04:38.930 --> 00:04:41.670 up and it's like, oh, I don't really have time. 00:04:41.730 --> 00:04:44.209 Like that's just rude in my opinion. So I still 00:04:44.209 --> 00:04:47.170 kind of wanted to incorporate both, but I was 00:04:47.170 --> 00:04:50.569 unsuccessful with doing that. And so I just decided 00:04:50.569 --> 00:04:55.290 to go the DPC route. My membership is $80 a month, 00:04:55.410 --> 00:04:58.889 but I did it that way because when I compare 00:04:58.889 --> 00:05:01.389 myself and I look at the bigger picture of, you 00:05:01.389 --> 00:05:04.350 know, the other DPCs. in my area, I do offer 00:05:04.350 --> 00:05:08.949 more services that are just not only to primary 00:05:08.949 --> 00:05:11.949 care. I also do regenerative medicine. I also 00:05:11.949 --> 00:05:15.310 do Botox and I don't limit patients. So you don't 00:05:15.310 --> 00:05:19.050 have to be a member of my concierge service to 00:05:19.050 --> 00:05:21.990 do any of my other services here in my office. 00:05:22.269 --> 00:05:24.069 That's very cool. Do you feel like your background 00:05:24.069 --> 00:05:27.120 in emergency medicine? helped you to get those 00:05:27.120 --> 00:05:29.480 additional services like your PRP injections, 00:05:29.819 --> 00:05:31.959 your Botox? I mean, you feel comfortable with 00:05:31.959 --> 00:05:35.040 a needle. I definitely feel comfortable with 00:05:35.040 --> 00:05:38.339 a needle. Yes. I loved, you know, just starting 00:05:38.339 --> 00:05:41.540 IVs, you know, in the emergency room. You know, 00:05:41.540 --> 00:05:43.759 that's a skill that you have to be really good 00:05:43.759 --> 00:05:47.579 at. I didn't actually get into regenerative medicine 00:05:47.579 --> 00:05:49.959 until I became a nurse practitioner. And that 00:05:49.959 --> 00:05:52.180 was actually my first nurse practitioner job. 00:05:52.379 --> 00:05:55.120 I worked in a regenerative medicine clinic. And 00:05:55.120 --> 00:05:59.319 I really liked it. I just kind of felt like as 00:05:59.319 --> 00:06:01.899 a new grad nurse, like I kind of and I kind of 00:06:01.899 --> 00:06:03.259 think like everybody goes through this. I was 00:06:03.259 --> 00:06:05.699 kind of like, I think I need to like just gain 00:06:05.699 --> 00:06:08.060 a little bit more experience. Like if I ever 00:06:08.060 --> 00:06:10.540 wanted to like go back into the emergency room, 00:06:10.639 --> 00:06:12.980 like I want to be comfortable knowing, you know, 00:06:13.019 --> 00:06:16.519 my medications and broadening my scope. And so 00:06:16.519 --> 00:06:18.620 that's kind of why I transitioned into primary 00:06:18.620 --> 00:06:21.560 care. And then I just never really left. And 00:06:21.560 --> 00:06:23.500 then when I opened my own clinic, I was like. 00:06:23.769 --> 00:06:26.470 I'm going to do it all because I can't. I know 00:06:26.470 --> 00:06:29.769 how to. I really, really missed doing PRP and 00:06:29.769 --> 00:06:32.170 a little bit, and I did a little bit of aesthetics 00:06:32.170 --> 00:06:35.930 on the side, but I wasn't too active until I 00:06:35.930 --> 00:06:38.649 started my own practice. And for those at home 00:06:38.649 --> 00:06:40.990 that are unfamiliar with what a DTC practice 00:06:40.990 --> 00:06:43.370 is, can you just tell us a little bit about it? 00:06:43.490 --> 00:06:46.689 Sure. So concierge style practice is, most appointments 00:06:46.689 --> 00:06:49.769 I'll say are 60 minutes long. You pay a monthly 00:06:49.769 --> 00:06:53.079 membership fee. describe it as like a subscription. 00:06:53.279 --> 00:06:55.420 Like think of it as like, like your Netflix, 00:06:55.519 --> 00:06:57.360 you know, you can watch as little or as much 00:06:57.360 --> 00:06:59.579 as you want. You probably won't get popcorn here. 00:06:59.759 --> 00:07:01.740 You know, you probably won't get popcorn included 00:07:01.740 --> 00:07:04.779 with your Netflix subscription, but it's unlimited 00:07:04.779 --> 00:07:07.899 visits that are all 60 minutes long. You can 00:07:07.899 --> 00:07:09.860 see me, you know, as little or as much as you 00:07:09.860 --> 00:07:12.480 want, you know, unlike the traditional corporate 00:07:12.480 --> 00:07:15.040 medicine where, you know, you message your provider 00:07:15.040 --> 00:07:16.819 on the portal and it's like, Hey, I'm sick. And 00:07:16.819 --> 00:07:18.160 they're like, Oh, well you got to come in for 00:07:18.160 --> 00:07:20.829 a visit so I can bill you. That's not how this 00:07:20.829 --> 00:07:23.350 is over here. You get sick, I treat you right 00:07:23.350 --> 00:07:25.629 away. Yeah, the flexibility is absolutely phenomenal. 00:07:25.889 --> 00:07:27.829 And we do the same model here with the hormone 00:07:27.829 --> 00:07:29.970 clinic. We're a very concierge white glove service. 00:07:30.170 --> 00:07:32.889 So our patients are only a text away. They're 00:07:32.889 --> 00:07:35.670 a call away. And they know that and they appreciate 00:07:35.670 --> 00:07:38.449 that because in the traditional insurance -based 00:07:38.449 --> 00:07:40.569 medicine world, well, guess what? You're three 00:07:40.569 --> 00:07:42.750 months out for a small little thing that can 00:07:42.750 --> 00:07:46.389 be taken care of immediately, guys. Yeah, I completely 00:07:46.389 --> 00:07:49.680 agree. And I think medicine is... You know, with 00:07:49.680 --> 00:07:52.959 all the changes to insurance coming up and the 00:07:52.959 --> 00:07:55.800 things that have happened, it'll be really it'll 00:07:55.800 --> 00:07:57.480 be really interesting to see what happens in 00:07:57.480 --> 00:07:59.879 the last in the next couple of years. But I do 00:07:59.879 --> 00:08:01.439 really think that this is the way medicine is 00:08:01.439 --> 00:08:03.519 going to be going. I agree. And like, how do 00:08:03.519 --> 00:08:05.439 you feel like you made a TikTok once that I absolutely 00:08:05.439 --> 00:08:08.579 loved? I think it was like why seven minute appointments 00:08:08.579 --> 00:08:11.079 with your provider isn't enough. Right. And it 00:08:11.079 --> 00:08:13.660 really encapsulates that when you're being seen 00:08:13.660 --> 00:08:15.680 by a clinic who takes insurance. And I have a 00:08:15.680 --> 00:08:18.240 lot of friends who do this. You're getting inundated. 00:08:18.519 --> 00:08:20.240 With patients, patients are being sent to you 00:08:20.240 --> 00:08:23.879 all the time. And how can you see 30 plus patients 00:08:23.879 --> 00:08:27.120 a day and spend any amount of time with them? 00:08:27.180 --> 00:08:29.199 What are some of the benefits to being able to 00:08:29.199 --> 00:08:31.379 have more time with these patients to actually 00:08:31.379 --> 00:08:33.600 kind of flesh out some of their issues? It's 00:08:33.600 --> 00:08:36.159 been so nice. I've had a really decent following 00:08:36.159 --> 00:08:38.840 of just my patients that I've taken care of now 00:08:38.840 --> 00:08:42.419 for, you know, over three years. I have just 00:08:42.419 --> 00:08:44.299 been able to like sit down with them and be like, 00:08:44.340 --> 00:08:46.899 hey, we're doing a thorough family history. And 00:08:46.899 --> 00:08:49.960 I have learned so much more about my patients 00:08:49.960 --> 00:08:52.679 that I don't think I ever would have known had 00:08:52.679 --> 00:08:55.120 I. you know, worked in the corporate, I was just, 00:08:55.159 --> 00:08:57.480 you know, filling their medications because they've 00:08:57.480 --> 00:09:00.440 been on it for so long until I like, I started 00:09:00.440 --> 00:09:03.019 my own practice where I, I knew I had time. I 00:09:03.019 --> 00:09:05.200 knew I had an hour with them and if it went over, 00:09:05.240 --> 00:09:07.220 you know, I went over because, you know, that 00:09:07.220 --> 00:09:09.759 that's with the flexibility and, you know, call 00:09:09.759 --> 00:09:11.360 and text your patients and be like, Hey, I'm 00:09:11.360 --> 00:09:13.960 running a little bit behind. Like, can you, you 00:09:13.960 --> 00:09:17.080 know, come in like 10, 15 minutes later? So I 00:09:17.080 --> 00:09:20.259 am just like super grateful that, uh, you know, 00:09:20.259 --> 00:09:24.529 time just means everything to me. anybody. You 00:09:24.529 --> 00:09:27.769 know, even if you take just the extra five minutes 00:09:27.769 --> 00:09:30.289 of sitting with someone, it might be someone's 00:09:30.289 --> 00:09:33.690 worst day of their life and they just need someone 00:09:33.690 --> 00:09:36.269 to just sit there and listen. And that's the 00:09:36.269 --> 00:09:39.830 difference of, you know, a provider wanting to 00:09:39.830 --> 00:09:43.429 explore, you know, the other avenues of, especially 00:09:43.429 --> 00:09:46.350 concierge service, where you can give that time 00:09:46.350 --> 00:09:49.019 back. your patients. Right. Time to actually 00:09:49.019 --> 00:09:51.320 be heard, right? Because oftentimes, you know, 00:09:51.320 --> 00:09:53.279 patients just feel like they're just talking 00:09:53.279 --> 00:09:55.700 and they're never being heard, right? The patients 00:09:55.700 --> 00:09:58.549 don't. care what you know until they know you 00:09:58.549 --> 00:10:00.750 care. And that's the reality. That's any one 00:10:00.750 --> 00:10:02.629 of us. If you're talking to someone about some 00:10:02.629 --> 00:10:04.750 of your major pain points, your major issues, 00:10:04.889 --> 00:10:06.909 and they're just discrediting it like, okay, 00:10:06.950 --> 00:10:09.169 yeah, sorry, sorry, sorry. It doesn't do me any 00:10:09.169 --> 00:10:11.009 good. I want to be heard. I want to have a good 00:10:11.009 --> 00:10:13.269 dialogue. I want to talk to you as a person, 00:10:13.429 --> 00:10:15.450 you know, and I think that that's one of the 00:10:15.450 --> 00:10:18.330 biggest factors of burnout in healthcare is that 00:10:18.330 --> 00:10:20.649 we are just, we're trying to give as much as 00:10:20.649 --> 00:10:23.669 we can to someone in such a small amount of time 00:10:23.669 --> 00:10:26.600 that it's just impossible because We can't give 00:10:26.600 --> 00:10:29.039 the care that we want to, right? And that's why 00:10:29.039 --> 00:10:31.419 we all got into healthcare to begin with is to 00:10:31.419 --> 00:10:33.580 help people. Well, and I have to kind of ask 00:10:33.580 --> 00:10:36.000 you, you know, with you starting your own business 00:10:36.000 --> 00:10:39.179 and going the hormone and weight loss route, 00:10:39.320 --> 00:10:43.019 do you find like with like your patients that 00:10:43.019 --> 00:10:45.659 you have in your clinic that like they were like 00:10:45.659 --> 00:10:49.100 discredited by their primary care provider and 00:10:49.100 --> 00:10:52.259 like that's why they kind of ventured out to 00:10:52.259 --> 00:10:58.980 come to you? Hormones are tricky, guys, and things 00:10:58.980 --> 00:11:01.539 are always changing. To stay up to date, check 00:11:01.539 --> 00:11:04.740 out the blog on stillcity -trt .com. Now back 00:11:04.740 --> 00:11:09.720 to the podcast. Yeah, all the time. And, you 00:11:09.720 --> 00:11:11.500 know, this is the thing. I don't like to put 00:11:11.500 --> 00:11:13.720 the blame on primary care because having been 00:11:13.720 --> 00:11:17.059 there, I know how difficult it is to treat something 00:11:17.059 --> 00:11:20.460 when you know how you can't. Your hands are chained. 00:11:20.600 --> 00:11:22.860 Not to mention, believe it or not, there's no 00:11:22.860 --> 00:11:25.580 formal education, whether you go to medical school, 00:11:25.720 --> 00:11:29.299 NPPA. You don't get that training. Okay. So I 00:11:29.299 --> 00:11:31.919 always tell them it's not your provider's fault. 00:11:31.980 --> 00:11:34.480 I understand. But when we'll take a woman, for 00:11:34.480 --> 00:11:36.940 example, goes in and says, hey, I'm not sleeping. 00:11:37.059 --> 00:11:39.820 I have no energy during the day. No limbito. 00:11:40.059 --> 00:11:42.379 I'd like to get my hormones checked. And what 00:11:42.379 --> 00:11:45.059 they hear is welcome to the club. That's normal. 00:11:45.279 --> 00:11:47.679 This is menopause, right? Like that is the most 00:11:47.679 --> 00:11:50.440 invalidating, upsetting thing you can hear because 00:11:50.440 --> 00:11:54.320 you know something's wrong and they know something's 00:11:54.320 --> 00:11:56.240 wrong. But guess what? We're not going to do 00:11:56.240 --> 00:11:59.279 anything. And I see it all the time, right? Myself 00:11:59.279 --> 00:12:01.379 included. When I went to my primary and I asked 00:12:01.379 --> 00:12:03.480 to get my hormones checked, she's like, you're 00:12:03.480 --> 00:12:06.279 33. What do you mean you want your hormones checked? 00:12:06.460 --> 00:12:09.879 Like, are you crazy? And it's like, you know, 00:12:09.879 --> 00:12:12.000 it was just always a very uncomfortable situation. 00:12:12.320 --> 00:12:16.019 And so, yeah, absolutely. I think that just being 00:12:16.019 --> 00:12:19.039 discredited in general sucks, you know? And I 00:12:19.039 --> 00:12:20.940 think when patients have that happen to them, 00:12:21.039 --> 00:12:23.460 they not only lose trust in that provider, but 00:12:23.460 --> 00:12:26.720 in the whole medical system. They're out to get 00:12:26.720 --> 00:12:29.240 us, right? And that's not true. And what I really 00:12:29.240 --> 00:12:32.820 love about the DPC model is that the flexibility, 00:12:33.019 --> 00:12:35.860 right? Because people say, why do I want to pay 00:12:35.860 --> 00:12:38.700 monthly when I have health insurance? But what 00:12:38.700 --> 00:12:41.879 people don't understand is all the red tape that 00:12:41.879 --> 00:12:45.179 comes with insurance and the availability that 00:12:45.179 --> 00:12:48.370 we can do. People don't know, hey. I can actually 00:12:48.370 --> 00:12:50.409 pay out of pocket for a lot of this stuff. People 00:12:50.409 --> 00:12:51.889 don't know this. People don't know I can pay 00:12:51.889 --> 00:12:53.629 out of pocket for imaging. I could pay out of 00:12:53.629 --> 00:12:55.730 pocket for labs. Now, granted, you know, sometimes, 00:12:56.009 --> 00:12:58.909 you know, I think you use insurance to the patient's 00:12:58.909 --> 00:13:01.370 insurance for labs and stuff, too. Yes. So it's 00:13:01.370 --> 00:13:03.450 there. It's there for a reason. I do. I do it, 00:13:03.470 --> 00:13:05.750 too. But sometimes you can get cheaper prices 00:13:05.750 --> 00:13:08.669 for imaging for labs with cash. So you always 00:13:08.669 --> 00:13:11.330 got to look. You always got to look and do some 00:13:11.330 --> 00:13:14.250 cost analysis and compare things. But, you know, 00:13:14.309 --> 00:13:17.460 what kind of things can a patient expect? from 00:13:17.460 --> 00:13:19.919 a DPC model versus like a traditional insurance 00:13:19.919 --> 00:13:22.759 care? I think that, you know, the major difference 00:13:22.759 --> 00:13:26.240 is, you know, it just comes down to quality of 00:13:26.240 --> 00:13:30.460 time. If you really want to, you know, not make 00:13:30.460 --> 00:13:34.259 six doctor visits to talk about, you know, three 00:13:34.259 --> 00:13:37.059 different topics because like you're out of time 00:13:37.059 --> 00:13:40.899 in like your 20 minutes, like we have time in 00:13:40.899 --> 00:13:45.669 a DPC to go over. the things that need to be 00:13:45.669 --> 00:13:48.350 addressed. I mean, obviously you and I have primary 00:13:48.350 --> 00:13:51.389 care and ER experience and it's very difficult 00:13:51.389 --> 00:13:55.769 to find time in those environments. Absolutely. 00:13:56.009 --> 00:13:58.629 I went from seeing 16 people a day to seeing 00:13:58.629 --> 00:14:01.490 six people a day and people are like, oh my gosh, 00:14:01.690 --> 00:14:04.350 like that is insane. And it's like, but it is 00:14:04.350 --> 00:14:08.549 so nice because I like, you know, I'm able to 00:14:08.549 --> 00:14:13.720 really turn my brain off when I go to work. when 00:14:13.720 --> 00:14:18.659 I go home from work because I got through everything. 00:14:18.940 --> 00:14:21.600 I know that I'm not going to come to work with, 00:14:21.600 --> 00:14:23.940 you know, you know, with an empty task bucket 00:14:23.940 --> 00:14:27.039 leaving work and then come back to like 80 tasks 00:14:27.039 --> 00:14:29.799 the next day that I'm going to have to go over. 00:14:29.980 --> 00:14:32.279 It's mentally and physically and emotionally 00:14:32.279 --> 00:14:35.759 exhausting. And I feel like I can be a better 00:14:35.759 --> 00:14:40.129 provider as well because I am rested. you know, 00:14:40.129 --> 00:14:43.110 don't need to carry things over like day to day. 00:14:43.149 --> 00:14:46.070 I, you know, I spend so much time with my patients 00:14:46.070 --> 00:14:48.309 and I just, and I think that that's what like 00:14:48.309 --> 00:14:50.590 healthcare needs to be. It just needs to be fun. 00:14:50.710 --> 00:14:52.830 It needs, the people should want to come see 00:14:52.830 --> 00:14:56.450 their provider because they want to feel like, 00:14:56.549 --> 00:14:58.809 okay, I have a checklist and I want to check 00:14:58.809 --> 00:15:01.250 everything off. It shouldn't feel like a chore. 00:15:01.470 --> 00:15:03.269 You're right. This is a right that we should 00:15:03.269 --> 00:15:05.789 have. I'm a huge advocate for the patient should 00:15:05.789 --> 00:15:08.049 have some say in their healthcare. You should 00:15:08.049 --> 00:15:10.470 have say in what your health care looks like. 00:15:10.509 --> 00:15:12.929 And too often, it's almost kind of like a dictatorship, 00:15:13.129 --> 00:15:15.389 not a decision making process where they're just 00:15:15.389 --> 00:15:18.210 being told, hey, you need to do ABC. And it's 00:15:18.210 --> 00:15:20.370 like, well, you know, sometimes what I like to 00:15:20.370 --> 00:15:22.529 tell the patients is you're in the driver's seat 00:15:22.529 --> 00:15:24.990 of this bus. I'm in the passenger seat giving 00:15:24.990 --> 00:15:27.450 directions. You know, I may say, hey, let's go 00:15:27.450 --> 00:15:29.929 right. You say, let's go left. If you could tell 00:15:29.929 --> 00:15:33.090 me why we should go left. OK, let's do it. Let's 00:15:33.090 --> 00:15:35.350 try it. Right. Like as long as it doesn't hurt 00:15:35.350 --> 00:15:38.000 someone. I'm on board because at the end of the 00:15:38.000 --> 00:15:40.460 day, no one's the same. And granted, you know, 00:15:40.500 --> 00:15:42.600 we have studies and we have all this literature, 00:15:42.720 --> 00:15:45.519 but it doesn't encapsulate everyone. And there's 00:15:45.519 --> 00:15:47.299 always, I don't want to put my tinfoil hat on, 00:15:47.360 --> 00:15:50.600 some agendas and biases and whatnot. So the reality 00:15:50.600 --> 00:15:54.519 is everyone's different. I precept a lot with 00:15:54.519 --> 00:15:56.919 nurse practitioner students. It's difficult, 00:15:57.059 --> 00:15:59.639 you know, coming out and you're like, oh my gosh, 00:15:59.700 --> 00:16:04.100 they trust me to like do this? I feel like I 00:16:04.100 --> 00:16:06.200 know what I'm doing, but like I don't. And like 00:16:06.200 --> 00:16:09.000 the first year of being, you know, I'll speak 00:16:09.000 --> 00:16:10.860 for myself as a nurse practitioner was super 00:16:10.860 --> 00:16:12.879 nerve wracking because, you know, I'm like, oh, 00:16:12.899 --> 00:16:15.059 my God, like I'm like in charge. And so, you 00:16:15.059 --> 00:16:16.759 know, the more that I've like, you know, obviously 00:16:16.759 --> 00:16:20.179 establishing myself in practice, I really go 00:16:20.179 --> 00:16:23.759 into my patients saying like, OK, and teaching 00:16:23.759 --> 00:16:27.340 my students like pick your top three to pick 00:16:27.340 --> 00:16:30.759 your top three medications. your top three antidepressants, 00:16:30.779 --> 00:16:33.120 your top three blood pressure medications. And 00:16:33.120 --> 00:16:36.019 I was like, and have rationale and know why you 00:16:36.019 --> 00:16:39.440 prescribe them, what they do and educate your 00:16:39.440 --> 00:16:42.179 patients. Like, hey, these are the couple different 00:16:42.179 --> 00:16:45.419 avenues that we can go down. What do you feel 00:16:45.419 --> 00:16:48.019 is going to be best? I can give you all of the 00:16:48.019 --> 00:16:50.379 information that I know, all of the experience 00:16:50.379 --> 00:16:53.480 that I have seen. But I mean, ultimately it's 00:16:53.480 --> 00:16:55.220 up to you. I always tell my patients like, you're 00:16:55.220 --> 00:16:57.940 not gonna hurt my feelings if my first choice 00:16:57.940 --> 00:17:01.759 was like, the worst option out there for you. 00:17:01.899 --> 00:17:04.160 Oh my God, Natalie, I felt awful. I'll be like, 00:17:04.240 --> 00:17:07.900 I'm so sorry. Now we have planned D's and C's, 00:17:08.039 --> 00:17:10.440 which one would you like to go with? Absolutely. 00:17:10.700 --> 00:17:13.859 You need plan D and E and F. Hey, exactly. Some 00:17:13.859 --> 00:17:16.559 people do, right? And so. The reality is, is 00:17:16.559 --> 00:17:19.380 with insurance, there's always these low charts, 00:17:19.559 --> 00:17:21.420 right? There's always these algorithms. And so 00:17:21.420 --> 00:17:23.839 you don't get that ability to make these decisions. 00:17:24.000 --> 00:17:26.660 You're stuck with doing this. If it fails, you 00:17:26.660 --> 00:17:29.579 do this, then this. And so you don't get to make 00:17:29.579 --> 00:17:32.039 these higher level decisions. They're made for 00:17:32.039 --> 00:17:34.359 you. And really, at the end of the day, what 00:17:34.359 --> 00:17:37.119 I feel like getting out of my medical training 00:17:37.119 --> 00:17:40.799 was I was a prescriber. So diagnose, prescribe, 00:17:41.160 --> 00:17:45.039 diagnose, prescribe. And that got so mind numbing. 00:17:45.400 --> 00:17:49.779 It was just absolute burnout central. And primary 00:17:49.779 --> 00:17:53.039 care is the most important specialty. I consider 00:17:53.039 --> 00:17:55.519 it a specialty that there is. It's the catch 00:17:55.519 --> 00:17:57.640 all. You're going to see something before any 00:17:57.640 --> 00:18:00.039 specialist does. And you have to have some degree 00:18:00.039 --> 00:18:02.440 of understanding on it. You wear all the hats. 00:18:02.539 --> 00:18:04.500 Absolutely. I always say that, like, you know, 00:18:04.500 --> 00:18:06.420 being a primary care provider, you know, you 00:18:06.420 --> 00:18:09.059 have to know a little about a lot. You don't 00:18:09.059 --> 00:18:11.559 have to know everything. But you do have to have 00:18:11.559 --> 00:18:14.200 some kind of information. I always, again, like 00:18:14.200 --> 00:18:16.299 tell, you know, my nurse practitioners, like 00:18:16.299 --> 00:18:19.220 we're not expected to know everything. Someone's 00:18:19.220 --> 00:18:22.559 not going to come to me if they have heart issues. 00:18:22.640 --> 00:18:25.019 And if they do, like we're going to go to the 00:18:25.019 --> 00:18:28.119 specialists that need to be involved. I'm happy 00:18:28.119 --> 00:18:32.079 to get you there, but you don't want me to, you 00:18:32.079 --> 00:18:34.819 know, be that person. Yep. Yep. And that's the 00:18:34.819 --> 00:18:37.500 way I look at it. I stay in my lane when there's 00:18:37.500 --> 00:18:39.940 a primary care thing. I get them a primary care, 00:18:39.980 --> 00:18:41.460 right? That's the thing. I work with a lot of 00:18:41.460 --> 00:18:44.380 primary cares because the reality is I'm not 00:18:44.380 --> 00:18:47.400 it. I'm the hormone guy. And so what would you 00:18:47.400 --> 00:18:49.420 say, working in corporate America, some of the 00:18:49.420 --> 00:18:52.220 biggest shortcomings of our healthcare system 00:18:52.220 --> 00:18:54.519 regarding insurance is? What would you say some 00:18:54.519 --> 00:18:56.779 of the biggest issues you've seen with insurance 00:18:56.779 --> 00:18:59.640 -based care has been? I mean, not to throw, you 00:18:59.640 --> 00:19:03.440 know, Cigna under the bus. They know, they know 00:19:03.440 --> 00:19:06.779 what they're doing. I mean, as of October 1st, 00:19:06.779 --> 00:19:10.059 they passed a new policy that any provider that 00:19:10.059 --> 00:19:15.759 bills a 99204, 99205, or 21415, which, you know, 00:19:15.759 --> 00:19:17.339 that doesn't mean anything to like our listeners, 00:19:17.400 --> 00:19:19.880 but that's essentially how providers chart. And 00:19:19.880 --> 00:19:23.059 the more time you spend with providers, the higher 00:19:23.059 --> 00:19:26.779 up the number goes. They're essentially saying 00:19:26.779 --> 00:19:30.240 that providers are abusing the system. They're 00:19:30.240 --> 00:19:33.380 not being truthful in their charting. That's 00:19:33.380 --> 00:19:35.640 going to cause a lot of turmoil. Like if you 00:19:35.640 --> 00:19:38.759 can't, if insurance can't reimburse primary care 00:19:38.759 --> 00:19:41.480 providers, now there's another huge shortage 00:19:41.480 --> 00:19:44.700 that patients are going to experience because 00:19:44.700 --> 00:19:47.240 providers are like, well, I can't, you know, 00:19:47.259 --> 00:19:50.400 just keep billing low things and making, you 00:19:50.400 --> 00:19:52.609 know. Or it's going to turn into, hey, well, 00:19:52.670 --> 00:19:54.630 now this person needs to make, you know, an additional 00:19:54.630 --> 00:19:58.150 five more visits to talk about everything that 00:19:58.150 --> 00:20:00.950 they want to because we don't have the time to 00:20:00.950 --> 00:20:04.509 cover everything in this one session. And so 00:20:04.509 --> 00:20:07.849 it affects both people. And so, you know, again, 00:20:07.970 --> 00:20:11.430 the nice thing about DPC is I can take uninsured 00:20:11.430 --> 00:20:15.450 and I can take insured patients. Obviously, in 00:20:15.450 --> 00:20:18.230 the state of Colorado, it's, you know, per Medicaid. 00:20:18.970 --> 00:20:21.170 rules and regulations, it's illegal for Medicaid 00:20:21.170 --> 00:20:26.490 to see a DPC. We could get sued because they 00:20:26.490 --> 00:20:29.230 want Medicaid to be covered under a Medicaid 00:20:29.230 --> 00:20:31.990 specialist or primary care provider because they 00:20:31.990 --> 00:20:34.430 want their services paid for, which makes sense. 00:20:34.730 --> 00:20:36.529 Yeah, it's still very unfortunate, though. You 00:20:36.529 --> 00:20:38.869 kind of get tracked into that level of care because 00:20:38.869 --> 00:20:42.250 the reality is I've got a lot of patients who 00:20:42.250 --> 00:20:44.890 they don't even have insurance. They do all DPC 00:20:44.890 --> 00:20:48.619 stuff and they are. Very healthy people, right? 00:20:48.700 --> 00:20:51.279 These are the people who actually want to invest 00:20:51.279 --> 00:20:53.299 into their health. A lot of people look at health 00:20:53.299 --> 00:20:55.380 insurance like, I have it just in case something 00:20:55.380 --> 00:20:57.279 bad happens. Whereas when you're paying that 00:20:57.279 --> 00:21:00.099 monthly cost, you are actually invested. You're 00:21:00.099 --> 00:21:02.000 saying, I want to take the best control of my 00:21:02.000 --> 00:21:04.119 health. I want to prevent any major complication 00:21:04.119 --> 00:21:07.299 before it happens. And long -term down the road, 00:21:07.359 --> 00:21:09.200 guess what? We're preventing hospitalizations. 00:21:09.299 --> 00:21:11.740 We're preventing significant amounts of money 00:21:11.740 --> 00:21:14.680 down the road. with prevention, which I think 00:21:14.680 --> 00:21:16.859 should be the hallmark of everyone's mind. Absolutely. 00:21:17.059 --> 00:21:19.700 And I'll just speak for myself. So a little over 00:21:19.700 --> 00:21:22.539 three years ago, my mom passed away from thymic 00:21:22.539 --> 00:21:28.180 carcinoma, which is just like, I think 400 people 00:21:28.180 --> 00:21:31.519 a year get diagnosed with it. It is so, so rare, 00:21:31.519 --> 00:21:34.599 this cancer. But when I went to my provider, 00:21:34.720 --> 00:21:37.400 I was like, there's not any research out there 00:21:37.400 --> 00:21:38.920 that shows that there's any kind of genetic. 00:21:39.500 --> 00:21:42.400 opponent but the if you look and you look like 00:21:42.400 --> 00:21:45.140 there's a lot of people that are so young that 00:21:45.140 --> 00:21:48.200 are getting cancer and I'm a young person and 00:21:48.200 --> 00:21:50.140 I'm a young mom and I want to be there for my 00:21:50.140 --> 00:21:53.559 kids and so there's not like guidelines to you 00:21:53.559 --> 00:21:56.440 know do any kind of like protocol like when you're 00:21:56.440 --> 00:21:58.839 trying to do prevention and so I went to my primary 00:21:58.839 --> 00:22:00.279 care provider and I was like look I want a chest 00:22:00.279 --> 00:22:02.420 x -ray and I was like and I want a chest x -ray 00:22:02.420 --> 00:22:05.119 to make sure that I don't have a tumor good luck 00:22:05.119 --> 00:22:09.019 yeah and I know that You know, I think that if 00:22:09.019 --> 00:22:11.740 you have a provider that really cares about you, 00:22:11.779 --> 00:22:14.720 regardless if they're in corporate or DPC, they 00:22:14.720 --> 00:22:17.839 will provide that for you. But I mean, like there 00:22:17.839 --> 00:22:20.700 might be pushback. And so my my provider was 00:22:20.700 --> 00:22:22.559 like, absolutely, we're we're just going to get 00:22:22.559 --> 00:22:24.579 it done. Like and if like and she was like, if 00:22:24.579 --> 00:22:27.099 you want to go like an ultrasound route, you 00:22:27.099 --> 00:22:28.920 know, like every couple of years or you want 00:22:28.920 --> 00:22:31.559 to do like a CT scan, like she's like, we can 00:22:31.559 --> 00:22:33.480 figure out we'll just make whatever prevention 00:22:33.480 --> 00:22:36.700 looks like for you. for you that's awesome and 00:22:36.700 --> 00:22:39.079 that's the biggest i think people ask me how 00:22:39.079 --> 00:22:41.000 do you know a good provider from a bad provider 00:22:41.000 --> 00:22:42.980 and this is the thing i'm never going to say 00:22:42.980 --> 00:22:46.660 i'm not going to say that right but what i'm 00:22:46.660 --> 00:22:49.279 going to say is that someone who listens okay 00:22:49.279 --> 00:22:51.779 it doesn't matter i don't get too caught up they 00:22:51.779 --> 00:22:53.619 may not know everything i don't know everything 00:22:53.619 --> 00:22:56.200 no one knows everything but if they listen to 00:22:56.200 --> 00:22:59.480 you they are already top tier if they hear you 00:22:59.839 --> 00:23:02.079 They listen to you. They can have a conversation 00:23:02.079 --> 00:23:04.640 with you. That's top tier because that is something 00:23:04.640 --> 00:23:06.819 that I think is just fundamentally missing is 00:23:06.819 --> 00:23:10.079 just being able to hear someone talk to them 00:23:10.079 --> 00:23:11.960 and then come up with a plan. We always talk 00:23:11.960 --> 00:23:14.200 about this in school, if you remember, joint 00:23:14.200 --> 00:23:17.079 decision making process. But that never happens, 00:23:17.119 --> 00:23:19.339 right? It never happens. This is what it's going 00:23:19.339 --> 00:23:21.880 to be in education. There's no decision making 00:23:21.880 --> 00:23:23.839 process. And so that's the thing. When you can 00:23:23.839 --> 00:23:26.359 actually start having the patient give you input 00:23:26.359 --> 00:23:28.819 on what they want to do. I love it. I always 00:23:28.819 --> 00:23:31.200 ask, what do you want to do? And then we go over 00:23:31.200 --> 00:23:34.200 the options, the pros and cons. It's the best 00:23:34.200 --> 00:23:36.839 way to go through it because we're happy, they're 00:23:36.839 --> 00:23:39.240 happy, and they feel good. And that's what it 00:23:39.240 --> 00:23:42.759 all comes down to. We want everybody to feel 00:23:42.759 --> 00:23:46.880 their best. And how is that going to look for 00:23:46.880 --> 00:23:53.240 someone? Walk me through. Let's say... Enjoying 00:23:53.240 --> 00:23:55.569 the podcast? There's plenty more where that came 00:23:55.569 --> 00:24:00.230 from. Head over to stillcity -trt .com for expert 00:24:00.230 --> 00:24:02.670 insights, tips, and everything you need to know 00:24:02.670 --> 00:24:10.380 about HRT and TRT. Now let's dive back in. A 00:24:10.380 --> 00:24:12.119 patient comes in, what does it look like getting 00:24:12.119 --> 00:24:14.059 established with your practice? So I usually 00:24:14.059 --> 00:24:17.019 sit down, I talk about my practice. So E &O Wellness, 00:24:17.339 --> 00:24:19.500 E &O is named after my two children, Ella and 00:24:19.500 --> 00:24:21.839 Otto. I sit down, I kind of go through a little 00:24:21.839 --> 00:24:25.319 bit of like my membership, what I do for patients. 00:24:25.400 --> 00:24:28.359 All my members get a 10 % off any of my key or 00:24:28.359 --> 00:24:30.599 key injections, whether that's associated with 00:24:30.599 --> 00:24:32.940 like microneedling. joint injections or hair 00:24:32.940 --> 00:24:36.579 restoration. And then I also offer, um, neurotoxin 00:24:36.579 --> 00:24:39.920 and, uh, filler as well. Um, so I just kind of 00:24:39.920 --> 00:24:42.000 sit down, I go through that process and I, and 00:24:42.000 --> 00:24:44.759 I always ask like, are you okay with proceeding 00:24:44.759 --> 00:24:48.140 with this membership? If someone's not, I'm like 00:24:48.140 --> 00:24:51.299 totally fine. Like I do offer like a one -time 00:24:51.299 --> 00:24:54.380 visit of a hundred dollars for patients. Um, 00:24:54.579 --> 00:24:57.559 I, and if the, and more times than not, I feel 00:24:57.559 --> 00:24:59.799 like they do come back. I just want to establish 00:24:59.799 --> 00:25:02.660 here. But, you know, no one's going to hurt my 00:25:02.660 --> 00:25:05.039 feelings like whatsoever. And if like and if 00:25:05.039 --> 00:25:06.920 somebody just, you know, needs somebody to talk 00:25:06.920 --> 00:25:09.519 to, I will still do a visit. And everyone I feel 00:25:09.519 --> 00:25:11.279 like is always like, here, take my card. And 00:25:11.279 --> 00:25:13.279 I'm like, no, we'll do payment at the end. Like, 00:25:13.279 --> 00:25:17.339 not like that. I promise. But I like to have 00:25:17.339 --> 00:25:20.420 kind of like a like a chiller environment. Like 00:25:20.420 --> 00:25:23.519 we can do as little or as much as anybody wants. 00:25:23.700 --> 00:25:25.920 You know, the name of the podcast is Hormones 00:25:25.920 --> 00:25:28.859 Happen. And incidentally, you do hormones, right? 00:25:29.180 --> 00:25:31.400 Very cool. Very cool. How's that going? Is it 00:25:31.400 --> 00:25:33.240 pretty popular? Is it picking up for you? You 00:25:33.240 --> 00:25:37.019 know, there's obviously, as you know, there's 00:25:37.019 --> 00:25:39.920 a lot of hype about around hormones. I don't 00:25:39.920 --> 00:25:43.720 ever stray someone away from checking their hormones, 00:25:43.819 --> 00:25:46.619 but I always do tell them, like, just depending 00:25:46.619 --> 00:25:50.740 on like your age, like this may be costly. And 00:25:50.740 --> 00:25:54.200 I always try to be as transparent as possible. 00:25:54.480 --> 00:25:56.539 Insurance may not pick this up. And more times 00:25:56.539 --> 00:25:59.490 than not, people are like. you know, very receptive 00:25:59.490 --> 00:26:02.609 to that. I think it's a difficult field. I kind 00:26:02.609 --> 00:26:04.630 of want to learn first before I like go through 00:26:04.630 --> 00:26:07.170 with like my like answer. I want to know like 00:26:07.170 --> 00:26:11.829 how you kind of came up with this clinic that 00:26:11.829 --> 00:26:14.869 you own. Why did you pick hormones and weight 00:26:14.869 --> 00:26:17.130 loss? Absolutely. And there are no wrong answers 00:26:17.130 --> 00:26:19.369 here. So I was working in the prison setting. 00:26:19.490 --> 00:26:21.630 Everyone's heard me talk about that ad nauseum. 00:26:21.670 --> 00:26:25.640 And I was so tired. of being told how to practice. 00:26:25.740 --> 00:26:28.960 I was so tired being told what to do and how 00:26:28.960 --> 00:26:31.779 to do it. And I just I thought there has to be 00:26:31.779 --> 00:26:34.079 a better way. There just has to be a better way. 00:26:34.140 --> 00:26:36.299 I wasn't feeling fulfilled by it. I was burned 00:26:36.299 --> 00:26:38.339 out. I had been doing it for probably about four 00:26:38.339 --> 00:26:41.259 and a half years. I dreaded going to work. I 00:26:41.259 --> 00:26:43.660 didn't have that spark. I felt like I was doing 00:26:43.660 --> 00:26:46.220 a disservice to my patients. And so as far as 00:26:46.220 --> 00:26:48.279 hormones go, I've always been interested in hormones. 00:26:48.700 --> 00:26:51.500 I've always wanted to get on TRT. My wife has 00:26:51.500 --> 00:26:53.200 always been like, you don't need TRT. And I probably 00:26:53.200 --> 00:26:55.960 did. But The reality is I always wanted to. And 00:26:55.960 --> 00:26:57.900 so on the back of my mind, it's always been like, 00:26:58.000 --> 00:27:00.500 that's something I want to look into. I used 00:27:00.500 --> 00:27:02.420 to have a bad misconception about testosterone. 00:27:02.660 --> 00:27:05.539 I thought it was harmful. I thought it was unnecessary. 00:27:05.880 --> 00:27:07.779 And in the primary care setting, that's what 00:27:07.779 --> 00:27:11.259 we're taught. So I did a lot of research, a lot 00:27:11.259 --> 00:27:13.220 of independent research. And I found out, oh 00:27:13.220 --> 00:27:16.880 my God, testosterone is saving men's lives. And 00:27:16.880 --> 00:27:19.259 I started out as just a men's clinic. It was 00:27:19.259 --> 00:27:21.720 still city men's health and testosterone. And 00:27:21.720 --> 00:27:24.230 one day there was a woman who called, And it 00:27:24.230 --> 00:27:26.869 wasn't unusual for a female to call for her spouse, 00:27:27.089 --> 00:27:29.789 but she was crying. And she said, I know you're 00:27:29.789 --> 00:27:32.650 a men's clinic, but can you please, can you please 00:27:32.650 --> 00:27:35.190 help? And that's when I realized this whole time 00:27:35.190 --> 00:27:37.230 I've been focusing on guys, thinking that we're 00:27:37.230 --> 00:27:39.450 very underserved. That's when my eyes really 00:27:39.450 --> 00:27:42.789 opened up to women are the most underserved population 00:27:42.789 --> 00:27:44.829 that there is. It just, there's no doubt about 00:27:44.829 --> 00:27:48.730 it. And so I just dove into research for women's 00:27:48.730 --> 00:27:50.829 health, women's hormones, and I actually treat 00:27:50.829 --> 00:27:53.710 more women than men at this point. I'm not surprised 00:27:53.710 --> 00:27:56.250 by that. The name is Still City, HRT and weight 00:27:56.250 --> 00:27:59.690 loss. And it has just been so incredibly rewarding. 00:27:59.789 --> 00:28:02.269 Just getting a text message from one of my patients 00:28:02.269 --> 00:28:04.869 saying, I finally feel normal, right? Like that, 00:28:04.890 --> 00:28:06.910 that just can bring tears to your eyes because 00:28:06.910 --> 00:28:10.529 you've gone so long suffering, saying, I'm not 00:28:10.529 --> 00:28:13.410 crazy. There's something. And people are saying. 00:28:13.799 --> 00:28:16.519 Your labs are normal. You're fine. Like that 00:28:16.519 --> 00:28:18.640 is the craziest thing. And so to finally get 00:28:18.640 --> 00:28:21.579 validation and feel good and actually know I 00:28:21.579 --> 00:28:23.279 was right. Of course, you're right. It's your 00:28:23.279 --> 00:28:26.359 body. If you're saying something's wrong, something's 00:28:26.359 --> 00:28:28.740 wrong. And so, you know, hormones, I've always 00:28:28.740 --> 00:28:31.480 kind of had a fascination with it. And then after 00:28:31.480 --> 00:28:33.279 I started hormones, same thing with the weight 00:28:33.279 --> 00:28:35.740 loss meds. I used to talk crap about JLP1s all 00:28:35.740 --> 00:28:37.759 the time. I actually did some research, jumped 00:28:37.759 --> 00:28:40.339 on them myself, loved them. And so I'm like, 00:28:40.380 --> 00:28:43.000 oh my God, dude, this is. This is amazing. So 00:28:43.000 --> 00:28:46.380 weight loss came, peptides, just all the new 00:28:46.380 --> 00:28:48.880 things. And I never say never anymore. I never 00:28:48.880 --> 00:28:51.079 say never. If there's something new emerging, 00:28:51.259 --> 00:28:53.460 let's see what it's about, you know? And that's 00:28:53.460 --> 00:28:55.619 just my view on it. And so that's what kind of 00:28:55.619 --> 00:28:57.680 got me into the clinic is I was just so burnt 00:28:57.680 --> 00:29:01.140 out from insurance -based policies and procedures. 00:29:01.559 --> 00:29:04.559 For sure. Is it like a... like a regulation, 00:29:04.579 --> 00:29:06.960 like at your clinic, like everybody has to get 00:29:06.960 --> 00:29:09.940 their hormones checked before they start hormone 00:29:09.940 --> 00:29:12.720 replacement therapy? Yes. Yeah, absolutely. So 00:29:12.720 --> 00:29:15.000 we definitely get some blood work and it's not 00:29:15.000 --> 00:29:16.400 just hormones. You know, we definitely want to 00:29:16.400 --> 00:29:18.980 check CNP, CDC. There are some other markers 00:29:18.980 --> 00:29:21.539 too, but there are some providers who will say, 00:29:21.619 --> 00:29:23.819 hey, we just treat based off symptoms. I'm not 00:29:23.819 --> 00:29:25.339 going to say whether that's right or wrong. I 00:29:25.339 --> 00:29:27.000 don't think there's a wrong way or a right way 00:29:27.000 --> 00:29:29.500 to do it because 99 % of the time your symptoms 00:29:29.500 --> 00:29:33.099 are enough, right? The reality is sometimes having 00:29:33.099 --> 00:29:35.519 that validation. You still need levels. Absolutely. 00:29:35.839 --> 00:29:37.720 Some kind of baseline, right? You get a little 00:29:37.720 --> 00:29:39.819 bit of a baseline and you can actually visually 00:29:39.819 --> 00:29:43.259 see this and have this discussion to say, hey, 00:29:43.339 --> 00:29:45.279 these are the things that we're expecting to 00:29:45.279 --> 00:29:47.740 happen. Because there are specific abnormalities 00:29:47.740 --> 00:29:50.640 you'll see on your labs that you want to be aware 00:29:50.640 --> 00:29:52.839 of before you see them. Otherwise, it's like, 00:29:53.000 --> 00:29:56.160 oh, what the hell? Am I dying? And so, you know, 00:29:56.180 --> 00:29:59.180 just kind of that. pre -planning stage of setting 00:29:59.180 --> 00:30:01.559 the tone for how things will go, how we look 00:30:01.559 --> 00:30:04.019 right now, and the fact that we want to improve 00:30:04.019 --> 00:30:06.559 our overall metabolic health is important. So 00:30:06.559 --> 00:30:09.359 I always get the labs before, whether they get 00:30:09.359 --> 00:30:11.380 it through me, sometimes their providers will 00:30:11.380 --> 00:30:13.720 get it, and that's completely fine. Just as long 00:30:13.720 --> 00:30:15.839 as we have some recent labs within six months, 00:30:16.019 --> 00:30:18.099 I'm completely fine with that. But I do think 00:30:18.099 --> 00:30:20.779 it's a very important part of therapy. I would 00:30:20.779 --> 00:30:22.880 agree. Absolutely. Like you said, just to at 00:30:22.880 --> 00:30:25.000 least get a baseline. This is kind of where I 00:30:25.000 --> 00:30:27.880 feel bad for men. And, you know, again, kind 00:30:27.880 --> 00:30:30.079 of in like the corporate world, like, oh, you 00:30:30.079 --> 00:30:34.160 have to have two levels under 350 to initiate 00:30:34.160 --> 00:30:37.559 testosterone replacement therapy. Brutal. When 00:30:37.559 --> 00:30:41.200 someone who comes in and they're 36 years old 00:30:41.200 --> 00:30:43.500 and they're having difficulties with libido, 00:30:43.579 --> 00:30:47.660 that's not normal. No, it's not. It's not. It's 00:30:47.660 --> 00:30:49.519 kind of like, but then, you know, you check their 00:30:49.519 --> 00:30:51.880 testosterone. It's like, you know, like I like, 00:30:51.880 --> 00:30:54.420 you know, I can try, but it's going to take a 00:30:54.420 --> 00:30:57.329 while. Like it's just it's just such a it's just 00:30:57.329 --> 00:31:00.690 such a like a defeating feeling for, you know, 00:31:00.690 --> 00:31:02.710 again, like kind of like a provider that I would 00:31:02.710 --> 00:31:05.670 say also cares. And then your patient is just 00:31:05.670 --> 00:31:08.549 like, what am I supposed to do? Which. Right. 00:31:08.609 --> 00:31:12.130 Suffer. Right. Yeah. Yeah, absolutely. And so 00:31:12.130 --> 00:31:14.230 the reality is with the labs, we're comparing 00:31:14.230 --> 00:31:16.849 an individual to these population based labs. 00:31:16.950 --> 00:31:20.490 So we're comparing you to the population. I don't 00:31:20.490 --> 00:31:23.029 give a shit about that. I'm comparing you to 00:31:23.029 --> 00:31:25.450 when you felt your best. And if you say. I felt 00:31:25.450 --> 00:31:27.869 my best at 21. Well, did you get your labs at 00:31:27.869 --> 00:31:30.769 21? No one does, right? Who would? We get our 00:31:30.769 --> 00:31:32.150 labs when the wheels are falling off and that's 00:31:32.150 --> 00:31:34.049 completely fine. So at that point, we have to 00:31:34.049 --> 00:31:36.289 realize we're not going based off these traditional 00:31:36.289 --> 00:31:39.829 population -based numbers. We're going off symptomology 00:31:39.829 --> 00:31:42.829 because we want you to feel better. Frankly, 00:31:42.930 --> 00:31:45.329 I don't even like testosterone replacement therapy. 00:31:45.410 --> 00:31:48.210 I think optimization, okay? I always say optimization. 00:31:48.529 --> 00:31:51.289 Is there a difference? I don't know. It's a different 00:31:51.289 --> 00:31:54.839 word. But the reality is I always focus on I'm 00:31:54.839 --> 00:31:57.500 improving symptoms and avoiding any negative 00:31:57.500 --> 00:31:59.500 complications that we can. Right. I want to improve 00:31:59.500 --> 00:32:02.720 your entire life. I've seen marriages saved with 00:32:02.720 --> 00:32:05.180 this stuff. I've seen jobs saved. I've seen some 00:32:05.180 --> 00:32:07.940 really amazing things from hormones, both men 00:32:07.940 --> 00:32:10.960 and women. Absolutely. Yeah. And so with you 00:32:10.960 --> 00:32:13.319 specifically, like, do you feel the same way? 00:32:13.339 --> 00:32:15.900 Do you get labs first and then initiate therapy? 00:32:16.200 --> 00:32:18.799 I kind of go, I would say I'm like probably like 00:32:18.799 --> 00:32:22.259 70, 30. Sometimes I'm like, oh, like. you just 00:32:22.259 --> 00:32:25.359 had labs drawn like maybe a year ago. Like, I 00:32:25.359 --> 00:32:27.259 don't think we like really necessarily need to 00:32:27.259 --> 00:32:29.500 change if like a year ago you kind of felt the 00:32:29.500 --> 00:32:34.359 same way. So, I mean, again, I try to really 00:32:34.359 --> 00:32:36.319 just be like that provider, like, well, what 00:32:36.319 --> 00:32:39.420 do you want to do? Because more times than not, 00:32:39.559 --> 00:32:43.420 like, I feel like, you know, in reality, healthcare 00:32:43.420 --> 00:32:47.460 can be so simple if you just sit down with your 00:32:47.460 --> 00:32:49.440 patient because your patient already has a plan. 00:32:49.799 --> 00:32:53.680 They have already gone through their Dr. Google 00:32:53.680 --> 00:32:57.140 and figured out what they think that they need. 00:32:57.460 --> 00:33:01.740 And honestly, I don't ever promote Dr. Google, 00:33:01.880 --> 00:33:04.980 but I'm always happy to hear what Dr. Google 00:33:04.980 --> 00:33:08.160 and my patients have found on their own research 00:33:08.160 --> 00:33:10.940 and what they feel is going to benefit them. 00:33:11.079 --> 00:33:15.000 So I kind of go back and forth. I think that 00:33:15.000 --> 00:33:17.220 like I probably could be better like about checking 00:33:17.220 --> 00:33:19.460 like hormones like at a younger like individual. 00:33:19.819 --> 00:33:22.740 But it's hard to time it because, you know, if 00:33:22.740 --> 00:33:25.400 you have a girl that is young and, you know, 00:33:25.400 --> 00:33:27.579 she's normal on her period, it's like, well, 00:33:27.740 --> 00:33:30.460 like if you come in at this time, like and this 00:33:30.460 --> 00:33:32.259 is happening, like I'm probably going to get 00:33:32.259 --> 00:33:34.220 like a false reading. So you really have to come 00:33:34.220 --> 00:33:37.299 in like on this day, like specifically. Right. 00:33:37.539 --> 00:33:39.539 Time their cycles. It's really challenging. Some 00:33:39.539 --> 00:33:41.640 people will say get a day 20. So you're in luteal 00:33:41.640 --> 00:33:51.019 phase, but. You know, let's get real for a second. 00:33:51.259 --> 00:33:55.240 Yeah. Aging happens, but feeling exhausted, struggling 00:33:55.240 --> 00:33:58.039 with sleep, losing your edge in the bedroom and 00:33:58.039 --> 00:34:00.559 watching your confidence tank. That's not just 00:34:00.559 --> 00:34:03.299 getting older. That's a hormonal imbalance and 00:34:03.299 --> 00:34:05.559 you don't have to live with it. They'll tell 00:34:05.559 --> 00:34:08.380 you hormones are dangerous, but hand you a prescription 00:34:08.380 --> 00:34:11.320 with a mile -long list of effects. Enough is 00:34:11.320 --> 00:34:14.400 enough, guys. At Still City HRT and Weight Loss, 00:34:14.480 --> 00:34:18.380 we cut through the noise. We offer safe, bioidentical 00:34:18.380 --> 00:34:21.099 hormone therapy customized to you and backed 00:34:21.099 --> 00:34:23.599 by real lab monitoring and personalized care. 00:34:23.940 --> 00:34:26.099 Because your health isn't one size fits all. 00:34:26.519 --> 00:34:28.880 If you're done with the BS and ready to feel 00:34:28.880 --> 00:34:31.760 like yourself again, strong, focused, and confident, 00:34:31.980 --> 00:34:50.519 call or text us at 719 - The people that come 00:34:50.519 --> 00:34:52.340 to me have already been suffering for quite some 00:34:52.340 --> 00:34:54.780 time. I don't feel like saying, hey, sorry, 20 00:34:54.780 --> 00:34:57.699 more days. I'm like, it doesn't matter. And that's 00:34:57.699 --> 00:34:59.400 the biggest thing, especially with women who 00:34:59.400 --> 00:35:01.239 are still having their menstrual cycles. There 00:35:01.239 --> 00:35:02.679 are going to be periods of time where we expect 00:35:02.679 --> 00:35:04.780 those hormones to be high. And we expect them 00:35:04.780 --> 00:35:07.119 to be low. I'd say that it's really better utility 00:35:07.119 --> 00:35:09.639 in someone who's postmenopausal because then 00:35:09.639 --> 00:35:12.019 we can actually see these numbers and explain, 00:35:12.219 --> 00:35:14.300 you know, these are where your numbers are at. 00:35:14.420 --> 00:35:16.980 And these are some of the harms with low estradiol, 00:35:16.980 --> 00:35:19.500 for example. But when you're still cycling, it's 00:35:19.500 --> 00:35:21.320 hard to say we could be getting high enough. 00:35:21.380 --> 00:35:23.320 We don't really know where you're at, but that's 00:35:23.320 --> 00:35:25.079 where the symptoms come in. Because if you're 00:35:25.079 --> 00:35:27.019 still having symptoms, I don't care what that 00:35:27.019 --> 00:35:30.440 piece of paper says. But yeah. At the end of 00:35:30.440 --> 00:35:32.699 the day, it's just like, look good, feel good. 00:35:33.099 --> 00:35:36.159 That's what I was going to say. And, you know, 00:35:36.199 --> 00:35:39.179 maybe you can kind of talk about like your experience 00:35:39.179 --> 00:35:41.739 with this. Like, I kind of think that like, there 00:35:41.739 --> 00:35:44.460 are some certain times when I've had to have 00:35:44.460 --> 00:35:46.539 like, okay, we need to have a come to Jesus talk. 00:35:46.719 --> 00:35:49.159 Because patients all, you know, once you feel 00:35:49.159 --> 00:35:51.199 good, like, and you're like, you know, at like 00:35:51.199 --> 00:35:54.460 80%, like you want to get to that 110%. And like, 00:35:54.480 --> 00:35:58.429 that's just not realistic. I always kind of like 00:35:58.429 --> 00:36:01.210 compare it to like being blonde. Like if you're 00:36:01.210 --> 00:36:03.630 blonde, like you're never blonde enough. You 00:36:03.630 --> 00:36:05.849 always want to be blonder. Like because you see 00:36:05.849 --> 00:36:07.869 that girl with like the silver hair walking around, 00:36:07.929 --> 00:36:09.909 you're like, oh my God, like I need to have like 00:36:09.909 --> 00:36:12.349 that white hair. Is it true though, Natalie, 00:36:12.489 --> 00:36:14.750 that blondes have more fun? Of course. Yeah. 00:36:14.969 --> 00:36:17.449 I don't know otherwise, but I just assume so. 00:36:17.889 --> 00:36:20.150 Yeah. But you're right. You know, more is not 00:36:20.150 --> 00:36:22.389 always better. And that's, you know. I think 00:36:22.389 --> 00:36:24.829 we're all a victim to that. If a little bit's 00:36:24.829 --> 00:36:27.150 good, more must be better. And that's not always 00:36:27.150 --> 00:36:29.650 the case. I see this happen all the time. I'm 00:36:29.650 --> 00:36:32.690 a prime example. I treat guys with my TRT all 00:36:32.690 --> 00:36:35.110 the way up to 280 milligrams a week, which is 00:36:35.110 --> 00:36:39.610 very, very generous. I did it myself. I was at 00:36:39.610 --> 00:36:42.530 280 for probably a couple months. Acne was a 00:36:42.530 --> 00:36:46.730 bitch. I came down. I feel better at 210 milligrams 00:36:46.730 --> 00:36:49.320 a week than I did at 280. And that's a prime 00:36:49.320 --> 00:36:51.880 example of thinking more must be better. It is 00:36:51.880 --> 00:36:54.400 not. I feel mentally better, physically better, 00:36:54.460 --> 00:36:56.380 and I'm not having the acne. So that's just one 00:36:56.380 --> 00:36:59.159 example. But sometimes guys will, and this isn't 00:36:59.159 --> 00:37:00.880 so much with women, I feel like it's more with 00:37:00.880 --> 00:37:02.980 men. They will have this misconception that this 00:37:02.980 --> 00:37:05.239 testosterone is going to make them to where they 00:37:05.239 --> 00:37:08.340 never feel sad. They never feel mad. They never 00:37:08.340 --> 00:37:11.800 feel any emotion. And it's like, it's not a panacea 00:37:11.800 --> 00:37:14.360 to all your problems. It's an incredible tool, 00:37:14.480 --> 00:37:17.389 incredible tool. It's a horrible crutch. And 00:37:17.389 --> 00:37:19.409 you're still going to have struggles through 00:37:19.409 --> 00:37:21.670 your life, but it is going to help you more efficiently 00:37:21.670 --> 00:37:25.309 navigate them. So expectations are mandatory. 00:37:25.489 --> 00:37:28.289 You got to have realistic expectations. You got 00:37:28.289 --> 00:37:31.130 to have some type of goal in mind of what you 00:37:31.130 --> 00:37:32.789 want to achieve with therapy. Because if you 00:37:32.789 --> 00:37:34.909 come in nonchalant and say, well, I don't really 00:37:34.909 --> 00:37:36.869 know what to expect. Let's just see how it goes. 00:37:37.309 --> 00:37:39.909 That's a horrible plan. You really want to have 00:37:39.909 --> 00:37:42.510 some ideas of what am I looking to improve upon? 00:37:42.789 --> 00:37:44.690 What are some steps I'm going to take outside 00:37:44.690 --> 00:37:46.829 of just testosterone to do them, whether that 00:37:46.829 --> 00:37:49.489 be lifestyle change, exercise, diet, whatever, 00:37:49.590 --> 00:37:51.849 marriage counseling, and incorporate the two. 00:37:52.070 --> 00:37:54.389 That's the perfect way to incorporate hormone 00:37:54.389 --> 00:37:57.329 replacement therapy for a man or a woman, in 00:37:57.329 --> 00:38:01.730 my opinion. And I really love that point of view. 00:38:01.750 --> 00:38:03.610 I always kind of tell patients, especially kind 00:38:03.610 --> 00:38:05.610 of starting, like really any kind of regimen 00:38:05.610 --> 00:38:07.909 that's going to better fit. benefit them. I always 00:38:07.909 --> 00:38:10.969 say it's kind of like a 33 % rule. You have 33 00:38:10.969 --> 00:38:13.369 % like of medications that are going to help 00:38:13.369 --> 00:38:17.110 you. 33 % is going to be your exercise and 33 00:38:17.110 --> 00:38:19.949 % is going to be the food that you eat, but they 00:38:19.949 --> 00:38:23.289 all have to work together. If you do one third 00:38:23.289 --> 00:38:26.989 of, you know, that you're not going to feel, 00:38:27.050 --> 00:38:29.670 you know, as good as you would if you maybe did 00:38:29.670 --> 00:38:32.710 like two and a half thirds of it for the whole 00:38:32.710 --> 00:38:36.800 100%. You still got to put in the work, no matter 00:38:36.800 --> 00:38:39.539 what. There's no pill yet that you can just take 00:38:39.539 --> 00:38:41.699 and stop working. You always got to put in that 00:38:41.699 --> 00:38:44.219 work. If that existed, I'd hope I'd figure it 00:38:44.219 --> 00:38:47.119 out. I would take it in a heartbeat, a heartbeat. 00:38:47.420 --> 00:38:50.639 Now, do you also do telehealth? I do. Oh, perfect. 00:38:51.079 --> 00:38:53.699 Do you practice in any other states than Colorado? 00:38:53.920 --> 00:38:56.320 I don't, just Colorado. Are you looking at other 00:38:56.320 --> 00:39:00.239 states? It's been on my radar, but I'm not sure. 00:39:00.650 --> 00:39:02.769 I don't know about that yet. Sure. Yeah, absolutely. 00:39:03.010 --> 00:39:04.269 You got to get your feet wet. This has only been 00:39:04.269 --> 00:39:06.429 a month in. I mean, you're still like, man, this 00:39:06.429 --> 00:39:09.190 is it. And that's exciting. That's so exciting. 00:39:09.409 --> 00:39:11.949 And so one last parting thing before we leave, 00:39:12.130 --> 00:39:14.630 if there's someone who's kind of on the fence 00:39:14.630 --> 00:39:17.289 as far as like, I think the DPC model is right 00:39:17.289 --> 00:39:19.889 for me, but they're just not 100 % convinced. 00:39:20.050 --> 00:39:22.250 They're not 100 % sure. What's something you 00:39:22.250 --> 00:39:24.650 would tell them? to put their mind at ease that 00:39:24.650 --> 00:39:28.210 the DPC model is a fantastic method of primary 00:39:28.210 --> 00:39:30.369 care. I kind of just spin it a little bit on 00:39:30.369 --> 00:39:32.489 the patient. Like, what do you look for? Like 00:39:32.489 --> 00:39:35.110 when you go to any, any kind of appointment, 00:39:35.429 --> 00:39:38.469 you know, like does appearance matter? You know, 00:39:38.469 --> 00:39:41.050 cause nobody wants to walk in or have their doc 00:39:41.050 --> 00:39:42.909 or their provider walk in who looks like really 00:39:42.909 --> 00:39:45.130 disheveled and like super tired. You're kind 00:39:45.130 --> 00:39:48.429 of like, it's going to be a good visit. So I 00:39:48.429 --> 00:39:50.369 think like, you know, as superficial as that 00:39:50.369 --> 00:39:52.929 is, like, you know, people want someone that, 00:39:53.190 --> 00:39:55.269 you know, is going to always, you know, kind 00:39:55.269 --> 00:39:57.769 of look and feel their best. And I think that 00:39:57.769 --> 00:40:00.230 energy really matters. Like, you know, if you 00:40:00.230 --> 00:40:02.389 don't get like a good vibe with someone, like 00:40:02.389 --> 00:40:04.929 you're likely not going to come back. So I think 00:40:04.929 --> 00:40:07.269 that it's kind of more like a reflection on like 00:40:07.269 --> 00:40:09.510 the patients, like, what do you actually look 00:40:09.510 --> 00:40:12.860 for? in a provider? Who do you feel is going 00:40:12.860 --> 00:40:15.900 to, you know, sit down with you and discuss all 00:40:15.900 --> 00:40:17.739 the things? I actually have a new patient coming 00:40:17.739 --> 00:40:19.940 in today who was emailing me. She's like, I just 00:40:19.940 --> 00:40:21.800 have a couple of questions. Like what's going 00:40:21.800 --> 00:40:24.420 to go on in this visit? Do you really want a 00:40:24.420 --> 00:40:26.679 physical? And I'm like, if you want a physical, 00:40:26.760 --> 00:40:29.480 like we will make time for the physical, but 00:40:29.480 --> 00:40:32.380 I do also do like, I get to know you and you 00:40:32.380 --> 00:40:34.429 know. I always like to kind of have fun with 00:40:34.429 --> 00:40:37.150 my patients. Every single patient that walks 00:40:37.150 --> 00:40:39.889 into my room, I always say, tell me some fun 00:40:39.889 --> 00:40:42.349 facts about you. And they always like are kind 00:40:42.349 --> 00:40:44.730 of like caught off guard, like what? And I'm 00:40:44.730 --> 00:40:46.630 like, tell me where you're from, like what you 00:40:46.630 --> 00:40:49.610 like to do for fun. And it's kind of just like 00:40:49.610 --> 00:40:52.170 my little icebreaker that I just incorporated 00:40:52.170 --> 00:40:55.280 because, you know, like. And it's the same thing 00:40:55.280 --> 00:40:57.179 as just like asking someone like, you know, their 00:40:57.179 --> 00:41:00.219 name. Do you go by that? And if they're like, 00:41:00.340 --> 00:41:02.099 no, like, oh my gosh, like, you know, like I've 00:41:02.099 --> 00:41:04.519 been coming to like this place for like 20 years 00:41:04.519 --> 00:41:06.820 and like nobody's ever like asked me if I go 00:41:06.820 --> 00:41:09.340 by a different name. And I think that, you know, 00:41:09.340 --> 00:41:12.800 just for my personal, you know, experience, like 00:41:12.800 --> 00:41:15.079 that's how I function. Like I want to be friends 00:41:15.079 --> 00:41:17.730 with my patients. This isn't like. You know, 00:41:17.809 --> 00:41:20.369 like, you know, like you came to like the principal's 00:41:20.369 --> 00:41:23.070 office and like you're in trouble. Right, right. 00:41:23.329 --> 00:41:25.829 Like this is supposed to be fun. Like let's just 00:41:25.829 --> 00:41:28.849 work together. And again, like, you know, you 00:41:28.849 --> 00:41:32.230 get an hour visit with me. And if you need to, 00:41:32.230 --> 00:41:33.869 you know, if you need to come back, guess what? 00:41:33.889 --> 00:41:37.130 You get another hour. I love that. I love that. 00:41:37.190 --> 00:41:39.530 So guys, I'm going to have all the contact information 00:41:39.530 --> 00:41:42.090 for Natalie in the description. So if you're 00:41:42.090 --> 00:41:44.429 looking for a DPC practice, a really good provider, 00:41:44.590 --> 00:41:47.449 Natalie has you covered. Natalie, thank you so 00:41:47.449 --> 00:41:49.349 much for joining us. Thank you so much for having 00:41:49.349 --> 00:42:15.199 me. This was so fun. It's the easiest way to 00:42:15.199 --> 00:42:18.239 keep growing and learning. As always, we believe 00:42:18.239 --> 00:42:21.380 in your power to heal, thrive, and lead. Be the 00:42:21.380 --> 00:42:22.800 hero of your own story.