#34 Dr. Robin Berzin | Revolutionizing Modern Medicine with Digital Health and Combining Coventional Medicine with Functional Medicine

On today’s show is the brilliant Dr. Robin Berzin, founder and CEO of Parsley Health. Robin combined her passion for technology, health and helping people to create a truly modern medical practice that you can do online regardless of where you live. Parsley Health takes the best of conventional medicine and combines it with FUNCTIONAL health. We have to stop treating just the symptoms and Dr. Berzin has figured out how to bring it all together in an easy to navigate more affordable way. Oh, and if you are an entrepreneur her story is inspiring and speaks to what is possible when people dream big and ask “why not?” Enjoy!

Listen to the episode here:

[podcast_subscribe id=”5950″]

Key Topics:

• Dr. Robin’s Medicine Journey [00:06:32]
• Yoga and Body Enlightenment [00:08:10]
• Tackling Med School and Residency [00:12:37]
• Health Starts with Food [00:19:26]
• Parsley Health Being Patient-centric [00:22:47]
• Mental Health and Physical Health are One [00:32:21]
• Working with Doctors and Coaches [00:34:37]
• Referring to Other Specialists [00:38:09]
• Accessibility with a Membership Model [00:43:10]
• Healthcare and Technology [00:46:48]
• Pediatric Health and Post Pregnancy Lifestyle [00:50:25]
• Tips to Take Care of Your Health [00:57:40]

Dr. Robin Berzin – Revolutionizing Modern Medicine

My guest is Dr. Robin Berzin. She is the CEO and Founder of Parsley Health. They are moving in the right direction. They’re getting it right. It is the best of conventional primary care with a functional approach to health. Imagine that. They’re not just trying to talk about the symptoms, but they’re trying to get to the root of things.

They talk about nutrition, exercise, lifestyle, stress management, and all these protocols. They’ll have someone there to help support you on this journey if you need a little more coaching. It’s amazing because you can be a part of Parsley Health anywhere. They’re trying to figure out ways to make it even more affordable and get this to as many people as possible. If you have something that managing through your lifestyle won’t fix, they can help you with that, too. If you need prescriptions or if it’s something else, they will navigate that for you as well.

What I love though is that she’s also an entrepreneur. She was in technology, followed a passion there, and decided she wanted to get into medicine. She went to Columbia. After going to Internal Medicine at Mount Sinai, she thought, “Maybe I’m going to do this differently.” She’s brilliant yet so human. She makes it so clear. She’s doing all of it with two small children. I hope you enjoy my conversation with Dr. Robin Berzin as much as I did.

—

Are you guys practicing? Obviously, you can but what does that look like?

For us, telemedicine was already our norm. Even for our members who work with us out of one of our centers, over 60% of our visits were already via video. Before COVID, we had launched our fully remote service in about ten states. Now we’re at 40 states. Before all of this, we were on this trajectory to build a national telemedicine service for our care. Our LA center reopened, which is awesome, and we’re stoked to reopen New York. Because we do so much online, there wasn’t an interruption in care, which was super lucky.

I was thinking about what you’re doing with Parsley Health. It represents something very modern already. I was like, “Finally.” Because in a way, we’ve done some things in the past well and we lost those practices, and then we had Western medicine. What you’re doing is bridging these two worlds. It’s helpful for people even to say that you’re doing it online, in the real world that we live in.

I was listening to some of your conversations around Parsley and it’s also meeting people where they live. It feels like you’re ushering the old or the foundational parts of the medicine lifestyle into the modern with the coaches, and then into where we are now online. Where I want to start is you never planned on being a doctor.

Nope. I’m an undergrad. I was not pre-med. I have some made-up major in international relations. It’s one of those liberal arts majors that people like me who can’t do math do.

I’ve also seen that you had done a session where you were doing things like learning to draw blood and doing things like that.

After college, I worked in New York and my first job was as a paralegal at the US Attorney’s Office. I was helping to prosecute securities fraud. I was like, “I’m so glad somebody prosecute securities fraud. This is a very important thing to do. I should not do this job.” I got into yoga at the time. I got interested in the connection between the mind and the body and health on a personal level.

I then went and worked in research at NYU and there I learned to draw blood and do EKGs. I said, “I like medicine. I like this idea of the tangibility of helping somebody with their physical health.” My dad’s a doctor, but my parents were shocked that I went to med school. It was never something I was pushed into and we never thought about, but here I am. He’s a primary care internal medicine and he retired in Baltimore.

Did you personally have something happen to you by having that practice, maybe something that got connected that wasn’t connected prior to that yoga and maybe the lifestyle around that?

[bctt tweet=”We’re a guide to helping you live your way to better health. We’re not in charge.”]

I was this hyper-achiever, living that New York early after college life, running around, and living on coffee and protein bars and wine like some of us did. I was always a top student and I was good at school. I got out into the world and I was like, “I’m good at school. I’m not good at life.” Yoga helped me reconnect myself to be present. A lot of us walk around with what I call the proverbial concrete wall between our heads and our bodies. We don’t pay much attention to what’s happening in our bodies until somebody is in pain or we’re off the rails.

It’s not only a problem from a big macro healthcare standpoint. It’s also a problem we miss out on because our bodies have a lot of wisdom and they’re telling us a lot. I felt like yoga helped me plug into myself and then set me on this trajectory into medicine, which was super interesting and I fell in love with it but then, of course, I felt like it had some missing pieces. Parsley is about trying to bridge that gap or put those pieces together as I see them.

I know there’s only so much time in the day. If you went to a certain doctor for something specific, it does fascinate me how little a lot of doctors know about the impact of nutrition. I know that that’s not what they’re studying in school, so it’s hard to present the idea of when they would have time to go and learn it separately, what would be the resource that they can all agree on, and all that.

I’m always curious, where did we lose the value of the medicine of food? I understand when it became a commodity. People are making money. Now it’s about ease, cost, and taste. Somehow, we have disconnected that it is the medicine. You went to Columbia. When you’re in it, were you like, “This is for me,” or was that hard? It’s interesting when someone’s determined their whole life, like, “I’m going to be a doctor.” You hear all the stories and everything. What was that like for you?

It was cool because a lot of us had jobs before. We hadn’t gone straight from undergrad. We were there because we chose to be there, more than 50 of my class. That was cool because when you’re a little bit older, you’re like, “I’m making this choice. I want to be here.” You’ve been a professional in some sense of the word.

When you’re an undergrad, school is the whole world to you and there’s nothing outside of that. As you grow up and do have a job and work with other people, you learn to compartmentalize a little bit. It made med school easier for those of us who were there who had done other things because we had that perspective.

In college, I was like, “I have to get straight A’s.” The world ends if I don’t get straight A’s. I went into med school and I was like, “I want to do well.” I’ve proven that I can get 100 on a test now about 1,000 times over. I want to have a great experience. I commend Columbia because I always call it the med school that draws a bunch of us who are a little bit weird. At least in their admissions process, they seem to value that on some level. It was an amazing experience.

The school part of it wasn’t hard. The part that was hard about Columbia, in a medical school like that, I always joke that everyone at Columbia is there to be a cardiac surgeon. It’s a very specialty-focused, surgery-focused type of place because a lot of the top schools are. I was always interested in primary care, public health, prevention, and chronic disease. That made me the odd duck out.

Along the way, I got interested in technology and how technology could transform healthcare. At the end of school, I started a company with a buddy of mine from med school, who was also one of those weird people who’d done other things before school. That part of it made it hard because it’s a certain kind of place, but I loved it.

I know you were joking about coffee bars and wine. At this time in your life, were you already having a different type of relationship or awareness? There’s yoga practice and other things, but were you practicing nutritionally personally certain specific things by then?

Yeah. When I got to med school, my one friend at school who was head of the social committee or something jokingly called me yoga so I call them pizza. Yoga for me was that a-ha lightbulb moment of, “Let’s care about what’s happening from the neck down and take care of this body.” Whenever you start to get interested in health and wellness, whatever that first thing is, it opens your eyes to the world in a new way and you can’t unsee what you’ve seen. It could be food, it could be fitness, it could be meditation, it could be the environment, whatever it is. I already was interested in healthy eating and being mindful of what I put in my body.

The starkest contrast to that was I remember in residency, they feed you lunch because your lunchtime is not like a break. This is at Mount Sinai in internal medicine in New York. It’s like when you do more learning during the day when you’re working in the hospital. At this point, you’re out of medical school. You’re working in a hospital. They would buy us lunch, but lunch was always bad take-out, pizza, or something.

There was one girl, Mike and I would always bring her lunch. I always had an avocado sandwich or something. Everyone made fun of me there, too, but I was like, “Do you realize that the things that you’re eating right now are the reason that 90% of the people who are in this hospital are here?” There was this total disconnect.

Something that people don’t realize is that people who are interested in medicine aren’t necessarily interested in health and that medicine and health are related but they’re not the same. To your point, it got lost somewhere. When they made the medical education books, that chapter got deleted. We’ve forgotten that food is medicine but yet it is the first medicine.

At Parsley, our prescription pad starts with nutrition, then includes lifestyle, which is fitness, sleep, and stress. The third is what we call prescriptions. Prescriptions include both supplements and drugs. We’re not denying the power of prescription drugs or the power of modern medicine. Those things are wonderful. We can’t forget the power of the other stuff either.

Do you think it’s that we don’t want to look at it because it’s too easy to be like, “This tastes good. I can get it to-go.” They’re not willing to look at it or it seems like too much effort. What do you see over and over when you have someone come in and the first and foremost is the food?

It’s two things. One, we learn how to tie our shoes and brush our teeth, but we don’t learn about our bodies. We don’t learn how to self-soothe. We don’t learn how to eat to take care of ourselves. It’s not part of our culture. That connection is not made in school. In the past fifteen years or so, people are starting to be like, “We can’t eat 60% of the American diet, at least it’s ultra-refined.” Another 30% is like, “Regular refined. We are not eating real food. We are eating Franken foods. We’re eating processed, refined sugars, refined flours, stuff filled with chemicals, and wondering why our chronic disease rates are up into the right.” It’s like, “These things are connected.”

I don’t think that we bridge that gap for people where we teach people like, “This is you taking care of your body. This isn’t some esoteric idea.” That’s reinforced by medicine because medicine never says what you’re eating is part of the problem. Medicine says, “I have the solution for you and only I can write this prescription.” I don’t know if that’s deliberate. I just know that that’s how it is.

What we find at Parsley is that when a doctor tells you to eat this food and not that food because of your data, your disease, your symptom, your life, and your goals, it’s very different than this ambient information that a lot of us swim in, which is like, “I should cut out sugar. I’m eating the health bars.” When Dr. Berzin says there are 25 grams of sugar in that bar and that was your whole sugar allotment for the day and you had it as a snack, that’s where the rubber meets the road for people.

I want to touch on something you said. When you talk about self-soothing, you mean in the way that we live, we do live stressful lives and we have a lot of feelings about things. One of the ways that we do make ourselves feel better is food. It’s quick. It’s easy. It’s right there. It’s legal. Are you also saying in that way of teaching people to look at their feelings and then habits around their responses to their feelings when you talk about self-soothing?

Absolutely. Managing our emotions, our inner life, and stress. Stress is chronic and constant now, not episodic and intermittent in the way that at least we think that it might have been in times of early humanity. Because stress is chronic, we learn in our culture physically destructive ways of managing stress. We eat, we look at media, we sit, and we use an often-abused substance, alcohol. We distract ourselves from ourselves with our relationships with some people.

[bctt tweet=”Fifteen minutes isn’t enough to know anything about anybody.”]

We learn a lot of destructive ways of dealing with our emotions and we don’t learn a lot of constructive ways. To your point, the earliest thing that we learned is that’s okay. As a parent, I get it. My kid is freaking out and I see a lot of people using food to help their kids stop freaking out. We don’t teach meditation, breathing, taking time to yourself, and going for a walk as a tool in our tool belt alongside sugar. A lot of people don’t sugar.

If I come in and I’m a new patient, I see you first. Is that right?

You sign up and you see the doctor as your first step, whether online or in person.

What are the hurdles? When you have a new person sign up and they come on, what are they meeting that’s so new or different or uncomfortable for them?

The first thing that’s revolutionary is so basic. We think of going to the doctor’s office and filling out all this paperwork and all this stuff. You end up writing down on the same three sheets of paper the same information over and over again. You’re like, “What? I did that last year at my OB.” I’m sitting there writing and I’m like, “Why am I doing this right now? I’m so annoyed and it’s so confusing.”

What happens first with Parsley is before you even meet the doctor, you sign up online and you schedule your first visit online. You can cancel. You can schedule. You can do all the things you can do in any other service. You also answer a bunch of questions online that I guarantee no other doctors ever asked you. We ask you what you’re eating. We ask you how you’re moving. We ask you if you have meaning and purpose in your life, if you’re happy, what your relationships are like, if you’re using trackers and wearables, what conditions you had as a kid, and if you’re sleeping.

You do what we call build your profile or build your health biography. The story of your health is a story of your life. Construct that online before you meet us. I hear this all the time from people, “I’m going through this Parsley intake form and I called my mom.” I always smile because over and over again, people say, “I don’t know if I was breastfed. I don’t know what things I had as a kid. I know I had a lot of medications, digestive issues, ear infections, and antibiotics, but I don’t know.”

They’ll say, “I was filling out your forms.” It was online. There’s no paper at Parsley. They’ll say, “I put it together. I’ve been having these migraines. You asked how long I’ve been having the migraines and when they started. I thought back to the past ten years and it was seven years ago when I moved to this new city and I got this job. I started sitting and I stopped running.” Whatever the thing was.

The telling of the story is often the most beyond the lab data. We do a lot of fancy pants tests at Parsley. The telling of the story is that first step that’s different. The second first step that’s different is then you meet with a doctor and you spend an hour with them. Most people spend about 15, max 20 minutes a year with a doctor and it’s like, “What do you got? Here’s your prescription. Your blood pressure is not so scary that I’m going to send you to the hospital. Here’s your medication.” Fifteen minutes isn’t enough to know anything about anybody.

When you sit with the doctors in the room, there’s something weirdly uncomfortable about that. When you’re sitting on the paper crinkling as you’re moving. Should you sit on the chair? Should you sit on the bed? It’s a very strange thing. The doctor whips in and they look at your chart, and here you go. There’s something interesting that you might be even more honest about. Have any of your doctors said, “These first visits are so different from the way I used to practice.”

I hadn’t thought about the honesty part. We love having health coaches because people will tell our coaches things that they do not tell their doctor. They will meet with the doctor and be like, “I will eat that Twinkie once a month.” They talk to the health coach and they’re like, “I eat one every day.”

Come on screen, do you have a coat with your name on it?

Never worn them. When we started, we required you to come in person for the first visit, and then we let you do any visit after over video. What we learned over a couple of years was that people were coming in for their first visit and we saw two crazy things. One crazy thing was that after that inclusive of the in-person visit overall, about 60% of all visits were via video. Even if people were up the street, they were like, “It’s more convenient. I can see you on my lunch break or from home,” or whatever.

The second thing we saw was that 10% of our members had traveled from another city, state, or country to see us for that first visit in person at 1 of our 3 locations. We were like, “Why are people spending more on New York, LA, and San Francisco? Why are people spending more on a plane ticket and getting here? Why are we making people do this? This is dumb.”

We’re focused on helping people resolve chronic issues and optimize health. For those things, we do all of that online as easily as in person than we were. We had members in 20 states and 10 countries before we launched our fully remote version of our service. Interesting questions to see if people will be more honest.

I’ve always loved us not wearing white coats because we’re a guide to helping you live your way to better health. We’re not in charge. I’m very interested in how we level the playing fields. In our physical centers, our tables are round. You sit there and there’s no big doctor’s desk stacked with papers and scary things. It’s a conversation that’s happening for us, whether you’re in person or not.

If someone comes, do they get to visit and then become a member? How does that work for the membership?

You sign up. If you change your mind, we have a very fair cancellation policy.

Do you find that there are people who are still like, “I don’t want to know all that stuff. It’s too much. Just give me the pill and call it.” What are you guys experiencing when people shift over?

First of all, we’ll do that. Doctors love being bossy. We’ll tell you, “Take this thing. Eat this food. Take the supplement. This is the plan.” You spent all this time in school learning how to tell people what to do. When I think about the engagement requests, people sometimes do face maybe a little crisis of confidence like, “Can I make these changes? Is this real? Is this going to help?” Because they’ve been told by so many doctors over the years, “What you eat doesn’t matter. How you move doesn’t matter.” All the things. That is a mind shift.

When they’re signing up, bring it back to why they signed up. Tapping into that. They’re frustrated with something. Maybe they’re on five pills, but they’re not happier. They’re not losing weight. They still have high blood pressure. They still have high cholesterol. They still have high blood sugar. They still have digestive issues. Usually, they’re getting worse, not better.

Back to something you said about treating the root cause, medications manage the symptoms. Those are the leaves, but nutrition and lifestyle treat the roots. Our data shows that we significantly reduce the overall burden of chronic drugs and we get people off of medications. That isn’t necessarily our stated goal. Sometimes medications are appropriate.

For a lot of people, you’re not suffering from a deficiency in a high blood pressure medication. You’re not lying awake at night because you have an Ambien deficiency. There’s a why. We’re getting at the why. That initial, like, “I have to change something,” is coupled with that hopefulness that we all have any time we go to a doctor, which is like, “I want to be better.” We try to focus on that.

[bctt tweet=”We don’t pay much attention to what’s happening in our bodies until somebody is in pain or we’re off the rails.”]

There are so many nuanced reasons why we’re doing what we’re doing. If we’ve had trauma or a particularly stressful time or there’s been suffering or divorce or whatever, the health coach is almost having to act in that very delicate way. How do they manage intangible parts?

It starts with the doctor, too. We don’t view mind and body as separate at Parsley. We have this artificial distinction in medicine, like, “Your mental health is over here and your physical health is over here, and they’re not relevant to each other.” That is fundamentally wrong. We get a lot of referrals from the site community, therapists, and psychiatrists, because they’re like, “You guys are identifying the low thyroid function that’s causing depression. The connection between all the bloating and constipation and the anxiety. The behaviors or the underlying inflammation that’s leading to lack of sleep.”

It mystifies me because at least the psychiatrists have gone to medical school. You know that there’s all this other stuff there. Technically, you could write this prescription or you can order this test, but you don’t. It’s not your department. On the primary care on the medical side, they don’t see the mental health or the behavioral health as their department either. I call it the missing department in medicine, which is the department that is Parsley Health.

Even in your first meetings with your doctor, you’re talking about your happiness, your mood, and your emotional eating. We also survey your intake and your willingness to make changes across different domains. “Are you willing to make changes in your diet or take supplements or do testing?” Because we want to understand where your head is at.

It’s reinforced with the health coaches. Some of our members are super type-A folks and they’re like, “I got this in my sleep. You told me to do this and I did this. I’m a perfect A student patient.” Others are like, “I want to do all this stuff, but I’ve got to start somewhere.” We’re okay with that, too. They work with their coach to devise a version of our plan that’s going to work for them in their life. Maybe they need to start with their emotional eating.

For some people, if you’re chronically sleep deprived, everything else is pointless. Everything else is game over. One bad night of sleep and you were fundamentally pre-diabetic the next day in terms of your ability to balance blood sugar, and then you crave sugar, you’re exhausted, and you have too much caffeine. You have the wine to get rid of the caffeine buzz or whatever it is. You’re too tired to work out. Sometimes we have to start with getting people sleeping effectively again. That’s awesome. The coaches can be a powerful support for healthy people to start.

This person would thrive with this particular health coach. When you assess them and a doctor meets the patient, you go, “This one needs some extra love.”

We do. Our doctors meet and oftentimes our members have already selected a coach because they can do that when they’re signing up. They can schedule at the doctor and then they see, “I want to meet with this coach.” If that’s happened, we don’t get them in the way and get in the way, but otherwise, absolutely.

All of our coaches and our doctors go through an in-house fellowship program, a training program for everybody. When we’re hiring doctors across the country and they’re coming from private practice or they might have been a hospitalist in a hospital or an ER doc or whatever, sometimes we’ve had specialists give up specialty care to work with us.

They all go through the Parsley training because our methodology is quite unique and we want to make sure that that’s how we guarantee not only are we hiring smart, great docs with all the credentials, all the letters, and all that stuff. We’re hiring people who then go through our methodology so that we’re all on the same page.

You have people being very emotional and personable with the doctor. You have doctors who go to medical school to deal with patients, but they are probably like, “I never expected that I’d be in this other aspect with the patient.”

We do this meeting every Friday with all of our medical providers and we talk about what’s going on. We do cases, we have speakers, and we have this whole continuing medical education. After the fellowship, it doesn’t stop. We’re always learning and we’ve documented our protocols. The collaboration is amazing. I always say you get 50 brains for the price of one because no one person can know everything.

Something that we talk about is how to hold space if we sense that someone’s trauma or they’re in pain or the divorce they’re going through or the loss, or whatever it is. We talk a lot about, “Name the elephant in the room.” Because if we don’t talk about this, if we don’t create space for this, this thing that we’re not acknowledging will prevent us from getting anywhere when it’s about your blood pressure. Your blood pressure is high because you’re stressed, you’re sitting, what you’re eating, and perhaps other medications that you’re taking.

If we’re not like, “Your blood pressure is high. Here’s a pill to bring it down. Bye,” it’s fine to keep you from dying of high blood pressure. That’s important. If we want to be like, “Why do you have high blood pressure?” Then we have to name the elephant in the room and we have to get comfortable having those types of conversations or having people cry in our office, even though we’re not the therapist. I find those distinctions so artificial.

For a lot of your doctors who had practiced more traditionally, it must be something of a relief. I have a friend who is a heart surgeon and he’s probably in his early 70s. Very healthy guy and active. I think about ten years ago or so. He was talking and he was like, “I sometimes wish I had gotten into preventative medicine because a lot of times, by the time they get to me, it’s not that it’s too late but I am putting band-aids on things.” If you have a patient after a year or two who is not willing to make the changes and not able to make the changes, do you fire them? Do you say, “We’re not the best place for you.” Are there big guns that you have to bring in?

We play quarterback in a way, which is something that’s missing for a lot of people in their health. It’s not that we don’t refer to specialists. If you need that echo, we need to refer you to the cardiologist. If you’re 50 and it’s time for your colonoscopy or if you’re bleeding or there’s something wrong, we need you to go get that colonoscopy and see the GI. We do refer out. We just have a broader array of people we refer to.

We refer to acupuncture for certain things. We might refer to a cardiologist for certain things. For other things, we’re doing the opposite. We’re bringing the specialty in-house because for a lot of blood sugar issues, hormone issues, and GI issues, we’re fixing those problems or helping people manage them. Autoimmune is another big one, especially for women. We ended up having them not need the specialists so much anymore.

We’re dealing with the thyroid problem or the fertility issue or the PCOS or the menopause or whatever it is and you don’t need that rheumatologist, that endocrinologist, that GI either so much or at all. That part’s cool. We have two things happen. Somebody does everything we say and then they get better. One, we have different tiers of membership. Some people want to do maybe a lighter weight membership this year. That’s fine. We have that. The other thing that we see and that I see over and over again is that health is dynamic. It’s always changing.

[bctt tweet=”We’ve forgotten that food is medicine but yet it is the first medicine.”]

People come for one thing and they stay for another. That sounds silly. I have a guy who came in initially at 30 years old, picture of health, one of those Tim Ferriss health optimizer guys with no body fat, all the things. I’m like, “Pretty easy.” He came because he’d done the 23andMe test, so he had known that his genetics showed that he had two copies of ApoE4, so he was much more likely to get Alzheimer’s earlier than 65. We know that Alzheimer’s in some forms is Type 3 diabetes or is very related to cardiovascular disease.

He says, “Is there anything that we can do?” We’re like, “Let’s look at your heart healthier, inflammation, all these things.” We see that he also has elevated certain types of cholesterol. He’s been doing all this keto type of diet. The first stop was, “The high-fat diet is not for you, sir. I’m sorry. You need to do much more plant-based, higher fiber.” We got him on a supplement regimen that was okay because he was one of these people who’s willing to experiment and buy a lot of stuff off the internet. The supplement world can be great but can be scary.

What’s interesting over the course of time is he got a tick bite, he got Lyme disease. We treated that. He’s dealing with some ADD stuff. We’re helping him because he doesn’t want to go back on Adderall. We’re helping him with dealing with that. He’s had all these things along the way. You will see this guy walking down the street and be like, “There’s no healthier specimen of humanity than this kid.” Like most of us, he has health concerns or health issues. 2020 will be his third year of membership so we’re both optimizing, managing, and treating.

If someone’s in Kansas and they have a consultation, is it like, “You’re going to go to a lab near you and you send in the profile you want.”

We can send in any LabCorp or Quest or BioReference labs. We also have some of our in-depth testing that gets dropshipped to your house and you do at home and mail in. We can prescribe to any local pharmacy. A doctor online, you’ll see your health coach online, and then we have messaging in between. A lot of the basic stuff like, “I have a sinus infection or UTI,” or something, we tend to handle a lot of that over our messaging platform. You don’t have to use one of your visits with your doctor, which is 30 to 60 minutes long to talk about UTI. That for us is happening along the way.

Another conversation around insurance from either naturopathic medicine or things like that is cost. You guys are trying to figure out a way to integrate as much as you can.

When I started Parsley, I saw this beautiful form of medicine that was very inaccessible. It was $1,000 an hour. It was happening in private practices around the country. No one was tracking outcomes or systematizing things in a smart way. The Cleveland Clinic had started to do some of that work. I saw a big opportunity to bring this out of the very niche and high-end into something much more accessible.

The membership model allows us to do that, the $150 monthly membership model. You can submit for out-of-network reimbursement and you can also use FSA and HAS. Everyone’s like, “Why don’t you bill insurance?” The reason is that when we started and today, we say, “The insurance companies don’t pay me to spend an hour with you or to get you off of medications or to solve all these problems. They aren’t recognizing what we’re doing.” Insurance hasn’t caught up with us.

That said, we’ve had a lot of inbound insurance companies wanting to work with us. I shouldn’t tell the story, but I will. I talked to somebody in their innovation group and one of their other groups is trying to do new models of care, and I applaud them for that. These two people on the phone said to me, “We’re not sure it fits into any of our existing programs so we’re not sure we can do it.” It was like, “They’re the innovation people?”

There are versions of our care that do fit into existing programs so we can get there. What I love about Parsley is that most medical care is incentivized by volume. They get paid for the visit. We’re not incentivized to see you more. We’re incentivized to give you a great experience and help you get better because of the membership model.

People say, “Why the membership model?” I’m like, “It’s aligned with you. We don’t have to bill you for every email. All your visits are included.” The short answer is we are going to work with insurance. As we’ve grown, we’re now in a more of a position to do that. When we were small, insurance crushes a lot of these medical practices. They can’t afford to go and network the overhead of billing and insurance.

By the way, people don’t understand, doctor bills insurance doesn’t get paid for 90 days. Can you imagine if someone cut your hair and you said to them, “I’m not going to pay you for 90 days,” and how that person would stay in business? Insurance has made it very difficult for smaller groups and for anyone to frankly do anything new or different.

I said, “I want to do the right medicine. Not the medicine that the big insurance company currently pays for because I don’t agree that that’s the right medicine.” In order to do something differently, we had to be outside of the system. Now that we’re larger and we’re getting these calls from the insurance companies, that’s exciting. We’re working on ways where we can bring the prices down even further.

People also often don’t realize that the $150 a month includes your doctor visits and includes your health coaching. It’s not that it’s extra. That’s all included for the hours and hours of time and the unlimited access that we give you. I know people who spend more on coffee a month if they added up than the $4 a day that the Parsley membership costs. I understand that it’s not accessible to everyone.

It pushes me more into your entrepreneur side because you’re a doctor and you went to a medical school. It’s so entrepreneurial. People can say, “Yeah, she’s doing that and she’s a doctor.” What you’re doing is so hard. What you have created to get to this point, I can only imagine the amount of work that this has taken. Now it’s like, “I’m going to take on this next big thing.” How did you do that?

Two things happened. One, along the way, I started another company that’s a software company that still exists. That’s more for hospital systems and solving problems like that. It’s not a patient-facing thing. I got interested in technology. I got a little bit of exposure to the startup world in that experience and I liked it. After training, I was doing a mix of consulting in the health tech space and practicing medicine in one of these fancy integrative medicine clinics in New York. That was a wonderful experience.

I looked at my health tech world and I looked at what was happening in my clinical practice. It was just probably me trying to figure out how to bring these two worlds together rather than picking one. I had a great bird’s eye view of the healthcare world in the health tech space of what’s happening in healthcare. Also, some of the big tailwinds that were happening around moving to this idea of paying for value and not volume and how much people are spending out of pocket already on medical services.

People are like, “I already spent all this money on my insurance.” People forget about that deductible. Everyone’s spending consumer dollars on medical care before they hit that deductible anyway. You might as well spend it on something good. There was a whole rise in consumer health that I saw. In medical school, I remember being taught, like, “People don’t care about their health. They’re not going to spend any money on it. They’re not going to do anything about it,” which is a ridiculous perspective.

When you look at the $4 trillion global consumer health market, which includes everything from supplements to fitness to genetics and testing, all of that comes down to, “I care about my body. I care about my health. I’m willing to spend money on it.” Those things plus my experience in this integrative medicine world where I was like, “We’re doing a lot of good work here but we’re doing it in a way that’s only going to reach very few people,” crystallized for me. I’m a harebrained person that wants to try to solve a big problem. I don’t know why I’m like that. Parsley started in 2016 and I’m still here. We’re going to keep going. Now we’re almost a 150-person company.

What’s the youngest someone can be? Do you have to be 18?

We do have a pediatrics practice in New York. That one isn’t nationwide right now. Many of our members asked us to see their kids. We hired a Cornell pediatrician and we started doing it. We haven’t scaled that to date, mainly because as an entrepreneur and starting a company, it’s focus, focus, and focus. We’re focused right now on adults. Mainly it’s 18 and up. I have bright shiny thing syndrome so our team is charged with making sure that Robin doesn’t constantly add the next thing that we’re going to do.

[bctt tweet=”What you put in your mouth every day is determining a lot of how you feel today and how you will feel tomorrow.”]

You have a son, right?

I have a 3-year-old boy and I have a 4-month-old girl.

I have three daughters, one’s grown. One is 16 and one is 12. What’s interesting is to watch them all make the loop. “This is what we eat at dinner.” We prepare food at home. They all come back to it. There are certain things in my house, but I don’t put up big barriers because I know it’s going to become a fixation.

“If you want to eat a chip, you eat a chip. If you want to eat that weird frosting that I don’t know what’s in, knock yourself out. I know that you’re aware enough to know how you feel and what practice is.” You see them come around. Let’s say you have a kid who lives in a certain house. They could receive so much information from a health coach who would almost be like a friend. That time, especially through puberty, is so stressful. You could support them through better eating.

When I was at Mount Sinai of adolescent medicine, it was one of the rotations. In medical school in training, you constantly are rotating through different departments and how it works. I did this month and I loved it. I loved that age group because you can be super real with them and they’re game for anything. Ultimately, I think that we are hopefully setting a new bar for what medicine can be and should be. Hopefully, this is the way that everyone is treated and this permeates far beyond Parsley.

If you can get them set up like you’ve set up your kids with, “This is the baseline,” because if our baseline is healthy, we can deviate a little bit. When your baseline is inflamed, high blood sugar, not sleeping, eating crap, not moving, and staring at screens all day, any little thing makes it worse. When your baseline is active, eating whole foods, sleeping well, and taking care of stress in a healthy way, then you have that horrible weird I’ve seen that you’ve no idea what is in it. You have that occasionally.

The pendulum doesn’t swing too far. You can heal. The ultimate message for people that medicine doesn’t tell us is that you can heal. The body has an innate ability to heal. We all have that innate ability and it’s about unlocking it. How can we use the science of medicine, the physiology, and biology that we understand? Using prescription drugs as one tool. Using testing is another tool to help us unlock that healing.

I recognize that it doesn’t take care of 100% of it, but it takes care of a lot. By the way, it takes care of 90% of our health care costs, which are lifestyle-driven chronic illnesses. We have a huge power to influence but we’ve given up that agency. At least from our corner of the world in medicine, we’re saying we’re here to help people take that agency back.

Hearing you as a professional, a doctor, a businessperson, and a mom, there are certain things you’ve naturally come to the Earth with your curiosity, your wattage, your IQ. What are things that you’re doing in your life that you’re able to keep the flywheel spinning? We all have days. I’m not suggesting that I’m viewing it thinking I know it’s going perfect for you. You have a 4-month-old. That means you’re sleeping less. What are you doing that’s helping you manage all that you are taking?

She’s sleeping now, which is awesome. I’m no longer sleep-deprived. I do prioritize sleep. I go to bed by 10:30 every night. You know with little kids, they’re up so you’re not sleeping in. I can’t get away with that. Meditation is a huge part of my life. I have a personal meditation spiritual practice that is my coming back to ground zero or grounding for myself. I am someone who can live in my head, spin out, get mad, and get anxious. I learned that about myself early on.

My meditation practice and my yoga practice are my coming home, my coming back to baseline. Even I can forget sometimes. You forget you have things that you know work for you, but I always come back to them. Healthy eating isn’t deprivation in our house. Healthy eating is, “I’m so excited I’m putting my vital choice for well-sourced seafood and we’re going to cook a new recipe,” or, “We’re picking up all these great vegetables from the grocery store.”

That is a privilege. We’ve accepted in this country that access to healthy food and understanding healthy food is a privilege. The cheap stuff is all high fructose corn syrup. It’s a privilege of education as much as it is a wealth. It’s both. I acknowledge that. If I eat crap, I feel like crap. Even before travel, people are like, “You travel a lot.” I’m like, “These are all excuses. I would pack food before I left on the plane.” I’m not going to eat the cheeses or whatever on the plane. I’m not going to do it because I know what those things do to my body. It’s not like, “I’m preventing high cholesterol twenty years from now.” It’s like, “Right now in this plane flight, I will feel terrible.” Those are the things, sleep, eating well, and then having some practices that are grounded.

Were you supplementing now that you’ve had a child because your body’s given so much and is giving so much right now? Do you boost yourself in a way that supports you?

Yeah. I take our pre-pregnancy, during pregnancy, and after pregnancy. We recommend that our moms take it for at least six months after. Ours has Omega-3 fish oil in it. Breastfeeding, which I’m doing now, I’m staring at my pump which is waiting for me, that I will not miss. You are depleted. A lot of women, especially between babies, don’t replete. That’s where the accumulation of fatigue and poor health starts.

I’m taking our Parsley prenatal or I take our rebuilt protein shake, which has a multi in it. I have certain genetics, which means my mood suffers when I don’t have my methylated B vitamins. It’s a world through rose-colored glasses versus a world through gray glasses is how I describe it. I know I feel when I’m not taking those B’s. I take magnesium glycinate to sleep because it helps me unwind in a healthy way. It mellows me a little bit.

Your dad is a doctor. What have the conversations been? Of course, I know he’s proud of you. That’s not what I’m suggesting. This way, you’re practicing medicine. Do you guys take care of him? What was that like?

It’s funny, there was a shock that I went to medical school. That in and of itself was a surprise. They never pushed me in the direction of a particular career. To be honest with you, for the first couple of years of Parsley, he didn’t get it. Doctors are risk-averse people typically. Starting a company was a crazy thing. Fundraising with venture capitalists was a crazy thing. Let alone doing this other kind of medicine is a crazy thing. He thought it was all crazy.

Now that he understands it a little bit better, he loves it and he’s so proud. Before he retired, he was the chairman of medicine at this hospital, which is a community hospital in Baltimore. They do these monthly talks. I went down and did one with him, and he was over the moon. Everywhere people are starting to realize how important this is. He gets it. Even though he comes from a place of as conventional medicine as it gets, he’s embracing that slowly.

Everyone reading knows this space so well and they’d say, “I’m not ready to join a membership,” or, “I’m not able to. I live in a place and I don’t have a support system.” In an oversimplification, reminders that you would remind people as they’re thinking about, “Maybe I should start to participate.”

We’re all about conscious choices towards change, not painstaking choices towards perfection. This is an opportunity for us to make choices that change a little bit. Getting rid of your Instagram and your phones and such before bed at least an hour is critical. Food is medicine. What you put in your mouth every day is determining a lot of how you feel today and how you will feel tomorrow.

Get out the refined sugars or fine flours or packaged foods. If you don’t know how to do that, Parsley’s blog and newsletter have a ton of great articles and how to do an elimination diet recipe. Another program is the Whole30. Just go do it. The Whole30 is an elimination diet. That’s all it is, which is not to knock it. It’s an incredibly powerful tool.

Do something to set yourself up some ground rules around how you’re eating and what you’re cooking every day. Find some way to relax the nervous system that is healthy for you. That could be gardening, it could be walking, it could be doing a simple breathing practice where you inhale for 4 and exhale for 5, which helps calm the nervous system. If your exhale is longer than your inhale, it could be 3 and 5. It could be 4 and 6. I don’t care. Something like that. Do it for two minutes a day. It could be yoga. Find something that isn’t sugar or substances or media to deal with how you feel. Especially at this moment when there’s a lot of collective anxiety, I don’t know a single person, no matter how stoic and strong, that wouldn’t benefit from that.

Thank you. I appreciate Parsley and this opportunity for people to go to a place where they can have a full conversation about their health. It’s so important. Thank you so much.

Thank you for having me on. It’s truly an honor. You’re an amazing host.

—

Thanks so much for being here. If you’d like, rate, subscribe, and leave us a review. All of my music was graciously done by Frank Zummo and Tom Thacker. If you want to see some of the behind-the-scenes action, follow me @GabbyReece. Remember, don’t miss new episodes every Monday.

Subscribe to The Gabby Reece Show

[podcast_subscribe id=”5950″]

Resources mentioned:

• Parsley Health
• 23andMe
• Whole30
• @GabbyReece

---

About Dr. Robin Berzin