Preventive and Functional Medicine

PREVENTIVE MEDICINE

PREDICTIVE TESTING

YUSUF (JP) SALEEBY, MD

PRIORITY HEALTH OF THE CAROLINAS

ZIMETRY

21ST CENTURY PARADIGM

• STEPPING AWAY FROM THE ''PILL FOR THE ILL'' SYSTEM

• STEPPING AWAY FROM AGENCY AND INSURANCE INDUSTRY HURDLES

• STEPPING TOWARD EVIDENCE BASED (EBM) INTEGRATIVE MEDICINE

• STEPPING TOWARD REDUCTION IN POLYPHARMACY

21ST CENTURY PARADIGM

• APPLICATION OF ''NATURAL'' REMEDIES FOR WELLNESS & DISEASE PREVENTION

• APPLICATION OF LIFESTYLE MODIFICATION A TRUE "PRIMARY" PREVENTIVE

MEASURE

• USE OF PREDICTIVE ADVANCED LABORATORY BIOMARKERS AND PREDICTIVE

GENOMICS

• EMBRACING FUNCTIONAL MEDICINE

AWAY WITH THE “PILL FOR THE ILL”

• NON SUSTAINABLE OLD-SCHOOL PHILOSOPHY

• DISEASE BASED – DISEASE CHASING

• LEADS TO POLYPHARMACY

• COSTLY

• MONETARILY (EXPENSIVE MODEL)

• QUALITY OF LIFE (QOL) – OVERALL LOWER QUALITY OF LIFE

• DRIVEN BY BIG PHARMA, INSURANCE & GOVERNMENT MANDATES – THE STATUS

QUO

• PROVIDERS AT PRIORITY HEALTH IN MURRELLS INLET, SC

• PROVIDERS AT PRIORITY HEALTH TRIANGLE IN CARY, NC

• PROVIDERS AT CHARLESTON HOLISTIC MEDICINE IN MT. PLEASANT, SC

WWW.PHC365.COM

WWW.GETMYTHYROIDFIXED.COM

WWW.PRIORITYHEALTHSC.COM WWW.PHTRIANGLE.COM

WWW.CHARLESTONHOLISTICMEDICINE.COM

(800) 965-8482

DIRECT PAY… WAY TO GO

• INSURANCE INDUSTRY

• ICD-9 AND ICD-10 DISEASE BASED TEMPLATE

• INABILITY TO UNDERSTAND PREVENTIVE & PREDICTIVE MEDICINE ALGORISMS

• GOVERNMENT OVERSIGHT

• CMS – BUREAUCRATIC, CUMBERSOME, CORE MEASURES AND MEANINGFUL USE =

FAILURES

• LIMITING, OBSTRUCTIVE & RESTRICTIVE

• HAS NOT MET HEALTHCARE IMPROVEMENT FOR ALL

EBM

• EVIDENCE BASED MEDICINE (EBM)

• STANDARD OF CARE

• DRIVES PRACTICE “GUIDELINES”

• SOMETIMES USED TO SANCTION AND DISCIPLINE

FORWARD THINKING/VISIONARY PRACTITIONERS

WHO STRAY FROM THE “NORM”

EBM

• CAVEAT:

• WHOSE EVIDENCE ?

• SPONSORED STUDIES, AGENDAS, BIG-PHARMA INFLUENCE, GREED,

AVARICE, EGOS

• SEVERAL STUDIES – YIELD DIFFERENT OUTCOMES

• WHO TO BELIEVE

• REDACTIONS AND RETRACTIONS AND OVERTURNS

• IN THE USA:

• COSTS: $2,197 PER CAPITA/YEAR MORE THAN EXPECTED

• YIELDS: 3.1 LIFE YEARS LESS THAN EXPECTED

POLYPHARMACY

• POLYPHARMACY

• DEF: TOO MANY MEDICATIONS (A RELATIVE PROPOSITION)

• ISSUES:

• COST

• DRUG-DRUG INTERACTIONS, (PGX)

• DRUGS TO TX OTHER DRUG SIDE EFFECTS

• TOXICITY

• SIDE EFFECTS

• UNTOWARD EFFECTS

POLYPHARMACY

• POLYPHARMACY

• A STAGGERING PROBLEM OBSERVED IN THE PAST 5-DECADES IN

AMERICA

• NON-MEDICAL USE – ESCALATING PROBLEM

• FROM (2009-2012) 21.8 % OF PERSONS USING THREE OR MORE PRESCRIPTION

DRUGS

• NUMBER OF DRUGS ORDERED OR PROVIDED BY PHYSICIANS AT TIME OF OFFICE

VISIT: 2.6 BILLION RX / YR

• 75.1% OF OFFICE VISITS INVOLVING DRUG THERAPY

• NEARLY 70% OF AMERICANS ARE ON AT LEAST ONE PRESCRIPTION DRUG, AND

MORE THAN HALF RECEIVE AT LEAST TWO PRESCRIPTIONS

• (SOURCE: WWW.DRUGABUSE.GOV / WWW.CDC.GOV/NCHS)

• CAN BE SAID FOR SUPPLEMENTS TOO.

NATURAL / ORTHOMOLECULAR MEDICINE

• FUNCTIONAL MEDICINE

• INTEGRATIVE - WEST MEETS EAST

• IDENTIFY AND ADDRESS NUTRIENT DEFICIENCIES

• NUTRIGENOMICS (GENE EXPRESSION AND EPI-GENETICS)

• RELIANCE ON SAFER, FEWER SIDE EFFECTS AND SUBSTANCES NOT FOREIGN TO

OUR BODIES

• PHARMACEUTICALS – SYNTHETIC, LIVER HAS NO NATURAL WAY TO DETOXIFY

• HERBALS – EXPOSED TO OUR SYSTEM AND LIVER OVER THE MILLENNIA;

EVOLUTIONARILY ADAPTED

LIFESTYLE MODIFICATION

• CHIEF AND MOST IMPORTANT IN CHANGING TO A WELL AND FIT PERSON

• PRIMARY PREVENTION IS LIFESTYLE MODIFICATION – MOST IMPORTANT!

• THE MOST SIMPLE AND LEAST EXPENSIVE

• THE MOST DIFFICULT TO REMAIN ADHERENT AND COMPLIANT

• EXERCISE

• SLEEP

• DIET & NUTRITION

• STRESS REDUCTION

• AVOIDANCE OF ENVIRONMENTAL TOXINS AND HORMONE DISRUPTORS

• SAFETY AND SMART LIVING

Q: DOES ANNUAL BLOOD WORK IN AN ASYMPTOMATIC PATIENT PROVE WORTHWHILE ?

PREDICTIVE TESTING

• USUAL ANNUAL LAB TESTS ARE OF NO VALUE.

• (SOURCE: WWW.NCBI.NLM.NIH.GOV/NBK82767)

• READ DR. H. GILBERT WELSH’S BOOK “LESS MEDICINE, MORE HEALTH”

• PREDICTIVE GENOMICS & PHARMACOGENOMICS, SPECIALIZED ADVANCED

BIOMARKERS

• NUTRIGENOMICS

PREDICTIVE TESTING

• GOING AFTER WHAT “HURTS OR KILLS” MOST AMERICANS

• CARDIOVASCULAR DISEASE (HEART ATTACKS & STROKES)

• CANCER

• DIABETES AND OBESITY (DIABESITY)

• T2DM, T1.5DM & T3DM

PREDICTIVE TESTING

• ADVENT OF PREDICTIVE AND ADVANCE LABORATORY TESTING AND DIAGNOSTICS

• ADVANCED LIPID ANALYSIS

• INFLAMMATORY BIOMARKERS (HS-CRP, FIBRINOGEN, LP-PLA2, IL-6, …)

• BIOMARKERS FOR BONE TURNOVER, TELOMERE LENGTH, HORMONES

• GENOMICS (APO-E; MTHFR; COMT, FACTOR II AND FACTOR V LEIDEN, …)

• CANCER BIOMARKERS FOR SCREENING (LIQUID BX)

• NON-INVASIVE (COLONSENTRY; EARLY CDT-LUNG, …)

• LESS OR NO IONIZING RADIATION

SPECIALIZED LABS

• CUTTING EDGE TECHNOLOGIES/ADVANCED LIPID ANALYSIS/RISK

STRATIFICATION AND RELATIVE RISK FOR CVD, CVA, CANCERS, …

• GENOMIC TESTING TO DETERMINE “ACHILLES HEEL”

• 3-DIMENSIONAL DIABETES AND GLUCOSE METABOLISM SCREENING

• COMPREHENSIVE H-P-A HORMONE ANALYSIS

• PITUITARY, THYROID, ADRENAL AND GONADAL

SPECIALIZED LABS

• TESTS TO TAKE PLACE OF INVASIVE AND RELATIVELY DANGEROUS

AND EXPENSIVE CURRENT SOC TESTS

• COLONSENTRY VS FIBEROPTIC COLONOSCOPY

• CARDIODX LABS CORUS-CAD VS HEART CATHERIZATION

• NEW BIOMARKER FOR BREAST CANCER VS ANNUAL SCREENING

MAMMOGRAPHY

• EARLY CDT-LUNG GENE EXPRESSION TESTING VS CT CHEST OR CHEST-

XRAY

SPECIALIZED DEVICES

• EXAMPLES:

• I-RHYTM’S ZIO-XT

• TAKE HOME WEARABLE DEVICE FOR SLEEP APNEA TESTING

• SLEEPIMAGE CPC/ECG AND BODY POSITION MONITOR

• FDA APPROVED / CLINICAL STUDIES SUPPORT

• WEARABLE APNEA DETECTION DEVICE (WADD)

• IN CLINICAL TRIAL IN THE UK

Q: HOW LONG ON AVERAGE DOES A DOCTOR IN AMERICA SPEND WITH HIS/HER

PATIENTS?

PATIENT – PHYSICIAN PARTNERSHIPS

• PHYSICIAN’S ROLE AS EDUCATOR AND CONSULTANT

• NOT AS PRESCRIBER

• NO LONGER DEMANDING COMPLIANCE BY FIAT

• WHO TO CONSULT?

• HOLISTIC / INTEGRATIVE / FUNCTIONAL MEDICINE

• ONE WHO SPENDS TIME LISTENING

• ONE WHO IS NOT DISMISSIVE (COLLABORATIVE EFFORT TO MANAGE

HEALTH)

• ONE WHO IS OPEN MINDED

• COST: NOTHING GOOD IN LIFE IS FREE. CONSIDER IT AN

INVESTMENT IN YOUR HEALTH AND WELL BEING.

MURRELLS INLET STAFF

• J.P. SALEEBY, MD (MEDICAL DIRECTOR)

• KRISTIN RICHARDSON, PA-C

• A. CHERYL MASSIE, FNP-BC

• FOCUS ON:

• BHRT

• THYROID

• CHRONIC LYME DISEASE

• PREVENTIVE MEDICINE

• PREDICTIVE TESTING; FUNCTIONAL MEDICINE

Mr. Michael Goulding, MSW, LCSW

Cary, NC Staff

Dr. Priscilla Evans, ND

Andrea Saffer, FNP (DNP)

Charleston Office

Family Nurse Practitioner

Doctorate in Nursing (PhD)

• Focus on Preventive Medicine• Predictive Testing• bHRT

Will be team leader in Charleston (Mt. Pleasant) office.

www.CharlestonHolisticMedicine

ZIMETRY.COM LAUNCHED SEP 2015

• PATIENT DRIVEN

• SELF-TESTING

• SELF-MONITORING

• PATIENT/CLIENT CENTERED

• TAKING HEALTHCARE INTO YOUR OWN HANDS

• COST CONTAINMENT

• EFFICIENT

• SELF GUIDED

• DIRECT TO CONSUMER

MY THREE SUPPLEMENTSYOU SHOULD NOT DO WITHOUT

• OMEGA-3 FATTY ACIDS (FISH OIL)

• CURCUMIN (BCM-95 IN PARTICULAR)

• ADAPTOGEN HERB –SEVERAL TO CHOOSE FROM, MAKE ONE A

DAILY

• VITAMIN D3 (NOT ACTUALLY A VITAMIN)

• L-METHYL-FOLATE • (WHEN MTHFR-PHENOTYPE / METHYLATION PATHWAY CORRUPTION IS FOUND)

• PROVIDERS AT PRIORITY HEALTH IN MURRELLS INLET, SC

• PROVIDERS AT PRIORITY HEALTH TRIANGLE IN CARY, NC

• PROVIDERS AT CHARLESTON HOLISTIC MEDICINE IN MT. PLEASANT, SC

WWW.PHC365.COM

WWW.GETMYTHYROIDFIXED.COM

WWW.PRIORITYHEALTHSC.COM WWW.PHTRIANGLE.COM

WWW.CHARLESTONHOLISTICMEDICINE.COM

(800) 965-8482

STAFF

• ROXANNE ALTMAN, RN - HEAD NURSE

• SHELLEY FEGETT, LPN - NURSE IN CHARGE OF SATELLITE OFFICES/HOUSE CALLS

• DAMA BLACK - RECEPTIONIST

• LINDA DEIGHAN - OFFICE / PRACTICE MANAGER

• MID-LEVEL PROVIDERS: KRISTIN RICHARDSON, PA-C; ANDREA SAFFER, FNP

(PHD)

• DOCTORS: JP SALEEBY, MD; PRISCILLA EVANS, ND

• HEALERS: MICHAEL GOULDING, MSW (PRANIC HEALER)

Q & A