Taking Healthcare by Storm: Industry Insights with Dr. Elizabeth Markle

In this episode of Taking Healthcare by Storm, Quality Insights Medical Director Dr. Jean Storm speaks with Elizabeth Markle, Ph.D., a licensed psychologist, speaker, writer, researcher, Associate Professor of Community Mental Health at California Institute of Integral Studies, and Co-Founder and Executive Director of Open Source Wellness.

Dr. Markle explains how co-founding Open Source Wellness was driven by the “behavioral prescription” gap in primary care and her experience with intentional community, inspiring a “behavioral pharmacy” that replaces shame-inducing advice with joyful, culturally relevant, trauma-informed, community-based support. She shares outcomes from the community-as-medicine model, argues for team-based care led by coaches to reduce provider burnout, and outlines plans to scale through YMCAs and clinic-community partnerships.

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The views and opinions expressed by the host and guests are their own and do not necessarily reflect the views, positions, or policies of Quality Insights. Publication number QI-030626-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.

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Hello everyone, and welcome to another episode of Taking Healthcare by Storm. I am Dr. Jean Storm, the medical director at Quality Insights, and today I am thrilled to welcome Dr. Elizabeth Markle, a licensed psychologist, researcher, speaker, and the co-founder and executive director of Open Source Wellness.

Dr. Markle is a nationally recognized thought leader in community mental health clinic, community integration, and what she powerfully calls community as medicine, which I have been reading about and I love this. Concept through open source wellness. She's helping reimagine how we support behavioral health, moving beyond isolated advice, like exercise more and eat better, which, you know, I'm recording this at the beginning of the new year, and I hope people are not just saying that and not along with other advice, and instead creating accessible, joyful, community-based spaces where people can actually practice the behaviors that lead to health and wellbeing.

With a background that spans clinical psychology, academia, and social entrepreneurship. Dr. Markle brings a deeply human lens to some of healthcare's most pressing challenges, burnout, chronic disease stigma, and the ongoing behavioral impacts of the COVID-19 pandemic. I feel like it goes on and on. Her connections, belonging, and intentional community can become essential.

Parts of care. I am so excited to explore her journey, the vision behind open source wellness, and what the future of community as medicine could mean for individuals, healthcare systems, and society as a whole. Liz, I am so excited to jump into the conversation. Thank you for joining me today for these important topics.

Wow. Jean, thank you so much. I'm happy to be here, and I think that was the best introduction I've ever heard. I feel like you just did it right there. Well, good. So I just wanna jump in. You've worn many hats, as I said, psychologists, academic, social entrepreneur. What personal or professional moments most shaped your decision to co-found open source wellness?

Well, I'll give you one of both because it really has been a personal professional journey.  Professionally. I think that this, this sort of awakened in me when I was an intern as a psychologist. We do these pre-doc and post-doc intern years, and I was working at Cambridge Health Alliance in Boston, which is, uh.

hospital and a series of federally qualified health center clinics  serving a very, very diverse, , demographic of patients. And I was doing what we call integrated primary care behavioral health, which is just a lot of words for being the behavioral health clinician on the primary care team helping both patients and providers with all the social, emotional, behavioral as.

Aspects of care, and it was that, it was during that time where I was getting to observe and support hundreds of primary care appointments that I started thinking about the language of behavioral prescriptions, and you named some of these. These are what patients are, are walking out of primary care appointments, receiving verbally, things like you need to exercise better, or you need to eat differently, or you need to reduce your stress.

All of which are such good advice, right? The data's there. I have no argument with the, with the content of the prescription. The problem is what happens next because so often those prescriptions are followed by the clinician saying something like, Alrighty, then see you in six months. Good luck with that.

Let me know how it goes and off the patient goes. And that's the end of it. And I remember saying to Dr. Ben Embert Aaronson, who had become my co-founder saying, can you imagine if we said you need antibiotics? Good luck finding them off you go. Like that would be malpractice. Clearly we have a whole, national infrastructure, the pharmacies, for making sure that people don't just talk about medication, but they actually get it, that their insurance covers it, that they know how to take it, et cetera.

And so. I think it was around then that we started saying, what would it look like to take behavioral prescriptions as seriously as we take medication prescriptions? What would a behavioral pharmacy look like? And that was really  the impetus for starting open source wellness and what would become the community as medicine model was saying, Hey, we know that patients are being told four things, eat better, reduce your stress, exercise more, and get some social support or some social connection.

What would it look like to create a delivery system for that? So that's the professional story. And then lemme just pause there. Anything you wanna say about that or shall I share the personal I just like you're speaking my language because I, you know, as a primary care physician, I would never say.

Hey, you have pneumonia, go out and forage for your antibiotics. Like, right,  so  I, I agree a hundred percent. Yes. You have to give people actionable ways to achieve what we're telling them to achieve. Yeah. And before we say, oh, behavior change doesn't work, or they're non-compliant, or they're resistant or whatever, like, have we actually provided a delivery system?

Yeah, that was the professional. And then personally speaking, part of my journey has been that I have. Chosen to live in various forms of intentional community since I was 21. And this has ranged from cooperatives to things that look more like co-housing, which is an amazing Danish model of community where.

Individuals or families have their own small homes that are centered around a large common house where there's shared resources, like a big commercial kitchen and laundry and guest rooms, and a yoga space and a bike shop, and all of those things. You know, my experience of living in community has shown me, first of all, that getting along with people is really hard work.

Don't wanna discount that, but second, that there are ways to design life such that the healthy thing becomes the easy thing. And you know, as a simple example when you share food, when you share cooking duties with a number of adults, you come home sometimes and your job is to cook for a lot of people.

And it's a lot of work. But other days you just roll home and dinner is made. And as I was an exhausted intern working in a health system, getting that I was. Supported in being, well, not because I had wealth, 'cause I didn't, and not because I had willpower, because I didn't particularly, but because there were social structures surrounding me that made it easy.

That was sort of the personal moment where I said, aha, most of the American population is not crazy enough to wanna live in community, however. How could we take the active ingredients of community living and distill them into an healthcare integrated pay covered model that would help people achieve their health and wellness goals in a way that was joyful and sustainable and culturally relevant and all of that.

So I think it was that sort of the professional disillusionment combined with this personal inspiration that guided us to say, you know  we have to try this. Yeah  I love that and I love the idea. I think people are very, maybe in our. Current environment in this country, maybe around the world, very black and white in their thinking, like, oh, that worked there.

But this is not that. This is, you know, the intentional community is not a nursing home. Right? That's struggling with staffing or, or whatever. But. I think what you do need to do is distill down those things that work because we're all human beings. And then take those aspects that are working to bring people together, to make people feel seen and have meaning in their lives and all these things, and then use them in other areas.

So  I love that. I'd love that. So when you and your founder, a co-founder. First imagined open source wellness, which you've been talking about, what gap in traditional healthcare did you feel was most urgent for you to address? Because there's a lot, right? Like I think I would feel very overwhelmed mm-hmm.

In, in kind of facing what I wanted to address first. So I'm curious what you felt was most urgent. Yeah. You know, I think when we started this, I wasn't even present to the size of it. You know, I, I, I was trained as a psychologist, not a public health or a healthcare executive, and so there was so much I didn't even know at that time, 10 years ago, but, well, here's what I was present to first.

You know, we already talked about this behavioral prescription gap, the moment of do this, do that, good luck.  And I was so committed that we had to do something better there. But the other piece that I've, I've been able to articulate better over time is that. That I think some of our healthcare standard operating procedures are complicit in creating an experience of shame and a sense of personal failure for our patient.

So to sort of break that down a little bit, you know, imagine a patient who is working multiple jobs. They live in a place where there's not safe sidewalks to walk. There's a food desert. They're trying to care for kids, they're managing generational trauma and, all the stressors that, combine to weigh down people's sense of vitality and wellbeing and self-efficacy.

See, we, we know how this works. And then being told you need to exercise more, so you should be going to the gym and you need to be eating more fresh produce. So you should be, going to the, the nice grocery store and buying organic produce and preparing it and feeding it to the kids and cleaning up and helping with homework.

And then you're supposed to meditate and see your friends. Like  it is a setup. For people to say, okay, doc, okay. And then leave, and then be faced with the impossibility of it as it relates to the social conditions surrounding their lives. And tragically, most people are living inside of a power dynamic with their primary care providers.

And so they're not in the moment saying, doc, you're crazy. There's no way that's gonna work in my life. They're just saying, okay. And then they leave. And what can happen is this insidious sense of. I wasn't able to do this, and it must be my fault. I must be bad. And we hear this in our patient's language, like, I just didn't have the willpower, or I'm sorry, I'll try harder next time.

 And I think you don't have to be a psychologist to know what shame feels like and the. The sort of deeply depressant effect it can have on motivation, on empowerment, on self-efficacy, on desire to make change in one's life. And so, I watched our system create this, our watch our providers be kind of complicit in this.

You know, we talk about moral injury and burnout, and I think part of that is being complicit in a system that's not doing no harm. Idealistic though it was, we were sort of saying what would it look like to build a behavioral pharmacy that didn't generate shame, but instead generated belonging, joyfulness, shared humanity, where like a place where we're all saying, yeah, I have challenges in my wellbeing too and here's what I'm gonna do for it this week.

That's a fundamentally different experience creator than healthcare is as we know it. Does that make sense? Oh yeah it definitely makes sense And, you know, I wanted to kind of lead in because I just, the community is a form of medicine, is I love that statement and what it means, and  I'm really curious about, and, and I'm wondering if maybe we should, you could share some success stories.

You know, thinking about that concept, moving beyond metaphor   and telling us how that community is, a form of medicine actually creates measurable impact in people's lives. Happy to do that.  And I can share with you some statistics or data that might help on the back end of this. You know, there's something that happens.

So when people are prescribed into the community as medicine now by their primary care doc or by their therapist  we get their information and then someone on our team, or someone on our partners teams where, you know, we're working with YMCAs. Scale this model, so I can speak about that. But essentially a community as medicine facilitator who's a health and wellness coach, would reach out to that participant  and this would not just be like an administrative enrollment call.

This would be a relationship building exploratory conversation. And at some point in that conversation, the coach would ask the patient a very simple question, which is, what do you want? What would make a difference in your life beyond what your doctor's saying, beyond what you think you should have  beyond all the advice you've been giving, what shift in your wellbeing would make a difference for you?

And you know, we, we train our coaches to do this in a really. Empathetic, curious, supportive way. But what we find is that if you drill down past all the shoulds and the sort of like layers of shame, people want things that relate to. Other human beings, right? People say, I wanna be well enough to play with my grandkids again, or I wanna get back to work.

I actually miss being with my colleagues and feeling a sense of purpose and connection and meaning in my relationships with the world and with other human beings.  And we, we really find this kind of across the board that what matters underneath all the other matters are relationships and human connection.

So I think that's kind of a fundamental piece. And then what we have learned having built and delivered this community as medicine model for almost 10 year now, 10 years now, is that all kinds of things shift, right? You know, we see blood pressure shift, we see depression and anxiety and belonging shift.

We see emergency department visits. Go down.  There are all kinds of objective shifts that happen, and the one that precedes that to the best of our understanding is something around human connection. That people say, I, I didn't feel alone anymore. Or I, you know, I had people that I would see every week and we would laugh together and then they would text me and say, how are you doing with that goal you set?

Or, it was a place where I could be vulnerable. And, you know, a coach from many, many years ago said it so well, he said to me. Liz, I, I think, I think this model is like a life force starter engine. And I don't know how you quantify that from a research perspective, but I think that the experience of holding our human, suffering  our inherent challenges with our wellbeing, not in shame and isolation, but in community where we get that we're not alone and we're not uniquely bad in having these challenges.

We're just working on it together In community that activates or potentiates. Or helps people gain traction in the process of making and meeting other goals. So suddenly when they don't feel as alone, then the idea of I'm gonna walk around the block three times a day, is not that overwhelming. We're trying another vegetable.

They're coming from a sense of vitality and fullness. Then they can take those things on.  we're seeing. Drops of about 50% in PHQ nine scores. We're seeing similar drops on the GD seven for anxiety. We're seeing systolic blood pressure dropping by about 19 points for patients with hypertension.

In one study, we saw about a 77% drop in emergency department visits and unplanned hospitalizations. The data bears this out. There's certainly more research to do in understanding exactly what the causative and the mediating factors are. but I think as you tie this to the broader field of literature, this really does hold up.

Oh my goodness. I mean, just the 50% with the PHQ nine for those out there, I mean, that's a depression screening. That's amazing to make people feel better. Mentally to make people feel better in their chronic disease. And, and obviously those two are linked, but, I mean, that's amazing without pharmaceuticals, right?

yeah, absolutely. I mean that alone, right? If we, if we can address depression at scale  that alone drives cost savings and sustainability in an incredible way. Yeah, so I wanted to kind of shift a little bit just to healthcare, staffing and talk about burnout. And it's, maybe it's a overused term, but I'm gonna use it here because it's, very common in healthcare.

I experienced it myself after the pandemic though, maybe we're still after the pandemic. Mm-hmm. From your perspective. What are we getting fundamentally wrong about how we support patients and providers? Yeah, that's a great question.  I'll take a shot at it and maybe we can, explore it together.

 I remember learning about the care pyramid and there was like primary care on the bottom and secondary care, and then tertiary care. And I didn't question it at the time  but where I sit now, it seems ridiculous that primary care is the bottom of the pyramid, right? Primary care providers are highly, highly trained.

They're highly expensive. They may or may not have the cultural relevance to really meet our patients in the way that they need to be met, and the systems aren't designed for them to really be an effective. Point of contact or primary relationship for our patients. So I would question whether it makes sense for PCPs to be the primary relationship holders and the sort of unit of care delivery.

I think, you know, what we've seen is as there's more. Recognition of social drivers of health and the need to be screening for, and assessing for all these various, social impacts on people's wellbeing. We put more and more on providers. So now providers are screening for a ton of different things and at the same time we're scrunching their schedules and and driving volume.

And this does drive burnout. It also just drives low quality of care. And I think, you know, because I sort of live in the lifestyle medicine arenas, what I see is that there are some absolutely heroic providers. Who are pioneering new models of care, right? They're the ones saying like, I'm gonna run a group.

And they, they just, you know, like they make the phone calls to the patients and they enroll people and they, they design their own curriculums and they come in at night. 'cause that's when the patients want to, and they just pour their hearts into it for a period of time. And then they go out on parental leave or they get burned out and they need to cut back their FTE.

And so these innovative integrative models. Collapse because they never became embedded in the structures of care. And so I guess what I would say is. We actually need to get serious about team-based approaches that have health and wellness coaches, community health workers, all the other sort of peer and paraprofessional level providers engaged so that the primary care providers actually an escalation up rather than the person doing the motivational interviewing and the relationship holding.

So this community as medicine model that we've. Built now and are spreading and scaling. It's delivered by health and wellness coaches and we, we train them and. There may or may not be a primary care provider involved. We love to deliver this model as a group medical visit, but even when we do as a group medical visit, the coaches are responsible for throwing the party.

They're the ones signing people up and welcoming them and leading. Physical movement and leading mindfulness and leading nutrition work and leading small group coaching. And the provider is just pulling patients aside for short top of scope visits and they're in communication with the coaches. So if something shows up that's outside that coach's scope of practice, they're gonna escalate it up to the provider and the Provider can escalate concerns down saying, Hey, this patient and I talked about what their diet needs to be for kidney health. Can you help them implement these changes? And what we find is that the providers who are delivering these community as medicine visits in partnership with our teams of health and wellness coaches say things like, this is the best part of my week.

This is how I imagined. Healthcare could be, and this gets me out of the fog of one-on-one visit after one-on-one visit all day long. So to sort of zoom out, I think what we get wrong is that we think providers have to be the unit of care and function in isolation to do everything.

And I think we need to really reimagine that. I love this model. I would agree like I'm as a primary care doctor yes. Bottom of pyramid, but I spent a lot of time in my clinical years just signing stuff and doing, I mean, just things that is what leaves to burnout, so.

Mm-hmm. I think this model just, it makes so much sense. Most definitely. Here's hoping that we can really drive the systems change and the support clinics and CFOs, and having the courage to try new things and to research it and to really, really sort of give it the implementation effort it deserves to do something different.

'cause I know it's hard. Yeah. Yes. So I just wanted to touch briefly about the pandemic. So how do you feel, you know, we're, we're years after the height of the pandemic. Mm-hmm. How is the COVID pandemic still shaping behavioral health needs and what are we underestimating in Its long-term effects.

That's a great question. You know, so often I sound a little doom and gloom about healthcare, so I'm actually gonna lean on the positive this time. I think that during the COVID-19 pandemic and in its aftermath. We started to take the conversation about social connection, social isolation, loneliness and belonging.

Seriously. And when we started Open Source Wellness 10 years ago, people only wanted to talk about chronic disease. Like even mental health was sort of like, ah. Like, we're not really ready to take that on. And then, you know, 7, 5, 5, 7 years ago, mental health was something we could really talk about and, outcomes around evidence or, you know, evidence-based processes and outcomes around behavioral health mattered.

And now we are there around. Social connection, social isolation, loneliness, et cetera, that Dr. Murthy's book came out, that, there have been so many major healthcare and medical institutions sort of coming out and saying, ah, mental health, physical health and social health all matter. Here's the next jump.

I hope we'll make. As a field, I hear and I appreciate this stand that the field is taking, that we need social connection. And I would suggest that's sort of like saying humans need food. Which is like fantastic. Yes, we do. And you know, as a field we have so much nuance about food, right?

We start with macronutrients. You need proteins and fats and carbohydrates and then vitamins and minerals and we, there's a whole world of precision nutrition and we have none of that. Really in our understanding of social connection. So I am excited and, and God willing, I'll get a book out there about really applying this metaphor of food and nourishment to social connection and help us not just say do you have friends or do you have connection?

But help us really bring some nuance to the conversation. Yeah. And I, I just will add, I'm curious like you've about your intentional community experience that type of connection versus like our social media connection, right? Mm-hmm. People are gonna say, I have all these friends on Facebook, but.

Like, is that type of connection more harmful to us than, you know? Like it's, it's a very challenging thing I think  so yeah, I'm very excited about this.  The, you hate to say the quality of connection, right? Yeah. And you know, just like we don't wanna prescribe one diet for everybody.

I don't think there's like a new social connection diet that everybody needs to follow. But I think bringing some attention to like, oh, what kinds of connection are actually nourishing? What might actually be depleting? Right? Like we wouldn't argue that lentil soup and Skittles are equivalent and like you're saying, maybe Facebook scrolling and sharing a meal are not equivalent  but there's so much further we can go and saying like, what.

What does actually make for the kind of connection that you walk away from feeling satisfied and happy and connected and from what do we actually walk away feeling worse? Yeah. Yeah. So I, I just wanted to touch on, I, and I think it was, I can't remember if it's on your website or something. You wrote this prescription to nowhere as the traditional behavioral advice.

Mm-hmm. So  it's not enough  to tell people to change habits. So what do you think needs to replace that prescription? To nowhere, which is, you know, telling people, just change your habits. What needs to replace that model? Yeah  this is where the conversation about equity comes in because if you have privilege, financial privilege, sociocultural privilege, and you get these prescriptions from your doctor, you actually have an entire boutique wellness industry waiting to help you Now.

You know, the quality may vary and your, your checkbook may, may take a hit, but there are lots of people who are ready to support  if you have the resources, to privately pay for it. What I'm interested in is how do we address the prescription to know where that exists for marginalized populations.

If you work in a federally qualified health center, these are not patients that are signing up for $3,000, health and wellness coaching private practice packages. They're just not. So I think that we need a delivery system for trauma-informed, culturally affirmative, place-based, accessible support for the practices that underlie human wellbeing and within the community as medicine model we've identified.

Four big practices. We like to abbreviate it, move, nourish, connect, and be so physical activity, healthy foods, stress reduction and social connection. And you know, right now we, we deliver this virtually and in person. We deliver it freestanding in the community and integrated with FQHCs and other clinical delivery systems.

We're delivering this in English, Spanish, and now Cantonese. And we are helping YMCAs around the country to build the capacity to deliver community as medicine on their own. And the idea is, is not just that this is for YMCA members, but we're helping YMCAs partner with their local FQHCs and their local payers and their local philanthropic organizations to make this workflow of prescription in a clinic.

Getting delivered at A-Y-M-C-A or another community org to really build the ecosystem of those partnerships and those value-based payment mechanisms and, and sort of revenue sharing and all the things that have to be in place so that it's a seamless experience for the patients who don't have access to the boutique wellness system.

Let me pause there. Did that all make sense? I know it's, it's a little bit of an ambitious vision and, and I think hopefully we're on our way. I think ambitions, ambitious visions are, this is the year for it. So I'm here for it. And I just wanted to maybe circle back on this. So, move, nourish, connect, be.

Mm-hmm. Love it. Yes. Simple. Yes. Love it. Yes. Makes sense to me. You know, there's certainly things we could add to that, right? Like, you know, sleep is so important and we address that in the b and the stress reduction and rest component and, and substance use and, you know, addressing risky substances and behaviors we try to address in the nourish and the B component.

So it's not, it's not  a hundred percent inclusive, um, but we do find that it's. It's, it works in a trans diagnostic way.  so much of lifestyle medicine and behavioral medicine has been diagnosis specific, right? Where we have like a depression group or a diabetes group and nothing against them but part of what we find in community-based implementation is that it's hard to get.

Enough patients signed up for that. Very specific, you know, like  the DPP, the diabetes prevention program, you gotta meet some pretty tight criteria to be eligible and then you have to stick with it for a long time. And so we designed the community as medicine model to be. Much more, much more of a, sort of a wider funnel.

 We're really welcoming anybody who has or is at risk for a behaviorally mediated chronic condition, and that's most of us. So whether it's a chronic disease challenge, a mental health challenge, a social health challenge, that's kind of the leading diagnosis, what we know is that underneath all of that comorbidity is the rule rather than the exception.

And so we've designed this model to really address the human universals. And to be, general enough that almost anybody can find themselves in it.  I just, well, I'm very curious  to jump into this last question and maybe it'll take a little bit of time 'cause it's kind of a two part.

So  as you look ahead five years, so we're talking about, you know, 20, 30 plus, where do you hope open source wellness will be? And this is part two, just because I love this question and I'm very curious about your answer. If you were suddenly in charge of mental healthcare in the US, what's the first systemic change you'd make?

And maybe these two parts intersect somehow. Hmm. Yeah. Well there's so much there. So I can speak to where we hope open source wellness will be. our dream is that. Anyone in the US could have access to community as medicine, where they live, work, play, learn, heal. And part of what that means is that we are bringing this model, or at least the active ingredients in this model

to meet people where they are, where they already feel comfortable.  And one of our first foci, for lack of a better word, is around the YMCAs. There's this incredible statistic that about 80% of the population lives within five miles of A YMC, A branch and. You know, what that says to me is that if we could help these YMCAs step into delivering community as medicine, which is by the way, is not technically mental health, you don't have to be a licensed mental health clinician to deliver this.

You, you become a health and wellness coach. That we, that we would train that if we can help the YMCAs do this in partnership with their local. Federally qualified health centers and social services and payers, et cetera, and we're starting to build an ecosystem of care that would be available to serve some of the most vulnerable populations in our country.

So I hope that in five years we are well on our way to that goal and that we are expanding beyond YMCAs to other clinical and community-based orgs that are.  Excited and mission aligned and ready to do this work. And to your second question, if we were suddenly in charge goodness I think we, we do need to unlock significant capital to invest in.

Ecosystem building, for lack of a better word, for breaking down silos for allowing clinic community integration to happen at another whole level.   And then what I think what I hope would come with that is that just like you said, I would never say you have pneumonia.  Go find your antibiotics, that within five to 10 years, it would start to seem equally ridiculous.

To say you need to change your lifestyle in a major way, good luck with that, and that we would instead be prescribing into this evidence-based, trauma-informed, culturally relevant, you know, really actually joyful approach to supporting human beings with the challenging aspects of having a body, having a mind, and getting along in this world.

I know this is a team effort. This will not just be open source wellness. This will be our small but mighty team and the many, many mission aligned organizations  surrounding us that are, that are helping bring this to fruition. I just love how you said that the challenges of being a human are something we all share.

I mean it that it made me smile. Just hearing you say, you know, being in a body with a mind and just trying to navigate this world is challenging.  Understanding that and supporting each other, it sounds very simple, but we. Seem to not be able to get it right. So maybe we can eventually, uh, may it be, so, hey, thank you so, so much.

I appreciate your, your curiosity and your resonance with this work and, and you're really working to bring this out into the broader conversation. Yes. I really enjoyed the conversation as well. So tell us, how can people find out more about you, about open source wellness? We'd love to link and we will link in the podcast, but tell us where people can find you.

Sure. Opensource wellness.org is our website. There you'll find all kinds of information about what we're doing, where we're working outcomes data. You'll find a TEDx talk by me that lays out some of what we spoke about here.  And then you'll also find opportunities to get involved. So there are opportunities to get trained as a community, as medicine, health and Wellness coach, there are opportunities for organizations to apply to participate in our 20 26 27 Community as medicine.

Learning, collaborative. And this is where we take organizations who wanna implement community as medicine and we guide them through sort of a  implementation process. So, and then, you know, of course, you know, folks are welcome to reach out to me and to our team. There's contact info on the website, and we're happy to just get you in touch with the right person.

Yeah, I would encourage everyone to do that.  The website is inspiring.  It truly is. It's given me hope for the future.  Dr. Elizabeth Markle, thank you so very much for joining me. I love the conversation. Thank you so, so much, Jean. What a pleasure.

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.

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