Episode 269 Show Notes
Grant and Heavey take a closer look at this new approach to health and fitness. Today’s guest is Dr. Ryan Greene from Monarch Athletic Club. Ryan is an osteopathic physician (D.O.) with a master’s degree in exercise physiology, immunology, and human nutrition. He did a fellowship in integrative medicine.
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[01:40] MD vs. DO: What’s the Difference?
Osteopathy is a field that was created to treat the body as a unity. DO’s or osteopaths have the same basic knowledge and skillset as MD’s or allopaths, but they’re also required to learn numerous different manipulations and soft tissue techniques.
They’re licensed to do anything a chiropractor or physical therapist would do. They basically treat the entire body versus just looking at symptoms or signs of disease and trying to provide a remedy for it. Manipulation work may help the body fight what’s going on and heal itself with its innate healing capacity.
Today, MDs and DOs are relatively similar in terms of how they practice. They take the same licensing exams and do similar residencies with other MDs. Some MDs even go to a DO hospital and do a residency. It’s not to say that one is better than the other but they just approach things differently.
[04:15] How Much Time Do Doctors Spend on Patients?
The time most practitioners these days will treat a patient is relatively constrained by the hospital system they work with. A private practitioner would usually have an hour for every individual so they can do an assessment.
Nowadays, volume = revenue = payment. Most physicians are constrained by the limitations set forth by the system in which they work.
[05:20] Do DO’s Prescribe Medicine?
DO’s take the same licensing exams as any MD so they have the same rights and privileges. It just depends on how the individual wants to practice. For instance, Ryan is less heavy on medications as much as possible, even with supplements.
Meanwhile, even the supplement space can be frothed with marketing fraud and things that are just not accurate. A lot of people place their hope and belief in supplements. Just because you’re not taking prescription medicine doesn’t mean you’re healthier. Those may not even lead to positive results.
[06:05] Doing Basic Things for the Body to Heal Itself
Ryan approaches people with the premise of common things are common. He looks at how they move, how they feel their body, and how they recover and take care of themselves. He also looks at the labwork to try to put together a roadmap that allows them to do the basic things effectively. Hopefully, the body will take care of itself from there.
And if further intervention is needed, he can prescribe and do a treatment. In sports medicine, he has the capacity to do more invasive stuff. But for the most part, he allows the body to do what it’s supposed to do.
Unfortunately, most people these days beat themselves up to the point that they lose the capacity to heal on their own. Hence, he tries to let people do simple things on a daily basis so their body can do what it’s designed to do. And if they need to layer on more complex levels of intervention, they have the ability to do that, but they try to do step 1 correct before getting to steps 2, 3, and 4.
[08:23] The Birth of Monarch Athletic Club
During residency, Ryan realized he wasn’t able to introduce health preventive medicine in a way he knew people needed. And they’re not able to attain this due to the construct of the system.
After residency, he thought of going to academia and publish papers. He did a fellowship at Mayo Clinic in clinical sports medicine and research. Eventually, he realized spending much of his time jostling for grant funding wasn’t going to be suitable for him.
At that point, his buddy who was a professional athlete in training came to him to ask about a fitness concept they could do to separate themselves from the rest. This has led them to Monarch Athletic Club.
[10:55] What Monarch Athletic Club Does
It’s a one-stop-shop. They wanted to create a place where all the individual has to do is show up. All key aspects of a validated effective health and wellness program are onsite and can be utilized by every member.
Regardless of your fitness level, they can help you reach your goals. People know the language of exercise. But at the end of the day, it’s what you eat, how you take care of yourself, whether you’re getting enough sleep, and if you’re paying attention to what’s going on under the hood.
They look at various basic biomarkers, hormones, etc. And if you do those things, your body takes care of those things.
[12:35] A Uniquely Designed Program
They designed a program where fitness is its foundation. But each member’s program includes aspects of preventive medicine. They get quarterly evaluations with Ryan himself, a physical therapist, chiropractor, and a trainer.
They use previously validated and existing technology platforms to collect metrics in real-time. Those metrics are associated with subjective health. (i.e.quality of your sleep, how you feel today, are you sore)versus objective metrics (ie. weight, body composition, biomarkers). They closely monitor these things and do a quarterly assessment with each individual.
[13:30] What to Expect
By the end of each quarterly assessment, they talk about what’s been improved, what hasn’t improved and why, and what should be done the next quarter.
The individual has access to information related to how they’re doing. Having this knowledge will help them move to manifest change. At the same time, they feel like they have a multidisciplinary team designed to help them achieve whatever they want to achieve.
On top of the steps provided to individuals, they want to provide you with a supportive community. It’s also some sort of reeducation process. A lot of people may never get a blood test or they only get it when they’re really, really ill. So they’re trying to re-educate folks. And as they improve and notice positive health improvements, they’re able to feel better and connect better with loved ones, colleagues, etc.
[16:45] A Closer Look at What They Do
Once a member joins, they get a preventive medical evaluation. This includes their medical history and the things they need to pay attention to. They use a proprietary lab testing technology that only uses a finger prick to test standard labs, markers of inflammation and parameters for metabolic disease. The lab data is uploaded into a HIPAA-compliant user interface.
The U.S. alone spends $4 trillion subsidizing chronic lifestyle-associated diseases. Literally, if you just change how you exercise and how you slept, we could save trillions of dollars.
Most routine physical evaluations do not include a hormone panel, however, they review hormone panels. Many of the things we ingest or are exposed to on a day-to-day basis affect basic hormonal function from thyroid to adrenals.
If those are out of balance, you need to know. But most people may never get a blood test annually or they only get one. And one data point is not sufficient to make tangible change. It’s not reasonable.
[18:58] Physical Therapy Assessment and Training Modalities
Alongside this, every member gets a joint-by-joint physical therapy assessment. They want to know how they move, what is functional and what’s not. They sit down as a team and go over every new member. They discuss things like things to avoid during training, or they put together a daily rehab program.
From a training perspective, they put together a program design based upon training specifications. They look at their strength and cardiovascular endurance. They sit down again every quarter with every individual. They discuss where they were, where they are now, and things for improvement. They then amend the program as necessary since it takes three months to sustain change in human physiology.
In other words, they’re reforming the doctor-patient relationship that existed for hundreds of years. Patients should enjoy talking with physicians. They shouldn’t be afraid to say something. They’re trying to take a more scientific and educated approach to how people pursue an overall health improvement program.
[22:00] Their Patient Demographics Now and Hopefully Soon
Monarch Athletic Club has a mix of individuals. The early adopters are those who are more in tune with what’s effective in health and wellness. They emphasize principles over trends. So they’re not going to be doing anything trendy that may just disappear. All stuff has been validated.
People that come to them are those with multiple co-morbidities, health issues. They may not even realize at this point that it’s something that could be beneficial for them. As of now, they’re working with “higher performers.”
In the long term, they’re looking at how they can integrate into corporate wellness programs. They’re looking at insurance subsidization that will allow this model to spread across the country where anyone can access it.
Companies and insurance providers are looking for ways to incentivise people to participate in healthy behaviors because not only does it make a healthier population, it also has the potential to save the company from having to treat preventable chronic conditions.
[25:45] Access to Primary Care
Ryan actually did an extra fellowship in integrated medicine with Dr.Andrew Weil, the father of nutritional medicine. He created True Food Kitchen.
He has seen a lot of other doctors that are dissatisfied with their profession or how they’re forced to practice now. There’s nothing they’re doing that a nurse practitioner or a PA couldn’t do either. That said, they have the ability to scale because there’s nothing so intricate or so specific that it can’t be completed by another medical professional.
Again, common things are common. They want to build their platform in a way they can expand and they don’t have to worry about too much technicality or technology required.
[28:20] What If You’ve Got Strep?
All members have access to Ryan as their concierge physician. Call him or email him and he will evaluate you on Skype or in person. He will assess what needs to be done. Again, if there’s something that needs more advanced emergent intervention, he’s happy to refer you to where you need to go to.
They have the urgent care or emergency room system. If it’s out of his scope or it’s not something he’s comfortable doing onsite, they will have to send you elsewhere. But for the most part, they can handle it.
[29:10] They’ve Got Massage!
Monarch has physical therapy and chiropractic services. They have acupuncture and soft-tissue bodywork, myofascial release, cold laser. They have recovery modalities (PT and chiro) built into your program.
They offer an unlimited personal training model so everyone who joins can work with a personal trainer every single day.
[30:05] Ready-to-Train Score
They have also created a ready-to-train score, which many colleges and professionals are using. The member has the ability to do contrast therapies, all things that will allow you to come back the following day and do what you’re supposed to do.
If you’re trying to strain your system where you’re not ready to do it, your risk for injury goes through the roof. So they don’t want to put you in a position that knocks you out.
Sports psychology is something they want to bring as well. They’re currently looking at different apps they can use in the future.
[34:20] Nutrition Covered Too
Ryan helped establish a health bar that emphasizes portion control and healthy food options for individuals looking to lose, maintain, or gain weight.
They also go over nutrition in their member’s medical evaluation. They have a full-sized kitchen on site. They have a chef on-site that can put together locally sourced meals. They have a high-quality meal service that’s reasonably priced. They put together fresh meals for you that you can pick up onsite before or after working out.
[36:33] Training Program
The program they use allows your trainor to set up your training cycle essentially weeks or months in advance.
If you’re traveling, you have the ability to pull out the platform and see what you can do for training every day. You can check off if you did it or modify weight reps. Then their team will be able to see what you did or did not do.
They’ve also created a program where you can go to another site and they can pull up your information. So they have the ability to do any of that at any location. It’s a seamless flow so there’s no reason you can’t be compliant.
[38:00] Group Classes
They’re limiting their membership to a small number. Aside from the available space they have, they want to make sure it remains intimate and exclusive feel for now. They’re doing smaller group boxing and bootcamp type stuff on the weekends. But most of their members enjoy working one-on-one with their trainor.
[39:15] Members’ Lounge
Monarch has a member’s lounge and they have a bar. Ryan is not discouraging people from enjoying a scotch a day. That said, he’s a huge wine advocate (in moderation of course. 🙂
[42:15] Plans for Expansion
They plan to expand to other markets like New York, Miami, and San Francisco. The long-term goal is to streamline so they can create a package where they can sell it to other fitness gyms. Moreover, they see to introduce change to the younger population. They want to do something that’s not difficult to use so they can launch the platform all over the country.
Financially, they’ve built in metrics they’ve collected so they can produce real data and real results so that entities can reward you financially for participating in a validated health-promoting program.
They’re using data points to work for you. They attempt to make companies incentivize people to join Monarch Club and they’re going to give the money back. They’re getting money for doing something healthy. So they’ve saving money on the backend.
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