Iβm a board-certified dermatologist who saves lives (!) by helping people reduce their risk of succumbing to common chronic diseases by fixing their immune systems and getting great looking and feeling skin, hair, and nails along the way. My weekly newsletter is an opportunity for you to get to know and trust me by learning from what I'm building in life and business.
Chronic inflammation is like chronic anxietyβ¦ ππ¦ π§
Welcome to the February 8, 2024 edition of the Above & Beyond Dermatology Newsletter (better late than never). Thanks for reading. As always, feedback is encouraged and appreciated.
If you want to hear the rest of that story and so much more from the amazing Dr. Robert Kornfeld, check out the most recent episode of The Direct Care Derm podcast.
The Direct Care Derm
The show is up to 749 listens in 5 weeks. Thanks to all of you who have listened, subscribed, rated, reviewed, and given me feedback/encouragement. It helps keep the train running.
Episode #008 is out today!
New York City-based functional medicine doctor for chronic foot and ankle pain, Dr. Robert Kornfeld, shares his journey from the doldrums of insurance-dependency to a thriving and joyful, direct care, functional podiatry practice.
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βIn this episode:
βπ₯ The good ol' days of indemnity health insurance
π₯ 50 patients a day and "everybody was expecting a lot from me"
π₯ Dr. Kornfeld's tipping point: "I started to develop symptoms..."
π₯ "Nothing was done for me except pills."
π₯ "My whole world changed... this resonates with me, and I'm having fun!"
π₯ It's not your fault that you're suffering. It's your fault that you're cooperating with the suffering.
π₯ In a world of insurance dependency, you have to work fast. A lot of doctors have their heads buried in their computers. They're not really present.
π₯ Not everyone needs a 60 minute visit, but some people do, and it requires a flexible business model to serve these people.
π₯ How having skin in the game matters for patients.
π₯ "The Last Stop Doc" -- You have to give them a compelling reason.
π₯ A virtuous cycle
π₯ How to handle criticism for peers
π₯ The skinny on supplements
π₯ The morbidity threshold
π₯ The art of communicating as a teacher
π₯ Branding and Marketing: Focusing on benefits, not features.
π₯ Doctors who answer the phone -- "I do all my own reception work."
π₯ The only real edge you'll always have over everyone else and how to use it
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Dr. Kornfeld has been practicing functional medicine for chronic foot and ankle pain for 37 years. In the year 2000, he left insurance-dependency so he could direct the care his patients needed and not be controlled by insurance companies.
He is the Founder of The Institute for Functional Podiatric Medicine β a teaching institute for podiatrists who want to take their practice to the next level of care and create a practice free from the stresses and constraints of commercial health insurance and Medicare.
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βπ Connect with Dr. Kornfeldβ
π¦Ά Dr. Kornfeld's Chronic Foot Pain Center (Manhattan & Long Island)
βπ Institute for Functional Podiatric Medicine (Dr. Kornfeld's course and coaching)β
π₯ LinkedInβ
$kin in the game
In this short clip from this week's episode of the podcast, Dr. Kornfeld and I talk explore the impact of people having some "skin in the game" when it comes to their healthcare transformation journey.
I've said it before, and I'll say it again: people who pay, pay attention.
What I'm Writing
On LinkedIn, I wrote about Dr. Bryce Bowers and I (Episode #007) sharing a laugh and talking about how owning your true self is the ultimate strategy for personal and professional growth.
It takes a long time and a lot of work to know your true self, but spending as much time as possible trying to be you speeds up that process and resonates with others.
It's also the only thing you'll always have that sets you apart from everyone else, so don't waste it!
(Apologies for the glitchiness in my part of the video β it's not you, it's me.)
What I'm Thinking
The more I learn about chronic inflammation, the more I begin to understand ways to communicate about it to people who are curious.
Chronic inflammation is like chronic anxiety for your immune system.
Inflammation and anxiety are both normal and necessary parts of human nature. They both serve important roles, but they can also both wreak havoc on the extremes. And modern life has made these extremes (especially with respect to high levels) alarmingly prevalent.
Inflammation is an adaptive and restorative response to bodily insults such as injury and infection. The first thing you learn about wound healing in medical school is the importance of an appropriate inflammatory response. When your body is otherwise in a state of wellness, your immune system can easily turn inflammation on and off as needed.
Similarly, anxiety is an adaptive response. It's helpful and protective to have some degree of worry or concern about future events. When your body is otherwise in a state of wellness, your nervous system has an easier time regulating anxiety levels. When it's not, things get uncomfortable or downright dangerous.
As I alluded to in the talk I gave about the gut microbiome, which I'll eventually share here and on my podcast feed, what and how we eat has a huge impact on the presence or absence of chronic inflammation because the gut is the home of >70% of our immune system.
While our skin acts as a barrier that helps keep bad things out, the gut is the way our body interacts with the outside world: it lets good things in and keeps bad things out.
I heard Dr. Will Bulsiewicz, gastroenterologist, gut health expert, and author of Fiber Fueled and the Fiber Fueled Cookbook, call the gut a beautiful river. Don't think about that too hard, but it makes sense.
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This river carries helpful and sometimes harmful things. A healthy gut lining lets the good things in and keeps the bad things out. The unique array of trillions of microbes living inside each one of us are the stewards of this barrier, so it behooves us to take care of them
For now β just think about the 2 Fs: fiber (just eat a larger quantity and variety of plants, especially colorful ones) and fermented foods. These are two things weβve done well throughout human history until the last century or so due to the rise in quantity and availability of processed foods.
The poorer your gut health, the more likely you are to suffer from chronic inflammation (and chronic anxiety, I would bet). This uncontrolled inflammation exhausts your immune system and makes it less able to differentiate good things from bad.
Constantly on high alert, it's more likely to make mistakes and either miss things (increased risk of infection and cancer) or fire away when it shouldn't (increased risk of autoimmune disease).
Over time, this contributes to dermatologic diseases that I'm passionate about such as psoriasis, atopic dermatitis, and hidradenitis suppurativa as well as other chronic inflammatory diseases like rheumatoid arthritis and inflammatory bowel disease (Crohn's disease and ulcerative colitis).
The more lifestyle changes we make that help alleviate chronic inflammation (think nutrition, sleep quantity and quality, body movement, mindfulness, joy, etc.), the less likely we are to suffer from diseases like these as well as common killers like heart disease, cancer, and dementia.
If you're still confused about chronic inflammation or have questions, I'd be happy to try to answer them or find someone else who can.
Celebrate the Small Wins
This segment is part of my "practice what you preach" philosophy.
I teach people about staying in the Gain and celebrating how far you've come as frequently as is reasonable. I'm holding myself accountable to doing that, too.
βAbove & Beyond Dermatology received its first Google Review yesterday. πβ¨
It feels good. Thanks, Bryson! It was a pleasure to take care of you.
Chestnutπ° Checkers
This recurring segment was inspired by an episode of Nathan Barry and Rachel Rodgers' excellent podcast Billion Dollar Creator, in which they explored ways that some creators are playing chess while others are playing checkers.
They referred to this as "chess not checkers," but Nathan mentioned that some people thought they said "chestnut checkers" and were confused. I laughed. π€·ββοΈ
So, where am I playing Chestnut Checkers?
I'm choosing not to ignore the fundamentals of on-the-ground, grassroots branding and marketing within my local community.
The phrase "a doctor who knocks on doors" popped into my head the other day. I'm not saying I'm doing that, per se, but I'm putting my brain to work thinking about this kind of thing.
With so much attention and money spent on social media and digital trends, many business owners are clearly undervaluing the simple act of telling the people around you (in real life!) who you are and what you're doing.
Work with your local chamber of commerce. If your town or city doesn't have one, find the closest one that does.
Give talks or volunteer at a YMCA, a school, or other community institution.
Hand out cards or samples at a farmer's market.
Partner with businesses that are likely to have customers that overlap with your ideal customer avatar.
Put your business card anywhere you see other business cards aggregating (think bulletin boards at coffee shops).
Yesterday morning, I gave a speech about the importance of the gut microbiome at my local Toastmasters meeting. One of Wausau's mayoral candidates, Doug Diny, happened to be there and asked me some questions afterwards. He now knows who I am and what I'm building.
Little sparks make big fires. Snowflakes, with a bit of momentum, make big snowballs.
One of my appointments this morning was at a local radio station (shout out WAVE 100.5!) where I had the pleasure of chatting with Cindy Opichka about Above & Beyond Dermatology and some basics of persistent adult acne in women for an upcoming episode of Cindy's show, Wellness Wednesday, that will be on the radio and their podcast feed on February 14, 2024.
I'm grateful to Cindy and the WAVE team for their hospitality and for sharing the mic with me. I plan to be a regular contributor to Wellness Wednesday.
I'm also in talks about a recurring segment with one of the anchors of a local TV news affiliate (shout out Hannah Borchert!), so stay tuned for that.
There's so much value in your local community, but you have to get out there and make yourself known.
They say all politics is local. I feel that about business, too.
Catnip (Dognip?)
You can't make this stuff up. π€£π€·ββοΈ
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As usual, I'd like to express my gratitude to each of you for being one of my first 136 subscribers! It means the world to me. If you know anyone else who may enjoy or benefit from this newsletter, please share this note with them or send them here to sign up and get a free gift from me. Talk soon, Stephen β P.S. β Above & Beyond Dermatology, my dermatology practice is open for virtual visits to residents of Wisconsin (full branding and website as well as brick and mortar location coming soon). If you or someone you know lives in Wisconsin and needs the help of a dermatologist, simply email me at drlewellis@aboveandbeyondderm.com or text me at 715-391-9774 with any inquiries. I'm happy to give you a no obligation, good faith estimate over the phone. Heard me talk about Sun Powder and want to try it? You can order it here and beat the Amazon price by almost 20%. β |
βAbove & Beyond Dermatology
Stephen Lewellis, MD, PhD
Iβm a board-certified dermatologist who saves lives (!) by helping people reduce their risk of succumbing to common chronic diseases by fixing their immune systems and getting great looking and feeling skin, hair, and nails along the way. My weekly newsletter is an opportunity for you to get to know and trust me by learning from what I'm building in life and business.
I'm setting up the first brick and mortar outpost of Above & Beyond Dermatolgoy. It's a leap of faith, but I'm confident. My office/consultation space is single room I'm renting inside a fantastic independent fitness center in Plover, WI. If I'm not the only dermatologist located inside a gym in the country, I'm one of very few. I arrived this morning to bring some boxes from home, set some things up, and do a workout. I was hardly through the front door when an elderly patron in a Packers...
Welcome to this week's edition of the Above & Beyond Dermatology Newsletter. Thanks for reading. Feedback is encouraged and appreciated. If there's something you'd like to see more (or less) of here, please let me know by replying to this email. I want this to be worth your time and attention. If you have a dermatology or other health-related question that you'd like me to answer in the newsletter, let me know! At a glance (for my skimmers β I see and honor you π) πDid Tax Day Make Your Hair...
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