 Hey everybody, I am here with Dr. Saxena and so excited to bring you today the topic. We were just gabbing a little before that's why we're just a little late to get started about our topic today and it's we're going to dive into some of the really important components we have both learned not only personally but professionally about healing and embracing not just the masculine driven to do this protocolized healing energy but going more into this how do we connect in social situations how do we embrace our feminine energy how do we embrace our intuition in medicine I am so excited to talk about this talk topic today it's so relevant so you are in for a treat before we dive in I just want to do a little bit of housekeeping you can find all kinds of resources and free blogs at my website Jill Carney hand calm and if you want any products you can find those at Dr. Jill health com we are live on YouTube on my channel under my name there's over almost 80 interviews now and we're also live on iTunes and Stitcher and all of the places that you find podcasting so you can find us and listen to all the other episodes and there's pretty much a new one coming out every week so I first want to introduce my colleague we have just been in the same circles for probably a decade with IFM and A4M and all the different organizations that teach functional medicine she has been just a leader and someone I look up to in this realm and we'll talk a little bit about her journey and some of the things she's doing that are unique to medicine she is a board certified family practice physician whose passion and purpose came to life through sharing her innovative patient education and practice management solutions in her classic keep it simple style I love that she serves as faculty with the Institute of functional medicine and the Andrew Weil Center for Integrative Medicine she also serves as clinical expert for CM vitals program at the Lifestyle Matrix Resource Center Dr. Saxena is an expert in the group visit medical model we'll talk a little bit about that and creator of group visit toolkits and co-author of the ingredients matter India she currently serves as chief medical officer of Forum Health a national wide network of functional and integrated physicians committed to bringing the health and the care into our health care industry she as you can tell is a game changer a leader and I am totally honored to be with you today Dr. Saxena welcome thank you so much I am just beyond happy to have this conversation with you and with everybody who's listening really I think it's going to be very intuitive and hopefully inspiring yeah and we were just saying I love how we roll because most of you who listen you know I don't ever have an agenda I often ask people if they have some questions to send me beforehand and most time I forget to look at them so I love this whole energy of just showing up being present and seeing where things go having an idea but that's where we're going today I love to start with a little bit about your story and your journey into medicine like what drove you that way and what direction and turns it took so if you want to start registering a little bit of that that'd be amazing sure well I have this stereotypical story I'm a firstborn child of an immigrant family of Asian Indian descent and so you may have heard that many times we are directed to become doctors or engineers or something so I actually wanted to be an artist and my father very conveniently said that's nice you're going to be a doctor so you know I went into medicine I really did enjoy being with people and I chose family medicine because I was really indecisive about which part of the body I liked in fact I liked all parts of them and I couldn't imagine as a creative spirit kind of doing the same thing over and over and over again so family medicine shows me and I particularly loved taking care of when I used to deliver babies I'm an FP OB by training so I love the idea of the continuum of life helping people you know from the time that they're in womb and nurturing the mother so that the baby is healthy all the way to the end portions of life if you will I did that and I really thought I was in the business of healing when I was in training I really was like okay we're going to heal people here's the magic and then residency slowly became like this awakening like wait a second there's a lot of other factors that are going on besides a pill for every ill so I graduated and worked in an underserved area in north Jacksonville so it was where rural and urban underserved came together and what I found out very quickly was goodness there is like a machine that's happening with medicine and that was really dissatisfying in fact I kind of jokingly said I feel like a legalized drug dealer like just every few months people come in they get the refills and you know in this population they even had something that the name of the visit was called a lexus refill it was a lore tab a xanax or a soma and it was called a lexus refill I'm like this is bad when we would have a name for the type of visit so I said okay this doesn't work for me I open my own practice in 2000 just to clarify for those listening if we have I mean basically sleeping pill antidepressant and what was the third one a pain pill yeah so so just to clarify okay pain sleeping pill or antidepressant and you're out the door right I mean that's kind of how it came down to totally understand and sadly the state and what people maybe don't know is in medical training I mean we had the best training in the world we are in allopathic and when you have trauma heart disease or any of these things that's where you want to go but the difficulty is in medical school we're taught to give a label and then there's a one treatment usually a drug there's not a lot of thought as to what happened why did it happen and I'll let you continue the story but that's the background because we weren't really taught anything different but you and I and anyone else who is a little bit more awake starts to wonder is this really why I went into medicine right exactly yeah I have a funny way of remembering it it's like we named it we blamed it like oh it's the diabetes that's doing this to you we treat it and then we street it like okay I'll see you in three months like name it blame it treat it's treated and that's what we keep doing and it seemed like we were making a difference until again we awoke to hey what's the difference between what I learned about being healthy and then the disease what's the big space in between for how you went from one stage to another that's I didn't know that was called functional and integrative medicine honestly at the time so I started my practice and many of my patients who came to see me were taking supplements and I thought I've not learned a single thing about supplements and growing up as an Asian Indian in an immigrant's home like we use turmeric and ginger we had all these concoctions and kinds of things that my mother wouldn't give me if I was ill so I wasn't close-minded to people taking supplements I just was ignorant to it and what I noticed was they were very cautious about telling me as though like you know they were doing some illegal activity and I was going to scold them or something like that and so I said no I really need to know everything that's going in your mouth whether it's pharmaceutical or supplement because that's the only way I can give you the best you know recommendation so I started researching supplements on my patient's behalf and got open to this whole other world because these patients were smart they weren't just like hey I saw this infomercial they were bringing me clinical trials and published papers and I thought where was all this in my training and so I started doing training and at the Institute for Functional Medicine and then I just completely got sucked into this is the missing piece this is what I've always been thinking I was going to be doing as a doctor and it's just been a whirlwind like just adventure fun fulfillment ever since we always joke kind of like we get the virus right like we get infected with that kind of interesting nowadays to say that but like when you get the function and like you and myself and so many other practitioners like ourselves that I've heard we know in our hearts what we wanted to do why we went into medicine but at the time at least for me and you we didn't know the name and then we discovered oh this is what I've been I've known in my heart that ever since I went into medicine this is the kind of medicine I wanted to practice I just didn't know there was a term and a name and an education and like you I dove full-fledged never to look back into functional and integrative medicine for that reason yeah so much that it more satisfying really because you get to really dig deep and solve problems and all the things that we enjoy as practitioners absolutely and I actually had a personal thing going on because most of us have a personal physical challenge that we're also kind of putting through the allopathic model and we're hitting roadblocks if it's not us it's usually someone that we care for who's not getting somewhere with the name it blame it treated street model so I was dealing with infertility at at age 28 and mind you at that time I was in residency delivering babies of 12 13 14 15 year olds on average and I was really wondering when I was going to the reproductive endocrinologist like seriously like why can't you figure out what's going on with me I'm eating well eating well exercising I thought I was doing all eating my low carb tortillas like doing all what I thought was healthy based on my training and they couldn't figure out what it was they named it PCOS it was the closest thing that it was and and that and I went through a probably what I would look back and say a depression at that phase I didn't know it because that wasn't a terminology that my culture really allowed me to explore it was more of a suck it up be strong like get warrior about this and that's we're going to be talking about that here in a second so I'm just kind of worked through it and it but at that time I am sure that there was a seed that was planted about what was missing in the model that was that I was being trained in and what would I won't say fail me but it surely didn't create the long-term solution I was seeking for so that when people started talking to me about supplements and how it was helping them with things the pills did not help I was ready because that was planted early I'm I'm positive that if I had a healthy child from the get-go and you know I didn't go through any medical issues I would look at other people who were taking supplements and or like bucking the system and I would say like come on you're crazy I'm sure I would yeah I was trained to think that way totally I couldn't agree more it said that like the opening and as many people know I'd cancer 25 and I had to do the same thing is like okay well first of all why did this happen at 25 and second of all I went the conventional way for treatment but how do I recover from all that toxicity that it created and it's the same thing we have our journeys and and when we find our system that we were trained in has amazing things about it but there are some limitations and when we buck up against those limitations then we of course if we're open minded we're looking for more answers so love that journey and yes you set us up so well because you talked about and I just I think back so we're going to talk a little bit about masculine feminine energy and some of the healing things about this and I want to clarify this isn't male or female this is like we all have both and embracing those in equal degrees is important because often we come out in in one way or the other a little bit tilted and you mentioned this it sounds like our stories are similar most of us they go into medicine are very driven very very goal-oriented very ambitious I used to have these five ten-year plans and lists and all of those things and I always joke with another colleague of mine in the beginning when I spoke you and I've been speaking for 10 15 years or more I would wear the black pants suit because it was this male dominated you know and I laugh now because I would never be caught dead in a black pants suit I always now wear dresses and flowing and very feminine but it took me a while to be how do we say it like feel confident enough in myself to actually realize number one I can be a badass and also a delicate flower right like you can still be have that driven energy but like I can embrace the feminine in healing and in showing up in the world and actually that approach is much more connected it's more intuitive and some of our greatest discoveries as far as for me find problem-solving in medicine is is embracing that part because it brings a sense of the gut feeling and some of those things tell tell me more about your thoughts on this because this is such an interesting topic to me you know oh gosh like where can we start so number one I think I was trained to interface with patients in a very masculine way like what is their chief complaint yeah what is the history of present illness like how much pain when did it start like a very linear very black and white there was you know we had our soap notes which is the order in which you ask your questions and document your note and you know feminine energy knows that people don't talk according to our note structure you know so when I would see patients and they would you know want to talk about something that wasn't in the order of the way I was meant to document there were times that I would initially guide them back if you will to that protocol method I'm like okay my assessment and my plan right I realized this I'm losing connection with this person because I'm being too structured and there was this flow and this intuition that I was ignoring because there were certain things they were saying that I wanted to explore but I wouldn't because it wasn't part of the linear algorithm I was supposed to follow now listen there are times when the linear algorithm is the way to go like if somebody's having chest pain right I'm going to stay linear because it's an urgent kind of situation urgent emergent but there are many times yeah yeah right exactly so I realized that what people really wanted was to be heard like half of the healing is in the listening of who you are and it's just natural I was a big sister I loved educating just from a standpoint of being the person in my family that bridge the the cultural connect between our roots and this whole new way of living in America so I loved learning about people and they loved that I was interested in just being open to whatever their intuition said and that was a very feminine aspect of me showing up even though I didn't know it is feminine I just thought it was polite and respectful and really genuinely caring to see what they thought which was not part of our medical training yeah it's more like get a history not connect yeah and and what we were taught is okay you get this history very clinically linear um and then you take that you do tests just scientifically prove what you think could be the differential which means the different types of things that it could be as far as diagnosis and then you come to a conclusion and present that and present a treatment just linear xyz what you're describing is much more of this first of all holding space creating a safe place for that person to share and I know you and I both were taught in medical school that you need to remain objective you must not share personal stories you must not never shed a tear right and I remember like I'm emotional and engaged and and when I started being okay with actually expressing my own emotion or expressing compassion with a tear once in a while if it if it came or just being so open to let them kind of go and lead me versus me lead them the magic happens there because number one they start to really feel heard and seen and human connection which is what we'll talk about as well is the foundation of healing so when they feel honestly you've seen the studies and we don't need studies to tell us this but it's that connection that trust that actually starts the healing process with your practitioner and if you're listening out there you all have examples of great experiences where you all you did was you cried because you felt heard for the first time in your life by a practitioner who listened to you and took you seriously and didn't downplay your concerns and then you've had as I have other practitioners who literally in and out maybe five minutes seven minutes and you just left like completely confused like what just happened I don't think they even know my name let alone why I'm here right yeah yeah like handled almost yeah and I do think you know I've it's interesting like how things happen in your life if if you are open to seeing how if you will God or the universe or nature guides you whatever the belief system is I just started reading and studying the work of Dr. Stephen Porges and he has a whole kind of field of study he's been working on for decades called polyvagal theory and what it says is that humans basically for treatment to work they must first feel safe oh yes because if they don't feel safe the the natural autonomic which is that kind of automatic nervous system that alerts you like danger danger if they if your autonomic system senses danger danger then healing even if it's the right treatment yeah doesn't have a chance to get integrated because it's like your body knows like beware yeah and I think what feminine energy is so wonderful at is that nurturing response that says you're safe with me yeah and when you create that which I think many of the times is because a person feels heard and what I use the term is recreated like not just I'm listening but I am processing and saying back to you what I believe you're saying and your intuition and your words matter to me like what you think is going on matters to me so then all of a sudden the patient feels safe and if I do if I create that space like you mentioned for a patient and then initiate treatment a and let's say another practitioner initiates treatment a but doesn't create the safety space the data shows that the person will get better with me yeah yeah even though it's the same treatment love that and don't you find too I find all the time of course we're learned I learn every day for my patients and it's often like the time where they're like a little like if they have a safe spot that we've created where we're listening and really wanting them to hear what they have to say and then we say sometimes I'm sure you say this to what do you think is going on and this often hesitate and they're like a little bit like well you might think I'm crazy or but this kind of makes me wonder about x y or z and you know what so many times they are right on but they're scared to say or they're a little bit or they've been made to feel bad about this strange thing they're thinking except it's not strange at all and I so often find if we just listen the patients really know themselves they know what's going on and we can be as a guide and maybe with more experience in whatever realm we're dealing with but it's so powerful isn't it oh absolutely I mean I I think you've been around as long as I have in healthcare where it used to be called doctors orders oh yeah after orders you must do this you must do this like here's your prescription doctors orders and then it became like culturally doctors recommendations okay but recommendations really is just a softer version of doctor knows best right right right and so now it's shared decision making or informed decision making where finally we recognize hey patients have a tremendous amount of understanding potential if we just actually partner with them versus have this hierarchical doctor patient kind of space so just even in the language we are shifting from a male energy like patriarchal orders yes it kind of got a little bit into the feminine with recommendations but I think this shared decision making is the center of feminine energy I love that and that's exactly so two things I'm thinking I want to talk about your you have been a pioneer with group visits and this has been a game changer you've been teaching it to their physicians I want to go there in just a minute before we do practically speaking say someone out there is listening and they're like I Dr. Saxena and Dr. Carnahan you I have had so many bad experience with doctors I you know I've been ignored I've been told I just needed antidepressant I mean you guys listening know you've been there what would you talk to the patient as far as advocating for them and how could they show up not that it's all their responsibility but what tools could we give a patient who's been struggling with this not either feeling hurt or safe or seen and some things we're talking about I think number one to be prepared with what you know and be confident about what you know you might take an extra step and do some research and bring it to the doctor especially or the you know the nurse practitioner physician assistant because they may be stuck in a model where they really do only have five to ten minutes with you so as a partner come prepared with what you think might be a set of options for the provider to consider along with you as opposed to coming in just kind of if you will dumping on the provider and then just hoping they figure it out so because you know on the flip side of it there is this whole thing called provider burnout from this responsibility of quote unquote having to fix and protect like a very male energy burnout kind of thing so I think being prepared being an advocate for yourself coming to the table as a partner is great now you might do all that and you still have someone who's not willing to participate as a partner does not really honor your word you don't feel a connection you don't feel safe then I think it would make sense to go find someone that you do because just with the research as we're pointing out and just from experience treatments are just may may not stick if you don't feel safe with this person and you know there's so many great ways on social media to find out those practitioners that are great listeners obviously I would direct you to a functional and integrative medicine provider because that's what we're trained in part of what we do is functional medicine practitioners is one identifying address the underlying cause but number two is in the context of a therapeutic partnership like those are the two principles not just find the root cause but then partner with the patient so find one of us there's many different directories at IFM, AFRM that you can just look up you know what what you're searching for as an expertise and I would say go to the websites and get a sense of the flavor your intuition is strong trust what I'm getting a little star wars about this but like trust your Jedi instincts you know honestly though that's the root like we're talking about love and acceptance and safety number one so not only loving trusting yourself but that trusting your intuition we're talking about as practitioners how powerful it is when we model that trusting your intuition in a direction for patients but we're saying the same if you're a patient looking for trust your intuition and if you don't first find answers your doctor says hey your labs are all normal come back in a year I don't see anything wrong and here's a sleeping medicine a pain medicine or anti-depressant that those are inappropriate at times we have no problem with that but again if there's a deeper thing trust your intuition and keep looking don't give up and then the second thing is that just finding that space where you feel heard it doesn't have to be an hour visit it could be a shorter visit but just a space where you feel heard and practically we're both involved with IFM and AFRM you can go to ifm.org search AFRM both of those have practitioner links and resources so you can actually search by zip code and find docs that are in your area and I would totally agree that's usually where I send people as well so group visits you have been such a pioneer in this and of course love this tell us first of all what is the research show around the power of groups and healing and then what's practical ways for either patients to find groups or what do you do in your clinic just tell us a little bit about group visits yes so I want to just preface it to say like this is common sense whether you are a patient or a provider I'm sure you know that community is medicine like from personal experience you know whether you on a softball team or at a church there's something powerful about group so now let's talk about group in healthcare so in conventional medicine which is that allopathic model that Jill and I were both trained in what we started realizing is is that when a group comes together and is able to share their successes and or struggles about whatever topic somehow the people who are in the group are smarter so they have higher knowledge scores they have better outcomes because somehow in the sharing there is more what we call self-efficacy like a sense that I can do it yes that starts to rise and then because there's more time in a group medical appointment there's just more space for more questions to be answered and so there's just this compliance thing that just happens because you don't have to come back for a second and third and fourth appointment to find out excuse me is there gluten in wine like you know that's a funny thing that people ask you know when they when you go gluten-free but these little questions having the answers to them make the difference and then being with other people who have similar questions somehow makes you feel not alone you're like oh so I'm not I'm not crazy this is a valid question okay Susie wanted to know that answer too so there's a self-confidence that's building there's also like humor that happens when people are joking about like you know the oh it's so hard being gluten free if let's say that's what the group is about so there's something in the sharing that improves outcomes not only in conventional medicine but there was a landmark study that the Center for Functional Medicine did where they proved that functional medicine delivered in a group format did better than individual appointments as it related to lifestyle and really addressing the root cause so community is medicine full stop periods the question is how can you create community whether it's in your medical office or even like a group of friends that are all committed to we're all going gluten free we're all going to eat anti-inflammatory for a month yeah yeah I mean that's why organizations like Weight Watchers for years have had so much success because they get people into connection and groups and this is key so um two questions first of all how do you do that in your practice like what would that look like in just a nutshell for people to uh and then how would patients find something like that that that might be the other question yeah so it would form health what we did was we have a national network of physicians and so we started creating zoom groups love it yeah so all of our providers would uh refer into these zoom groups that were run by myself and a health coach so we have one right now all around mental health using amino acids as neurotransmitter fuel makers if you will we teach people about brain health neurotransmitters and literally we all gather on zoom and what's beautiful is is this is a mental health topic and on zoom people can hide by video they can change their name so they can be superwoman as you know we tell them name yourself a superhero or your favorite color whatever you want and then if they have a question they can actually privately chat the health coach who will then bring up the question but now the person didn't have to raise their hand in a physical audience because that's what we did pre-covid people would gather in our lobby and I would have hummus and crudité and like cucumber mint water you know I would kind of create the old school group kind of waiting but it's interesting especially around certain topics like mental health the virtual group is working well and we we offer that to non-patients to come in and do our programs because we really do want people to access the benefit of group it's going to take a while before like healthcare all of a sudden is doing a ton of group medical appointments so this is a way people can dabble in it and really get community as another therapeutic tool I love that because the thing about the pandemic that's really helped is it really has expanded whether we can see I mean I've always seen people virtually after an initial in-person visit but it's really broad in medicine in general to be more open to these virtual visits and then second you can have a group that's all over the United States I mean you have people from all over now that's much easier without travel and and so interesting too because different you know areas of the US are seeing things differently and I think it brings such a wide perspective I'm sure that's so yeah and a oneness because when somebody in Florida is in a group with someone in Utah and Illinois and they see like oh they have the same questions I do so affirming to people to know like I'm not alone and that's that connection piece that belongingness that's social health ingredient I mean social health is just as important as broccoli oh I love that that's a beautiful sound by social health is as important as broccoli I love that in fact if we promote this I think we're going to put that as a transition brilliant quote honestly it's really good I love it I'm being serious I think but that transitions into this other thing and we can maybe start to wrap up on this note we've been in a pandemic and we thought it was over and it's not and this is our life and I know that there's been so much stress on our patients I remember in the very beginning thinking I have no problem with the protocols with the all of the things we did to keep people safe but I remember thinking at the very beginning isolation is not good for people this could be so dangerous and we're seeing extended now granted many people are able to get out and about in safe ways however there's still patients I know that haven't left their house in nine months or 12 months talk a little bit about the unintended consequences of isolation on our health and how that's because I'm seeing and I'm sure you are we're in a pandemic now of mental health issues and because the isolation and we have to think of all these things again not at the expense of safety but let's talk about isolation and how it does affect us yeah so I think that we always knew that loneliness and isolation wasn't a great human nutrient I mean humans are social beings so the CDC has actually amassed some data that shows that loneliness and isolation will increase your risk for all diseases all diseases and just for an example heart disease and stroke being lonely and isolated increases your risk by 29 percent 29 percent so we used to say that sitting is the new smoking right like sitting for eight hours a day I want to say that social isolation you know is right up there as a risk factor and isolation to me is not necessarily just being physically isolated but it's being if you will like socially in the sense like you you're not a part of a group you're not a part of a community you're not a part of a bigger one and you know because there's many people who can still say connected virtually if they still feel comfortable if you will hunkering down in their house for nine months but you know if you're facebooking and you're zooming and you're this you reduce the impact of loneliness and social isolation yeah that's good and that's important and of course we have with a little stretching and yoga and that in between your sitting and then yes right oh good um this is so important and I hope those of you who are listening um are able to take some of this and find a practitioner that you trust that you can have some of that intuitive energy that you can bring new information to and partner with uh just so critical in your own healing journey um lastly I often ask my guest what would you say has been your biggest victory in the last year or two like what would you say again we've had kind of a tough year but talk a little bit about your victories or what's something that you're um proud to have gotten through or accomplished in this last bit oh this is just a lovely question I'm going to be a little personal here on this one you know um this pandemic I think has created a lot of new challenges for all people and I really thought that my biggest challenge was going to be okay how am I going to be a physician in the COVID pandemic with people frantic scared you know mad irritated all these things that people are showing up at our office I thought that was going to be my biggest challenge however in my personal world my youngest sister has a medical condition that the trauma of what is happening has created a worsening to where we were in the emergency room with her 15 to 20 times during the early parts of the pandemic and if you remember those days it was like once you left the ER you had to go through like a hazmat sequence before you know you went back into your house and then you would quarantine that poor person for X amount of days before they were allowed to come out and even talk to someone you know like yes voluntary and and what I what I what my biggest success in this last year is being with situations that I cannot fix yes okay like just trusting that there's some richness in the pain or some richness in this friction and just being with it because my automatic if you will mail energy is gotta fix it gotta figure out what's going on with my sister must protect her oh I'm the doctor like how bad it looks if I can't even solve her issue I'm supposedly a functional medicine doctor I'm supposedly a teacher of this like who are like all that imposter second guessing of yourself had and it did like come up moment to moment and my biggest my biggest success is being able to be with that and say like okay I get that you're thinking that right now and that's okay but we're going to take a new action today and let's hope it makes a difference and if not we'll deal with that and that's been huge to just be with uncertainty and change I love that I'm almost in tears just listening to you because this is so relevant to everybody listening and what you did is just bring verbiage and be out there on the stuff that all of us are feeling and you know what it fits so well as we end our conversation Adele because today because the old same journey as you I could just say the same story this surrender to um not knowing the answer all the time to the uncertainty and to trusting that it will work out and then in the journey in the suffering in the difficulty there are jewels to be had if we don't miss picking them up along the way like if we if we let go of that I'm supposed to must all of those words that are all masculine right and we surrender and say what is here that is precious like maybe your relationship your sister is probably closer and same with me right like so there are these precious jewels and I think this is relevant to you listening because I think at some extent every one of you out there is suffering in some way there's just challenges right now so thank you for being so vulnerable and sharing because it's very relevant to every single one of us and I just encourage if you're listening um as difficult as your situation might be look for the jewels because they're there to be found and it's almost like we have to put on those glasses not rose covered glasses and ignore the difficulty but the glasses that say what else is possible what is here that's actually a benefit to my life and my psyche and my relationship so thank you thank you for sharing it's so relevant to every one of us oh thank you for bringing this all out like you just modeled the feminine energy beautifully right here right in this conversation you created space for me to be safe about saying that because listen I could have said something very male energy and I don't mean yeah like I was a chief medical officer and our business grew right it's a great thing like thank goodness I have the male energy to be able to do that as well too um so I'm proud of that too but uh you created the space for my feminine achievement if you will my feminine energy achievement to show up thank you and again we hopefully allow those of you listening to fill this I mean because again you touched me by sharing um thank you for your time for your beautiful heart um loved talking to you today so much I really appreciate it oh thank you so much for having me always a pleasure to be with you you're welcome