Transcript

[0:00] It was remarkable because I got to see Community emergency medicine as well as Inner City emergency medicine and what I loved about it Brandi was that,
you never knew at any moment of your 12 hour shift what might be coming through the door.

[0:17] Music.

[0:22] Paging dr. cook paging dr. cook dr. cook you’re wanted in the o.r. dr.

[0:29] Music.

[0:51] Hello everyone and welcome to prescription for Success I’m dr. Randy cook your host for the podcast.
Which is a production of MD coaches providing leadership and Executive coaching for Physicians by physicians.
To overcome burnout transition your career develop as a leader or whatever your goal might be.
Visit MD coaches on the web at my MD coaches.com because you’re not in this alone my guest today started his career in medicine as an eager and optimistic emergency room physician.
But gradually he started to feel something was missing and then after some very serious soul-searching he decided to hit restart on his career.
And soon he became one of the pioneers and a new approach to healthcare called integrative medicine so let’s hear a dr. Russell Greenfield tell his story.

[1:49] Music.

[2:02] It’s a great pleasure for me today to be talking with dr. Russell Greenfield who is coming to us from Bentonville Arkansas today Rush thank you so much for taking the time to be with us I’m looking forward to the conversation.
Randy what a privilege for me thank you.

[2:19] Well you’re very kind and I know that you have some familiarity some familiarity with our podcast and surely you know that I’m going to,
I asked you to tell me a little bit about your very beginning and that’s exactly right.

[2:34] You are were born in Pennsylvania near Abington Pennsylvania near Philadelphia right indeed and is that where you did most of your growing up,
no you know my wife likes to say that she married a gypsy but I was born in Pennsylvania spent a few months in Florida just about 10 years in Connecticut,
a little more than six years on Long Island,
College outside of Boston med school in Chicago initial training in Los Angeles settle in North Carolina for years in Arizona,
back to North Carolina now in Arkansas I like to tell yes I’m just running from the law it’s all good so you really did do a lot of getting around I did,
and and I suspect having heard that that it was unlikely that you grew up in a medical family it’s true actually my,
my dad’s employment was actually in the computer industry and he because of that in engineering he had multiple opportunities
and So my poor brother he had to shift schools quite a number of times I only had to do so once and at the end of fifth grade but I will tell you that was not an easy transition for me and I still remembered.

[3:50] Yeah I bet you do
so where then did the influence to study medicine come about I appreciate you asking the question because it’s actually a seminal moment in my life my brother is eight years older than I,
and when I was 10 years old my brother was in a very very bad car accident.
Hmm and I as a ten-year-old I didn’t really understand everything that was going on I just knew that around 1:30 2:00 in the morning I was.
Waking from sleep and my mom dad and I went to the local emergency department where I heard my brother calling out and I just remember us finally going upstairs my brother going to the Intensive Care Unit.
And my mom dad and I in a darkened waiting area where there’s a little bit of light coming in from the hallway again I didn’t understand all those going on.
Other than news that my mom and dad were embracing it was the first time in my life I’d seen my wow fast forward three months later,
my brother is able to leave the hospital and everybody’s really happy and in my simple Mind of a ten-year-old I thought wow
how cool would that be if you could take people from being really sad to being really happy and that was my first inkling that maybe I would have the opportunity to participate in.

[5:13] That’s a great story and and when you enrolled in undergrad at Brandeis University was that the intention at that time.
It was and I must tell you however that during freshman year,
I explored political science classes and sociology and I started thinking maybe there’s more to this than just science and I started
looking far afield and finally came back
so much so that where everybody else was a biology major chemistry major suddenly
I found myself junior year being a Psychology major having never taken a psychology course and realizing I better figure this out quickly and was fortunate to be able to graduate
with the degree and general science well that’s pretty good story and you know I have to tell you that I’m a little bit,
older than you but at the time that I enrolled in medical school they were saying we really want you to have a broad base
liberal arts education it sounds like that’s exactly
what you gotta do you think it really benefited you later on or not you know I think if I had planned it it would have been one thing Randy but I think I was simply very fortunate because I think you and I and.
Those who are fortunate peers I think.

[6:38] The majority of us were called to the healing profession through the humanities.
And I think part of the shame of that is that we once we have the if we are fortunate to be accepted into whatever,
professional school that we might be engaged in the profession for the rest of our careers we really never touch on those Humanities again unless it’s on our free time all that sugar is one of the failings of.

[7:06] Medical training these days we get called to it through heart and Humanities and yet almost all of the training has to do with the hard Sciences.
And I’ll bet we’re going to come back to that some more when we talk about Integrative Medicine back to medical school when you got there did you did you feel like.
I’m really in the right place or did you have any misgivings along the way what was medical school like for you.
So again I was a very fortunate person because you know chemistry biology organic chem
some of those courses are interesting to me and undergraduate school but they weren’t didn’t necessarily really grabbed me but I really was grabbed by medical school I loved
the majority of the course work in the experience and I really loved my classmates so I had
the unusual experience I would say of medical school that I really enjoyed it not everybody says that.

[8:06] Yeah you’re so right about that in fact I get a lot of people who say well you know those first,
two years were a real struggle but after I started seeing patients who got better and I hear stories like that but rarely do I hear anybody say yeah beginning to end I knew exactly,
that I was in the right place on the learning I mean just the you know the amazing.
The the magic of the human body and to just you know hear how things actually work and then you know.
You ready for my harken back to remember getting medical student disease which was everything we learned we were like I have that symptom I have acted as and you know you’d go through all this going,
how is it that the human body even stays healthy at all with all the potential pitfalls and downfalls and so again it speaks to just the magic the inherent magic of the human body and then to be
engaged in the opportunity to try and help people.

[9:09] Facilitate their innate capacity to heal taking advantage of those gifts of healing them we are all born with together with the best of conventional Medical Care was simply put it’s an unbelievable privilege.
So true so sounds like medical school was very enjoyable and then the next step was,
picking what was going to be your postgraduate training and indeed you took you took yourself right back to where you got the inspiration you went back to the emergency room.

[9:42] You know that’s really interesting you know here I am 63 years old and I never put that together ready that’s for that’s pretty cut that’s kind of funny
I’m not even going to you for that you know my my.
Years prior to medical school I knew in my heart of hearts.
That I wanted to return to a small town I grew up in Connecticut it was a very small town I wanted to return to a small town to be the small town family doctor,
and just.
Be friends with my patients know the community help people from birth to end of life and everything in between and I knew that’s what I wanted to do and I was,
I’m in my second year of medical school I had the opportunity to participate in an elective about emergency medicine.
And I was really engaged I was really interested but I was like no no no I’m going to family medicine and I couldn’t wait because my very first rotation,
my third year of medical school is Family Medicine so I knew this was going to you know
be foundational is going to cement my path forward and I really did not enjoy my family medicine rotation when I was like holy moly and,
really tell me some more about that what went wrong the the Family Medicine doc that I worked with was actually quite wonderful and in many ways ahead of his time I just didn’t understand.

[11:08] And so in part he was an Osteopath.
And about eighty percent of the work that he did was manual care of people coming through his doors which I had no prior experience of and didn’t really understand what he was doing
and then a significant proportion of the rest of the work that he did was really more medical triage,
so in a very simplistic way it seemed to me again with a
yeah The Beginner’s mind of sorts but also a very judgmental one at that time was he might see somebody with.
Mild chest discomfort and make a referral to the cardiologist or somebody with a little bit of abdominal discomfort and make the referral to the gastroenterologist not doing a whole lot of care himself.
And that bothered me I wanted to do more of the getting down into the,
weeds of trying to help people decipher what’s actually going on try and get into the diagnostic aspect and again having had no background in the manual therapies which now I wish I’d picked much more attention to.
I was I was concerned that maybe this is my calling after all with that bit of confusion going on what was it.

[12:27] Later on in medical school that made you think the emergency room was the place to find where you really wanted to be.
Well it having had that experience with primary care and feeling like gosh this isn’t the place where I really might be able to intervene I started taking electives and emergency medicine around the country.
So I did an elective in Harlem in New York City and elective in Akron.
Ohio and elective in Winston-Salem North Carolina and an elective in Denver Colorado.
Trying to quite an experience it was remarkable because I got to see Community emergency medicine as well as Inner City emergency medicine and what I loved about it Randy was that,
you never knew at any moment of your 12 hour shift what might be coming through the door
yeah so you had to be ready at any given moment to intervene and you might have 11 hours of colds and sniffles and things like that and.

[13:30] At 11 and a half hour mark there might be a vehicular trauma with multiple victims or
gunshot wound or a heart attack or a stroke or the opportunity to deliver a baby and the Emergency Physician struck me as they had to be prepared for all of that.
And also know how to deal with just the run-of-the-mill kind of urgent care things that might come through the doors well and that just struck me as just,
through the sheer breadth
of knowledge that was necessary and the ability to act on it and short-form was both really challenging to me but also really compelling to me.

[14:10] Yeah I should think that that that experience.
Would get the attention of most any medical student and I think it probably does there are parts of it obviously that.

[14:24] Some people don’t find so and inviting but the immediate gratification part I think is very appealing and obviously it appealed.
To you and you not only did an internship re year and a couple of residents a years.
An additional Fellowship which according to your CV was also in emergency medicine what was that extra year about it was.
Really a wonderful year because I plans to enter academics.
And so I had the opportunity to really learn from wonderful mentors what it means to.
I had the privilege of standing before an audience and trying to share information that they might find beneficial.
To serve in that way to say you know I learned this and I think this might be a benefit to you and.
To just learn the craft I guess of.

[15:24] Do my best to be a teacher as well as a practitioner and so I was surrounded by wonderful wonderful mentors and had the opportunity to work with residents in a different way that really gave me the opportunity to thank you know I
I think I really want to go the academics room hmm it sounds a lot like what we refer to as the chief residents year and.

[15:48] Surgical training actually it’s very much like what was indeed become more of a mentor as well which is very satisfying
hi I’m Rhonda Crowe founder and CEO Forum D coaches here on rx4s success we interview a lot of great medical professionals on how they grew their careers
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[18:11] Music.

[18:21] Bit of a gap between that and your Integrative Medicine.
Fellowship and I’m really interested in what happened there you clearly did some decision-making in that eight or nine years where were you were you.
In a more or less sort of standard emergency room practice doing shift work during those years or what was your life like.
So it’s a wonderful question because I feel like my answer has some.

[18:57] Depth about it that speaks to I guess who I am which I hope will inform folks with regards to some of the decisions that people may have the chance to make for themselves again Randy I honestly don’t know.
Anybody more fortunate than myself I often share with people that my story if written really couldn’t be.
Necessarily it might be understood but it wouldn’t be believable and so I started out working with a
private emergency medicine group in North Carolina I had had the opportunity to stay on faculty in my residency training
but wanted to get closer to my family in North Carolina it’s a return in North Carolina they didn’t have an academic job available at the time but they were working with a private emergency medicine group that was helping to provide some of the oversight for the residents
and also you could participate in The Residency program training so I signed up with them.

[19:57] And had a wonderful experience for four years before one of my mentors in emergency medicine a gentleman by the name of John Marks came and became the chairperson of the emergency medicine program and so
I then shifted and joined the academic Department of Emergency medicine and started really being more engaged in the,
oversight of the knowledge of the care but the training of the residents getting more involved in.
Presentations around the country and writing and all that comes with it and then a funny thing happened I got married.
And when I did I realized you all this work that you have to do publish or perish or things like that is taking me away from the woman that I love,
and how do I put all this together and I finally came to the understanding simply for myself not for anybody else.
That I really wanted to spend more time at home and that I might have to say so long to academics after all.
So I was very fortunate then to be offered,
the position of directorship of a community emergency department where I was living and so left academics to pursue
role where I could both provide clinical care and being an administrator there what I discovered is that.

[21:21] The clinical exposure in a community emergency department is very very different from the kinds of patients seen in a level one Trauma Center Residency program so true.
And so there my challenge was that.
There wasn’t the same breath and the same degree of challenge necessarily day in day out in the community emergency department as it was working with,
brilliant residents and teachers and being the level 1 Trauma Center
and then the administrative work simply wasn’t quite as fulfilling as I thought it might be but I thought you know again I am one lucky critter.
I’ve got a great job I’m happily married with two munchkins and diapers my family’s nearby I have a pretty good gig and you know I’m going to be very fortunate doing this for the rest of my career until.
I was returning from giving a lecture for the American College of Emergency Physicians and my plane was delayed and this is why I say Randy you couldn’t write the story and make it believable.

[22:27] And so I’m just scanning the magazine columns rows and I come across this magazine where there’s a gentleman.
With a bald pate and white hair or just around his ears all covered in mud holding onto a plant and the cover story is can this guy change medicine.
And so I picked it up and looking through it and I’m Jewish and the reason why I mentioned that is that the very top of the magazine also says they have a story on Jews across America.
And I’m coming through and they call my plate and I never buy magazines at the,
like never I was like well you know I’ll just pick this up and so I put it in my backpack head home to my wife and Munchkins and I’m going through my backpack and I take out the magazine.
Well it’s one of these magazines that is primarily pictures so I’m just thumbing through them but then there’s this article about this fellow dr. Andrew Weil.
And how he and his colleagues at the University of Arizona are starting a brand new fellowship program.
We’re at the stated purpose of the integrative medicine program is to right the ship of healthcare and make it actually be about health.

[23:44] That really appealed to me because at the time again at being very fortunate having a wonderful job I couldn’t help but notice in my shifts in the emergency department.
I was one of the only people happy there the patients were certainly unhappy the nursing staff chronically understaffed were unhappy,
the doctors that we would call in the middle of the night very unhappy administrators typically pretty unhappy insurance companies very unhappy and looking around going.
Something is wrong here and then the many of the patients that we would take care of.

[24:19] Often times they have received excellent physical care for their physical maladies but in many ways it was really only a Band-Aid care because I’ve never touched on the other aspects of health and well-being and if I might I share one,
patient encounter that was really informative to me but all these new retrospect because I missed it upfront
and that’s just being honest so it was a one of those famous
321 never shifts and so it was a little after 1:30 in the morning,
when I picked up a chart and I did exactly the wrong thing Randy the chart said flare of rheumatoid arthritis.
And so with a maybe a 50th year old young lady
who was on multiple medications and had it was experiencing flare of her joint pain and as I was walking to the room I was already deciding what I might offer for her.

[25:18] And doing exactly the wrong thing and so when I entered the room I introduced myself and I said how might I be of service and I usually use my first name.

[25:27] And she said well Russ I’ve had rheumatoid arthritis for 15 years I’ve been on Methotrexate in the past I’ve been a gold in the past I’ve been on this on this and she looked at me again this is 13 in the morning she says and I want you to fix me now.
And I was not too much to ask right well I was quite surprised and that and I was like whoa and so we sat we talked for a little while and I you know I don’t remember exactly what I did but I probably
you increased your steroids it’s off I could get her into the rheumatologist office and Rapid fashion.

[26:02] But the next day when I was thinking back on my shift I realized I had missed.

[26:08] Because honestly thank goodness she didn’t have a fever she really didn’t have significant swelling
her urgency if you will really wasn’t her physical malady at the time
in retrospect I think what was going on as she was having a different kind of urgency maybe even emergency which was more along the lines of this really stinks.
I can’t get control over this it’s impacting my life and here at 1:30 in the morning I need somebody to witness and validate what I’m going through and give me some sense of hope for the future.

[26:41] And I missed it and I’d like to believe that I am.

[26:48] Somebody who cares about people and can can can connect in a meaningful way however what I really was looking at there was
and Expediting the process and trying to take care of as many people as I could and that’s when I realized that I perhaps I had lost my way.

[27:06] And that was never how I was prior to going to medical school and so it led me to thinking about this.
How do we make Health Care really about health question and so I was really intrigued by the offering of the integrative Medicine initiative
but I will share with you again going back to
my own shortcomings here is what I looked at the application I distinctly look for are they going to ask me about myself,
is this about psychology and stuff like that because at the time Randy honestly I believed I eat stress that’s why an Emergency Physician,
this is what I go on this is my juice I don’t need any of that stuff so it’s that kind of program I’m not even interested but it wasn’t there,
and so I applied and interviewed on Valentine’s Day 1997,
and a week later I was fortunate to be given the opportunity to matriculate in the program so I want to.
Explore a little bit of what I find really fascinating and really Courageous about what you just said,
this was profoundly new territory at the time in fact I think we could probably agree that it’s still.
Is in a state of emergency but this is something that you elected to do.

[28:32] At a time when very few people were talking about it and it and to me it causes me to point out that you really are.
Quite a Pioneer you probably too modest to admit that but it’s a big step.
At the point of your career when you made that decision and I’m curious.

[28:56] Very curious about what was going on around you with your people coming up to you saying Russ,
you might be off your rocker a little bit are you sure you want to go do this Voodoo stuff you know the this is way Outside the Lines what were you hearing from the people around you and what effect did it have on you.
Randy I just broke into a smile because I heard that word voodoo more than once during and and I thank you for being so kind and.
Assessing me at that time but really and truly I really do mean this is not false modesty I was really lucky because in some ways I didn’t know what I was getting into.
What I was looking for was to say,
there’s got to be more and I don’t like the arrogance of conventional medicine to say that things like acupuncture or herbs or things that have been used through traditional healthcare for a millennia couldn’t possibly be a benefit to our patients
I want to see where’s the science and how can we apply it and how can we use this to make Healthcare better for folks and so I went in very naively because I was in the very first class of the program back in 1997.
So there was nothing no background information about it was could we as the first class could we participate in a way that might actually oh contribute for others.

[30:17] And so it was that you know.
Nascent desire to be a part of a movement rather than a new field of medicine that really kind of called me and one of the things that was compelling about it was.

[30:36] It was hard to figure out what actually integrated medicine was at the time in fact I’ll share a story in just a moment about how that
came full circle for me but when I announced to my emergency medicine group that I was leaving and what I was going to leave for I would say nine out of 10 of my colleagues
I really do think you know rush you have lost your mind you know you have this amazing job and you’re going to go do what
and so most of my peers were
looking a little scats of me and frankly we’re a little worried about my wife and kids but there were a small number of folks who said you know Russ I wish I could do what you’re about to do.

[31:20] Which left me thinking well you know you could it’s just you know we often believe we’re stuck even though we’re not
and so I had the Good Fortune to Simply explore but I was also I was literally is nothing less than this word I was blessed with having a wonderful wife
who literally said to me Russ you haven’t starved us yet let’s do whatever you need to do and so we moved out to Arizona with.

[31:48] Two munchkins under two years of old two years of age and started a new life out there.
And so it was intriguing Randy for a number of different reasons not the least of which is I was looking simply for evidence and data and how this could be rolled into conventional medicine I knew the program was not about me,
little to find out is that you know a few months in.
To learn that indeed in many ways the program really is about me because I suddenly found out that you even though I thought I had lived and.
Breathe stress and Stress Management I found oh my goodness I’m just like everybody else.
But that informed everything because then I had a different way of engaging with people,
where we could have shared vulnerabilities and shared dreams and thereby create a partnership rather than some hierarchical.
And that really changed everything and I will say that it started very very early.

[32:51] The second day of the fellowship program we were you know the they were only four of us in the program at that time we were kind of like the beta test and hour.
Presenter one morning was a professor of virality he studied viruses but he was also somebody who is very interested in the philosophy of science.

[33:12] And he was giving us a presentation on Paradigm shifts because he put forth to us that we were engaged in nothing less than a paradigm shift.
That’s your to being to make Healthcare really and truly about health rather than disease management so he spoke to us about Copernicus and Galileo and we studied these philosophers and then he said you know I want to put forth.
A philosophy for you guys that I adhere to and this philosophy was that there are three forms of knowledge.

[33:44] He said there’s belief there’s opinion and there’s fact.

[33:50] And we had the opportunity reflect on that for a moment he said so you guys let’s just assume that to be true for the moment give me a fact.
Now remember Randy we were all really nervous we don’t know what we’re doing that’s a fact I don’t know and somebody said the Earth is round he goes great that’s really good you know,
we actually have really good data that the Earth is round we’ve got data from space we have geologic data we have mathematical data the Earth really is round.
Then he paused and said give me a fact in medicine.

[34:21] Now remember the four of us in that class we had all been practicing medicine for some time and yet here we were kind of like what is he asking for.
And so he let us off the hook and he said well let’s put it this way let me give you an opportunity here I study viruses.
How about the HIV virus causes AIDS we’re like yeah you guys will certainly strong Association but let me ask you something.
Why thank goodness if the HIV virus causes AIDS are there so many people who are HIV positive but don’t have AIDS.

[34:56] Maybe it’s a protein that actually causes the disease but it’s only activated in the presence of a certain number of viruses.
Maybe it’s this maybe it’s that and Randy in that moment.
Everything changed for me because it went from the algorithmic model of healthcare the linearity of each person.
And their health Destiny to the possibility that resides within each person and that may be the role of a health care practitioner,
while certainly to take care of urgencies and emergencies and to do whatever they can to prevent illness in the first place but it’s also to facilitate the optimal functioning of the innate Gifts of healing that each person was born.
And so everything shifted very early on for me and I rediscovered my love for billing it being in The Healing Arts that’s really profound.

[35:55] So what was it like that next two years what you know we most of the people I don’t know.
I was about to say most of the people who hear this podcast of been through fairly,
conventional training where you you know you go to work you make rounds you discuss things with faculty and
you you act on the best evidence and
things of that nature but you were entirely in new territory here so I’m wondering what Fellowship in Integrative Medicine looked like,
when you are face to face with the patient.
Well you know early on I actually had one of the instructors asked me how the heck did you get into this program because I was really pretty well steeped in conventional medicine you know Sheree the evidence
and you know a lot of this stuff is just who we here I thought I was pretty open-minded Randy but I had walked in,
with adding a recognized either myself not as open-minded as I needed to be.
And so I started exploring things because the first two months of the fellowship program we didn’t see any patients at all they were simply setting the stage,
for us to consider things a new you know literally asking the question well if the body has the innate capacity to heal many instances.
What does a healthcare practitioner do.

[37:22] And I really you know outside of urgencies in emergencies I had not considered that question and you know how if is there a healing system with each person and how can we help that,
function optimally well for the person who has had.
Heart attack over here and the person who’s had a heart attack over here why are their outcomes oftentimes so,
and the person who has every one of us in healthcare has been.

[37:51] Presented with somebody who has a poor prognosis and yet somehow has beaten that prognosis back,
how does that happen and why does it happen and all too often what happens for us is we go that’s amazing congratulations I need to go back to work and send us saying how did they do that,
what can we learn from them and is it applicable to other people so really what happened early on as I was getting my mind blown.
And then trying to figure out how do I take that experience and create a different kind of relationship when sitting across from folks where we’re not unduly optimistic but never taking away somebody sense of hope.

[38:36] That’s so profound and it really gives me chills too.

[38:47] To contemplate on the very things that you’re talking about and I and obviously it had.
A tremendous impact on you because you’ve done you’ve embraced this new mindset and you’ve done very well with it.
And it leads me right into the next question.

[39:09] And that is here you are a fully trained physician now.

[39:16] Trained in an area that has been overlooked for centuries and now you got to go out into the world and sell it.
So how did that happen eventually you got back to the Carolinas and you were able to.

[39:31] Get this new methodology integrated into a very reputable Health Care System how’d you do that
how is it again just fortunate a ways that are almost unbelievable so when I first was speaking with the it was the Healthcare System I had worked with previously and literally
one of the lead administrators said Russ Russ what happened to your eye you like shaking rattles now and holding crystals what’s going on but at the time,
there was in 1997 a seminal article was published in the New England Journal of Medicine showing that.
About 33 34 percent of the u.s. population was engaging in complementary if not frankly alternative medicine.
And the sheer number of dollars being spent out-of-pocket exceeded what was being spent,
through conventional means so that got people paying attention because if for no other reason if your Healthcare System you’re looking this could be another source of Revenue.
Beyond trying to help people it may might make business sense.
So the administrator saw the opportunity for this but when I came back to North Carolina and my peers were like,
Russ have you gone to the dark side and so we would literally and so we would have conversations about this and so where we want people over.

[40:57] My team and I initially was that at least two things.
You my peers in the community are especially Primary Care Providers you are trying to help people with certain maladies for which there’s no prescription.

[41:13] And you may be at your the end of your options with regards to how you’re going to help this person those kinds of people send my way with for my team and I because we are using evidence-based,
interventions whether they be Chinese medicine whether they be mind-body interventions May whether they be this small,
number of Trials at that time looking at select vitamin supplements and herbs whatever the case may be that could be used.
In a way that might help patients so we try to share that whether it was our peers or the patient population we were fortunate to serve too often the equation looks like either or.
Either we’re going to use conventional medicine or we’re going to use these complementary alternative modalities we try to take that either or and make it and,
how can you safely take control where you can through diet and lifestyle measures and select complementary modalities together with the best of conventional medicine all in service to your Optimal Health but also to lessen your Reliance on
those conventional medical modalities and then the second part Randy was engaging our.

[42:20] Colleagues and discussions about hey we need to keep our patients safe because there’s a lot of stuff out there that actually isn’t in their best interest.

[42:30] Yeah a lot of wisdom in that and it’s a great credit to you that you’re able to.
To frame it in terms that really made sense obviously there was potential economic advantage and as I was listening to you it occurred to me how many times I have.
Seeing that happened I actually did my very first clinical rotation as a medical student was in family practice and I was reflecting on the number of patients that came through the office.

[43:04] During that two months that I was there again and again and again and again nothing changed and yet.
We kept doing the same things again and again and again but again the,
the reality that there might be some economic Advantage was obviously something that would get the attention.
And it did and you were.

[43:28] Very successful with it in the Carolinas Healthcare System and and now moving on to,
Bentonville and the Whole Health Institute you want to tell us about how that came about,
sure sometimes during those intervening years from 2001 until just this past year
I was very fortunate to be able to participate in a lot of different things so I worked for Carolinas Healthcare System I worked for Novant Health I work for Wake Forest all of them
typically for as consultants I had my own one day a week.

[44:05] I did consultancy with a large supermarket chain in the Mid-Atlantic
initially working on their Community Wellness initiatives and then subsequently on their employee Wellness initiatives I had the Good Fortune to consult with some remarkable entities and also one of those being the VA system.
So in 2012 the VA launched a program called Whole Health,
and it was largely because at the time the circumstances were dire around caring for veterans with chronic pain
the opioid crisis was in full swing especially in the VA who were folks on way too many medications comorbidities rampant and so worried emotional and behavioral health issues
VA recognized they had a problem we’re open to bold new initiatives
and so it as it turns out my program director at the University of Arizona integrative medicine program,
took over the reins at the VA of an integrative Medicine initiative called hold health.

[45:06] And it was launched in early 2012 mainly through
educational for and experiential forms and then it was launched actually to the patient population and a significantly important aspect of this without so much of it was
peer-to-peer support amongst the veterans it wasn’t so – so much health care practitioners telling the veterans you need to do this or you need to do that it was offering them the opportunity to explore for themselves
if they were going to embark on a journey of optimizing their health and well-being where would they want to start,
and then once they identified that starting point how could we as their HealthCare Partners support them in doing so.
Well that all sounds very very nice and maybe a little pie-in-the-sky except that their year-on-year outcomes show that the veterans really,
embraced the whole health approach you know it was looking at self-care strategies like diet and optimizing sleep and you’re trying to take care of themselves with environment and all but was also taking a look and seeing okay
no
which Health Care team are you going to be working with is it your conventional doctor we do have acupuncture we have Chiropractic how do you create an individualized program for each person to get better.

[46:25] And then the other part of it that really drove things home ready and you touched on it is not only did the veterans benefit from it,
but year-on-year it’s saved 30 percent on the average expense for a veteran being cared for.
This most recent year of 2020 the data coming back would suggest that when you.
Control for certain variables the savings were over 50%.

[46:50] No surprise to me at all I mean I I can remember my experience in the VA in my Surgical Clinic and when the patients came in they all weighed
always had a bag full of Medicine.

[47:06] Right and that stuff’s expensive so it’s pretty easy to put that two and two together I apologize for the interruption but do go ahead.
And I know it I thank you for sharing that because that’s a lot of what you ended up seeing
like here the VA was taking a leadership position not only amongst the VA hospitals but actually being able to show what might happen in the community keeping in mind that the VA is a
capitated facility you know here we are in the community moving towards value-based reimbursement.
And the thought is can the VA experience be extrapolated to be successful in the community as well,
and that’s really what the Whole Health Institute exists to do so again I want to go back to my good fortune because again it overflows we are a not-for-profit entity
funded through the largesse of Alice Walton of the Walton family and Walmart.
How we exist separately from Walmart but it is a not-for-profit set up through the vision of Alice Walton to see what can be done to transform healthcare for everybody.
The idea is really to focus in Northwest Arkansas initially because that’s the home of The Waltons and they love their Community here and they want to see what they can do to serve
the people of their Community but all with the idea to make Northwest Arkansas demonstration project that can be replicated around the country.

[48:32] So here at the whole thing else Institute we have a number of verticals and horizontals if you will so the.

[48:38] Deployment arms are Healthcare redesign.
And community outreach and then the arm that I’m fortunate to oversee witches employee whole.
And why I get excited about that Randy is well all the other.

[48:54] Entity that exists under this roof of Whole Health are wonderful and critically important components to transforming Healthcare I honestly believe that the area where we are
most likely to rapidly move the needle if we’re able to do so is going to be with businesses,
and so over here I can look and see you’ve got 18 to 20 percent year-on-year increases in Insurance costs you have
overages with the number of employees that businesses have to hire door to make up for absenteeism you’ve got the great resignation going on now is to retention and recruitment is really
important and so what we’re fortunate in finding out when I go out and meet with.
Business Leaders is I’m not going out to them saying you need to care about your employees we’re going to take for granted that they do.
But what I will go out the state of them is everything you care about from a businessmen’s perspective.

[49:45] Productivity profitability retention recruitment absenteeism and presenteeism reducing error rates etc etc
all of those reliable heavily upon the health and well-being of your employees do I think that we can create a return on investment for you.
By utilizing some of what we learned as the VA I do but I’m also careful to say Randy we’re not going out the same we have the answer for you.
Again because of the way we are funded we can go out to folks and say you don’t need to write us a check.
We simply want to partner with you and think about together could we come up with a solution that might Bridge the gaps that you’re experiencing and then share that with other businesses all in service towards Transforming Our Healthcare System and making it better for everyone.

[50:32] Well that is a brilliant brilliant idea and I Can Only Imagine,
how proud you must feel that you made that decision back in what was it 2012.
I haven’t lost my nose it’s unbelievable and that’s why I say you can’t write this and make it believable and so it’s I just
you know I share with folks sometimes and I don’t mean to be goofy or but I really do mean this if I have discomfort at all about,
my present position it is that.
The opportunity is so wonderful and so palpable I simply want to make certain that I can meet.
The opportunity and if not exceeded in collaboration with my colleagues.

[51:19] Yeah I am looking back at my notes now and it was actually back in 1997
when you made this decision to to embrace our integrative medicine and when I think about the state of mind that we were in with respect to Health Care back then
you truly were way ahead of your time and,
congratulations for sticking to your guns and helping bring us all to a better place because I think that’s exactly what you’ve done.
You’re very kind Randy thank you I have really enjoyed this conversation and I want to move along at this point and give you an opportunity to speak to us
pie and I guaranteed no interruptions
so I’m going to close my Mike temporarily and dr. Russell Greenfield will give us his personal prescriptions for success.

[52:14] So I want to again thank you for this opportunity Randy and it is,
honestly I’m hard for me to speak about something like this topic about you know my personal prescription for Success because,
I honestly think that success however it is defined I’m not going to claim it I really leave that to others to decide have I done.
With my life and my career what I had the opportunity to do or what I should have done and I hope I will live up to that,
opportunity and Merit opportunities like this Randy to be on your on your show what I can do is share with listeners some things that at least have been.
Important to me and I think I may not have realized early on in my career as much as or in my life as I recognize now so when I was thinking about this reflecting on that I came up with.
Three words beginning with the letter S as in Sam and the first s is special the second has service and the third s actually is Sabbath.
And so as I speak about special because the opportunity to interact with people.

[53:34] In their hour of need is one of the things that I explored significantly when I was in emergency medicine but I found also that when I had more time with people.
I could really sit down with them and talk about what is they really wanted to do with their life if they were out really well and really explore issues of
meaning aspiration of purpose not being a psychologist but just trying to get a lead about what my homework might be it enriched my practice of medicine in ways that I couldn’t even imagine
and when speaking with my colleagues about this they say well rust that’s.

[54:10] Impossible to do in this day of productivity standards and seeing as many patients per day as we have to and what I shared with them was what I learned from many many others it’s that sometimes
it’s simply an appropriate touch on the arm or the shoulder or a caring statement
or an open my open-ended question that sends the message that we honestly care about you we might be not be able to take care of everything in these 15 minutes
but I want you to know that I’m here to be your partner because we’re all engaged in this walk on this planet and we help one another.
As has been said by many far smarter than myself carrying or treatment goes in One Direction but healing is bi-directional.
And the opportunity to work with folks in that way from The Healing Arts perspective we learn so much from our patients.
That special part is about the people in our lives beyond our families
the opportunity to interact with people when they have need and we have the opportunity to share what we have been exposed to and learn in a way that maybe in Our Hope of hopes might help them to heal.

[55:19] Service because again that’s what we’re called to do.

[55:24] The Healing Arts really are calling and unfortunately sometimes we get so busy and then this age of covid we get so stressed and at the end of our rope it is very very easy to lose track of the privilege
being able to live in service nowadays people will sometimes ask me who you know would you recommend
for your children to God to health care if they ever shared that desire and I would always say number one
that’s their decision but if they asked my opinion I would wholeheartedly say going to healthcare because many of us are.
Feeling like you know we really need to do in this planet to make things better is to reach out and try and help people to the extent that we can
those of us in health care we get paid to help people how many people have that opportunity it’s unbelievable yes there are challenges yes I don’t like electronic medical records yes there are lots and lots of issues in healthcare but at the,
at the end of the day
we are called upon to help our sisters and brothers and we actually get reimbursed for doing so it’s quite a remarkable.
Place that we find ourselves in and then lastly if I might say I speak of the Sabbath I am not a very religious person.
I have my own belief system again I said I’m Jewish but.

[56:48] I don’t often attend services I don’t adhere to many of the things that I should do frankly but the one thing that I have done,
and it started about now 2324 years ago is I take the Sabbath.
Now I don’t do it necessarily in again this is my one of my failings it’s not from a religious perspective it is from a save my life perspective
can I say that I meaningless meaning it because I started this when our kids were very young and I was a seven-day-a-week work guy,
and my wife and I discussed that it just wasn’t working out that way and I needed to find a way to stop.
My work and so we decided that Friday night at 5:00 until Saturday night I would not work,
well the first Friday about 4:50 I’m looking at all the work I have to do and the kids playing off to the side and I’m like this is not going to work very well
but I stopped at 5:00 went to go play with the kids but honestly I was thinking about all the work.
The next week honestly the kids were playing at 5:00 and I was like well I’ll just finish up a couple of emails and get it done but again my my wonderful wife and I we sat down together and said no it’s got to be hard and fast at 5:00 I need to stop.

[58:09] And so I did that following week and I was stressed all I can think about is that if I could just use a little more time to get some more work done I would do better.
But it wasn’t until the next week that I realized something that I often share with my patients is that come 5:00 on Friday I was free.
I had made the commitment to myself that I couldn’t do any more work.
I was nervous about what my peers my colleagues might think if I told him I wasn’t available except for emergencies after 5:00 on Friday.
And it was really Randy was my stuff.
They honored it they valued it they said that’s fine if it’s an emergency we know how to get hold of you but otherwise that sounds great it was me worrying about what folks would think rather than what it actually turned into so since that time,
I have stopped work at 5:00 on Friday but I’ve only expanded the time that I don’t do work until Sunday,
and what I have found is that ready you me all those we love and care about and lister’s to we all have tons and tons of checkboxes.
But if we work 24/7 365 we’re still going to have work to do.

[59:18] In Chinese medicine there’s this wonderful adage that those who work and work and work and work give and give and give and give without taking time to replenish their energies run the risk of becoming depleted.
The depleted State doesn’t cause illness but it can open the doorway to it.
So all that I ask people to do listeners to is offer yourself the kindness that I learned from others about creating an opportunity to pause during your week not stop.
Little paws to rejuvenate to gain back some of your energy to put that in.
Reserve so that you never become part of the problem as you are doing your best going out to try and make the world a better place.

[1:00:04] And Randy I will leave you with that because again all these things that I’ve shared they weren’t learned on my own generally I had wonderful mentors and teachers along the way
and I’ve just been again extraordinarily fortunate and I really love the opportunity now to share it with your listeners thank.

[1:00:24] Rush that’s really profound and I am so grateful that you were willing to come and share with us today it’s a great message and I know it’s going to mean a lot to many of our listeners
before we go I want to give you an opportunity to let our listeners know where they can find
you personally if you like as well as Publications and email addresses and Twitter handles or anything that you might like to share because I’m confident that
does some of the people at here this podcast are going to want to know more about you so where should we look.
Thank you well the first I would offer is to go to the Whole Health Website and so it’s hold wh0 Ellie health
Dot o– r– g– and there you’ll learn about our program which really when you break it down it’s you’ll see and power equip treat
and connect and that last part is about Community creating community and so I would love to be part of a larger community of folks who also feel the way that you and I do Randy and so I might be you know the entire Institute
and all of our work is here in service to collaborate and partner with others who are of like minds and hearts so if ever I can be of service my email addresses are Greenfield,
add whole health.org and I would welcome the opportunity to be in touch with you.

[1:01:52] Dr. Russell Greenfield a true Pioneer in the world of Integrative Medicine has been a great pleasure thanks for being here.

[1:02:01] Music.

[1:02:07] Thank you so much for listening with us today.
Remember you can get more information about our guests as well as hear them face my rapid fire questions at our patreon site and while you’re there you can also subscribe to the podcast.
Give us a rating and hopefully offer suggestions on what you’d like to hear in future episodes.
Thanks very much to Ryan Jones who composed and performs our theme music for us.
That’s all we have for now so please be sure and fill your prescription for success with my next episode.

[1:02:41] Music.