Latest / Gladden Longevity Podcast / Transforming Healthcare Perspectives - Episode 317
Transcript
- 0:00core deficiencies that I identified as the reason why primary care lost its way.
- 0:05one is that the insurance fee-for-service model incentivizes doctors to focus on volume as opposed to quality of care.
- 0:14So we need to get rid of the insurance piece and change the incentives so that doctors are incentivized by outcomes, not volume.
- 0:23to be able to really round out their expertise and support a patient holistically.
- 0:28So we have a care team model where our physicians work with a registered dietitian.
- 0:33But if our physicians are not only board certified in family medicine, they also have additional training in integrative medicine and or functional medicine.
- 0:40Because our hope is that by bundling functional medicine, longevity into primary care, we're not only there when people get sick, we're also there when their health stabilizes
- 0:50and they can start to think about what you're referring to, which is, how do I live until I'm
- 0:57plus, but more so like how do I have the quality of life of a 30 year old and the brain capacity also of a 30 year old or even let's say, guess what you're saying is 300,
- 1:35Welcome everybody to this edition of the Gladden Longevity Podcast.
- 1:38I'm your host, Dr.
- 1:39Jeffrey Gladden, and we're here hacking age as best we can and actually very successfully, I might add.
- 1:46And we're still asking the five questions that motivate us.
- 1:51You know, how good can you be?
- 1:52How do you make 100's a new 30?
- 1:54How do you live well beyond 120?
- 1:56How do we live young for a lifetime?
- 1:58And how do we develop a 300 year old mind?
- 2:01And today I'm going to be talking with Chloe.
- 2:05Harrouche and Chloe is a breast cancer survivor.
- 2:08She was diagnosed at age 23 and through her own journey through the sick care system developed a company called the land by L.A.N.
- 2:17B.Y.
- 2:19It's a pretty interesting conversation, actually a very interesting conversation ah that goes through not only her journey, but also what it is she's developing, the vision that
- 2:29she has for it.
- 2:29So I think you're really going to enjoy this conversation.
- 2:32Welcome everybody to this edition of the Gladden Longevity Podcast.
- 2:35I'm your host, Dr.
- 2:36Jeffrey Gladden, and I'm seated across from virtually that is from Chloe Harrouche Chloe, welcome to the show.
- 2:45Thank you.
- 2:46Thank you so much for having me.
- 2:47I'm excited to chat with you.
- 2:49Yeah, well, great.
- 2:50So just so the audience kind of understands, know, you're doing some really interesting things now in the health care space, but I don't know that that was always your
- 2:58trajectory.
- 2:59Maybe you could tell us kind of what trajectory you were on and then maybe what caused that trajectory to change.
- 3:06Yeah, well, interestingly, I've always been passionate about healthcare and I've always been, you know, focused on being in the medical slash healthcare space.
- 3:17I studied bioengineering when I was at UPenn and then went into healthcare consulting.
- 3:21And so I always worked closely with doctors in various different capacities and through those capacities understood how the healthcare system operated, but very much saw it from
- 3:30the lens of.
- 3:32awe and admiration more so than having the critical eye.
- 3:37And so, you know, it wasn't until I myself was diagnosed with breast cancer at the very young age of 23 that I started to look at the healthcare system a bit differently.
- 3:48So I was someone who did not have any family history of breast cancer.
- 3:51This sort of very much came out of the blue for me and sort of beyond the shock of the diagnosis itself.
- 3:58I think the bigger shock was, you know,
- 4:01post-treatment after I was done with the standard of care and things were no longer so explicitly outlined for me as like, is the next step?
- 4:10That's when I started to question.
- 4:13yeah, well, that's a big, I mean, that is a big shock.
- 4:15Let's just stop there for a second.
- 4:17You were in your early 20s and you get this diagnosis.
- 4:21how, was that something you discovered or you went in for a standard mammogram?
- 4:25That seems a little unusual at that age.
- 4:27So was it something you picked up on or?
- 4:30Yeah, you know, my mom had always taught me to do self-exams and it was one of those things where I was drying myself after the shower and I felt a lump and went to the
- 4:43gynecologist, asked her to check it out when I was in a routine OB-GYN visit and it wasn't concerning to her at all so we sort of dismissed it then.
- 4:51And then six months later, the mass started to get harder and a little bit bigger and that's when oh
- 4:58I called the doctor back and said, seems to be a little bit concerning.
- 5:02And she sent me in for an ultrasound.
- 5:04And even at that point, the radiologist wasn't concerned, thought it was just some sort of benign tissue.
- 5:11And then when we did a biopsy, it came back as having cancer cells.
- 5:16And being so young, even though I have this bioengineering degree and I've been in healthcare, when the doctor said, we've identified cancer cells, that still didn't even...
- 5:27you know, process in my mind is, I have cancer.
- 5:30And it took me a little bit of time to really absorb this idea that I was diagnosed with breast cancer.
- 5:37It was wild.
- 5:38You know, you never really feel like it's real.
- 5:41Right.
- 5:41It's surreal, right?
- 5:42I mean, it's a surreal experience.
- 5:44um
- 5:45and you definitely don't hear of the many people that age getting breast cancer.
- 5:49So it just felt so, so confusing.
- 5:51Yeah, just, I was just like, is this a mistake?
- 5:54It felt like a mistake.
- 5:56yeah, like no peer group and probably lots of questions about, you know, what's my future and what's the impact on, you know, whatever relationships and family and whatever else,
- 6:06right?
- 6:06Lots of things.
- 6:07It's it's a big it's a big deal.
- 6:09Did you get any any help kind of thinking those things through with that diagnosis?
- 6:13each specialist that I saw, they all offered different recommendations on how to be proactive about my long-term risk.
- 6:23So I remember my oncologist recommended that I do IVF.
- 6:28My breast surgeon was guiding me through the decision of doing a single mastectomy versus a double mastectomy, recognizing that a single mastectomy would require more ongoing
- 6:37imaging and monitoring.
- 6:39So that was sort of a decision around, you know, what is the level of risk that I'm willing to tolerate and slash also what is the level of upkeep that I'm willing to
- 6:47tolerate.
- 6:48And that's a pretty personal decision.
- 6:50I obviously wanted to be as aggressive as possible because I felt like I had my whole life ahead of me.
- 6:55I didn't want to be getting imaging done every six months and having that hang over my head.
- 7:00And then I remember when it came to egg freezing, you know, there was obviously this concern of
- 7:07we don't know the impact that chemotherapy will have on your ovarian health.
- 7:10And so we want to give you sort of this precaution, this plan B in the event that it is hard for you to um get pregnant naturally post treatment, which did happen, but it wasn't
- 7:23actually because of chemotherapy.
- 7:25was still able to get more healthy eggs post chemotherapy, but there was sort of a whole other side to the story that.
- 7:35uh
- 7:36happy to get into, but that sort of is where the real shocker for me came about.
- 7:42So the shocker came, if I'm getting this right, the shocker came in terms of the impact it might have on your fertility.
- 7:48Is that what you're saying?
- 7:50So actually, I mean, if I continue on with where I was at when I was done with treatment, I went back to my oncologist who was sort of my go-to main doctor overseeing my care.
- 8:01And I said to him, you know, I've finished treatment.
- 8:04Now what?
- 8:04What is the next step?
- 8:05And he said, well, you're done with treatment.
- 8:07You know, the next step is come back in six months and we'll evaluate you then, but you're pretty much good to go.
- 8:14Just stay on Tamoxifen.
- 8:15We'll keep you on it for the next 10 years.
- 8:17And as long as you're not obese or exhibiting any other major risk factors, there's really nothing else you can do.
- 8:25And this was at a time, I mean, it was 10 years ago.
- 8:27So it was at a time where the wellness industry was starting to grow and longevity conversations were also starting to happen.
- 8:34And I was realizing that there was so much power in food, in exercise, in sleep, in supplements.
- 8:40And I wanted to be able to tap into that.
- 8:42And I felt like the person that I should
- 8:44go to for that guidance was my oncologist and one who was designed to treat cancer should also be the person designed to prevent cancer.
- 8:52But really that's not the case as sad as that is completely.
- 8:59in the oncologist's mind, they're, really interventionalists.
- 9:02In fact, medicine in general are interventionalists, right?
- 9:04It's a, it's a reactive, will intervene when something pops up uh or happens.
- 9:10Yeah.
- 9:10So that's, you had quite the education in the, what I call the sick care industry, right?
- 9:15It's really not healthcare.
- 9:16It's sick care, right?
- 9:17So, yeah, well, that's intriguing.
- 9:20And so.
- 9:21You know, based on that, you then made some decisions about, know, you've always had this interest in quote unquote healthcare.
- 9:29You realized that you have a sick care system surrounding you.
- 9:31So then you did what?
- 9:33So I basically dove into the wellness industry and I said, I can figure this out.
- 9:37I'm going to learn everything that I can from the Peter Atiyahs of the world, Mark Hyman, Andrew Huberman.
- 9:43And I was listening to all the podcasts, I was reading all the books and I was like, you know what?
- 9:49I can figure this out.
- 9:50I'm going to just.
- 9:51hear what it is that the research they're quoting and I'm gonna implement it.
- 9:54And that's what I did.
- 9:55I was doing all of the things, intermittent fasting, I cut out carbs and sugar and alcohol, I was exercising five, six, seven days a week, depending on the week.
- 10:06I was pushing my body in every possible way that I could.
- 10:09And about four years into that journey, obviously with every year you're getting more and more intense as you grow your wellness knowledge, I lost my period.
- 10:17And I went back to my oncologist and I said, why is this happening?
- 10:20Is this the long-term ramifications of chemotherapy or is this something else?
- 10:25And he said, we don't know.
- 10:26We don't know because there aren't that many 23 year old survivors that are, you know, that we sort of have to look at to see what the long-term impacts are.
- 10:35And so his answer was, I don't know.
- 10:38And I'm not really going to figure it out.
- 10:40So I went to my OBGYN with the same question and she didn't know because she obviously also doesn't have that many patients that have had chemotherapy.
- 10:48And so, you no doctor, regardless of how much money I was willing to spend, was gonna figure it out for me.
- 10:55And that's when I started to explore primary care, because it felt like what I really needed was someone to connect the dots across my reproductive health, my cancer history,
- 11:03my long-term goals of starting a family, know, someone being young, you know, all these other...
- 11:08questions that I have about my long-term health.
- 11:11And again, went through the rabbit hole of evaluating all these different primary care doctors from the in-networks to the concierge doctors.
- 11:18And they all sort of had very similar rudimentary approach to wellness, which was like eat your vegetables, exercise moderate amount, and that's really all you can do.
- 11:28It wasn't specific, it wasn't personalized, it wasn't data-driven.
- 11:31so for me, who was someone who is very,
- 11:35engineering focused, however you want to call it.
- 11:38I wanted the data.
- 11:40wanted, you know, tracking.
- 11:41wanted, you know, some, some conviction around like, what is it that I need to be doing explicitly to be able to advance my health?
- 11:49And so ultimately, when no doctor was able to, you know, give me that support, that satisfaction, I just said, well, it's not like wellness could do me any harm, right?
- 11:58Like I'm going to just continue to do what I'm doing and I'm going to take matters into my own hands.
- 12:03I don't need healthcare.
- 12:04Why do I need healthcare if it's just sick care?
- 12:06And I think sort of then going back into the whole fertility journey, when I was ready to start a family, again, the sort of reactive suggestion to me not being able to get
- 12:17pregnant because I don't have a period was let's go through IVF.
- 12:21And in IVF, they sort of give you the same spiel, which is, take these hormones and we'll create a period and we'll help you ovulate and you'll get pregnant.
- 12:30And I did get pregnant.
- 12:31After four rounds of IVF, I got pregnant twice, but I miscarried twice.
- 12:36And so there was a clear pattern there around like something being pretty imbalanced in my body.
- 12:43And again, once I saw that no one was gonna figure it out for me, I stopped my fertility journey and decided to explore functional medicine, which really is what I should have
- 12:53done all along.
- 12:54And with functional medicine, I was able to uncover that I had
- 12:58hypothalmic amenorrhea, which is basically a complete state of stress, whether it's malnutrition, over exercise, or just emotional, psychological stress.
- 13:08And I think for me, it was a combination of all three.
- 13:12Yeah, OK, that makes sense.
- 13:14The first thing that popped in my head when you told me you lost your period is that you were overdoing your exercise and you were probably pretty stressed.
- 13:20Right.
- 13:21So right.
- 13:22because I was so obsessed with wellness.
- 13:25And again, like going back to this idea that wellness is only good, well, no, if you're doing wellness in the generic sense of the word, maybe it's not all good and you're not
- 13:37tracking the impacts that it's having on your hormone health, on your cortisol levels.
- 13:42And I also think that...
- 13:44You know, for me, I was sort of following guidance that was very much geared towards male anatomy, not towards the female anatomy.
- 13:50And there's a lot of sensitivities that women should be considering.
- 13:53it brings it brings up a really good point.
- 13:55Just interrupt for a second.
- 13:57And that is that you had to be in a situation where you were trying to regain control, right?
- 14:03Things were out of control.
- 14:05And because of that, you you didn't really feel safe, right?
- 14:08Because you weren't.
- 14:09And so, you know, God bless you in a way you were trying to get back a sense of control.
- 14:15And by doing the wellness piece and the exercising, following the recommendations of people that you
- 14:20had learned from, this is my way to take back control, right?
- 14:24And at the same time, there's another kind of lesson in there that you learned as well, is that biology is really an economy of balance.
- 14:33It's not about how far can you push it.
- 14:35It's about how do you keep it in balance?
- 14:37Not only how do you keep it in balance, how do you keep it rhythmically in balance, right?
- 14:41It's really a symphony the way we talk about it.
- 14:43And so being able to
- 14:46It's really interesting to watch you kind of bump your way into this, you know, this knowledge that you've gained, right?
- 14:52It's all through good intention and from the idea of I need some sense of control in this situation.
- 14:58I need to feel safe again and know that I can have a family and, you know, carry on my life, right?
- 15:03So, I mean, that's, yeah.
- 15:05Totally, and again, I think I see this now more and more where people are gravitating away from the healthcare industry because they're not finding the value, they're not finding
- 15:15the prevention, and so they're instead turning to the wellness industry.
- 15:19And so for me, when I sort of completed this journey of functional medicine being the answer to actually diagnosing what was wrong with me, I said to myself, if I were to look
- 15:30back and answer why
- 15:32why this happened, like what could I have done differently?
- 15:35I think the answer is that I wish that I had had this more functional oversight to be able to really identify the impacts that these wellness interventions were having on my health
- 15:47as I was implementing them so that I could really be confident in that they were actually doing good, not necessarily hurting me or putting me in a state of stress.
- 15:58And I think, especially in New York, which is where I live,
- 16:01it's not even this hyper-focussed-ness on wellness, it's everything that we do.
- 16:07It's the work that we do, it's the relationships that we're trying to build, the careers we're trying to build, the families we're trying to create, which are sort of adding
- 16:14stress on top of stress on top of stress.
- 16:16And so, you know, when I thought about how do I solve this, it was really like, okay, why does this experience not exist in healthcare?
- 16:24And how can we work backwards to create that experience so that we can provide
- 16:30this level of care to patients that are looking to take control over their health.
- 16:35Yep.
- 16:35No, I think that's, I think that's well said.
- 16:37You know, one of the things that we've learned here also is that, you know, and in our, you know, I don't know if you've looked at, at much of, to know much about us, but you
- 16:47know, we have basically sort of five circles that we're working with in the life energy circle, which is the whole psycho spiritual space is really the circle that binds them all
- 16:56because being able to give yourself a sense of safety, right.
- 16:59And, and actually being able to.
- 17:03live a life to where we're not stressed, right, which is really kind of the goal, quite honestly.
- 17:11And that is something that medicine, sick care certainly has no answer for except to throw a pill at it.
- 17:17And even functional medicine doesn't really have all the tools that I think it should have, quite honestly, to help people with that.
- 17:25Because I think what's happened is that we accept that stress is just part of life, and it just has to be that way.
- 17:32And now it becomes a question of coping mechanisms, right?
- 17:35And maybe there's some ways, if you learn to meditate or increase your heart rate variability or use a parasympathetic nerve stimulator or something like that, where you
- 17:44can actually bring your nervous system into a state of regulation, right?
- 17:49or use a brain tap or some other things, some of the other headbands and whatever else to help pull you into that beta alpha, out of beta, it's a theta and alpha states.
- 17:58But that's pretty much the extent of it.
- 18:00But I know for a fact that it's actually possible to go beyond that.
- 18:04It's possible to actually transcend these scenarios to where you can live life from a perspective where...
- 18:10You're actually grateful for everything that's happening.
- 18:14You're actually not here to sort of effort against life.
- 18:17You're actually here to receive and in that receiving it, there's equanimity and it's, it's a very sort of calming place to be.
- 18:26And the interesting thing about living from such a calming place is that our biology does so much better.
- 18:35It really, when we're, when we are,
- 18:38in a very sort of calm state, a state of equanimity, if you will.
- 18:44And we're living from that place of being grateful for everything that's going on and what a gift it is to be here and what a beautiful day it is and what a lovely opportunity to
- 18:52have a conversation, you all those things.
- 18:54Then it has a massive impact actually on the epigenetic expression of our DNA, which actually keeps us healthy.
- 19:01And interestingly enough, when people are able to go into
- 19:05this sort of state or even go into a deep meditation state like a theta state, regenerative procedures have been shown to work so much better.
- 19:13The body heals so much more from the stem cells or the peptides or whatever else is going on, right?
- 19:17And there was an interesting study on Buddhist monks where they had them go into a theta state, a deep meditation, and about 10, 15 minutes later, they were actually releasing
- 19:27their own exogenous stem cells to come out and heal the body, right?
- 19:31So I tell people that, I tell this to my clients all the time, that I think all of life boils down to one thing, and that is optimizing the nervous system.
- 19:40How we think, how we feel, what we believe is true, what we believe is possible, all of that.
- 19:45And so when we come at it from that place, that's really the starting place.
- 19:51Because when we have that on our side, it's such a massive.
- 19:55has such a massive impact on the biology, it makes all the biological things that much easier, right?
- 20:00Rather than looking to fix the biology and leave the nervous system out of the picture.
- 20:06I know if that makes sense.
- 20:08totally makes sense.
- 20:09I think that that's the sort of one of the biggest levers that most people are not leveraging is like the ability to shift their nervous system from the sympathetic to the
- 20:20parasympathetic.
- 20:21I don't think we know how to do that.
- 20:22And I think people are starting to do it more with meditation.
- 20:25think gratitude practices are incredibly powerful.
- 20:28ah But I think you're right in that the majority of people
- 20:33sort of almost find it exhilarating to be in this continuous state of stress.
- 20:37And we think that it's normal because the people around us are also stressed.
- 20:42And I think that we sort of need a societal shift in like, how do we sort of embed that into our day-to-day practice?
- 20:50And it's not a matter of being lazy or slowing down.
- 20:54It's a matter of, you know, power, truly.
- 20:59It's, that's a really good word that you use.
- 21:01It is a sense of power because you don't have to effort to get everything done.
- 21:07in other words, you can get, you can actually get more done with less effort when you're in that place of tranquility and gratitude than if you're being fueled by the anxiety of
- 21:18like, it's like, it's like being in college, right?
- 21:20Where you wait till the last minute to do something because then I'll have the, I'll have the drive to get it done.
- 21:25Right.
- 21:26So
- 21:26You're kind of living off that stress.
- 21:29And the interesting thing is that a lot of people, to your point, are addicted to stress, right?
- 21:33Whether they're a trader or whether they're, you know, attorneys or, you know, whatever, just physicians for that matter, right?
- 21:39It's the stress of the moment.
- 21:40And we have clients that come in and say, oh, yeah, no, I live for stress.
- 21:44It's like, oh, really?
- 21:45Tell me about that.
- 21:47Tell me what that's like.
- 21:48Right.
- 21:49And then we have the ability to test everybody's nervous system and sort of show them, OK, well, here's here's what's actually happening.
- 21:55Yeah.
- 21:56and the impact it has on your body.
- 21:58my point is in your own journey, and I'm just speaking to you personally now, I think one of the key elements for you is yes, sorting out the biology of the fitness, diet, all
- 22:07those things are important, but really the ace in the hole is the nervous system.
- 22:12So I think that's true for all of us, right?
- 22:14Yeah.
- 22:15Totally, totally.
- 22:16And I think it's also a matter of like figuring out the wellness interventions that aren't going to exacerbate that like already heightened nervous system.
- 22:26That's right.
- 22:27That's right.
- 22:28Yeah.
- 22:29It's like people, I think, you know, and this is true for people that aren't necessarily having a health challenge per se, but people can also derive meaning in life from the
- 22:42activity that they're doing.
- 22:44And so I think, I think about athletes, right?
- 22:47So we work with some endurance athletes and things like that.
- 22:50And so they will push.
- 22:53past an injury because, my gosh, if I stop my training, you my life is going to collapse, right?
- 22:59So their whole identity and meaning is tied up in this activity.
- 23:03And I think that goes on in many, many areas in life, right?
- 23:07People become identified by their profession, by their title, by their degree, where they, you know, blah, blah, blah.
- 23:13And yet it puts us on this merry-go-round of stress that just really tears us apart.
- 23:19So, yeah, it's like a centrifugal force on a merry-go-round.
- 23:22Right?
- 23:24Yeah.
- 23:24I have to say though, it's also easier said than done.
- 23:27Like we could talk about all of these, you know, ways to slow down and be more present and be more grateful and have less, just have less forced effort.
- 23:39But at the same time, when you're so used to being on all the time, it's really hard to turn off.
- 23:45And I think that it's like,
- 23:48I think it's probably one of the hardest things I've struggled with.
- 23:52Yep.
- 23:52I would agree.
- 23:53think it is.
- 23:54I think it took me a long, long, long, long time.
- 23:57Right.
- 23:58And I got a couple of years on you on the planet.
- 24:01Right.
- 24:01So it's one of those things that I think, you know, we sort of fell into a stressful environment.
- 24:10just kind of we were adapting to the environment we were in, whether it was school or family or business or whatever else.
- 24:17But it's almost like we need to have training to where you can practice getting right to this other place.
- 24:25Because to your point, it's very difficult to do it.
- 24:28I mean, if all you've ever known is this, it's very hard to say, yeah, I see that over there.
- 24:32But there's like this magic, the chasm there.
- 24:34I'm not sure how to get over there unless you have somebody that can take you over there and help teach you how to actually be there.
- 24:41Right.
- 24:41So it seems like in the, I don't even like the word wellness.
- 24:45I will just confess because for me, wellness is a term that was coined by sick care as a way to tell people that you don't have any identifiable disease with traditional medical
- 24:56testing.
- 24:57And so that, I don't like that part of it.
- 25:00And so for me, it's about health optimization, life optimization.
- 25:03prefer the word optimization.
- 25:05So anyway, if you're in sort of an optimization standpoint, then seeking out people that can actually help take you there.
- 25:11or integrating that, like we've integrated that into our practice, right?
- 25:15And that kind of thing, right?
- 25:17Because it is so important, so important, yeah.
- 25:20Totally, totally.
- 25:21And I think what we've tried to do is integrate that into primary care, because primary care had very much lost its way.
- 25:29No one was using primary care.
- 25:30Most people my age, know, bracket don't even have a primary care doctor.
- 25:35And the reason obviously that's a huge issue is because then people just go straight to specialty care.
- 25:41People wait.
- 25:42for issues to get so bad that they end up being more costly and more burdensome on their day to day.
- 25:48And they're spending also more time going to urgent care and getting inadequate care.
- 25:54And care ends up being super siloed.
- 25:56And we're ending up with so much more chronic disease than we need to.
- 26:00So I think for us, it was like, let's use this model of health optimization.
- 26:06to reclaim primary care as a true quarterback, not only when you're in a state of needing to figure out the root cause of an issue, but also thinking about how can I be proactive
- 26:16in a personalized way?
- 26:18I think that's truly what's missing in this, you call it wellness or something else, but in this industry that's blowing up right now, there's no personalization.
- 26:27People are just doing diagnostics for the sake of doing diagnostics because they feel like more data equals more control.
- 26:35when really it ends up almost being a scam when you're doing it without any sort of clinical oversight or any guidance as to why should you do this test and what are you
- 26:45gonna learn and how are you gonna then apply those insights into your day to day.
- 26:50And I think what's happening today is you're seeing so much data overwhelm the consumer and they're almost landing flat, not doing anything with that data because it's confusing
- 27:00them.
- 27:00And so they end up like.
- 27:02trying to be more invested in their wellness, but then turning around and saying, nevermind, like this is way too overwhelming for me.
- 27:09ah And so our hope is that with a model like the Lambi, we can actually guide people in a way that actually meets them where they're at, but then also helps sort of make longevity,
- 27:20if you want to call it longevity or prevention, just a little bit more practical.
- 27:25And effortless because the reason why it ends up being effortless is because we're super targeted about what we want you to invest your time and energy in.
- 27:33Knowing what your genetic predispositions are, knowing what your lab results show about what's happening in your body right now, knowing what your lifestyle, how your lifestyle
- 27:42increases your risk of certain diseases or not.
- 27:45And then I think that that's where we can start to move the needle on effective prevention.
- 27:51Yeah, I would agree.
- 27:52And I would agree with your assessment about primary care.
- 27:56You know, when you think about testing in general, you see really the way we think about it is it's a testing becomes.
- 28:03a direct result of the questions that you're asking.
- 28:06So many times testing is done as a function of asking the question, I don't want to miss something.
- 28:11So we're to do this test, right?
- 28:14That's one question you can ask.
- 28:16But another question you can ask is, how do I actually, the question we're asking is when I'm a hundred years old, how do I have the body of a 30 year old and the mind of a 300
- 28:27year old, right?
- 28:28So when you're asking that question, it's like, oh,
- 28:31Well, there's some things here I need to understand if I'm going to have a body of a 30 year old.
- 28:34Right.
- 28:34So now the testing you're doing it because of the question you're asking.
- 28:38And so you may end up doing more tests, but now it becomes an integrated system as to how do I maintain or get back to that 30 year old body, right.
- 28:46Which is for us, the optimization element of it.
- 28:48so in your, in your world with land V, it sounds like you're asking, I'm curious to know what question you're asking.
- 28:55that's driving what you're doing.
- 28:57So maybe just tell us a little bit about land being and all of that.
- 29:00Yeah.
- 29:01So the way that our model was developed was getting at these
- 29:06core deficiencies that I identified as the reason why primary care lost its way.
- 29:11one is that the insurance fee-for-service model incentivizes doctors to focus on volume as opposed to quality of care.
- 29:21So we need to get rid of the insurance piece and change the incentives so that doctors are incentivized by outcomes, not volume.
- 29:29Two is doctors aren't trained on wellness, nutrition, functional medicine, integrative medicine, longevity medicine at all in their medical school training.
- 29:39And so how do we complement their expertise with either additional training for the physician or an extra resource, for us it's a registered dietitian,
- 29:48to be able to really round out their expertise and support a patient holistically.
- 29:53So we have a care team model where our physicians work with a registered dietitian.
- 29:58But if our physicians are not only board certified in family medicine, they also have additional training in integrative medicine and or functional medicine.
- 30:06And then thirdly is coordination of care, right?
- 30:09Like we want to be the ones quarterbacking which specialists they're seeing, how those are then funneling back into the land be as being that overarching umbrella of their home base
- 30:21for health.
- 30:21And so we have a member advocate on the team that
- 30:25coordinates all of their care, ensures alignment, ensures ongoing engagement, ensures progress, and ensures just ease of use, right?
- 30:31So for us, that allows for the doctor to really focus on clinical care, not coordinating visits, not dealing with getting on the phone with a pharmacy or an imaging facility.
- 30:42So we're able to handle a lot for the patient, but really by extending the reach of the health care team.
- 30:49So that's our care team model.
- 30:51And then obviously,
- 30:52because we don't take insurance, we have a membership-based model where patients pay an annual fee, and with that, it's all-inclusive care.
- 30:59So they don't pay an additional fee for each visit.
- 31:02It's an all-inclusive model where all of the visits are included.
- 31:06We don't cap the number of visits.
- 31:07We sort of have a quarterly cadence in which we check in on patients to be able to monitor their progress with labs, potentially weave in advanced diagnostics when they do get to a
- 31:16healthy baseline and can start optimizing.
- 31:19And that's sort of what allows us to really make sure that patients are getting those quick wins, but also starting to think through, where else do I want to focus next?
- 31:30Because our hope is that by bundling functional medicine, longevity into primary care, we're not only there when people get sick, we're also there when their health stabilizes
- 31:40and they can start to think about what you're referring to, which is, how do I live until I'm
- 31:46plus, but more so like how do I have the quality of life of a 30 year old and the brain capacity also of a 30 year old or even let's say, guess what you're saying is 300,
- 31:55because you're so wise at that point.
- 31:57But yeah, so that's essentially our model.
- 32:00And for me, it was really important again to not let go of the primary care piece.
- 32:05I think so many longevity doctors and functional medicine doctors become siloed in their own niches.
- 32:11because they only wanna be doing longevity medicine.
- 32:13They only wanna be doing functional medicine.
- 32:15And then for a patient that becomes really challenging because they then have to have another doctor that they go to when they get sick, which is inevitable, unfortunately, no
- 32:22matter how much you invest in your longevity, you may still get a cold, you may still catch the flu, you may still unfortunately get diagnosed with breast cancer, right?
- 32:31And so how do you get that support in a holistic way from the people who really know you?
- 32:38and want to be able to support you when you're going through those health challenges as well.
- 32:43Yeah, I know it's a nice vision that you have and that you've executed on.
- 32:48It's an interesting bridge, right, between elements of sick care, but actually kind of flipping them, inverting them, if you will, and turning them into healthcare.
- 33:00That's really kind of what you're doing, it sounds like.
- 33:02It is in the sense that also, you know, traditional concierge medicine was, was created to provide people with more access when they are sick.
- 33:11Whereas for us, we've sort of modernized the definition of concierge medicine for those people who are just looking to be more proactive about their health.
- 33:19So our emphasis isn't on being available 24 seven, you know, call us at 10 PM at night.
- 33:24We do have that service, but more importantly, we have the ability to,
- 33:29focus on your long-term health in a much more personalized, thoughtful way.
- 33:36Mm hmm.
- 33:36Yeah, no, exactly.
- 33:38Now it's interesting.
- 33:39And so where are you located?
- 33:41Where's where's land being located?
- 33:43Is it a national thing or is it a New York thing or what is it?
- 33:48So our membership is based in New York.
- 33:50So our physical office is in New York and that's where the majority of our members live.
- 33:55But we do have members from all over the country and a lot of them are full on members.
- 34:01A lot of them are now consultative members where we sort of serve as their quarterback and guiding.
- 34:08uh
- 34:09both their health and their wellness, but we're not the ones on the ground locally administering their prescriptions and any physical exams that are needed.
- 34:15We sort of serve it in a consultative capacity.
- 34:18And then we also have a service called Just the Labs, which is for people who don't necessarily need that ongoing care and guidance, but really just want an understanding of
- 34:27what their health is telling them today based on what their labs show.
- 34:31And as you know, most...
- 34:33primary care doctors aren't doing extensive labs.
- 34:35They're not looking at your full hormone panel, your full cardiovascular panel, metabolic panel, nutrients.
- 34:40And so we do all of that.
- 34:42And then we meet in a consultation to go through the results with you so that you actually understand what they mean.
- 34:47And then we provide you with a care plan to really turn those deficiencies into actionable next steps.
- 34:53So that's also available nationally because the consultation takes place virtually and we can send a test kit really anywhere.
- 35:00And then we also have some virtual programs.
- 35:03We talked about how, what was it that we were talking about?
- 35:07so obviously stress management is so, so important to longevity, but metabolic health is sort of another function, which obviously is impacted by stress, but educating people on
- 35:18the importance of their metabolic health and also educating them on how to track and improve it.
- 35:23by using a continuous glucose monitor is something we're really passionate about.
- 35:27And so we have a virtual wellness program called CGM Mastery, which teaches people over a four week program how to use a continuous glucose monitor, interpret the data, and then
- 35:39use that data to be able to change their lifestyle habits.
- 35:42Again, going back to this idea of personalized wellness.
- 35:45And that's actually a completely free program available to everyone nationally.
- 35:50And so that's another way for us to be able to extend our reach beyond New York.
- 35:53but, know, do it in a way that's approachable and accessible and just gets more people, you know, working through these, these ideas in, in a really, um, convenient and
- 36:05self-guided way.
- 36:06Mm hmm.
- 36:08You know, when I think of New York and I think of your aspirations for the practice, it seems like New York is kind of one of those states that's kind of tough, right?
- 36:15It's difficult to order certain, right?
- 36:18Difficult to order certain tests there.
- 36:20It's difficult.
- 36:20We have clients from New York as well, it's difficult sometimes.
- 36:24And now we're here in Texas, of course, so we have, you know, we can do whatever we need to do here.
- 36:29But.
- 36:30But how do you navigate around that?
- 36:32Do you have a strategy around that, or how do you make good with that?
- 36:37Yeah, I mean, we do our best with what is possible.
- 36:40I mean, we're not ordering every functional diagnostic under the sun.
- 36:44And I think there are certain loopholes that we can create when members don't live in New York.
- 36:50It becomes a lot easier for us to order, especially those members who are in the Tri-C area, not exactly in New York.
- 36:58But you're right.
- 36:58I mean, I think even for gut microbiome testing, it's really challenging.
- 37:02we have...
- 37:03A solution, it's not the ideal solution, but we make it work.
- 37:07I think for us, mean, yeah, definitely the long-term goal is to be able to expand into other geographies and markets.
- 37:14But one thing that we've learned from other concierge models that grew too quickly is that when you grow too quickly, it's really hard to retain the same level of quality of care
- 37:25and consistency across care teams.
- 37:27And that's a
- 37:28very, very important element for me as we grow is to keep that quality of care high and that consistency high.
- 37:35So our next location will probably still be in New York.
- 37:39We're anticipating that we'll open something probably in Q2 of 2026.
- 37:44But then after that, I'm not yet sure where our next market will be, but I think it's not gonna be five locations in the span of two years, right?
- 37:53It's gonna be a lot more methodical than that.
- 37:56Gotcha.
- 37:57Okay.
- 37:57Well, that makes good sense.
- 38:00What's the big vision for you?
- 38:02Not that this isn't a substantial vision, but I can see your mind works in a way where you're probably thinking, you know, 18 steps down the road.
- 38:11You know, for me, think my long-term vision is that the vision of the Lambie, the mission of the Lambie holds true, even though we continue to get bigger and bigger.
- 38:22You know, for me, like, I want to continue to be a trusted resource for patients navigating their health and wellness.
- 38:31I don't want to lose that sense of trust and loyalty that our patients have with us today.
- 38:37um I care a lot about that patient, physician and company relationship.
- 38:43And that sort of transcends in ways in which we don't sell diagnostics, we don't sell supplements.
- 38:50We really try to avoid bundling things, even though some may say, it's cleaner to have everything looped into one membership and have everything be all included, but then you
- 39:00have...
- 39:01crazy expensive price and people aren't really sure what they're paying for.
- 39:04So for us, we really try to emphasize transparency in everything that we're doing.
- 39:10So I think that from a high, high level is really important to me.
- 39:14I think the other piece is extending care beyond adult medicine to pediatrics and sort of treating the family as a whole unit.
- 39:23That's also very important to me.
- 39:24I'm a relatively young mom.
- 39:26I have two young kids and I'm starting to see that
- 39:29finding holistic integrative care for children is even harder than it is for adults these days.
- 39:35And I think more and more as parents are getting educated on what's in their child's foods and what's in our environment, they're getting more and more concerned about what they
- 39:45don't know.
- 39:46And so to be able to layer this type of care into pediatrics is a huge goal of mine and something that we hope to also launch next year in 2026.
- 39:57And I think also just continuing to find ways to democratize this type of access to care in ways like our CGM Mastery Program or in just the labs where people can't necessarily
- 40:09afford a concierge level type of care, but can they sort of piece together things?
- 40:14And again, that's not the ideal solution, but it is a way to at least empower yourself to be asking the right questions and going to the doctor with the right perspective so that
- 40:24you're not just, you
- 40:26reacting to what they're telling you, you're really sort of in offensive mode.
- 40:30It's really interesting to think about the pediatric scenario.
- 40:33You know, we do a lot of genetic testing for our clients here and it's really incredibly helpful to understand how someone's built.
- 40:41You can really avoid a lot of things.
- 40:43It seems like being able to get some genetic tests on little people could really be super helpful to them, you know, rather, right?
- 40:52So.
- 40:52did genetic testing for myself and found that I am incredibly prone to chronic inflammation, that I don't methylate well, I have the APOE4 mutation.
- 41:05So there's a lot that sort of ties back to that, but there's also just general inflammation, high histamine response, et cetera.
- 41:12And one of the things that came out of the report was that could explain
- 41:18why I ended up having breast cancer.
- 41:20And maybe had I known that I had that genetic predisposition, I would have been more focused on nutrition than I was or more focused on detoxing and supporting my detox
- 41:30pathways.
- 41:31Because it's not necessarily about eliminating, which again, is I think where so much of people get scared with the wellness industry.
- 41:38It's more about adding and supporting.
- 41:41And again, like I think that the detoxing is something that anyone could sort of do better, whether it's through exercise, whether it's just through an infrared sauna,
- 41:50whether it's just through the vegetables that you eat, supplementation.
- 41:55I mean, there are so many avenues you could explore, but the fact that I wasn't doing anything was just out of pure ignorance.
- 42:01And I think, again, going back to why aren't more people doing genetic testing, I think the assumption is that it creates fear.
- 42:08fear of death, fear of what's gonna happen to me at a young age, am I gonna be on this earth for a long time or am I gonna die of Alzheimer's?
- 42:15And to your earlier point, there's so much that we can do to control our genetic, the...
- 42:21Yeah.
- 42:24Genetic expression is really a progrous, it's a set of proclivities is the way we think of it.
- 42:29mean, apart from, you know, cystic fibrosis or sickle cell or Tay-Sachs or something, but for the majority of conditions, your genes are really just a set of predispositions.
- 42:39And then if you know what they are, you can steer them away from the icebergs, which is really, you know, I think detox is such a massive, it's so empowering, right?
- 42:48So a detox is so important.
- 42:50Inflammation is so important.
- 42:52and, you know, and then cancer risk, right.
- 42:54It's so important, right.
- 42:55Because, you know, odd mutations pop up, you know, out of the blue.
- 42:59So yeah, no, I, I, I applaud you for thinking about the pediatric population.
- 43:04The other thing that came to mind for me was, you know, using biological dentists, because there's a lot of issues with people's mouths that also have an impact on their systemic
- 43:14health.
- 43:15And so we, we sort of partner with biological dentists here.
- 43:19to take care of those problems, because obviously we're not going to do that ourselves.
- 43:23But we do, we measure oral DNAs on everybody.
- 43:27And we find a lot of people that have, you know, things that are out of whack, or we know they've got root canals, you know, amalgams still in, or things like this, right, all of
- 43:35which can have a massive impact on their health.
- 43:37I'm just curious if you thought about maybe adding in functional or biological dentistry at some point.
- 43:43Honestly, I haven't.
- 43:45I think it could probably be something that we would refer out for.
- 43:51It's an interesting, mean, yeah, exactly, a collaboration.
- 43:55We've thought about, like, is there a world in which we layer in, you know, the routine?
- 44:02screenings that people should be doing that they just avoid, whether it's the dermatologist screening or the dentist.
- 44:08mean, people just avoid the dentist and it's terrible because there is so much that's happening in our mouths that is even causing inflammation and people don't realize it.
- 44:18But yeah, think it's right now not the priority.
- 44:21I think the priority is to just do primary care super, super well and find ways to
- 44:28like take what we're already doing and being able to sort of offer it in different capacities, but still focus on what it is that we're delivering and doing that really
- 44:36well.
- 44:37Nice.
- 44:37Well, it's been a pleasure chatting with you, Chloe.
- 44:40Appreciate you coming on the show.
- 44:42Yeah.
- 44:42Yeah.
- 44:42you for having me.
- 44:43I appreciate it.
- 44:44was a fun conversation.
- 44:46Yeah.
- 44:47Before we go, does land be?
- 44:51it mean something?
- 44:52there a name after somebody you know?
- 44:55Your favorite pet?
- 44:56I don't know.
- 44:58well, yes and no.
- 44:59So no in that, you know, I think we really wanted the name to stand apart from all of the other health and wellness companies out there.
- 45:11We didn't want to create a brand that was, you know, just similar to like a white spa experience or
- 45:20Mm-hmm.
- 45:20you know, a clinical stale transactional experience.
- 45:24We really wanted almost to sort of draw inspiration from the hospitality industry where people feel welcome, people, it's a warm environment.
- 45:31You know, people know your name.
- 45:32It's almost like the old school experience of going to the doctor.
- 45:35And so one, we took inspiration from some of our favorite hotels in New York.
- 45:40So the Bowery, the Whitby, the Crosby.
- 45:43And then there was also this old ball sock play where there was a patient
- 45:48Lambert who was a hypochondriac and so we also really liked that there was this element of how can we support hypochondriacs who are so concerned about their health because they
- 45:57don't have the support to get their questions answered and so we just sort of sort of toggled both of those together and ended up with the land bee and funny enough if you
- 46:07google the land bee or land bee it's a buoy it's you know a lifeboat or a lifesaver thing you know for the ocean yeah so so you know
- 46:17Right.
- 46:17about it is like we are sort of saving people amidst this very vast ocean of confusion and, you know, stuff noise.
- 46:24Yeah.
- 46:26good.
- 46:26I'm sure if we go to the website, we'll probably find a line of hypochondriacs lined up kind of.
- 46:34That's very cute.
- 46:35So good stuff.
- 46:37All right.
- 46:37Well, great.
- 46:38Well, great.
- 46:39We will we'll sign off now and then we'll probably catch up with you again in the future when you know, you've opened some more clinics.
- 46:46Yeah, sounds good.
- 46:47Have a good one.
- 46:48Thank you.
- 46:49Yep.