What if, instead of going to the doctor seeking treatment for a disease, you identified precursors of disease before they developed and were guided to prevent the disease from occurring altogether? This is the new paradigm of medical practice, known as “Medicine 3.0,” offered by Dr. Matt McEvoy and Dr. David Edwards at Paradigm Health, a new practice on Duke Drive in Franklin.
“If you think about modern medicine being 2.0, and before that was 1.0 when we didn’t have antibiotics, insulin, or even clean water, Medicine 3.0 is a shift," says McEvoy. "Instead of waiting for something to develop and then trying to treat it, we catch the signs of diseases early and take a proactive approach to prevent them.”
“If you feel healthy, why should you care about this now?," McEvoy continues. "15 percent of Americans have chronic kidney disease, 30 percent have fatty liver disease, a third have heart disease, 88 percent are metabolically unhealthy and 75-80 percent are unaware of these issues until they have symptoms. Instead of seeing a doctor for only ten minutes and not learning of these issues until they’re serious, we take the time that is needed to be thorough.”
The doctors are also believers in the achievements of modern medicine (Medicine 2.0). “My youngest daughter had stage IV lymphoma when she was four,” says McEvoy. “I’m thankful for chemotherapy and for the doctors who discovered the best treatment.”
A native Canadian, Edwards earned his M.D. and Ph.D. degrees at the University of Maryland and did specialty training at the University of Florida and the Harvard/Massachusetts General Hospital system. McEvoy also attended Harvard University, where he played center on the football team, before completing medical school and residency at the Medical University of South Carolina. At Vanderbilt, as Division Chief, Edwards developed multidisciplinary pain clinics where he cared for all aspects of a patient’s
health.
Similarly at Vanderbilt, as Vice-Chair, McEvoy built a medical optimization clinic for patients preparing to undergo major surgery.
“Our clinic evaluated every organ system, nutrition, psychological preparation, physical fitness, and more," he says. "We were a one-stop-shop for our patients, leveraging colleagues in cardiology, hematology, and pulmonology, to name a few."
But McEvoy's and Edwards' vision was broader; they wanted to practice Medicine 3.0. As an example of expanding the scope of their clinic, they achieved board certification in obesity medicine. “Many patients coming for surgery had diseases that resulted in excess weight that caused chronic pain,” explains Edwards. “I found myself treating the origin of the disease and their other conditions, and they would feel better, their blood glucose and blood pressure would normalize, they would even be more active, and weight would come off. In the end many didn’t need surgery or pain medicine.”
“The reason we left such great opportunities at Vanderbilt to start Paradigm Health,” says McEvoy, “is because patients needed more help but the current health system isn’t set up to allow for that.” The doctors refer to themselves as “trail guides,” helping patients chart an individual course, make lifestyle changes and address root causes of disease.
So why don’t all doctors focus on proactive Medicine 3.0? “Well, the current system is really one of sick care rather than promoting
health," says McEvoy. "From medical school to residency training, there is very little education in this comprehensive approach. No training on personalizing nutrition plans and no training on evidence-based exercise prescriptions or how to advise on supplements before reaching for prescriptions."
"We like to ask our patients what they want to be enjoying when they are 90 years old and then talk about what needs to be done now to help them achieve those goals,” says Edwards. “The evidence shows that if we focus on optimizing metabolic, musculoskeletal, and aerobic health, and assess for leading causes of death and combat those, we extend healthspan (living longer healthier). The current story of aging and disease in America does not need to be your story.”
Both doctors plan to cap their patient load at about 200 members, whereas a typical primary care physician has 1,500 to 4,500 patients. Members of Paradigm Health contact the doctors anytime via HIPAA-compliant email or even text. The clinic feels more like a comfortable home with welcoming, coordinated furnishings, rugs and artwork. A gym and kitchen exist alongside private rooms for conferring with staff. Members don’t wait in sterile rooms wearing paper gowns. Typically, members sit with doctors
discussing their health history in a comfortable office, on topics such as nutrition and exercise, hormone replacement, weight management, reducing heart and lung disease, and more. Members are encouraged to bring up ideas they read about. The doctors see health as an asset that belongs to the patient and one over which they should feel like they have control.
A team, including practice nurse Sarah Bolz, physical therapist Griffin Moore, member experience coordinator Naomi Donalson and practice manager Cait Carnahan, assist members who, so far, range in age from 18 to 88. This includes coordinating with outside specialists, when needed. More staff, including female physicians, will soon join the practice.
The initial workup includes extensive laboratory tests, most of which are not ordered with a typical annual physical, several imaging tests to look at heart health and body composition (DEXA scan with bone, muscle, and fat analysis). A cardiopulmonary exercise test is performed in the clinic to evaluate physical fitness and metabolism. Patients also spend extensive time with the physical therapist (who doubles as a strength and conditioning coach) to evaluate how every bone and joint moves in their body using the Dari Motion system.
The initial in-clinic evaluation takes about four hours, with time at the end to discuss the results with the doctors. Each member receives a a very extensive personalized report that details their results in a helpful layout that acts as the backbone of ongoing planning with the team.
In the end, the goal is optimizing health for the long run. “Patients often come to us and say things like, ‘I want to be able to travel when I’m in my 90s or, 'I want to run around Disneyland with my grandchildren,'’” says Edwards. “We craft personalized plans based on where they are now and with a long-range view in mind."
“The evidence-based principles of disease prevention are applicable to everyone- exercise, nutrition, sleep hygiene, cognitive and emotional wellness,” says McEvoy. "But the development and application of a health optimization plan is personalized for each member. What we do know is that wherever someone is in their health journey, we can meet them there.”
“It’s akin to hiring a wealth manager to pay attention to your retirement portfolio even when you can’t,” says Edwards. “Invest early in your health so that it pays dividends in healthspan down the road. If we’re not healthy and in our best shape, nothing else is worth much because we can’t enjoy it.”
To learn more about Paradigm Health and its membership plans, visit ParadigmHealth.org or email team@paradigmhealth.org