We are huge proponents of comprehensive care here at KindlyMD. We also believe in Complete Care, but that is a different topic for another post. Yet one of the keys to making complete and comprehensive care work for both providers and patients is asking and answering questions.
We love lots of questions in the clinical setting. Why? Because we are ultimately after answers. Yet it is impossible to find answers if you don't first ask the questions. So we say this to patients: ask every question that comes to mind about your health and wellbeing. And when a healthcare provider asks questions of you, answer them truthfully and as thoroughly as you can.
Before we go any further with the question-and-answer idea, a word about comprehensive care is an order. Comprehensive care is an approach to care rather than a specific modality. It is an approach that seeks to address a patient's total health at multiple levels: physical, emotional, psychological, and social.
A healthcare provider offering comprehensive care emphasizes:
If we had to sum all of this up in a single sentence, we would say that comprehensive care pulls out all the stops to treat a patient as a whole person rather than just a body that is not feeling well.
Doctors and advanced practice nurses are known for asking a lot of questions regardless of the setting in which they practice. But if you have experienced our comprehensive care, you know that our team tends to ask more questions. Why? The best way to explain it is to use the example of treating persistent pain.
There is no diagnostic test for identifying and measuring pain. A healthcare provider needs to rely on interactions with the patient to figure things out. So the provider asks questions. In addition to direct answers, the provider is also paying attention to tone of voice, body language, and other factors that all work together to tell them how a patient is truly feeling. If we do not ask questions, we will never know.
Questions are our door into the emotional, psychological, and social aspects of how you feel. When we lack the ability to conduct diagnostic tests, questions also offer a window into your physical experience.
In comprehensive care, we want patients to ask questions, too. That means you. We want you to know as much about your health as possible. We want you to understand why you feel the way you do, why we think certain treatments could help, and so on. And if you are ever concerned about the care you receive, we want you to feel free to express those concerns.
Questions represent your opportunity to participate in your care. We want that for you. In fact, this is why we practice comprehensive care. We believe it is the best way to treat a patient's whole person for better health overall.
We practice what is known as 'Complete Care' here at KindlyMD. Complete Care is known by several key characteristics. One of those characteristics is something known as stepped care. You may have already experienced stepped care if the KindlyMD team has helped you obtain your Utah Medical Card.
Stepped care is a big part of the greater Complete Care concept. This post will explain why. If you are new to the whole Complete Care thing, know that stepped care is an integral part of treating you as a whole person. We do not want to merely treat your symptoms.
A good way to describe stepped care is to say that it is gradual care that begins with the least invasive and intrusive form of treatment. A fair number of our patients need help managing persistent pain, so we will use them as an example.
One approach to managing persistent pain is to go right to a narcotic painkiller prescription. But from a Complete Care perspective, such a treatment is not necessarily a reasonable first-step option. There are other things we can try first. There are gentler, less intrusive treatments.
We might start by recommending OTC analgesics along with physical therapy and some lifestyle changes. If necessary, we might step up to prescription analgesics. If the patient still hasn't achieved the desired amount of relief, the next step might be to apply for a Medical Card so that we can introduce plant-based medicines.
Hopefully, this illustration makes stepped care easier for you to understand. Stepped care seeks to intervene in natural healing as little as possible. Now, let us apply that to the Medical Card concept.
The Utah Medical Card is somewhat unique in that it gives holders access to plant-based medicines that cannot be obtained in any other way. The cards represent different kinds of medicine that isn't considered conventional in most healthcare circles. Therefore, there are not a lot of generally accepted standards dictating how the medicines should be used.
A stepped care approach recommends using the smallest amount of plant-based medicine necessary to achieve the desired level of relief. As we like to say when making recommendations, start low and slow.
We recommend that new Medical Card patients begin with a minimal dose and see how it makes them feel. If they have achieved some relief but not as much as they would like, we recommend adding a bit more. The goal is to find the most appropriate amount without taking too much.
One of the reasons stepped care works better in a Complete Care setting is the fact that it requires a team approach. In most allopathic settings, the team approach is virtually nonexistent. But in Complete Care, patients are treated by a team of clinicians, allied staff, and support staff.
Getting back to the Medical Card, a patient might see a doctor or nurse practitioner for the initial assessment required under the program. That provider diagnoses the patient and recommends a card. Then the patient might consult with both his healthcare provider and pharmacy provider to figure out the best way to use plant-based medicines. The patient also consults with a therapist to address the mental and emotional aspects of his health.
As a team that includes the patient himself, all work together to achieve better wellbeing for the patient. Teamwork is part and parcel with stepped care. And from our point of view, stepped care is the way to go in so many cases.
Many of the patients visiting KindlyMD for the first time come to us based on a recommendation from a friend or relative who explains that we can help them get a Utah Medical Card. Indeed, we can. But our goal is to go much further. We also offer patients Complete Care in addition to assistance with their cards.
Given that a significant percentage of our patients are dealing with persistent pain, the remainder of this post will focus on Complete Care in a pain management setting. Through it, we hope to give you a better understanding of what Complete Care actually looks like. The best way for us to explain it is to describe five key characteristics you will certainly observe here at KindlyMD.
At the root of Complete Care is the understanding that human beings are more than just the bodies they occupy. In a pain management setting, Complete Care takes a holistic approach that recognizes the biological, psychological, and social factors that contribute to pain. The goal is to address all the components rather than focusing on the body alone.
One of the byproducts of this approach is what we refer to as 'whole person care'. Another way to look at it is to note that we do not treat just a person's pain. We do not even stop at the condition responsible for the pain. We treat the whole person on multiple levels.
Complete Care is an integrated form of care. By this, we mean that patients are not handed off to a single doctor who is then made responsible for everything. Our approach involves an entire team of healthcare professionals who all work together to help the patient feel better. Best of all, patients are treated as valuable members of their own teams. Clinicians want and expect patient input at every turn.
In a pain management setting, Complete Care dictates beginning with the least intensive and invasive treatment options. We start with something easy and simple. Then we add to it, as necessary. In this way, the patient is not being directed to unnecessary treatments. This saves time, money, and frustration.
Specifically where the Utah Medical Card is concerned, utilizing the stepped care approach encourages using the least amount of plant-based medicine possible. Patients are urged not to use more than they need to achieve the desired relief. We can explain why on your next visit to KindlyMD.
Pain management tends to focus heavily on pharmacological treatments. There is nothing wrong with pharmacology per se, but Complete Care suggests a multimodal approach. What does this mean? It means clinicians look at every treatment option. In most cases, multiple treatments are recommended to achieve the best possible results.
Multimodal care tends to fully embrace complimentary treatments, alternative treatments, and even plant-based medicines made available through the Medical Card program. Nothing is off the table until a patient's team determines that a particular treatment is inappropriate.
If you haven't picked up on it yet, the last of our five key characteristics is patient-centered care. Complete Care practitioners firmly believe that healthcare is always about the patient. We would have it no other way. At KindlyMD, you are always in control of your healthcare. Our job is to help you feel better in whatever way we can.
We believe Complete Care is the best way to approach pain management. If you agree, consider making an appointment at our Salt Lake CIty clinic. We cannot wait to meet you.
Honesty time: Have you ever looked at someone who is obese and thought to yourself, "That person lacks the willpower to eat less and exercise." Almost declaring them less than or deserving of their condition? You are not alone in this thought, but let me be very clear: you are wrong.
According to the American Psychological Association, willpower is the ability to resist short-term temptations in order to meet long-term goals. (APA, 2012). We can further define this as overriding unwanted thoughts, feelings, or impulses. In this regard, it seems reasonable to connect an inability to overcome the temptation of overeating to a person's willpower. But willpower depletes when conditions diminish. Studies show that if a person feels persistently bombarded with choices and stress, they will eventually break down and succumb to temptation. So yes, your mother was right when she warned you about hanging out with those friends she saw as bad influences.
If willpower is the ability to resist short-term temptations and impulses in order to achieve long-term goals, it involves the capacity to override an unwanted thought, feeling, or impulse, and is often likened to a muscle that can be strengthened with use but also fatigured. While willpower can play a role in many aspects of life like diet and exercise, it's important to understand that it is not the sole factor determining body weight.
In summary, while sheer will can contribute to making healthier choices, it's not even close to the sole determinant of an individual's weight. Acknowledging the broader range of factors involved in weight management is crucial for developing more effective and compassionate approaches to addressing obesity and promoting overall health.
When willpower is overcome by all the factors discussed above, some people experience shame for the inability to control their cravings, hunger, and weight. Shame is the single most destructive experience for those who struggle with the idea that they are not their ideal weight. With the help of a holistic medically managed weight program, GLP-1 medications, and integrated mental health programming, millions of people can now achieve their ideal, healthy weight. More importantly, they can now maintain it throughout their life.
If you or someone close to you struggles with their weight, call 801-851-5554 today or email hello@kindlymd.com to set up a free consultation with a healthcare professional and discuss the right treatment plan for you.
The weight a person carries is something that goes beyond simple lifestyle and choices. It involves complex and complicated genetic, environmental, and physical factors. This is why there are entire industries that have been built on weight loss, diets, and exercise. It's why you can scroll forever watching fitness and diet influencers on Instagram and TikTok spewing their advice to everyone that will listen.
But all "body positivity" aside, those struggling to lose weight may want to consider the role medication plays in managing weight effectively and efficiently.
"Not everyone can eat less, exercise, and lose weight with willpower alone. Often times genes, hormones, environment, sleep, and mental health play a huge role."
Tim Pickett, PA-C, medical weight loss expert and founder of KindlyMD
While nutrition and physical activity are fundamental to weight management, they are not enough for everyone. Medications provide an additional tool that can help overcome the biological barriers to weight loss faced by many.
Appetite is regulated by hormones. The stomach, pancreas, intestines, and fat cells secrete chemicals that tell the brain to eat. Some of us are then drawn to certain foods more than others. I like cookies, cakes, and baked goods, while my wife enjoys salty chips and fruity candy. Hormones and other chemical signals are regulated by functions evolved over hundreds of thousands of years. These hormones provide the drive to feed the body with calories, which it then converts to energy. Energy equals survival.
The primary hormone sending hunger signals to the brain is called Ghrelin, and it is produced in the stomach. Remove most of the stomach (like what happens in a sleeve gastrectomy surgery) and you reduce the body's ability to produce Ghrelin. This makes sleeve gastrectomy surgery the most common bariatric surgery performed today, with a 25-35% overall weight loss success rate. If you have more than 100 pounds to lose, surgery may still be the best medical route to take.
Hunger, however, is not the only reason people gain weight over the years. Multiple factors lead to body weight. Genetics, environment, medical conditions, inflammation, sleep hygiene, injuries, emotional factors, finances, stress, hormones, medications, behavior, and many other factors also contribute to weight gain.
Despite what we've all been told, calories in and calories out isn't the answer either. This theory assumes we absorb 100% of all the calories we consume, and we certainly do not. Hormones play a role here, too — insulin specifically.
Consider the number of people in the world with hormone imbalances. Cortisol, the stress hormone, is linked to increased weight gain. Many have thyroid problems also, another hormonal concern that has huge implications for weight issues.
Furthermore, when the body loses weight, the brain kicks in to protect us from starvation. This launches a cascade of hunger hormone release and a reduction of the feeling of fullness. The metabolic process actually slows down. You read that correctly: your metabolism actually slows down when you lose weight. It makes sense from an evolutionary standpoint of survival, but for us modern humans, it has very little, if any, real benefit. In fact, it's a major hurdle to overcome in a weight loss journey.
The body seems to have it's own weight set point: the size it wants to be, regardless of your situation. I'm built like my dad, you're built like your mom. Interviews with obese patients often find that people try out 20 or more diet or exercise programs before finding a solution or giving up entirely. For some, trying new fad diets, joining gyms, paying trainers, and following health influencers online is a lifetime commitment.
Now, this isn't all to say you should avoid exercise or eat whatever you want. It's meant to show that weight loss is not one-size-fits-all with a set willpower-driven solution. While you may temporarily reduce your caloric intake, the odds are stacked against you to keep the weight off long term.
GLP-1 (Glucagon-Like Peptide-1) medications, also known as GLP-1 receptor agonists, are a class of a drugs commonly used in the treatment of type 2 diabetes. These medications have taken the world by storm after being approved for use by the FDA for weight loss. They mimic the effects of GLP-1, a natural hormone involved in the regulation of blood glucose levels. GLP-1 medications have many effects and functions on the body.
There are many FDA-approved medications for patients looking to lose weight. Phentermine, Orlistat, Contrave, Saxenda, etc., though none are more popular right now than the GLP-1 medications Semaglutide (Ozempic & Wegovy) and Tirzepatide (Mounjaro & ZepBound). These medications are helping people lose weight at such a pace that it has taken the media by storm. As a result, you've likely seen articles claiming "the end of obesity" written by doctors and surgeons who are convinced we are at an inflection point in American healthcare, body positivity be damned.
Let's compare these popular medications and what they do.
Medications should be a part of a broader plan that includes dietary changes, physical activity, and psychological support. It's essential to tailor the approach to each patient, taking into consideration their medical history, lifestyle, and weight loss goals.
Lifestyle changes, including nutrition, physical activity, sleep, stress reduction, and mental healthcare are still the cornerstone of weight management. Any program that doesn't include follow-up education on functional progress, muscle building, nutrition, and mental healthcare are not effective long-term. Rather, the inclusion of these things makes a medical weight loss program including GLP-1 medications that much more successful, offering promise to millions looking to make a change.
At KindlyMD, our mission is to revolutionize holistic healthcare by integrating medically managed weight loss as a cornerstone of our Complete Care service. We are dedicated to empowering individuals on their health journey through a combination of cutting edge medications, such as Ozempic/Wegovy (Semaglutide) and Mounjaro/ZepBound (Tirzepatide), with personalized mental health support, body composition analysis, and nutrition and exercise counseling. Our approach is rooted in compassion, innovation, and the belief that optimal health encompasses both the mind and body, ensuring every patient achieves sustainable success.
Call 801-851-5554 today or email hello@kindlymd.com to set up a free consultation with a healthcare professional and discuss the right treatment plan for you.
Obesity is a global health crisis, affecting millions of people worldwide. It's not just about excess weight. It's a complex medical condition linked to numerous health risks including type 2 diabetes, heart disease, high blood pressure, chronic pain, and certain types of cancer. Traditional methods like diet and exercise are essential, but for many, they are not enough to achieve and maintain significant weight loss. This is where GLP-1 medications such as Mounjaro, Ozempic, Semaglutide, and ZepBound come into play, offering new hope and better outcomes.
I've never seen medications with this much potential to change people's lives for the long term and for the better. I worked in weight loss surgery for seven years and these drugs are a breakthrough.
Tim Pickett, PA-C, founder of KindlyMD
The FDA recently approved GLP-1 (Glucagon-Like Peptide-1) receptor agonists, a class of injectable medications originally approved to manage blood sugar levels in type 2 diabetes patients, to help people lose weight. Medications like Mounjaro (tirzepatide), Ozempic (semaglutide), and the newer ZepBound are some of the fastest-growing medications in the U.S.
GLP-1 medications mimic the action of the natural hormone GLP-1, released in response to eating. These drugs enhance insulin secretion, suppress glucagon production, and slow gastric emptying. They basically slow down the GI system so you can't eat as much. This results in a decrease in appetite and an increase in feeling full, which leads to significant weight loss.
GLP-1 medications:
Extensive clinical trials have been done on GLP-1 medications in weight management. For instance, studies on 2,500 obese adults who took 5mg or more of Mounjaro showed that participants lost up to 15-20% of their body weight. Similar results have been observed with Ozempic and other GLP-1 medications, making them a powerful tool against obesity.
Recently, FDA approved GLP-1 medications like Mounjaro to treat obesity in patients with a BMI over 27 with at least one weight-related health condition such as high blood pressure, type 2 diabetes, or high cholesterol. This marks a significant shift toward recognizing these medications as a primary treatment for weight management. This does not mean your insurance will pay for the drug, however. It does mean that insurance will cover the medical management of the medications (visits, labs, etc.) while you pay for the medication out of pocket.
Only incorporate GLP-1 medications into a weight loss program under medical supervision. It involves a comprehensive approach that includes dietary changes, physical activity, and regular monitoring of health parameters. At KindlyMD, our healthcare providers offer guidance on the optimal use of these medications, tailor them to your individual health needs and goals, and integrate them into a holistic approach to healthcare. We practice the MEANS model of weight management: Medical, Emotional, Activity, Nutrition, Sleep.
Each GLP-1 medication has its own unique profile
Like all medications, GLP-1 receptor agonists come with potential side effects. Common ones include gastrointestinal symptoms such as nausea, bloating, diarrhea, and constipation. Rare but serious side effects can also occur, so patients should work closely with their healthcare providers during treatment.
Our case studies show that real-world use of GLP-1 medications combined with integrated diet and physical activity guidance, can lead to life-changing weight loss and health improvements. Patients can report not only reduced body weight but also improved overall health markers, including lower blood pressure, improved cholesterol, and reduced prescription medications for related conditions. Even more exciting is the mental health gains patients see with the positive change. Our integrated approach helps paitents make the change long-term and lasting.
The approval of GLP-1 medications for weight loss is a watershed moment in the management of obesity. With their ability to significantly reduce weight and improve metabolic health, these drugs represent a paradigm shift in the treatment of a condition that has long been challenging to manage effectively. As research continues and more long-term data becomes available, GLP-1 medications are set to become a cornerstone of obesity management, providing hope to those who have struggled with weight loss for years.
If you are someone you know strugges with weight they just cannot seem to lose, give us a call at 801-851-5554 or email hello@kindlymd.com and our team can schedule a no-risk, no-cost consultation with a weight loss provider.
Offering comprehensive and complete care is part of the KindlyMD business model. Our services include assistance with the Utah Medical Card along with medication management, pain treatment, mental health services, sleep support, and weight loss. We want patients to feel like they are getting complete care. We also want them to be satisfied.
Are the two related? Does a patient's satisfaction directly align with their perception of complete care? We believe so. We can cite a number of studies suggesting a relationship between satisfaction and care perception, including one published by JAMA Network Open in December 2022.
The study in question enrolled 408 participants who were given the opportunity to undergo bariatric surgery for weight loss. The researchers wanted to know if patient perceptions of quality care impacted their decisions to go forward with the surgery. Interestingly enough, they did. Here are two key quotes from this study:
Patient satisfaction was measured via seven different metrics. General satisfaction was at the top of the list. Other metrics included interpersonal manner, communication, and financial aspects. Researchers even looked at the amount of time patients spent with their doctors.
Patients were asked to report their satisfaction levels using a standard questionnaire. In the end, the data pointed to a simple truth: patients with higher perceptions of satisfaction were more likely to move forward with the surgery than those whose perceptions were lower.
To us, the study lines up nicely with the idea that what a patient thinks impacts how that person feels. It is true for all of us. If we are constantly dwelling on negative thoughts, we are likely to feel certain emotional and physical impacts as a result. The opposite is also true.
So how do we apply this to the concept of complete patient care? At KindlyMD, it is all in our approach. First and foremost, we believe in collaboration between patient and healthcare team. A visit with us should never be little more than spending 10-15 minutes listening to a medical provider lecture and giving instructions. This is not complete care. It is also not collaborative.
We believe in shared decision making. We believe in engaging with patients, educating and informing them, and equipping them to make as many decisions about their own health as they care to. We also believe in personalized treatment plans.
The concept of complete care is neither new nor unique to KindlyMD. It has been part of medicine for many, many years. It has only recently come into its own due to our medical system's shift away from fee-for-service in favor of outcome-based medicine.
Complete care is built on a foundation of every patient being unique. How you feel is unique to you. Any treatment we can recommend should be equally unique. Our main goal is to help you based on your health, your symptoms, and your daily circumstances.
We firmly believe that your perception of the quality and completeness of our care directly impacts your satisfaction and vice versa. The relationship between the two is very real and scientifically documented. If your perceptions of our care are ever negative, please don't hesitate to let us know. We want the opportunity to do things better. Feel free to contact us.
Healthcare providers emphasizing complete and comprehensive care do not want to merely write prescriptions and send patients on their way. They want to provide ongoing care that accounts for changes in a patient's condition, lifestyle, and circumstances. It is the sort of care we provide here at KindlyMD.
That being the case, we encourage patients to take advantage of our ongoing care and dosage adjustments, especially when patients have their Utah Medical Cards. Dosage adjustments are an important part of continuity of care.
For the record, the Utah Med Card opens the door to plant-based medicines that cannot be accessed in any other way. The medicines are not provided through traditional prescriptions. That's why patients need a valid Med Card to take them.
If you are new to the whole Med Card thing, you should also know that there are a variety of medicines to choose from. You will not be given a single bottle of pills with black-and-white instructions on how to use them. For that reason alone, dosage isn't an exact science.
Stopping by a pharmacy to pick up your medicines will quickly reveal that you have options. There are different products along with multiple delivery methods and a variety of doses. Your medical provider can help you make sense of it all. Likewise, the pharmacy staff can assist you.
For our part, we want to help you for as long as you continue to use your Med Card and associated medicines. We want to help you along your journey with plant-based medicines.
Patients brand new to plant-based medicines through the Utah Med Card program usually don't figure out the best product and dosage on the first try. The idea is to take the least amount of medicine possible to get the relief the patient needs. But figuring it out can take time.
One of the things we recommend is keeping records. We advise patients to write down when they medicate, the dosage they take, and how they feel afterwards. This is valuable information that can help us make recommendations about dosage modifications.
Something else you might not know if you are new to the Med Card program is that delivery dosage impacts a medicine's effect and how long those effects last. Perhaps your condition calls for a higher dosage and a delivery method that relieves your symptoms nearly instantaneously. On the other hand, you might be better served by a lower dose delivered over a longer period of time.
We offer ongoing care and dosage adjustments because we know that things rarely stay the same. How you feel today will probably not be identical to how you feel a year from now. Your condition may improve. On the other hand, it may worsen. You might be dealing with additional medical conditions years from now.
All this plays into dosage adjustments in the sense that your medications might have to be modified in order to provide continued relief. As Qualified Medical Providers (QMPs), we know that ongoing care is best for patients in the long run.
KindlyMD offers a range of services including Med Card assistance and medication management. We invite you to learn more about our services and whether they are right for you. If they are, we urge you to take advantage of our ongoing care and dosage adjustments.
Here at KindlyMD, we take pride in the fact that we are different. We are what we are by design. One of the things that sets us apart is our commitment to the Complete Care Model (CCM), a model of healthcare delivery that is slowly catching on around the country. We are happy to be at the forefront.
Complete Care is not necessarily new. However, it has not received much attention in this country because most healthcare providers operate on a fee-for-service model. “Fee-for-service" means doctors and other healthcare providers are compensated for each service performed. CCM didn't start coming into its own until about a decade ago, when we began shifting our focus to outcomes and patient satisfaction.
The CCM starts with people. It is a patient-centered approach to healthcare delivery that focuses on providing the best end results. It also recognizes that Complete Care requires the involvement of an entire healthcare team rather than a single doctor or nurse practitioner making all the decisions.
The model rests on three core principles:
Complete Care is suitable for every patient regardless of health and existing medical conditions. That said, it is especially helpful for people living with chronic conditions. Things like chronic pain, PTSD, and mental health conditions cannot be “fixed” overnight. They are considered chronic for a reason. They require ongoing care by way of a competent healthcare team.
If you haven't picked up on it yet, comprehensive care is a holistic approach to care. CCM providers do not focus exclusively on symptoms. They don't treat just the body. Instead, they believe healthcare should treat the whole person, including support for mental health.
A holistic approach recognizes the natural connections between body and mind. It recognizes that what a person thinks often impacts how that person feels – and vice versa. Most importantly, the holistic approach to care recognizes that treating most conditions is rarely as simple as writing a prescription.
Healthcare is about so much more than medicine alone. Medicines can certainly help, but so can non-pharmacological treatments. When medicines are involved, patients often need assistance with medication management. Again, holistic care is about so much more than writing a prescription and hoping it works.
The CCM is a quite different way to approach healthcare. It is something we believe in here at KindlyMD. We practice the CCM in relation to all our services including mental health, the Utah Medical Card, medication management, sleep support, pain treatment, and weight loss.
If you don’t feel like your current healthcare provider is giving you Complete Care, we invite you to make an appointment at any one of our Utah clinics. We would be happy to sit down and discuss the benefits of Complete Care as they apply to your needs. We believe Complete Care is the only way to go. We hope our patients agree.
