Taking Healthcare by Storm: Industry Insights with Dr. Lori Carnsew

In this episode of Taking Healthcare by Storm, Quality Insights Medical Director Dr. Jean Storm speaks with Lori Carnsew, MD, family doctor, children’s author and lifestyle medicine advocate. 

Dr. Lori Carnsew discusses her transition from family medicine to opening Verity Primary Medicine and Lifestyle, a practice that emphasizes lifestyle medicine and prevention. She highlights the challenges and strategies for fostering lasting lifestyle changes in patients, and the importance of early education in lifelong health.

Learn more about Lori's children's book, How to Live Like a Superhero.

If you have any topics or guests you'd like to see on future episodes, reach out to us on our website.

Publication number QI-101025-GK

Transcript

Welcome to "Taking Healthcare by Storm: Industry Insights," the podcast that delves into the captivating intersection of innovation, science, compassion, and care. 

In each episode, Quality Insights’ Medical Director Dr. Jean Storm will have the privilege of engaging with leading experts across diverse fields, including dieticians, pharmacists, and brave patients navigating their own healthcare journeys. 

Our mission is to bring you the best healthcare insights, drawing from the expertise of professionals across West Virginia, Pennsylvania and the nation.

Subscribe now, and together, we can take healthcare by storm.

 Hello everyone, and welcome to another episode of Taking Healthcare by Storm. I am Dr. Jean Storm, the medical Director of Quality Insights, and today I am speaking with Lori Carnsew, a family physician who left traditional medicine behind to build. Something different. She is a trailblazer. Most definitely after 25 years in conventional practice, she founded Verity Primary Medicine and Lifestyle, a direct primary care practice that combines hands-on teaching lifestyle, medicine, and even a teaching.

Kitchen, which I love to help patients take control of their health. Dr. Carnsew or Dr. Lori as her patients call her, is also the author of the New Children's book, how to Live Like a Superhero, where She's Bringing Healthy Habits to her Youngest Patients. So we're gonna be talking today about real challenges patients face in making lifestyle changes, how she created.

Space that supports whole person care and why she believes the future of family medicine. Medicine in general must focus on prevention, not just prescription. So I am very excited to get started. Dr. Lori, thank you so much for joining us today. You're welcome. I'm so glad to be here. It's so exciting to be on this podcast featured with all these other innovative people.

Yeah. So let's jump in. So you began your career as an electrical engineer. So what led you to shift from engineering to family medicine and then later towards integrating lifestyle medicine into your practice? So I've always been interested in health, but I'm also curious, I've considered myself a scientist because I was always finding out how things worked.

So I went into engineering because that's what all the tests in school said I needed to be doing, and I liked it. But it wasn't passion and that was became very clear during my last couple of years when I chose to start looking at biomedical engineering. And then I realized I was really much more interested in the people themselves than the equipment and the tools that were taking care of them.

So I went on into uh, medical school and the rest is history. Yes.  It just sounds like you have experience in so many different areas, which I think  obviously helped you be where you are today. So from your experience, what are the biggest challenges patients face when trying to make lasting lifestyle changes, even when they know it can improve their health?

Mostly. It's the culture in which we live and the beliefs that people have. So people are busy, we're all busy, and as we have more access to tools and technology and internet, we see more and we do more. And we must have more.   Some people call that fear of missing out, but the hardest part is, to change those things and to get back to this old fashioned medicine.

And so when I tell someone you need to sleep more, or you need to take a walk in nature, or you need to eat the fruits and vegetables that's hard to compete with all the new high tech stuff that can support you. That may not be just. Just the lifestyle stuff. So it sounds old fashioned, but it actually is extremely powerful and evidence-based.

When you actually look at the studies on sleep  the studies on physical movement, the studies on eating plants, fruits and vegetables, they're there. We have great evidence  that. It's not only what keeps us from getting diseases like diabetes and cancer but it also helps reverse a lot of those diseases.

And it's not something that people really wanna hear. I can prescribe a pill all day long and nobody bats an eye, but if I tell somebody that they need to be on a whole food, plant-based diet, then all of a sudden that's radical. Yeah.  I feel you. I hear you and I agree.  Very basic things like you're talking about sleep fruits and vegetables.

Increasing your social connections. Reducing your stress.   Very basic things  and then people are like, no, we're not gonna do those things.  Just give me a pill and Right.  It would be easier, but not the best. That's, yeah. So tell us about your decision to open a direct primary care practice and create a physical space, including a teaching kitchen that supports lifestyle medicine.

How has this changed your approach to patient care? Well, when I started as a family doctor in training back in 1997, I loved family medicine because you got to do all the things and all the parts and I thought back then family medicine was about the relationship  and that was the heart of medicine.

But over time, the system began to shift and all of a sudden. It was away from people in relationships and more towards check boxes and computer screens. So  patients began to feel lost and doctors, myself included, began to feel lost in the system. It wasn't,  working anymore. It wasn't working for my patients, and it wasn't working for me.

So. I opened Verity Primary Medicine and Lifestyle in 2017, and it's a direct primary care practice, which means I have more time to spend with my patients. I no longer participate with the insurance companies and Medicare and Medicaid who were putting a lot of these check boxes on us. So it's a direct relationship.

And now my, IM patients enjoy at least twice as much time with me and, and I respond every day to emails and texts. But I also did something that you don't usually see in a doctor's office, and that's putting in the teaching kitchen. It was the first of its kind  teaching kitchen in a doctor's office.

Kind of unheard of still. First one in South Carolina, perhaps in the country. 'cause you, you can't, I could tell people all day long to eat better, but if I show them and I get them involved, it is much more likely to stick. So lifestyle medicine in that way, it's not.   It's not easy, but it is rewarding or it can be.

Absolutely. And I, agree with you, you really, there's such a difference when you actually show patients directly.  I've talked to two physicians  who are doing walking appointments with their patients and you're doing cooking appointments with your pa like that is really making a difference.

And it, it's very exciting and it's  it's very basic, but  it works. It's it's really innovative. So even with education and hands-on tools like cooking classes, many patients do still struggle to change. Why do you think change remains so hard, and how do you help patients balance real life with healthier habits?

So it's culture. Culture is hard to change because we have eaten that way forever or this is what's available around me, but. Before I forget, you said the word balance, and that's a big part of it is I think there's an expectation that if I ask someone to change, it's a hundred percent all at once.

So if I ask someone to do a whole food, plant-based diet, they're like, what a vegetarian diet. And it's, that's not me. That doesn't fit with. My ego, my culture, it just doesn't fit. And I would've said the same thing 20 years ago, but as I started to learn the data and started to make changes, it wasn't a hundred percent.

And so now I eat and do things that I never would have seen myself doing  20 years ago when I, started on this journey. But, as far as why it's so hard to change, part of it is, our culture.  When you at the workplace look in medicine, most physicians and nurses don't have time to take a bathroom break, let alone.

Bring something good for lunch, there's nowhere to keep it.  Oftentimes the cafeterias or the fast food places in the hospitals aren't serving the nutritious food that, that we would need. It takes longer to eat it. You can't eat a salad in the car. But it's easy to eat a burger and fries in the car.

 You look at the business communities and they're  offering up what people like, at least in my area in South Carolina, upstate South Carolina I call it not just the standard American diet, but we have the Southern American diet and  we have higher rates of,   diabetes and strokes here.

 Some of the highest in the country. So it's hard to change because that's what's there. We go to churches, we go to scouts, we go to any professional organizations and it's hard to be the weirdo that asks for beans or something a little different, a mushroom burger or something. So that's the culture.

And you have to be in, I tell patients all the time, you almost have to be the weirdo a little bit and ask for something different or bring your own, food. So it takes. A lot more effort to make a lifestyle change than it does to take a pill. And it's challenging for people in our busy world.

A hundred percent.  And it's interesting. I was doing an education recently around opioids. And I mentioned you know, when, someone has a  is challenging as being challenged with substance use disorder, they really have to change their entire lifestyle to, to make that change, right? They have to almost change the way they live.

They have to have d. Friends, like they may have to  they just have to change their almost entire identity, but around like, if you think about somebody with chronic disease, it's challenging. Like how do you ask a person? You've gotta change your entire identity, right? Like their whole family may be eating fast food on a daily basis.

So yeah, exceedingly hard. Yeah  it's very hard. And comparing it to opiates, it's a great comparison. Whether it's opiates or alcohol, and we would call that drug abuse or abuse, and it's kind of looked down upon like, oh, this is a bad thing. But eating never has been. So it's so much harder to change eating habits than even that because  culturally, acceptable, but you're very right.

 It's very hard to change when you don't get out with new friends or new families or  being able to make those changes without a lot of support. Which is why when you find a doctor's office and you find doctors that start making community lifestyle programs  there are others  not everybody has a teaching kitchen.

I know. Somebody in Pittsburgh who has a fitness center in her office. Wow. And so when you start to have these communities. Then that's when people can enjoy and start to meet other people in the community and do get some support from lifestyle changes. Walk With A Doc is another great organization that  we're doctors all over the country and world now are getting people just to come out and walk in a non-threatening just community environment.

Yeah. So you mentioned that lifestyle balance isn't just important for patients, but also important for professionals, right? We saw during the pandemic tremendous amount of burnout. So how do you personally maintain balance while you're running your practice and you're supporting others? Yeah, it's a constant challenge and I love it because I'm not perfect and I never will be.

And so one of my something that I'm kind of proud of is,  authenticity.  I tell my patients don't expect to never see me eating a french fry. I try, but occasionally I am going to have something or, or I won't sleep enough some nights because I'm working on some new big project. But  it's a constant challenge.

Getting out of the system that I was in the healthcare system and starting verity was a huge benefit, not just for my patients, but I did it for myself and my family and my lifestyle as well because I got to make my own environment. I was the weirdo at my office. I was no longer the physician leader.

But as healthcare morphed, I became the weird doctor who ate different things and went outside and meditated when I got stressed and. Now I can set the tone of that here. So we have a teaching kitchen and we don't have people bringing junk food as gifts. I have people bringing  okra and herbs as gifts or, whatever the extras are in the garden.

So it's wonderful to have this shift of wellness because. If you can build it and stick to it, it does start to bubble over in the community. And that's what I'm hoping we, we can get to  is  a friendlier community where there's more access to plant-based foods and there's more access to easier movement and walking areas and green spaces.

Yeah, making it a lot easier. So your new children's book, how to Live Like a Superhero, focuses on Teaching Kids healthy Habits. What inspired you to target children specifically, and what role do you believe early education plays in lifelong health? Oh, absolutely.  Children's. My children because I do still do pediatric care.

They are so open to new ideas so much more than adults are. So even children's that, that come in and say, I hate vegetables or I hate this. They can be talked into trying things and they really are open to new things and I found that they remember stuff plus. I have just always loved children's books.

I've read all my life all of the books from my kids I have kept and I still have and I've always wanted to write one someday. And it finally just came to me as I'm talking to kids in the exam room about eating  the colors of the rainbow. And it resonates with kids because good health doesn't have to be.

Scary or boring. If you put it in a child's eye, it can be heroic and exciting and full of rainbow colored foods and puppies and mud puddles. So that's what the book is about. It's about how a child can live like a superhero. How that superpower keeps their powers up by doing all the healthy lifestyle things like sleeping and taking downtime and being outside in nature and eating the rainbow foods and staying away from clogging up foods.

So the other cool part is it does start to go to adult. So I have had a lot of grandparents buy the book and tell me that their grandchildren love it, or I've had people ask me to sign the book for their, brother or sister or someone who is in their forties, but really needed to hear the message.

That's super exciting, we will link the the book  in the podcast description. So looking back on your transition from traditional family medicine to a lifestyle focused practice, and I will say from my viewpoint, lifestyle focused is. Should be probably the traditional, because it  it makes more sense.

 But what advice would you give other physicians who are feeling frustrated? Like you said you were kind of, in a traditional model, so  what would you say to other physicians who are feeling frustrated in conventional healthcare models? So I would say what you have to do is start with yourself because it's almost like we used to say, see one, do one, teach one.

You really have to start with yourself and find where your weak parts are because we are ingrained in our model, and especially physician training is, hard. We burn out early and we, it's. You know, suck it up. up. And that's what we live and what we've learned. And so for us to turn and actually accept some love from ourselves to ourselves is very difficult to do, to allow ourselves time to sleep.

 You know, Sleep used to be  something that you would do when you were dead or you would do when you retired. Sleep is actually really I important for the bodies. And so really looking at your life. And so when I lecture to other doctors, we talk about balance.  Are you getting enough sleep? Do you have downtime?

Do you feel supported at work or in your family or in your communities, or are those just people that are around you? And it's not really a connected relationship. Are you eating fruits and vegetables? Have you counted it? We ask our patients to keep food diaries, but do you know, and I'm not talking about how many macros or how many calories, but how many fruits and vegetables, how many colorful foods are you getting?

Are you feeding that gut microbiome? All of these different nutrients and antioxidants that really help fuel not only our immune system, but our metabolism in general as well. So really taking a deep look at themselves and then. Not trying to change it all at once, but picking one thing that's sustainable like, can you take five minutes before you eat lunch and do some exercises next to your desk  a couple pushups, a couple air squats, and make that a priority.

And so starting with these very small things and then going from there. After that, you'll be, you'll find that you're automatically gonna tell your patients how to do it. Yeah   I agree and I love, um, I was a guest lecturer for  a diabetes prevention education group, and I talked to them about the idea of exercise snacks, so that the five, it's great.

Like why do not take an exercise? I love snack.  I just tell  people to try to make them  fruits and vegetables  as you mentioned, but exercise snacks are, great and  they're effective, right? It is. And, that little bit adds up. I used to have in my mind that an exercise session had to be one hour, one hour at the gym, or one hour dance class, one hour yoga class.

I, and I would never do it because I'd never had an hour. So I allowed myself to do a 15 minute session. I'm like, that's all I have time. I'm gonna stop at the gym. 15 minutes. I'm just gonna do a couple of these things, and all of a sudden. I'm doing it regularly. It may not be as much as what I would have considered perfect but you know, over three years your body changes quite a bit.

If you can do 15 minutes, two, three times a week  maybe that's all you have, but we can do it. Yes. Finally, where do you see the future of family medicine and lifestyle medicine intersecting, and what's your vision for how healthcare could better support patients in preventing disease, not just managing it?

Yeah. I do see lifestyle medicine merging with family medicine, and I am excited that. Those of us who studied before 2010 really had very little training on food and nutrition. And we're starting to see it slowly creep into medical schools and family medicine residency programs. And the more doctors that we have that are learning this, and not just doctors but other healthcare providers as well are teaching it.

So most of the students around me now are getting at least a little bit of this during training. And I think we're gonna learn with the, disease burden that we have right now. And it just continues to grow and every year there's more medications and yet diabetes really isn't getting any better control than it was 20 years ago.

And we definitely don't have. Less people diagnosed, so prevention, which would be lifestyle medicine. It is going to have to be the key or we're not gonna get anywhere. We're not robots. We may become robots someday. Who knows if we merge with ai, but  we're not gonna get there by continuing to do pills and procedures.

It's got to be lifestyle medicine. And I think we have some pretty clear evidence of that. It's just that we as humans who love technology and  my background's engineering, so do love technology, but I also like to look at the big picture. And technology isn't gonna get us. There. As humans, we've gotta do the lifestyle first.

So I do see those fields merging and I wouldn't be surprised in the  10, 20 years down the road if lifestyle training wasn't a standard part of primary care, internal medicine and pediatrics and probably psychology, psychiatry, and family medicine. So, the vision really is if we can plant the seeds of health in families and in children, hopefully those seeds will keep growing long after the doctors are gone, long after the medication's gone.

 That's what we want is to, people have this sustainable health. Yeah. Yes. Teach 'em to fish, right? Yes. Dr. Lori Carnsew. This was inspiring. I really enjoyed the conversation. If there are listeners who want to learn more about your direct primary care model, how can they do that? Do you have a website?

Yeah, so our Verity Primary Medicine and Lifestyle, the website is verity medicine, V-E-R-I-T-Y medicine.com. And that is our office. And if you are interested in the book, how to Live Like a Superhero, my website is loricarnsew-md.com. And there you can learn about other lifestyle courses and some of the courses that I teach in my kitchen, which may be online within the next six months.

How exciting. Well, I  wish you the best of success and thank you so much for joining us today. Thank you for having me. It was great to be here. 

Thank you for tuning in to Taking Healthcare by Storm: Industry Insights with Quality Insights Medical Director Dr. Jean Storm. We hope that you enjoyed this episode. If you found value in what you heard, please consider subscribing to our podcast on your favorite platform.

If you have any topics or guests you'd like to see on future episodes, you can reach out to us on our website. We would love to hear from you.

So, until next time, stay curious, stay compassionate, and keep taking healthcare by storm.