Latest / Customer Service Revolution | Customer Experience & Employee Experience for Business Leaders / How to Extend Your Healthspan with Dr. Sandeep Palakodeti

Transcript

How to Extend Your Healthspan with Dr. Sandeep Palakodeti · Customer Service Revolution | Customer Experience & Employee Experience for Business Leaders

0:59
Welcome back to another episode of the Customer Service Revolution Podcast.
1:04
I am John DiJulius Chief Revolution Officer of The DiJulius Group.
1:08
I'm so pumped to be speaking to Dr.
1:10
Sandeep Palakadetti, MD. Dr.
1:14
Deep has over two decades of experience in longevity,
1:18
medicine, and preventative health care.
1:21
He is recognized for his commitment to improving population health.
1:26
Outcomes through empathetic holistic approach to medicine.
1:32
As the CEO and founder of Velocity Health,
1:36
a nationwide digital first concierge precision medicine clinic,
1:42
Dr. Deep saw a grave disconnect in how traditional medicine was practiced.
1:48
It was highly reactive, short on time,
1:51
and impersonal. Velocity aims to be the
1:55
Beacon for what healthcare should actually look like and feel like.
1:59
Deeply personalized, proactive,
2:01
preventative, attentive, and catered to the individual.
2:05
Velocity Health serves CEOs, founders,
2:09
executives, athletes, and anyone seeking to optimize the prime of their lives.
2:16
Welcome, Dr. Deep.
2:19
Thank you, John. Very happy to be here.
2:21
Appreciate that intro and excited for our conversation today.
2:25
Yeah, I'm really excited. And you are,
2:27
I believe, in Columbus, Ohio.
2:30
That's right. I am right outside.
2:33
Nice, nice. And you have locations all over.
2:36
give us a little bat background velocity health.
2:39
Yeah, Velocity Health is a digital first na national clinic.
2:43
So we are all fifty states. We've got doctors all across the country.
2:48
Our team is all across the country.
2:49
We're licensed in all 50 states and we serve members wherever they are.
2:54
And explain to
2:56
us what digital first looks like.
2:58
So
2:59
Velocity is a concierge precision medicine clinic.
3:02
We really came to Velocity. You mentioned a little bit of it in the bio there,
3:07
but you know, just to give you a little bit more context,
3:10
you know, I'm a physician. I my father's a physician,
3:13
my brother's a physician, I grew up around healthcare and really grew
3:16
up around seeing how broken healthcare was and trying to understand how
3:20
we can fix it. I think every one of us has a story about healthcare that
3:25
is less than ideal, whether it's ourselves.
3:27
Our families. And so as I continue to go through my medical training
3:30
and started to see patients, the average time in this country that we
3:34
get with our patients is about 12 minutes.
3:36
We have 30, you know, our average primary care doc in this country
3:40
has around 2,500 patients on their panel.
3:43
And that's why we all feel like a number in in sort of the the broader scheme
3:49
of things. That's why we feel like we're just being rushed through and from the
3:53
Waiting
3:53
room and spending just a few minutes with our doc and moving on.
3:56
And so, you know, I never felt it never sort of sat right with me as a clinician.
4:01
And you know, I don't have the greatest genetics.
4:04
I have three grandparents who did not died in their 60s from heart attacks.
4:07
both my parents have heart disease and diabetes.
4:10
My dad had his first heart attack when he was 58,
4:13
I think, and so I I have got two young toddlers as well at home,
4:17
and I look at them, and I I don't really want to limp through the next.
4:21
20 years I want to really engineer what that that looks like and try to have
4:26
as much success as as possible.
4:29
And so we came to starting Velocity because we didn't really find a clinic like this
4:35
around the country that that really understood us personally deeply from
4:39
the ground up, from the genetic code,
4:42
through everything about our lives.
4:44
And so you know, Velocity is is.
4:48
Meant to be digital first, and that it we are,
4:52
you know, providing access to people all across the country.
4:55
We're meant for people who might not be in the same zip code for too long
5:00
and who are too busy to spend four hours coming downtown battling with traffic
5:05
and the parking garage just to spend that 12 minutes of time with their doc.
5:10
So patients come in, they are assigned a concierge who helps them sort
5:14
of navigate through the system.
5:15
A health coach, or we call them a human performance specialist,
5:19
who really wraps around them and helps them understand what the doctor's plan was,
5:25
how to incorporate that into your life,
5:27
what your your barriers to that might be,
5:30
you know, checks in on you to make sure you're doing what you said you were going
5:33
to do. And then you have a longevity health span trained physician who,
5:37
you know, where most of us are either internal medicine or family medicine.
5:42
trained. we've have learned and unlearned a lot about American healthcare.
5:45
There's a whole science around longevity now that takes a lot.
5:49
So we take we go very deep on the diagnostics.
5:52
I'm sure we'll talk about that a little bit,
5:54
but you know, then patients spend 90 minutes with their physician quarterly.
5:58
We go through all those, you know,
5:59
things like biomarkers and coronary scans and full body MRIs
6:04
and cancer screenings and talk about all of that.
6:06
And because we're 50 state licensed
6:08
We prescribe, we do things like peptides,
6:11
we do things like hormone replacement therapy,
6:13
and and we we do all the sort of advanced diagnostics and and therapeutics.
6:18
So you know, we're meant for people who are maybe waking up in their 40s
6:23
and 50s and are balancing a lot and are thinking,
6:26
man, I've just sort of missed a beat.
6:28
I I'm not moving like I used to,
6:30
I can't get rid of that stubborn 10 or 20 pounds.
6:34
I'm not as cognitively sharp as I need to be into my meetings in the afternoon.
6:39
I can't be show up for my kids in the evening like I want to.
6:42
And and it's not just part of aging.
6:45
I think that there's a real science underneath what's happening there.
6:48
And so we put that all together,
6:50
understand what's happening for each individual,
6:52
and try to optimize that prime for each person.
6:57
I love this. this is near and dear to my higher h heart.
7:00
Some of our listeners will, you know,
7:03
may be wondering why why are we talking about this on a customer service revolution
7:08
podcast and and and you know to give some context to it.
7:12
the last chapter of you know,
7:15
probably my best selling book of of all my books is titled Living
7:20
an Extraordinary Life, So Countless Others Do.
7:24
And and that has real and and I finish every presentation,
7:28
consulting, whatever I do, with like a an excerpt or something about living
7:33
an extraordinary life. And, you know,
7:35
so just to give some context for our listeners,
7:38
I don't want to live an extraordinary life only,
7:41
I guess, to say, you know, I have more bigger houses,
7:45
cars, trips, bank accounts. Like I genuinely feel that
7:51
we, you know, we all have seeds of potential,
7:54
right? And the the the undeveloped potential that that you know
8:00
we don't develop cheats those around us,
8:03
those we touch, influence and impact,
8:05
as well as deprive ourselves of joy,
8:08
satisfaction, and opportunity.
8:09
And so living our life to its fullest potential i to me is not an opportunity.
8:15
It's a responsibility, right? It's an obligation to be the best version
8:19
of ourselves.
8:20
we possibly can be every day, not just in in and for us and how
8:24
our life will benefit for all the people that are dependent on us,
8:28
spouse, children, friends, employees,
8:30
coworkers, you know, customers,
8:31
clients, patients, community. And you know,
8:34
I I I take that very, very seriously and and and you know,
8:39
feel, you know, that so I have a I I have a report card.
8:42
It's kinda you know different,
8:44
but you know, I I you you what do you call your markers?
8:47
biomarkers?
8:50
Yeah.
8:51
So my
8:52
biomarkers, and again it's not the same,
8:54
is I look at you know, nine nine buckets of if I'm living an extraordinary life.
8:59
And listen, more often I I'm not,
9:02
and so that's where I go to. It's like who am I hanging out with?
9:05
You know, what am I feeding my brain?
9:07
You know, all those types of what am I eating?
9:10
Workouts.
9:12
all that stuff and and I you know have become obsessed with it and similar
9:16
to you my my parents died young and they were old they were old sixty
9:23
my mom died at sixty nine and and and she might as well have been
9:26
90 something it's a different generation different lifestyle different education
9:31
you know of what they knew but while this has always been
9:36
a a primary compass. I advertise this to myself on my bathroom mirrors
9:40
and everything, you know, living extraordinary knife,
9:41
blah, blah, blah. Where it really got,
9:44
you know, serious, serious, is 17 years ago I lost my wife.
9:48
And so now I have three little boys that I need to take,
9:53
you know, it can't be just lip service,
9:55
right? I can't orphan them, you know,
9:58
and
9:58
you know, have anything so so I like totally got obsessed,
10:02
thank God. I also found aging,
10:05
turning 40, turning fifty, was a good thing because I I saw differences.
10:11
I saw that I couldn't eat whatever I wanted.
10:14
I saw that I couldn't, you know,
10:16
do whatever and bounce back like we could in our twenties and thirties,
10:19
which was great. I I felt it was you know getting old was a good thing.
10:24
Because it you know made me take things more seriously.
10:27
So all those things became you know really important.
10:30
I, you know, got in with a concierge.
10:33
I've been doing a lot of these things for decades.
10:36
And I'm not embarrassed to tell anyone.
10:38
Anyone I'm having a conversation with,
10:40
I will tell them I'm on testosterone,
10:42
I'm on GLP ones. Like you know,
10:44
I I I you know I take advantage of what could be there.
10:49
And again, I want you to
10:50
tell me where I'm off and all those things.
10:52
But we have so much, you know,
10:54
technology and so many more resources.
10:56
And then just to try to, you know,
10:58
close this off, whether I live to seventy,
11:02
eighty, ninety, I don't care. I I I want to be a young seventy,
11:07
eighty or ninety. And I don't want my kids having to,
11:12
you know, do what I had to do for for my mother,
11:15
right? And and and, you know
11:18
And just, you know, be that burden onto them.
11:21
And so I guess my first question is how much of of of how we turn out and
11:26
how we end up with the the potential of dementia,
11:31
Parkinson's, you know, all these other things.
11:34
How much is genetic and how much do we control?
11:38
Because tell me if I'm wrong, I feel like how I take care of myself in my forties,
11:42
fifties, sixties determines my quality of life later on.
11:47
You know, I hope I'm right, you know,
11:49
but I you know, so so you I guess that's my my first question to you is is
11:53
am I on the right path? You know,
11:55
is it is it no I have bad genetics,
11:58
forget about it, might as well drink and party my ass off,
12:01
or I can reduce those risks.
12:04
Yeah, first of all, thank you.
12:05
And I think it's a really good context for why we're even having this conversation.
12:10
just to respond to one thing there,
12:11
you know, we I I wrote a book and and one of the chapters is really about,
12:16
you know, why are human beings even around after the age of reproduction?
12:22
And a lot of other species kind of reproduce and die,
12:26
but then we have this long post-reproductive period,
12:29
and there's only a few other species that do.
12:31
And you look at them, things like elephants and wolves and others,
12:35
a lot of times there's this matriarch effect,
12:38
is what we call it, the grandmother effect,
12:39
where having the knowledge of wisdom of someone who's been around the block,
12:44
who knows, has experienced things in this world,
12:47
is important for the evolution of the species as a whole.
12:52
And I think what's ironic is that,
12:54
especially in in one's 40s and 50s,
12:56
and you mention it as you hit.
12:57
Those sort of aging milestones,
12:59
the exact decades when you should be imparting this wisdom that you've gained over
13:05
all of these years and decades is the exact decades where
13:08
our biological entropy starts to set in as well,
13:11
where our systems start to break down,
13:13
unless we're extremely sort of conscientious about it and we take a very clear path
13:19
to structuring our health rather than letting it sort of just happen.
13:24
To us, and so you know, you ask the kind of classic nature versus nurture question
13:29
around how much is genetically predispositioned,
13:33
and you know, there's some things that are obviously genetic where you can't sort
13:37
of get away from it, something like Tay Sachs disease or whatever that
13:41
we we screen for genetically now,
13:44
where you're pretty much guaranteed 100% to have this manifestation
13:48
of these conditions, but I think what we're mostly
13:52
About in this discussion are chronic diseases.
13:55
What are the polygenics? What are all the various risk factors that I have?
13:59
It's not as easy as saying, yes,
14:02
you have the gene or no, you don't,
14:03
so you are going to get this disease or not.
14:06
There's a cla a very good example.
14:09
One is called your APOE gene, APOE gene.
14:13
This codes for how our brains process cholesterol.
14:17
Saturated fats, it is very highly correlated with our risk of downstream dementia.
14:24
And so some people have the ApoE33 gene.
14:28
You have a three from your mother,
14:29
three from your father. That is what most of the population has.
14:32
Something like 75% of the population has it.
14:34
If you have a four from either parent,
14:36
you have about a five times higher chance of developing dementia than
14:42
the baseline population. If you have two fours,
14:44
you have about a 12.
14:45
12
14:45
times higher chance of developing dementia.
14:48
So I say that because yes, there's a genetic component to something very complex
14:53
like dementia, but is that deterministic?
14:56
Does that mean if you have two,
14:58
four variants, you're definitely going to get dementia?
15:01
No, it means you know your risk went from you know 0.1% or 0.5% up
15:07
to 5 or 10%, which is not nothing.
15:10
But what are all the
15:11
Things that we can do to prevent that.
15:14
We do know that really good sleep,
15:16
really good cardiovascular exercise,
15:19
decreasing your cardio your cholesterol burden,
15:22
improving your metabolic health with your blood sugars,
15:26
all of these things can help. And so I'm very much of the belief that nurture,
15:31
meaning our environment and the things that we do have a much bigger impact
15:36
on us than most of us believe.
15:38
On the genetic side, we are starting to more understand concepts like epigenetics,
15:45
where we can turn on and off certain genes by certain activities.
15:50
Even something very interesting,
15:52
like they've done studies on children who have played in the dirt
15:56
and done gardening and things like that,
15:59
and it literally turns on different pro different genes that code for.
16:03
Different proteins and have different expression in their lives.
16:07
And so even something like our genetics,
16:09
which we think is hardwired, are actually quite malleable through this epigenetic
16:14
kind of phenomenon. And so I'd say we are all born with a certain you know hand,
16:20
and we're dealt that certain hand,
16:22
but through our environment, through our nurturing,
16:25
we can force those in certain directions.
16:28
And you know, statistically, whether it's the US or globally,
16:34
are we living longer as a society?
16:37
Yeah.
16:38
Yeah, absolutely. I mean I think it's interesting when you look at some
16:41
of the statistics about, you know,
16:43
well, we used to only live to forty and fifty,
16:47
and that's not actually true. It's not like most people died at forty and fifty.
16:51
It's just that we had a really high infant mortality rate as well,
16:55
and many more people died in young adulthood from accidents or infections
17:01
or things like that that now we can Yeah,
17:03
Dinosaurs
17:04
whatever, right? Things like
17:06
that that we can
17:06
Cure and so that drags down the average.
17:09
We still had people living to their 80s and 90s,
17:13
you know, thousands of years ago,
17:14
but it just wasn't as common because there's so many more things that could sort
17:18
of take you out. But now, when we actually look at the actual true population
17:22
statistics, yes, we're definitely living longer now.
17:26
And you know, if you're a person of means in a developed country,
17:31
you're you're very likely to live well into.
17:33
Your 80s at this point. Now, you sort of mentioned it,
17:36
John, in your your initial dialogue,
17:39
which is most of us do not want to live into our 90s and 100s and not
17:46
be able to care for ourselves.
17:47
Functional independence is what we want,
17:50
right? We want to be able to be sound of mind,
17:52
sound of body and spirit, and be able to take care of ourselves
17:56
and not be dependent.
17:57
dependent on others and that is the science piece that we're starting
18:02
to understand a little bit and be able to engineer a little bit more as time goes
18:07
on as well.
18:09
So you mentioned your book, which is the ultimate asset,
18:12
extend the title, the ultimate asset asset,
18:16
extend your prime, not just your lifespan.
18:20
and I have I'm gonna put it in the show notes,
18:22
a link to Amazon unless you wanted a link somewhere else.
18:25
All
18:25
That's perfect. Yep.
18:27
right, good, good. That that's awesome.
18:29
So I also wanna unpackage
18:32
The traditional you know, medicine and your,
18:35
you know, physician, the you know,
18:39
family physician versus the concierge program,
18:41
which, you know, I don't want to assume everyone knows and y you kinda you know,
18:46
led with this. But yeah, I've had,
18:49
you know, in the past, before I went with a concierge program and
18:52
I cannot talk highly enough about it,
18:56
is you know, in the past I could be having some problem,
18:59
right? And
19:00
I don't care what the problem is,
19:02
right? It it could be, you know,
19:04
on the grand scheme of things,
19:05
my problem may pa pale in comparison to someone else's,
19:08
but it's still my problem, right?
19:10
Yeah.
19:10
It could
19:10
be back pain, it could be I've had,
19:12
you know, because I still play hardball at this old age,
19:17
I have had both shoulders replaced.
19:19
but you know, if you have a problem and you're like,
19:22
all right, I need to get in with a specialist or I need to go see my my my doctor.
19:27
And then you hear, you know, you know,
19:29
her first opening, his first opening is,
19:31
you know, you know, two months from now.
19:34
That's you know, and they're not doing anything wrong,
19:37
but that's just not acceptable.
19:39
We should not have to live with the quality of life.
19:42
And so, you know, I got introduced to a a a concierge physician,
19:47
if I'm saying it right, and and it's unbelievable.
19:49
I can't I cannot I I've turned so many people on to this.
19:54
I mean, you know, so the way I'll explain it,
19:56
and I want you to explain, you know,
19:58
you know, your program to make sure it it's aligning.
20:01
But I mean, I I could call him,
20:03
text him, you know, never have,
20:06
but 3 a.m. I could be out of the country and they'll get right back to
20:10
me and and and you know, I don't have to manage the other they'll make
20:14
an appointment for me at the specialty doctors.
20:16
They'll to me I call them the general contractor,
20:19
right? It's one stop shop.
20:21
And, you know, he'll t you know,
20:23
tell me what I have to do next.
20:25
And I just think that's the greatest flex and the greatest I mean,
20:29
we get to the bottom of it, you know,
20:31
Right.
20:31
instantly.
20:33
Am I explaining it correctly and what have I missed?
20:35
Yeah, absolutely.
20:36
And look I wanna
20:38
My dad was a family doc for forty years in the same community.
20:41
And I was a primary care doc for a decade before I came to this.
20:45
I've got a lot of colleagues who I really respect who are primary care physicians,
20:49
but the system is just not set up for giving us relationship-based care,
20:55
which is what most of us crave.
20:57
When you know your number, when your doctor is getting paid
21:00
by something called relative value units,
21:03
RVUs. It's literally the number of widgets
21:06
They can push through the system means they get more money.
21:10
So if it feels like you're rushed,
21:11
if it feels like there's a lot of people on the schedule,
21:13
it's because there probably is.
21:15
And whether it's probably not their fault.
21:18
They're probably not the ones saying,
21:19
Hey, I want to make as much money as possible,
21:22
put as many patients on my schedule as I can,
21:24
as you can, but 80% of physicians are employed by a health system
21:30
or a health insurer. you know,
21:32
out of a million, like
21:33
Licensed physicians in this country,
21:35
a hundred thousand of them are employed by Optimum or associated with Optimum Alone,
21:40
which is a United Health Group,
21:42
a big insurer. And so a tenth of our physician workforce is associated with
21:45
one insurer. And so they don't really have the autonomy.
21:49
Back in my dad's generation, every physician was a small business owner.
21:52
They graduated residency and hung up their shingle,
21:56
and they were a private business,
21:57
and they had to kind of earn and compete and have customers.
22:01
Reserve
22:01
This is before the the the big healthcare roll
22:01
it.
22:04
ups, correct?
22:04
Exactly.
22:04
Before all the consolidation and the HMOs and there's been good things that have
22:08
happened with those consolidations,
22:10
but you know, I I I'm an independent physician and I really believe that being
22:15
independent allows me to have one boss and one boss only,
22:18
and that's the patient. And I think that's what it all really comes down to.
22:22
I don't have an administrator telling me how many patients I need to see per day.
22:26
I don't have an insurer saying,
22:27
Hey, this person has you know heart disease,
22:30
you have to put them on a statin.
22:32
Okay, well they don't
22:33
Want to go on one, or there's a contraindication to that,
22:36
or there's some other reason why.
22:37
So I we're not gonna do that, right?
22:39
And there's a lot of reasons why,
22:41
and as a patient, as a physician,
22:43
we deserve that autonomy to have that relationship with someone who cares about
22:48
us and is accountable to us more than anyone else,
22:52
more than the system overlords.
22:54
And so, you know, concierge medicine is one expression of that.
22:58
There's direct
22:59
Direct primary care, you know,
23:01
there's there's other places where you can kind of go to get this kind
23:04
of relationship-based care, but we don't answer the phone at 3 a.m.
23:08
but everything else you said we do.
23:10
So the next day, you know. Yeah,
23:11
And he may not, I just mean that,
23:13
you know, yeah. Right.
23:13
I get it. But like the next business day,
23:15
we're getting back to you. You have my
23:16
Right.
23:17
text, you have my email, you're getting,
23:20
I have patients that DM me an article on Twitter and they're like,
23:24
hey, what do you think about this?
23:25
Yeah, I do that all the time. I do that all the time.
23:25
is something right and and
23:27
Yeah.
23:28
so and I love that and it's because I don't have thousands
23:31
of people constantly bombarding me I've got my crew of patients.
23:35
So let's explain that if you didn't ~ concierge doctors
23:36
Yep.
23:38
take a certain number.
23:40
We tend to take a smaller set.
23:42
And so again,
23:43
Yeah.
23:43
the typical primary care doc in this country has about twenty five hundred,
23:48
three thousand patients on their panel.
23:49
Most direct primary care concierge docks have five or six hundred.
23:53
We have two hundred. because we we don't want people to be overwhelmed.
23:58
Again, we want to have plenty of time with you.
24:00
And so you might be texting us,
24:02
you might be calling us, we might be starting you on a peptide therapy
24:05
or or a hormone therapy and we need to check in.
24:07
It's not
24:08
It's not okay for us to wait six months and just see how you're doing
24:13
and check in for 10 minutes. We should be getting labs within a few weeks.
24:17
We should be having another conversation within a couple of months
24:20
and really be proactive about these things.
24:24
And so yeah, so we you know we're we're kind of super concierge care in that way,
24:28
and then we we tend to be even more proactive and personalized in that
24:32
in that sense.
24:34
All right, let's
24:35
talk about I mean, you know, the changing and I'm sure it's always been,
24:39
but it just seems like there's so much more.
24:43
and and I'm surprised like how many people and and and well
24:49
to do people who, you know, still a it might be coming from,
24:53
you know, their their old school physician.
24:57
But like I've been on testosterone and again I'm I'm never afraid
25:01
to share with anybody because I think it's you know so great since I was forty,
25:05
you know, two decades. And, you know,
25:07
I love it. And and you know, it just put the bounce back in my step.
25:11
It obviously cuts a little weight off it,
25:13
you know, you you grow muscle easier,
25:15
easier at this age than you would without it.
25:19
you know, so you got that. You got peptides,
25:22
which there's a whole flurry of stuff.
25:24
Creatine. GLP 1s I've been on that is is is you know,
25:28
probably for three years. And I tell everyone,
25:31
you know, I I love it. It it it's it's there I and and correct me if wrong,
25:36
there's other than the side effects which I've been able to the only side effects
25:41
I've come across or heard about or read about is y you know,
25:45
the the the how you feel after you take it.
25:48
And I changed to micro dosing and which
25:52
it's eliminated the side effects.
25:53
So I'll I'll take, you know, the shots multiple times a week versus once a week.
25:58
So I'm taking lesser dose and I I don't have side effects.
26:02
but not only the stubborn weight I couldn't lose,
26:05
I lost. But I was never a big drinker,
26:09
but I'd socially drink. I can't stand the taste of alcohol now,
26:14
which
26:15
Isn't a bad thing to me. Like I remember the first 20 times after I got
26:20
on the you know a Zempic or whatever it is,
26:23
trisepatide, I'd go out and meet someone out for a drink and order a drink
26:27
and I could not finish the drink.
26:29
Like it was just like impossible be for me to finish the drink.
26:33
And you know, so like you know that that's you know great.
26:36
And I just saw a video on one of my stream,
26:39
you TikTok or YouTube. you know,
26:41
I like to watch those.
26:43
And I love this quote that someone said,
26:46
and it might sound harsh, but they said if you're an adult,
26:50
middle aged adult, they might have said,
26:53
and you've struggled with an unhealthy lifestyle,
26:58
weight, you know, you know, all that stuff,
27:01
they said something to the fact that you're losing at life,
27:05
at one of key components of life.
27:08
And I know that comes across
27:10
Harsh, but I mean that affects us in every area.
27:14
So, you know, I don't know, I threw a lot at you and it's confusing and you know,
27:19
I'm still confused with all the I haven't,
27:21
you know, gone down the peptide other than the GLP ones.
27:25
Creatine, I'm like, you know, that's being thrown at me.
27:28
w w what do you what do you suggest?
27:30
You know, it's for our listeners.
27:31
What's what am I right about,
27:33
Well I mean
27:34
you know?
27:34
I'll react to a few of those things and we can talk about some
27:37
Yeah.
27:37
specific compounds. One is you know,
27:41
often in this space I'll get this question I'm like,
27:45
well aren't you just ultimately suggesting
27:49
Better sleep, diet, exercise, mental health.
27:52
Well, yes, we are. And it's helpful,
27:55
however, for me to say, hey John,
27:58
it's not just your cholesterol that's off or your hemoglobin A1C that's off.
28:02
I've got these
28:02
I blood pressure.
28:04
Yeah, I've got these 20 different data points that all point to a cliff coming
28:09
up at some point in the next 10 years.
28:11
Here's how the next decade is going to sort of play out.
28:15
Can play out. And when you can sort of describe it to people like that
28:19
and give them a much more scientific answer around this.
28:23
So, for example, even on your workouts,
28:25
we check something called your VO2 max.
28:27
This is where an athlete wears a mask and they're running on the treadmill,
28:31
and it looks at your cardiac output,
28:33
your respiratory capacity, the health of your blood vessels,
28:37
the health it's actually measuring,
28:38
how many milliliters of oxygen per your mitochondria.
28:42
Using inside your cell to produce ATP,
28:45
which is the energy that our our cells use.
28:47
And so we use that as a very structured scientific way
28:51
to assess someone's cardiovascular output.
28:54
And we have all these calculations that say we know that you're gonna lose
28:57
10% of your VO2 max per decade.
29:00
And if you want to be 80 years old and hiking the Rockies with your family
29:05
or dancing at your granddaughter's wedding,
29:08
you're gonna need a VO2 max.
29:09
Of 25 or 30. And you're at a 25 or 30 right now in your 50.
29:14
So we need to juice this up by 50% right now in order for you to live that kind
29:20
of life that you need. And so we start with a very structured diagnostic base
29:26
to understand where someone is.
29:27
And then I think we build this very detailed intervention map around what's going
29:33
to move the lever the most.
29:36
Sleep is one of the biggest levers for most people.
29:38
then obviously exercise and and diet and and our sort of mental outlook on life.
29:44
But you know, you mentioned a couple different things.
29:46
One is, you know, how do you think about some of these compounds and when
29:52
to use them? I'd say most people look 70% of us are overweight or obese,
29:57
60% of us have diabetes or prediabetes.
30:00
Diabetes. We have neurocognitive disease like dementia skyrocketing,
30:04
cancer skyrocketing, childhood diabetes and obesity skyrocketing.
30:09
I mean, what we're doing is obviously not working.
30:13
And so anyone that says, well,
30:14
just do the status quo or follow the guidelines,
30:17
I would say, well, we followed the guidelines for 100 years or 50 years
30:21
and look where we've gotten. And so,
30:23
yes, what we are often trying to do is a very structured.
30:27
Approach to improving someone's VO2 max and some improving someone's muscle mass.
30:33
But what where we start is a more honest conversation.
30:36
We say, John, you've been on this journey for 30 years.
30:39
You know, when's the last time you felt really good?
30:42
If they say, well, 30 years ago when I was 16,
30:45
then you start to ask the question:
30:48
like, well, what's gonna change now?
30:50
Is there going to be some
30:52
Major catalyst in your life? Are you gonna change your job so that now
30:55
you have a lot of time for training?
30:57
Do you have some sort of childcare thing that you're gonna graduate into,
31:01
or what is it? And most people don't really have a good answer.
31:04
And so then you're left with saying,
31:06
okay, well, I think we need something to give you some momentum.
31:10
We need something to start to shift your life a little bit.
31:15
We need some sort of boost to give you a little bit of.
31:18
Reassurance that you got to keep this this sort of virtuous cycle going.
31:23
So that's where things like I think GLP1s and hormone replacement therapy
31:29
can be very, very powerful. you know,
31:32
there are morbidly obese people,
31:34
and that's an actual diagnosis that we use with BMI over 35,
31:38
and and they're having true complications,
31:40
and those are the people that these medications are are really.
31:43
Meant for, but I think there are plenty of folks in this obese
31:47
and overweight category, BMI of 25 to 35 or so,
31:51
which you know doesn't take much.
31:53
Most people are actually probably a lot have a lot more adipose than they than they
31:58
realize. ~
31:59
A lot more
32:01
a lot more fat tissue than they realize.
32:03
And and you know, if you really look at the stats,
32:06
again, more than half of people probably.
32:08
Fall into this category of just having too much too much fat tissue.
32:13
And so when we look at that in a structured way,
32:15
we get a DEXA scan on all of our patients.
32:17
We look at subcutaneous fat and visceral fat and lean muscle.
32:20
And so we do the actual calculation.
32:22
And you know, we we know that for men,
32:25
a subcutaneous fat, somewhere between 12 and 18 percent,
32:29
is the most correlated with longevity for women,
32:33
somewhere between 20 and 25%.
32:35
And so if you're above that, then we have to have the discussion of how
32:39
are we going to cut some of that adipose down?
32:41
How are we gonna add some of that muscle so that you're functionally independent
32:45
as an adult or as a senior and give you everything that you need to get there?
32:51
and so that's when some of these tools come into play.
32:54
If if someone says, Look, I I'm already working out as much as I think I am,
32:59
I feel like I'm doing my best with the doc.
33:01
I just need a little extra here.
33:02
That's where we we also only microdose usually on the GLPs,
33:07
and we we start low and use the absolute minimum viable dose necessary
33:13
to curb someone's appetite just enough to make sure that they're getting enough
33:18
protein, that they're getting enough substrate,
33:20
that they're getting enough, you know,
33:21
nutrients and electrolytes, but where
33:24
They look at the pizza and they don't want the third and the fourth
33:27
and the fifth slice. They're good after a couple of pieces.
33:30
They look at the dessert and they have a bite or two and they're fine.
33:34
They don't want to have it. It's actually interesting you mentioned
33:37
the alcohol thing. There are all sorts of studies ongoing right now,
33:40
but anecdotes abound around people decreasing tobacco use
33:45
and alcohol and gambling and other compulsive addictions.
33:49
So it's certainly hacking, these GLPs are.
33:52
Certainly hacking our dopamine circuits in our brain,
33:56
and and the same kind of quote unquote hit we get from you know the
34:00
the fried food or the sweet dessert or whatever it is is the same thing that
34:04
we get from some of these dangerous substances as well.
34:07
And so we do notice a decrease in consumption along those lines as well.
34:13
So, you know, we could go really deep down the peptide alley,
34:17
the FDA just had.
34:18
advisory committee at least voted to push through half a dozen peptides to
34:23
be on the bulk compounding list now and so the FDA will take that under advisement
34:28
and and vote on that in the coming month or two,
34:31
which will really open up the aperture even more to this space.
34:34
But I think whether the traditional system wants it or not,
34:38
patients are accessing these kinds of therapies and and finding these kinds of
34:44
compounds to utilize. So it's incumbent on physicians
34:47
to understand what's happening,
34:49
to you know, sort of engage in harm reduction where we can and guide people
34:53
to the safe places and to give them the best guidance that we can.
34:58
So is it me
34:59
or is it the golden era of, you know,
35:02
health resources? I mean, I don't remember a time and maybe because I was younger,
35:08
I didn't care or you know, think I needed it,
35:11
but it just seems like we have so many resources to us that we you know
35:16
the world never had in the past.
35:18
Yeah, I definitely think we are there's this cultural zeitgeist to monk upon us,
35:23
I think, that is happening where
35:26
Even the young people, you know,
35:28
you see the decrease in amount of alcohol consumption,
35:31
but bachelorette parties are now going to do cold plunges in infrared instead
35:36
of going to get wasted in Nashville or whatever,
35:39
right? And there's all sorts of
35:40
Right.
35:40
the I I I think, tip of the steer sort of cultural things that
35:44
are happening that show people are really engaged and excited about this.
35:48
We're still early in this. I mean,
35:50
again, you know I I
35:52
I I I love where I live and I
35:55
Just at the Ohio State Fair, and it's really good people watching.
35:58
But you know, you look around and you realize like this message
36:01
is probably resonates to those of us in our small echo chambers,
36:05
but most of the population is still living under the spell of a pretty unhealthy
36:09
Yeah.
36:10
lifestyle. So we have a long way to go,
36:12
but I do think that we are really starting to see that shift where
36:16
the cool thing now is being healthy.
36:19
I think you know that.
36:20
getting too heady and philosophical with it like where the next decade
36:23
or two go with with AI and things like universal basic income and
36:28
how it's gonna redefine people's you know identity and purpose because their whole
36:34
job or sectors are are sort of changed.
36:36
The one thing that we're still going to have to work towards is kind
36:40
of our our health in some ways.
36:42
And I think it'll be interesting,
36:43
you the GLPs will we have a now an oral
36:46
Class of these coming out. It might be 20 years from now that we live
36:51
in that futuristic sci-fi where we all just take the pill that keeps
36:54
us healthy and happy all day, every day,
36:56
and that's kind of where we are.
36:58
But I do think that kind of the new flex is is being healthy as well because it's
37:03
the one thing
37:03
Yeah.
37:04
you sort of have to work towards in a lot of ways.
37:06
Even as you mentioned, the TRT people have this misconception that they just start
37:11
taking.
37:11
I'm
37:11
Sorry, that's testosterone
37:11
sorry, explain what T R T is just for some of our listeners.
37:14
testosterone replacement therapy.
37:16
some guys will come to us and believe that if they just get on this magic molecule
37:20
that their lives will change, but you have to put the work in,
37:23
right? You actually have to give it the substrate needed to gotta do the workouts,
37:28
and then yes, it will probably help supercharge you a little bit,
37:32
but you have to do that kind of work,
37:34
and so I do think that there
37:36
I say that about GLP ones,
37:38
they're not a diet, right? You could still you you'll eat less,
37:43
but if you're still eating the pizza and the pastry and the stuff,
37:45
Yeah, you know, unfortunately
37:46
that's yeah.
37:47
what the studies showed is for some folks early on about forty percent
37:52
of the weight loss with GLPs were from muscle and and other organisms.
37:56
tissues and and then another set of data is around the number of people that that
38:03
regain the weight after coming off the GOP is pretty high and so they've lost muscle
38:08
mass and fat to some degree but then they put it all back on once they come back
38:12
off and or come off the medication and then that's all fat and so we've kind
38:16
of replaced muscle for fat and and then we've have to decide are are
38:20
we meaning for people to be on these medications
38:23
Right.
38:23
like
38:24
Lifelong or not. That's not how we see it.
38:26
I'm sure Pharma would love a recurring revenue customer for life,
38:30
but what we see, John, is what you're doing,
38:33
which is microdosing for a year or two,
38:36
kind of work at it. But in that year or two,
38:39
our job is to work together to change your lifestyle in a way that if
38:44
you were to slowly start stepping down off of that,
38:47
that you
38:48
Wouldn't run back to the pizza and the ice cream and the overeating.
38:52
You've now changed your life. You've lost 50 pounds,
38:55
but you also don't like the way alcohol makes you feel the next day.
38:59
You also don't like the way pizza makes you feel.
39:02
You also know how to count macros,
39:04
and you know how to partition food.
39:06
You know how to front-load protein.
39:09
And so we have to build, that's part of why our practices,
39:12
this whole comprehensive approach,
39:14
is it's not just about.
39:15
going to fill out some survey and getting a GLP one and getting checked
39:20
in on once or twice a year. It's we use this as a tool.
39:24
You will be seeing our dietitian,
39:26
you'll be working at our training program,
39:29
you'll be logging your workouts,
39:30
you'll be meeting with your doc quarterly,
39:32
you'll be meeting with your health coach and all of that helps lead to success.
39:36
So that once we step you off of this,
39:39
then you don't need it anymore.
39:41
And your new life allows you to sort of sustain that long term.
39:45
That's how I think we should really be using these medications long term.
39:49
Agreed, agreed.
39:50
I I say, you know, today I'm not surprised by the people and when I
39:55
say people it could be neighbors,
39:56
people, you know, or it could be celebrities,
40:00
right? I'm not surprised by the people who are on GLP 1s I'm surprised
40:04
by the people who aren't. Like it just amazes me,
40:07
you know, but it's education, it's resources,
40:10
it's it's knowing, you know, the right place to go and trust versus just going
40:15
on the
40:16
third market and you know that that's a little dangerous.
40:19
listen i i as I say this is the golden era I feel like and and hopefully
40:24
I'm wrong here but in my experience I feel like for men we've had a lot
40:29
of stuff but I feel like it's it's i if there's not a lot of clinics
40:34
or doctors around for for for women is that catching up do you guys take both
40:40
men and women
40:41
You know, a and and and a am I correct or am I wrong on that?
40:45
Yeah, I mean I think historically there have been a lot of these like testosterone
40:50
clinics around every corner and whatever.
40:52
think you a lot of them earned a bad reputation.
40:55
There's a lot of women's health clinics that earned a bad reputation as well,
40:58
doing thing you know, these pellets and things like that.
41:00
But it is a growing, burgeoning sort of you know investment field,
41:05
but you know I don't really see it as different.
41:07
Like we're all human beings and it's just different aspects of of the same kind
41:12
of care. There's very different kinds of things that go into men's
41:16
and women's health. We have an entire
41:18
women's health team led by all women you know women physicians
41:22
and researchers and health coaches and
41:25
Team members. so yes, we definitely take women,
41:27
we do perimenopausal care, we do hormone replacement therapy for women.
41:32
I think our all of our female docs are menopause society trained,
41:37
and so it is important, it is growing.
41:40
but you know, we really think that families,
41:43
couples doing this together, going through similar experiences together have
41:48
a much higher degree chance of success.
41:50
And so
41:51
Yeah.
41:51
what we sort of encourage is bringing your significant on with with you if you can.
41:57
Yeah. All right. If someone's thinking about this getting healthier,
42:01
which I'm I know it's always on everyone's radar,
42:04
what's three pieces of advice you'd you'd give and then after that,
42:08
how do people find out more about velocity health?
42:11
First I'd start with
42:12
your sleep. I think too many of us are underappreciating how important sleep
42:18
is as a pillar. you know we there's an interesting recent study that came
42:23
out that kind of triangulated around six and a half,
42:26
six to seven point five hours or so is kind of the sweet spot.
42:30
so many people I talk to wake up at two and three in the morning,
42:36
minds race.
42:37
Thinking about whatever can't get back to sleep,
42:40
and it plays out in the rest of their lives.
42:42
So figure out what's wrong with your sleep and work with people who understand why.
42:47
So that's probably piece of guidance number two,
42:49
which is you can only manage what you measure,
42:52
so measure things in the right kind of way,
42:54
but under the right kind of guidance.
42:56
So, you know, I don't think people should get neurotic about wearables,
43:00
but I do think it's helpful to do.
43:03
Things like sleep tracker, continuous glucosponder,
43:06
all the things that we mentioned,
43:08
things like the full body MRI and genetics.
43:10
You do that with a team that really understands these things and can help
43:16
put it into context. and and lastly,
43:18
I I would say that which is is is find a team or at least
43:21
a physician who understands these concepts,
43:24
is not going to just dismiss you,
43:26
is not going to treat you patriarchally and just you know rush.
43:31
you out of their office within 10 or 12 minutes,
43:34
but treat you like a human being,
43:36
treat you like a friend, treat you like someone who cares about their health more
43:39
than anyone else in this world,
43:41
because obviously you do about your own health.
43:43
And so you should be looking for a partner who's willing to have
43:47
the long format discussions with you more than anything.
43:50
We think that that's all what we provide here at Velocity Health.
43:54
People can find us at Velocity Health Clinic dot com.
43:58
Velocityhealthclinic.com. Again,
44:00
we are available in all 50 states.
44:02
We exist outside the insurance sort of construct,
44:05
so we're all cash pay and we you know with we have several different programs from
44:10
a one-time assessment, sort of our version of the executive physical,
44:14
to a program just focused on
44:17
Peptides and hormones to sort of more the the flagship concierge
44:22
all all inclusive program that has all the cardiac and cancer screening
44:26
and things like that as well. So we'd love to have you.
44:29
We're growing. For any of you that are business owners as well,
44:32
we we work with employers too.
44:34
So if you're thinking about a cool executive perk or you know for retention,
44:39
recruitment, doing something for your your
44:43
top tier team or rewarding you know your sales team or whatever it is
44:47
by giving them the gift of health,
44:49
by giving them the gift of a doctor who'll actually wrap around them in this
44:53
way and a team that understands them deeply in this way,
44:56
then we're always happy to chat about that too.
44:59
We've worked with several others like that.
45:01
Your velocityhealthclinic.com will be in the show notes along with your book.
45:07
I actually went to velocityhealth.com and it wasn't you.
45:10
So let's be clear about that. It's velocityhealthclinic.com.
45:11
Right. Let's get
45:17
Correct.
45:18
Dr. Deep, it was such a pleasure.
45:20
really enjoyed our conversation and and what you're doing,
45:24
and I think it's it's it's critical.
45:28
that we all live the best version that we can for those who it impacts.
45:32
so thank you for your time and and what you're doing out there for
45:36
for people's well being.
45:38
Yeah, well thank you and thank you for spreading this message and bringing this
45:42
to your audience. And I'm glad you're taking care of yourself in this kind
45:46
of way and it's resonating. But I think you're right that we are at this moment
45:50
in time. So I I hope the rest of you all listening found some benefit
45:54
to this and we'd love to chat.
45:56
So appreciate being on, John.
45:58
All right. Thank you, revolutionaries,
46:01
for joining us for another episode of the Customer Service Revolution Podcast.
46:05
We will see you next week.