James Maskell: The Evolution of Medicine

Welcome to Episode #17 of the Healing Pain Podcast with James Maskell! 

Today we are joined by James Maskell, founder of the Evolution of Medicine

James Maskell is leading the evolution of functional medicine. His mission is to empower and build a community of 100,000 integrative practitioners to become leaders and change agents in the movement to accelerate the evolution of medicine, by providing them with the tools, technology, and resources to thrive in a micropractice. He believes we can disrupt the current healthcare model, shifting the paradigm away from the over-dependency on an allopathic, disease-centered model, to create a more sustainable, preventative system. James believes community, not medicine, creates health. Just like in the Blue Zones, inhabitants all share one very strong trait: a powerful sense of community that result from various factors, one of which accountability to one another. Doctors need this too – support, camaraderie and social relationships to connect with each other and ultimately fuse the fragmentation.

How does James suggest we change the paradigm?

  • Leadership is a key part of the solution. Functional medicine practitioners are being held hostage by the current system, and a better model would empower them as leaders so that they can go from cogs in a wheel powered by big business, to the linchpin that accelerates the evolution of medicine.
  • In pushing the boundaries of the current discourse and challenging the status quo.
  • We need to take root-cause resolution from the fringe to the mainstream.
  • To create better health, we need to make a critical shift away from conventional, western medicine, with its disease-care focus and myopic view of illness and people, toward one that emphasizes root-cause resolutions, and that heals the whole person.

In This Episode You Will Learn:

  • The benefits of functional medicine versus traditional, allopathic medicine.
  • How functional medicine can impact chronic pain.
  • How to begin your own functional medicine micro-practice.
  • How to find a functional medicine practitioner.
  • Why is chronic pain such a key issue in the Evolution of Medicine?
  • Why Functional Medicine the best operating system for chronic disease.


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The Evolution of Medicine with James Maskell

Welcome to the Healing Pain podcast. I am your host Dr Joe Tad. It’s great to be here with you again for another week. Today on the podcast I have James Masco, he is leading the revolution in functional medicine with his evolution of medicine platform. James’s mission is to empower and build a community of over one hundred thousand integrated physicians and practitioners to become leaders and change agents in the movement to accelerate the evolution of medicine. Together he believes we can disrupt the current health care model, shifting the paradigm away from over dependency on allopathic disease centered model of care, to create a more sustainable, preventive system where people find access to true health. James Masco, welcome to the Healing Pain podcast. It’s great to have you here.

Great to be with you doc.

So let’s talk a little bit about chronic pain and why chronic pain is so important to the evolution of medicine. You know this whole platform you have around the evolution of medicine and creating a new paradigm for medicine in the future, my entire podcast really focuses, you know on natural strategies to help people heal from pain. But why do you hear this to be such an issue in, in the world you’re kind of working from?

Well you know what we’re looking at Joe, is can we create a really successful medical system that’s designed for chronic disease, rather than acute disease and chronic pain is an issue, which is the classic example of why this is needed. Is that you could have the same pain for one hundred different reasons and it takes some time to work out what that reason is, if you’re going to get rid of it for, you know for good.

And so you know the beauty of the functional medicine movement, is that it’s all about root cause resolution, working out what that root cause is. Dealing with it and we believe that functional medicine is the operating system for this future medical system that’s built around the needs of chronic disease. And so my work is all about scaling up that movement, you know making it easier for doctors to learn about it, getting doctors trained in it and then providing a structure where, or a physical location even, where doctors can deliver this type of care to the masses.

You know I think it’s a great point, you know you mention that there are so many different reasons for chronic pain and there are, there’s auto-immune reasons, there are metabolic reasons, there are changes that happen in the brain and nervous system. But just looking at functional medicine versus kind of a traditional system, why is functional medicine a better place or a better resolution for the chronic disease that we see, not only in the United States but some of the, you know something’s happening around the world?

You know most of these diseases are, you know most of the chronic diseases are not single cause-single effect. You know it’s not like at a communicable disease where you get a certain bug and you know it does something in there and you have to solve it with us an antibiotic single cause-single effect. You know a lot of these diseases are multi-systemic and happen over time. And so you know, if you have doctors where there’s an endocrinologist and you know and a gastroenterologist and you know, these docs don’t teach, don’t understand each other’s parts of the body and language specialized care. You need, you need doctors to understand across the organ disease or into organ disease. You need someone who understands the body as a web. And there’s no super generalist training or residency right. You need a real super generalist who understands all of it. So the quickest way to get to become a super generalist is to take functional medicine.

You know we really feel like that it, if you look at what’s needed to solve chronic disease and what’s needed to solve acute disease, we’re very good at acute but we need more innovation in chronic. And when I looked out over the last eleven years on this journey, the things that separate functional medicine for me is once you get to the root cause, you look at things in a systems way. You engage the patient to participate in their care, but you know there are other medical systems that have some of those ideas common, but what they don’t have is a reproducible operating system to scale the training of one hundred thousand doctors at the same time.

You know, you can’t, how many people can shadow you at any one time right? One or two, so that doesn’t really give us the scale that we need to grow the movement. And functional medicine has at its core, reproducible operating system that people can learn and then they can apply to a physical therapy practice. They can apply to a psychiatry practice, they can apply to an internal medicine or family medicine practice. And so you know, that’s, that’s part of the journey so far for us.

A lot of you’re saying is, you’re saying a functional medicine really can insert itself into almost any specialty that you have. Obviously as long as your somewhat of a licensed health care practitioner. But what, why is it that the current medical model, the kind of allopathic model has kind of been slow to adopt this, when we know that things like prevention, nutrition, healthy movement, reducing stress can all affect chronic diseases in a very positive way?

Totally. Look you know we’re in this movement from getting rid of diseases to creating health. They’re not the same at all in fact. There, in a lot of ways you know, sometimes opposite. You know, it’s funny you ask any doctor like, if a healthy person took the protocol that you were delivering them, would they get better or would they not get better? And the answer with most, you know pharmaceuticals is that they would not get better because that blocking certain pathways that designed to turn off certain receptors and so over time that’s actually causing, you know further degeneration now. In certain times that could be really useful to get patients through a hump. But it’s not health creation, and what the sort of elephant in the room, is that the healthiest places in the world are not places where there’s a lot of medicine. It’s where there’s a lot of communities, where community and the kind of things that you’re talking about in your podcast are just normal in society. And those people live to one hundred without chronic disease.

So when, it doesn’t matter which side of it you look, you see this is needed and honestly the reason why it hasn’t come more quickly is just because, there’s, you know there’s systemic issues you know, they say in medicine you know people have to actually die before things change. Like because, you know there’s, there’s a lot of, it’s very conservative and people have been slow to adapt to this new reality of this new environment. And that’s the business, our business is called The Evolution of Medicine because we’re helping medicine adapt to it’s new environment. And what we’re seeing is that the path of least resistance for this adaptation is not big scale change in medical systems. It’s doctors working out models that work with super low overhead to practice and actually delivering this you know, to patients where they are. They’re not relying on the building to switch over or anything like that. They’re just going in doing it and that’s why you’re seeing this kind of medicine delivered, a lot of times in a community type environment, like a co-working space or a strip mall or a church or cross fit or a, you know a pain center rather than like inside a wing of a hospital.

And I think it’s a great point you know. Going back to your, your topic of community basically. And obviously that community, you know are the patients and it’s also community from the practitioners, but I launched my second summit at The Healing Pain summit a couple weeks ago and for the first time I launched a Facebook support group. So it’s called The Healing Pain Support group, but I’ve had over five hundred people join that support group. And in that support group, I’m the moderator. But I have clear instructions that the, the attendees are there to help each other and support each other, kind of through their pain journey, through their pain experience. So tell me how you know, how a small practitioner, who’s thinking about entering into functional medicine can start to take some of that idea of community and bring it into their practice and help their practice grow?

Well, the first thing I would say is, it’s awesome that you’ve created that because peer to peer support is the only unlimited resource that we have right. And the cool thing is the person giving the advice gets benefit from it because they get to like really share something that they’ve gone through that would help other people, their pain is now worth something right to someone else. The other person getting the advice gets value from it so it’s a two way street and all you had to do is sort of set up the playground for people to play right. To speak to your earlier question, you know community, in a new model that we’re recommending and in the book that we’re teaching to doctors and we’ve done this through looking, it’s really, it’s very much around community.

So let me give you an example. So Dr. Pamela Wyble is this doctor, super interesting doctor but she was done with production line medicine, wanted to help people and decided she was going to start this practice. So the first thing that she did, she didn’t open a space, she didn’t rent a space, she didn’t get a marketing or a website. She had a meeting, she called a town hall meeting in her town, got as many people that could come as could common, invited people from all walks of life and sat them down and said, “Hey how is your medical system working for you? How’s it failing you?” And listen to her community. So got that feedback and then asked them, “OK, what would you like to see from an ideal medical practice?” And they said, “You know I want to spend more time with the doctor. I want a doctor who really knows me. I want appointments in the evening when I’m not working whatever.” And she was like, “OK. And would you guys be willing to pay for that? You know, how much would you be willing to pay?” And they say, “Yeah we’d be willing to pay a certain amount.”

So now she goes from industrialized medicine where her overhead is seventy four percent of the practice, she’s got insurance people. She’s seeing people in the seven minute visits. To a direct primary care model, where people pay a certain low flat fee for month. She doesn’t, you know throw people away or out because they don’t have enough money. She works out ways to help them out and her overhead is now ten percent. She has a  small little office and she’s fallen back in love with medicine. The patients love her and she sort of pre-sold that whole community by just listening to them. And I think that that’s you know, that’s the first example of community. There is so, there’s all the way through the story.

There are amazing examples of the power of community. I mean one thing that you should know if your audience Joe, is that you know social stress is like targeted rejection and relationships, play a huge role and inflammation play a huge role in our understanding. We only know this now because we can actually do, you know genomic profiling to see what is affecting gene expression and relationships and community play a key role. So from the micro to the macro of the blue zones and everything in between, how you interact with your social environment is absolutely key to health creation and also turns out the creation of a new health system.

Fascinating. I love the point of kind of the, genomics that you’ve kind of built into the, you know the social support, which is really interesting. So let’s start. I’ve watched really grow this platform, I’ve been to your, you know meet ups in New York City, which are awesome. And all sorts of different clinicians come together, and talking about this whole movement that you’ve created. What you know, take us five years from today, where do you think we will be and how our functional medicine have impacted our health care system and the health of, you know probably our nation and the world?

Interesting question. So let’s look at it from a few different ways. So I would say on one hand, this is what I would see would happen is that, you know the world is moving in our direction right. It’s gone of the days where you know, the world is, you know people in the space felt like the world is moving against them, the world is moving in this direction I’ll give you a few examples.

So first, outcomes based payment right. Payment based on outcomes, not on procedures. That is going to massively empower this movement because people are going to get paid for keeping people well, which is exactly what people know how to do in this space. So that’s a good sign, and so what we’re looking to do is sort of like a cross fit kind of model, you know cross fit, what they realize is they needed a way to empower people who had only ever been like employees, like a personal trainer to start their own business. So what do you have to do, what is different about a cross fit box compared to a gym, it’s super low overhead right. As low overhead as possible and there’s a reproducible system to training a lot of and you know trainers now start their own box, start their own business and have their own thing. So we trying to do that right now for doctors. Lower the overhead significantly, find ways to lower the overhead, have a reproducible system for creating how, those are really the two things that you need to do for that.

So that on one hand, I would see the proliferation of that. I would see insurance companies starting to value that, because they’re paying for outcomes based payment and you know as the Cleveland Clinic functional medicine center, it’s outcomes that are coming from an outcome studies, I expect that to happen.

But honestly Joe, like if I was to say in five years what it’ll look like, I think it’s going to look a lot more like Uber and a lot less like what you think it’s going to look like. You know I feel like the way that care will be delivered, you know the biggest trends I see right now are things like tele-nurse, all across the board. Where you don’t have to see the doctor all the time, if you’re a physical therapist or a chiropractor, we actually have to do physical work then of course.

For the majority of functional medicine is all about empowering different behaviors in the patient, monitoring more data points to know what’s really going on. That is not necessarily done in a physical office, so that’s why I think these low overhead practices are being enabled by technology.

So I would say that in five years time Joe, my prediction is that fifty percent of the population uses a totally different interaction with the medical system that they use right now. And that’s a bit bold but I would just say that I think it’s coming.

You see Silicon Valley, like investing in this sort of area of, you know genomics and personalized medicine and coaching. And I think those things are going to move much faster than you think. And I think there’s going to be really disruptive players in the next two years, that are going to challenge the authorities. You know, do you really think anyone under forty has any like alignment to Blue Cross, Blue Shield or Oxford or Etna. Like they don’t give a crap, like if Amazon or Facebook suddenly provided a health care thing they would move because they know these guys know how to operate in scale. And I don’t know who’s going to bring it, but I can tell you that, like medicine is just so bloated and so corrupt and so ready for innovation that I see, you know on every corner in Silicon Valley, companies with big ideas looking to really change the way medicines delivered. And I think I would bet on that before I would bet on you know Etna, you know innovating to get the attention and trust of the whole world. Like I just I can’t see that.

I probably would agree with you there. For me, in healthcare for twenty plus years and dealing with insurance companies both on a personal level as well as a business level, I don’t see them, they’re big machines. I think they’re very, very slow to change directions. So you mention the Cleveland Clinic, you mention the Cleveland Clinic has a functional medicine practice where they’re obviously treating patients. They’re also doing some research, where else around the country are we seeing these types of, you know functional medicine facility set up, in kind like the larger scale, where you know, they kind of do in some studies to prove the medicine so to speak?

Yeah I mean Cleveland Clinic is a shining example, you know, we have, we have covered other ones. So like there’s a Swedish medical system, which is mainly in the Pacific Northwest. That looks like it will be the second Cleveland Clinic, like starting a clinic. Starting to, you know put more time towards it. You know one of the cool things is in each of these places, we’ve had a functional for a meetup. So like back in March we had, you know over one hundred people at that meet up and you know getting the community together and they’re starting to see value in it. And you know, that you know, I don’t know if there’s that much. I do see innovation in like businesses trying to use functional medicine for like the most expensive part of their population, so maybe people with auto-immue disease.

So Fed Ex has one point four million employees and ten thousand of them generate eighty percent of the cost because they’re all on Humira. Like, let’s do, let’s help those people with functional medicine. So you know I see that kind of thing. But honestly, you know when we talk about the evolution of medicine, we talk about, you know adapting to its environment. Medicine adapted to its environment, but it typically adapts to sort of like a path of least resistance. And I think there is mega resistance there and so that’s why I’m sure that the path of least resistance is going to look more like Uber or cross fit and less like Etna.

Fascinating. I mean, I know you’re, you’re originally started this in in New York City, have the functional form going and then you and you’ve been around different parts of the country. And I have people on this podcast that are, that are, I see American and I invite people from around the globe. But in the United States, are you saying that functional medicine is kind of latching on in certain states or certain geographic regions more than another?

I mean, look. So this is the truth, is that the demand is outstripping the supply. That’s the problem. That’s the biggest problem, is that your podcast, all these summits, Mark Hyman’s ten books right, patients are getting it. They understand that if they take better care of themselves, they get healthier but because medicine doesn’t even like acknowledge at this point, it ends up causing this rift between doctors and patients, where they know they can smell the bullshit. But they just don’t know what to do about it, because there’s no other choice.

At this very moment right now, you think, you know we had the debate last night, you know there’s a lot of stuff happening. But I could tell you one thing that might change the whole election. more than anything. People are starting to get notices right now, of how much their insurance premiums are going up next year. And those insurance premiums, are like the biggest part of your whole income right. That’s the, you know the biggest chunk and it’s going up.

Like this guy, he was spent, last night thirty percent for a Cadillac plan. So that’s another four hundred dollars a month for his family. I think that’s going to be a big player in the you know, in the election because you know the open enrollment starts November first. You’ve got the numbers the seventh, so I would say, you know obviously on the coasts, you’ve seen a lot more early adaptation of like some healthy stuff.

But I think filling into the rest of the country is what’s happening now. We’re seeing clinics starting in and you know and innovation happening through all through the Midwest through the western states. So you know, I think what you’re seeing now in is like a filling in of the rest of the country. And just a sort of a level of confidence from the community, that this is doable. You know, in what I call functional medicine 1.0, which is sort of all the time up until now. The only doctors that did it was because, the ones that had sort of like a moral obligation to practice this type of medicine. But now you’re starting to see, you know more and more doctors seeing that this is a good lifestyle. People, doctors are happy practicing this way. There are models to copy on how to make it work. So you know there’s, there’s a lot I think that, that can be done. And I’m excited just to see, you know the progress.

Yeah, one of the interesting things I’ve seen here in New York City with some of the physicians who have embraced functional medicine, is not only it’s changed their practice, but it’s also changed their health in many ways, because the burnout level in traditional medicine is extremely high. And my functional medicine friends do not have the burnout, in any you know shape or form. Where if you look at, you know physicians, nurses, even the physical therapy profession, the burn out rate can be quite high. So they seem to have a lot more job satisfaction and seem to be really more engaged with what they’re creating.

Totally. Actually that, this is actually. So that’s something that I had observed too. But recently there was a study, the first thousand doctors study of functional medicine doctors and what they showed is that, on average. functional medicine doctors want to practice until beyond their seventy fifth birthday. So there is a huge job satisfaction, people love doing it and it’s really exciting to see that because the two biggest problems in medicine right now. One is chronic disease and two is doctor satisfaction. And I think the functional medicine is an elegant solution for them both.

So you have the functional forum, we have the evolution of medicine podcast and I know you have a new book that you just penned and authored. And it’s about to come out, so can you tell us about the book? The title and what it’s about?

Yes, so it’s called The Evolution of Medicine. The you know, the tagline is ‘Join the movement to solve chronic disease and fall back in love with medicine’. And hopefully it’s a handbook for doctors, on creating health and creating a practice that creates health. It’s really a hero’s journey, you know the ultimate hero in this medical system is the patient. You know fighting, seeing their disease and using it as an opportunity to learn from it and keeping themselves well and, and so forth.

But you know, it’s a hero’s journey for doctors to sort of break free of the mold and practice the type of medicine that’s more relevant for today’s diseases. And then the hardest test of that hero’s journey, is working out how to build a practice that does it successfully. And what we’ve done in the book, is just shared stories of heroic doctors that have gone before. And also given kind of a step by step guide for any doctor to build this low overhead micro practice model. That starts by engaging with your community and starts by you know really finding out what’s unique to them and what they’re looking for. And ends with you know the micro practice success, which can then either be a platform for a macro practice, if that’s what you want. Or it can be just a really, you know healthy productive way for everyone to, you know, to treat their own health conditions, to have a community practice.

And so, you know we take people through the clinical side of it. The tests and challenges with delivering it and the current payer system. And then you know, sort of like a step by step guide to using technology, provide teams, group visits to make the whole thing more efficient. I mean, the elephant in the room again is, it’s not that efficient right. If you’re going to spend it, an hour and a half or two hours in an intake with every new patient. There’s not enough time to go around for all the people that are sick. And so we were showcasing how people are doing and how people are innovating to create a better standard of care with you know with lower overhead and more automation and you know hopefully make it easy for doctors to reproduce that kind of model.

So if there’s a clinician listening to this and they pick up your book, it’s really kind of a blueprint of what functional medicine is and how they can begin to integrate it into their own practice if they’re thinking about transitioning?

Totally and you know, if you’re just passionate about the movement, you know go and get a book. It’s going to be free to download, October the eleventh through the sixteenth. So that time I would encourage everyone to download it, steal it, share it, I don’t care. I just want to get this book in as many hands, as many doctors, as much as possible. Like get this book, give it to your doctor. You know, write a little note tell him to read. It’s very easy to read. You can read it in about three hours. It’s not, it’s designed to be read by doctors and health professionals of all varieties. You know, I think that if you’re passionate about seeing how medicine is going to adapt to meet the needs of chronic disease and you’re not, and you’re like a health administrator, whatever, I think you might get value out of it. It’s not really for patients.

It’s really designed to target the next generation of health professionals and say, “Hey look, there’s a new opportunity in front of you. This opportunity will lead to massive satisfaction for you and it will lead to massive health in your community. Are you ready to come on this journey?” And that’s the purpose.

So do you have a link for the book? Where can people find this book?

I’m sure you can put a link in the show notes Joe.

Yeah I’ll stick a link in the show notes. But the book is called The Evolution of Medicine, it’s written by James Masco. And I want to thank him for being on The Healing Pain podcast, we’re talking about obviously, today pain chronic disease, functional medicine, and of course The Evolution of Medicine and how it’s changing healthcare in our country. Please stay tuned to Dr Joe Tad each week for The Healing Pain Podcast and we’ll see you next week

About James Maskell

With the soul of an advocate and the mind of an entrepreneur, James Maskell has spent the past decade sparking debate and encouraging a shift away from conventional western medicine and toward a wellness-centered, functional medicine model — starting with the doctors themselves. To that end, he created Functional Forum, the world’s largest integrative medicine conference with record-setting participation online and growing physician communities around the world. He’s also the founder of the Evolution of Medicine, a community e-commerce platform which provides highly curated and customized resources, tools, products, and services, making it easier and more affordable for conventional doctors to embark on a new way of managing healthcare.

An in-demand speaker and lively impresario, with a broad and thriving network in the functional medicine space, James lectures internationally, and has been featured on TEDMED, Huffpost Live, TEDx and more, and contributor to Huffington Post, KevinMD, thedoctorblog and MindBodyGreen. He serves on the faculty of George Washington University’s Metabolic Medicine Institute, and speaks regularly on the integrative medicine conference circuit. He graduated with honors from University of Nottingham with a degree in health economics.

You can learn more about James Maskell at www.functionalforum.com.


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