Does our behavior fit with the lives we evolved to live?

Does our behavior fit with the lives we evolved to live?

Q&A with Weil Lifestyle: Building the future of integrative medicine

Larry Tree is co-founder and CEO of Weil Lifestyle, the company behind drweil.com—a leading resource for information about integrative medicine—and the global product licensing efforts of Dr. Andrew Weil. Brad Lemley is the vice president for editorial of Weil Lifestyle, and NBJ spoke with both gentlemen from their offices in Phoenix, Arizona.

NBJ: Has your business model changed at all during the economic downturn?

Larry Tree: Our model has stayed pretty consistent. We have a really forwardlooking group of editorial and content folks here, and that content drives social media where we’ve seen double-digit growth every month. We have really jumped into the social media aspect of this, since it’s all about community. Dr. Weil has always been about community. We believe that we’re right on the edge of some really big things there. Traffic and performance stats on the website are definitely trending more towards community. We look at the stats a little bit differently now then we did back in 2003. We don’t just look at page views and unique visitors—it’s much more about interactivity.

With the soft economy and weak job market, people just can’t afford to get sick. There’s a lot more focus on preventative and integrative approaches now. From a cultural standpoint—and really an industry standpoint—we’ve passed a tipping point for integrative medicine.

Brad Lemley: We now have over 82,000 Facebook followers and over 275,000 Twitter followers and they continue to grow, so this is clearly a way people really like to interact with Dr. Weil. We don’t buy those numbers, so to speak. We don’t do contests and we don’t have a huge television presence. We really want to stay true to the integrity of the message and let it grow organically, not force things with contests or ‘like my page and pass it along’ inducements. We think that authenticity is really important, and then we will just be really patient with all of this.

NBJ: What about mobile? What does the future of online health portals look like?

LT: We think we are entering Web 3.0 around content and community. There are some folks out there doing some really unique things with electronic medical records—I’m particularly impressed with a company called Hello Health, who won the RFP for Apple’s 10,000-patient clinic in Cupertino with really elegant ways of creating community using software. We think there is a way to bring community to medical practice. That will become an even more important trend in the future, and we want to be a part of it.

Web 3.0 has more to do with practitioner and patient relationships online that cross boundaries set up by traditional medicine and the insurance companies. We believe there is going to be a groundswell toward breaking down those boundaries. We’re working hard on an initiative now called the Dr. Weil Health Network, which will become a way to educate and empower consumers as well as practitioners. We want to help caregivers improve their practices, create connections with patients, and promote outreach to alternative therapies. We should be using medical records in collaboration, not isolated in mega practices.

There will be all sorts of applications that go with mobile. Lots of companies are coming out with mobile diagnostic applications. Maybe they are a little gimmicky right now, but there are some motivated people out there who can really benefit. If you are a cancer patient or if you have heart disease, you are highly motivated to track your progress. Mobile has a real opportunity to be the next big wave here.

NBJ: What does the future of integrative medicine look like?

BL: When you talk about something as big as medical philosophy, it changes incrementally and you can see this change everywhere now. Maricopa County has just approved an option for county employees to use county insurance for an integrative clinic that is going to be constructed here. The clinic will be monitored for three years with a very rigorous look at outcomes of, say, a diabetic patient who goes through the integrative clinic versus one who goes to a different sort of clinic. The result will be a whole collection of very specific, objective results that Dr. Weil believes will show better outcomes at lower cost. That’s the kind of effort I think really has the potential to accelerate the acceptance of integrative medicine.

NBJ: Sounds like something of a showdown between integrative and conventional care.

BL: Yes and no. Dr. Weil often talks about medicine in conventional practice as an excellent way to treat emergencies. He often says that if he were hit by a bus, he would want to be taken straight to a state-of-the-art, high-tech emergency clinic, because that’s what you need in traumatic situations. But the problem with a lot of conventional American medicine is that everything is treated like a traumatic emergency and that’s not the appropriate level of care, particularly for a lot of these chronic, lifestyle-based diseases like cardiac diseases or diabetes. There is a huge collection of evidence that type II diabetes is reversible through lifestyle practices in a lot of people. The whole idea behind integrative medicine is to match the protocol, the therapy, to the condition.

When conventional drugs and surgeries are appropriate, that’s what you do. And when they are not, that’s not what you do. It really is the essence of common sense. I frankly don’t know how you can argue against it, except for the lack of profit potential for giving everyone an expensive, proprietary, patented pharmaceutical.

Americans spend more than twice as much per capita on healthcare as anybody else in the world, and yet we have among the worst outcomes in the developed world. So something has to give. Here we are in a balance-sheet recession, and it’s essential to save more money in medical care. If you can save money and get better outcomes, then you have to do that, you should do that, and people will do that.

NBJ: What plans do you have around dietary supplements? LT: We are taking a different approach in the future with our supplements. We will be announcing some exciting relationships in the first quarter of 2012 that position Dr. Weil to really endorse a broader range of supplements. There will be some direct health practitioner supplements involved with the Dr. Weil Health Network, as well as retail supplements with heavier promotion and lots of education. We dabbled in supplements with our own branded line, but we don’t think that’s the way to go. We see Dr. Weil as the great discerner, and there is almost an inherent conflict of interest if he just has his own brand. Even though Dr. Weil doesn’t make a dollar off of any supplement—he donates all of his profits from royalties from the sales of supplements to the Weil Foundation—we think that ingestibles and nutrition are an important part of his message. There’s a lot of work to do, aligning supplements with his message. The primary message is to get your nutrients from food first, and use supplements to fill gaps in your diet. We are concerned with nutrition as a whole. Supplements are part of that, but more as insurance to cover gaps in the diet.

NBJ: How can integrative practices better demonstrate outcomes with solid research and science?

BL: It’s challenging to prove efficacy, because the profit potential may not be there. If a drug is going to make billions in a year, a pharmaceutical manufacturer is more than willing to spend a lot of money on efficacy trials. But with a lifestyle practice—a certain exercise, or meditation, or a botanical that can’t be patent-protected—where is the profit potential that funds an up-front study?

Having said that, there are lots of studies out there. I used to work as a writer for Discover Magazine, where I was steeped in scientific controversy for years and years. I never really did get a good answer to this question—When does something become a fact? When is the preponderence of scientific evidence sufficiently compelling that something moves from a theory to a fact? Nobody rings a bell. There are still people who argue against the link between smoking and lung cancer. I think physicians have to look at the state of the science and whether there’s enough there to persuade them to change protocols.

You can also hold up various therapies to an evolutionary model. Dr. Weil talks about this often. If something is evolutionarily divergent—in other words, if it represents a practice that is very new in the human experience—it has a bigger hurdle of proof to get over in terms of safety than something human beings have been doing for 250,000 years. Take advocacy for exercise. People have been active and running around for a long time, and it obviously takes care of a lot of health concerns. Eating whole foods—these kinds of things have a lower evidentiary bar to cross, I think, just because they converge with our evolutionary history. There is more and more evidence for their efficacy as well, but I like to think it’s bolstered by that fact of the convergence with evolution. This is really sort of the focus of Spontaneous Happiness, which I helped Dr. Weil research. A lot of the depression epidemic is a function of divergent lifestyles and behaviors. We are basically living in ways that we were never designed to live. To me, that’s a really profitable way to start, if you want a filter or a lens to figure out what is healthy and what is unhealthy. Evolution gives you a good starting point.

NBJ: Is this related to Richard Louv’s ‘nature-deficit disorder’?

BL: Yes. Louv’s The Last Child in the Woods is a great book. I was reading an article the other day about how the territory covered by a young child is something like one-fifth as big as it was 30 years ago. You used to be able to map it and they would cover miles, really. Now it’s the backyard, and Louv has a lot to say about why that is—the attraction of electronic devices, the modern idea of ‘stranger danger.’

NBJ: Depression seems to be shaping up as the next great health epidemic in America. We continue to see great potential for nutrition products in the ‘brain space.’

BL: People are basically sedentary and they shouldn’t be. They are socially isolated and they shouldn’t be. They are awash in too much information and they shouldn’t be. They are sleep deprived and they shouldn’t be. These are all relatively new behaviors and they result in a lot of negative physical and mental repercussions. Reversing these problems has a lot to do with understanding the evolutionary crucible. Within the context of the modern world, you have to think yourself into healthier situations. It does take effort, but if you can ask yourself—Does this behavior fit with the lives we evolved to live?—that can be a powerful yardstick.

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