Dr Andrew Greenland: 0:00

Welcome back to Voices in Health a Moments. This is the podcast where we spotlight the innovators, disruptors, and frontline visionaries shaping the future of patient-centered care. Today's guest is someone who's worked right at the intersection of transformation and prevention. Anthony Masiello, co-founder of Lifestyle Telimedicine. Anthony's journey is deeply personal. After a number of health challenges, he went on to co-create a practice that helps others to do help themselves under the guidance of board-certified physicians. Anthony, welcome to the show. Thank you so much for joining us today.

Anthony Masiello: 0:32

Yeah, thanks so much for having me. I'm really happy to be here.

Dr Andrew Greenland: 0:35

Thank you. So I know you've shared your personal health transformation in other interviews, and it's incredibly inspiring. But could you perhaps walk us through that journey and how it led you to founding Lifestyle Telemedicine?

Anthony Masiello: 0:47

Yeah, well, uh I'll start at the very beginning. You know, I first accidentally became interested in healthcare. You know, I went to school for computer science in the early 90s, and I accidentally landed my first job at the National Institutes of Health working on the Human Genome Project. And they really uh they hired me for my ability to do web and database programming because they needed to share this genetic information that was being sequenced all around the world. But what happened was I got to work with some of these incredible scientists who were contributing to this project that was like so much bigger than themselves. And that was really new to me. And I quickly, you know, developed that passion myself for not only wanting to work to earn a living, but also to work towards to contribute towards something bigger. Um, and at that in that case, it was basically expanding the body of scientific knowledge around genetics and genomics with the intention that in the future that would lead towards better human health. That was something I could really kind of get my mind around and was proud to work on. A few years after, well, just shortly after the sequencing of the human genome was completed in 2002, my wife decided it was time to move back to New Jersey. We were work, we were living in the DC area at the time. Um and I used that as an opportunity to transfer my career into pharmaceutical research because they were caring about genetics and genomics, so they needed my database skills. But for me, I thought this was another opportunity to step even closer towards helping real people. Because now instead of expanding the scientific body of knowledge so that others could build on this, now I was working for a company who was actually developing therapies that were going to help people directly that was going to really improve lives. And um I felt I just made me feel great about going to work and working hard every day and proud to talk to people about the work I was doing. The um reality kind of hit me in the face while I was there. Um, you know, my wife and I were starting a family, and I applied for a 20-year term life insurance policy at age 33. It was really kind of a formality. It was like kind of what you did. You know, as you're starting to have kids, you get some life insurance so that if something happens to you as the as the you know the financial provider for the family, the family can take care of themselves. But um, what I wasn't prepared for was to be denied. Um, the insurance company took all of my health records and all of my information. And uh, you know, I know how data works, so they plugged it all into their systems, and uh it came back that I was essentially uninsurable, which to me I took as a death sentence, you know, meaning that they did not expect me to live for another 20 years. So here I am professionally, you know, feeling proud about helping other people to uh you know deal with diseases and medical conditions um through my work at at Novartis, and then realizing that I wasn't very healthy myself and I didn't know what to do. So I um yeah, I it took me a little while to process that. I did a lot of reflecting and took an objective look at what my life was like. You know, the reason I, you know, the the biggest reasons for my denial was I was morbidly obese. I weighed over 360 pounds, I had a 54-inch waist. Um my BMI, I think, was 45 or so. So way off the charts, you know, the those charts come in two pages, and I had to go to the second page, pretty far down on the on the other side. I had uh sleep apnea. I dealt with migraine headaches, I was on medication for high blood pressure, um, I had eczema on my fingers, I had psoriasis on the back of my neck, and you know, later I'm um learning, this is years after, that you know, these are autoimmune conditions, these are cardiovascular conditions, these are metabolic conditions, these are all of these problems, and and I just seem to have this perfect storm that um led this insurance company to think that I wasn't going to be around for very long. Um, I am proud to say, a little bit of a spoiler alert, I was denied that um insurance policy in October of 2005. So here we are, November 2025, and I have successfully beat them, right? Like, like I outlived the predictions. And uh really the unfortunate part is that not much of that credit for me doing so uh goes back to the conventional medical system. What I had to actually do was step out of that medical system that I was so proud to be working in in order to get myself healthy so that I could essentially survive.

Dr Andrew Greenland: 6:05

That's really, really interesting. Um it's amazing how many people I've talked to on these interviews that have had a personal health journey that has really kind of steered the direction of their travel and their career. So, from that point of um, you know, your personal health journey and improving your health, how has that led you to create um lifestyle telemedicine? And what does that platform look like now or that organization?

Anthony Masiello: 6:27

Okay, yeah. So what I did was I basically made a series of lifestyle changes. And those uh changes, including you know, eating a whole food plant-based diet, um, that was my first change, and that was a drastic change for me. And that led me to lose about 90 pounds in my first year. Then I started to incorporate exercise, and I just make that distinction because I think it's helpful for some people to know that the diet change uh um was really the biggest factor for me in my journey, and then the exercise I think was really helpful in the second half of my um weight loss in losing my, you know, the remainder of the 160 pounds that I had lost. But it's also exercise has now been critical in the maintenance of that for over the past 20 years. So so that, you know, what what that kind of equates to in modern terms is I use lifestyle medicine, which lifestyle medicine is the you know the uh kind of carefully planned or prescribed use of lifestyle changes to improve health and uh and health outcomes. So I did that for myself. I was still working in pharmaceutical research for years, but as I would walk around our campus that was here in New Jersey, it's a 500-acre campus. We had 10,000 people just working on this site, 120,000 people working around the world. And I just couldn't help but think that a large portion of what of the work that we were doing was to enable people to not have to make the same lifestyle changes that I did. You know, and what I learned through my personal journey is that getting healthy by making lifestyle changes comes with a whole bunch of positive side effects. My confidence went up, my energy levels increased, you know, things that I didn't expect my fingers to, you know, to clear up this eskema that I had been dealing with since I was a, you know, since I was in elementary school. I didn't expect for the psoriasis to disappear and never come back. You know, I didn't expect for all of these things to happen. I didn't expect to become a runner and someone who enjoyed the outside and exercise and um and things like that. So so I was really passionate about wanting to kind of help people to change the way that to change their lifestyle, to live healthier, because I think that that is the shortest path to improving overall quality of life, as well as you know, the things that we typically measure for someone's health, um, kind of health assessment. So uh again, I'm not a doctor, so I did not know, so I wasn't going to change the way I was practicing, because I wasn't, you know, I wasn't, I'm not a practicing physician, but um, I did start to do some health coaching, and I started thinking that you know I can reach a few people by health coaching, but how am I really going to help like masses of people? How am I gonna help thousands or tens of thousands or hundreds of thousands of people? And while I was immersing myself in the world of lifestyle medicine, I would go to conferences and I would see the same thing happen over and over and over. Like every single time there's either a physician or a scientist, or sometimes a physician scientist who's presenting some data and some information that they've learned, uh, you know, um sharing information that they've read in studies about how lifestyle changes impact a particular disease. Sometimes that would be for diabetes, sometimes for heart disease, sometimes for autoimmune, multiple sclerosis, all these conditions. Then they would share patient testimonials, people like myself, um, or people that they have helped, and they would show real-world examples on how what they had just explained impacts people's lives. And then they would go to the QA to the audience. And almost every single time, someone from the audience would raise their hand and say, Hello, my name is so-and-so. I also suffer from heart disease, you know, uh type 2 diabetes, autoimmune conditions, whatever the condition was. And they would ask the question, where can I find a doctor who can help me? And there was no good answer to that question. Um, because doctors who practice this kind of medicine are scattered at best. And even the ones that you can find are not necessarily practicing somewhere where you can go and book an appointment with them. You know, sometimes they're uh, you know, they have a wellness center where you have to go and stay for a period of time, or sometimes they're working in a hospital and they're kind of doing this in a as a um, you know, as something that they're interested in, but more of a niche practice. But you can't actually book an appointment for them. So I started to combine all the puzzle pieces in my mind. I knew a lot of doctors who wanted to practice better medicine. I knew a lot of potential patients who wanted a doctor who would help them to make lifestyle changes to heal. And um, you know, I had the kind of IT slash computer um experience to know to know that I could confidently build a telemedicine platform where these two groups could meet and interact. And that's what lifestyle telemedicine is. It's a platform for doctors who practice lifestyle medicine. Uh, we have we have seven doctors right now, and they're licensed to see patients in all 50 US states, and they also provide international consultations for anyone who's outside of the US. Um, the only difference there is since they're not actually practicing medicine for people outside the US because they're not plugged in. They won't be able to order labs because they don't, you know, because we're not plugged into the lab systems in all these other countries, and they also cannot prescribe medications for people who are outside of the US. But for people inside the US, um the doctors can, you know, they can take over care of many of your of patients' health conditions, they can order the testing that's needed, they can prescribe the medications that may or may not be needed, and they can help them to make lifestyle changes to ultimately reduce or eliminate medications when possible, but really start to live healthy and thrive.

Dr Andrew Greenland: 13:06

Amazing, amazing. So um thinking about this platform then. So do you get some sense of who you're actually serving? And then how does care typically unfold for a new patient?

Anthony Masiello: 13:17

Yeah, so so who we're serving and who we should be serving may be two different things, right? Um we've started within the niche. We we started reaching out to people who already know what lifestyle medicine is, and many people who have tried, the people who initially started working with our doctors are patients who had already been trying on their own. So they've read some books, they've listened to podcasts, they've watched YouTube videos, they've done a lot of their homework and they've made some significant changes to improve their health, but it hasn't quite worked well enough for them. So then they start to work with one of our doctors who can help them to be a little bit more prescriptive and can take all that general knowledge and information that they've gathered on their own and they can apply that very individualized, very specifically for that patient, giving that patient's medical history, current conditions, even things like uh preferences and habits and all of that. So the doctors each create individualized plans for every patient that they work with. We do have a couple of assessment packages that help people to understand their current state of heart disease or metabolic condition or you know, their or their heart health, I'm sorry, or their metabolic health, or even general health and wellness. But it always leads to a tailored plan that's specific for an individual. And you know, sometimes if that's a healthy person who's working on prevention, you know, someone who's much smarter than I am, who's actually catching this before their health is in the danger zone, then the doctors can help them to make little tweaks to make sure that they don't have issues to deal with down the road. If it's someone who's newly diagnosed with something like type 2 diabetes, the doctors can almost always help them to not need to go on medication or to get off their medication even if they are unduely prescribed. They really work with a wide variety of conditions, but I think the key is to is that they provide individualized care that focus on a lifestyle first approach to treating any medical conditions that the patient is concerned about.

Dr Andrew Greenland: 15:32

Thank you. Um I mean lifestyle medicine and telehealth are both evolving quickly, and you know, COVID certainly uh really accelerated the growth of telehealth. What big trends are you seeing right now in the industry that are influencing your work?

Anthony Masiello: 15:47

I mean, yeah, telehealth feels normal now, which is great, but because I started this in 2019 before COVID, and I was worried about two things. I was worried that people did not think that telemedicine was a real uh a way to deliver real medical care. And I was worried that people didn't believe, wouldn't believe that lifestyle medicine is actually an evidence-based scientific approach to uh treating actual medical conditions. Um so um time, COVID and time have erased the challenges around telehealth. Everyone, everyone is used to it, so that that's easy. And sometimes people prefer it because a half-hour appointment literally takes about you know 35 minutes out of a patient's day, right? There's not a lot of traveling and waiting involved, um, things like that. Lifestyle medicine is still a challenge, uh, helping people to understand. And the challenge is not that it doesn't make sense. Uh, you know, initially people might think that um the they might put lifestyle medicine into a category of um kind of alternative uh approaches, but when you really get down to it, it's so much more practical and pragmatic than that. It's like, you know, it's not that you know broccoli will will lower cholesterol or something like that, right? Like it's not like broccoli is this magic thing or that any one vegetable or something, you know, or or specific food type, any kind of food type, is gonna do something. But but what we have to realize is that the reason our health is deteriorating is because of this um the stress that we've been putting onto our systems for years. In my case, I had 33 years of basically beating myself up. And what really helped me the most was I stopped beating myself up. It's like if you're hitting yourself in the hand with a hammer, right? Sure, you can take medication, you can do all kinds of things to mask the pain. But the first thing you need to stop start doing is stop hitting yourself with the hammer, which is essentially what lifestyle medicine is in the beginning for most people. So you want to stop doing the things that are causing the damage in the beginning. And sure, then it looks like you know these changes healed you, but what you really did was you stopped hurting yourself over time. So uh lifestyle medicine still has a long way to go uh for people to really understand it and to people for people to start seeking lifestyle medicine approaches to treating medical conditions. So we are now stuck in a position where we're trying to both educate and serve at the same time. So if someone is lucky enough to have found us, which we're not very easy to find, and then they're also have confidence enough to book a first appointment, then the doctor starts working with them and has to help them to understand how making some lifestyle changes can actually improve their conditions.

Dr Andrew Greenland: 18:49

I was going to ask, do um do most patients come ready for change, or do you still need to do a lot of upfront education? I remember you mentioned about education being one of the pillars of what you do. Yeah. But just in terms of what most patients are showing up ready to commit to, what's it like at the moment?

Anthony Masiello: 19:03

Um, most of the patients that find us now are ready to change. And that's partially because we're not doing a great job of marketing. You know, we're not, you know, we're hard to find. So by the time someone actually finds us, then it's usually because they've been searching for this type of for the type of solution that we offer. What I would love to do is figure out how to reach more of kind of a general audience of people who don't understand that you can that doing things like managing your um your diet, your exercise, your sleep, your stress, your social connections, and all these things can help you to heal. And um then I think the weight of the education will become even more important. Um, because we're finding people who have already read some books or have already listened to some podcasts or have already have some level of understanding, which is wonderful for the doctors because it's it's fantastic. Pass it to get people who are ready to change. But I feel like the real magic to help society and the population at large is going to be to help people who don't even know that they need to make these changes, to help them to understand and then to implement and then to get well.

Dr Andrew Greenland: 20:18

Interesting. I I completely resonate with that because I have this I do functional medicine, which is a massive overlap with lifestyle medicine, and I completely get it. It's raising that awareness for somebody that doesn't necessarily realize they have the problem to get them to come to the table. So I completely get that. I was going to ask you about shifts in patient expectations and also things like insurance coverage or even clinician burnout and how that's affected your business and your perhaps your approach to growth.

Anthony Masiello: 20:47

Yeah. So we have obstacles here in the US. So first of all, the people are not used to paying for medical care. People are used to paying a lot of money for insurance, whether it's through their employer or on their own. And then their insurance is then paying for their care. The problem is that insurance is not yet reimbursing at a rate where a doctor practicing lifestyle medicine can spend the time and do the education and follow up with the patient the way that's to the extent that's necessary to actually help the patient to heal and to change and to get results. So we have to have patients pay out of pocket. So we're asking our patients, and we appreciate our patients every day for stepping outside of the medical system, and they're paying out of pocket for their appointments. Now, the shortest appointment that we have at Lifestyle Telemedicine is 30 minutes. Most new patient appointments are one hour, and that's a full hour or that's a full 30 minutes with your doctor. And we're trying to keep that as affordable as possible. You know, the rates are $175 for a 30-minute appointment, and it's exactly double $350 for a 60-minute appointment. And again, that's all time with the doctor. So if you are in the US and you do have private insurance, after the visit, we provide each patient with what's called a super bill. And that just includes the doctor's information, it includes all the diagnosis codes for the patient, and it includes the treatment codes so patients can submit that to their insurance for reimbursement. And some patients are fully reimbursed, some patients are partially reimbursed, and some are not reimbursed at all. What we find is that patients who have insurance with good out-of-network benefits and they have multiple chronic conditions are getting fully reimbursed for their visits. But if you don't have, you know, if you've not met your deductible or you don't have good out-of-network benefits, and um and you only have, you know, if you only have one or two chronic conditions, or you don't have any and you're working on prevention, then your insurance company is likely not going to reimburse the full amount for the appointment.

Dr Andrew Greenland: 23:07

Got it. Many of the conversations I'm having with people in North America, the insurance thing comes up in every single one. It's a little bit alien to me because we don't really have that situation in the UK because all of this is completely out of pocket. But it's interesting that the insurance thing always seems to rear its head in discussions of out-of-um-system care, which is interesting.

Anthony Masiello: 23:28

Well, yeah, and and it's unfortunate, honestly, but but what we've done is I would just had a conversation yesterday. You know, we pay people to cut our hair, we you know, we pay people to take, you know, to do all kinds of things for us, um, to take care of our motor vehicles, to to take care of our homes, to take care of our gardens, to do all of these things. We're used to paying for a lot of services. The one that people in the US are not used to paying for is healthcare, which I would argue is the most important thing. And it's probably the most risky thing to outsource to a system that you end up having very little control over. It really does set the patient up to be kind of dependent on you know whatever the insurance company wants uh to provide for care. So it's a it's a huge problem for us here in the US, especially for people who want better care than is offered from the kind of conventional processes and systems.

Dr Andrew Greenland: 24:29

Thank you. So this obviously is a business, you're running this as a business. I'm just curious to know what's working really well for you as this as a business model, which is what telemeds your your platform does. Yeah.

Anthony Masiello: 24:40

So you you asked also about the physicians and physician burnout and stuff. And and you know, we're so fortunate to have these seven physicians working for us, but I will add that they are all working uh part-time, uh practicing lifestyle medicine. Um most of them have other work that they do as well because they are as passionate about this as you are and as I am, and they're they're trying to figure out how to how to make this work. So, what works really well is when someone calls, a patient calls, and they say, Oh my gosh, I had no idea that I could have a doctor like this to care for me. And that that like, you know, that's a little bit of a kind of a feather in the hat, right? It's like, oh wow, you know, we're providing something that's useful. Or what's most important is when we hear from patients after they've had one or two or three visits with their doctor and they've started to get well, or they've gotten off their medications and they become so proud, and then they start telling other people, you know, about how how good they're feeling and how they're off their medications, or how they're no longer diabetic anymore, or they no longer have high cholesterol, and they don't have to take pills every day and those kinds of things. Um, from a from a business, from actually on the business side and purely on the financial side, you know, it's still challenging. Um the doctors are not paid what they should be paid. Uh, the company doesn't make what what it should be making, and there are periods of time where I am able to pay myself a very modest salary, and then there are there are long periods of time where I'm not able to pay myself. So it's really truly everyone is flying on passion. And I share that because um I would guess that there are others who are in similar situations, but in the big picture, it also makes these movements fragile, right? If they can't financially sustain themselves, and if we can't have a physician making a good living practicing lifestyle medicine, then how long are they going to be able to continue? Or if we can't have administrators, you know, uh making a fair fair wage for their for their work, you know, how long are they going to be able to continue? Um we went through a period of three years where we were partnered up with another company and we weren't really focused on growing the business, and we had six of our doctors left. When we joined that company, we had 11 doctors. Um we had six leave while we were there. And now we've had, since we've separated, we've had other doctors join us again. But the sad part to me is that none of those six doctors went on to practice lifestyle medicine. They all left to go back into conventional medicine because they needed to, they needed to um to work at a job where they could, you know, kind of make a make some more money or make a better living for themselves. And I just have the utmost respect for these physicians who are who are doing this on top of their other work because um it's not easy to become a doctor, right? I mean, like there never mind all the education and the schooling and the time and the investment that you have to do up front, and then paying back loans over periods of time, but then the amount of responsibility that a physician takes on in caring for a patient, it's it's incredible that they're that they're willing to you know to do this kind of work. And um, you know, if I can do anything to help them to become more fairly compensated for that, to for doing taking a lifestyle medicine approach, then uh, you know, that's something that I would that's a contribution that I would be proud to make if if I can help to figure that out.

Dr Andrew Greenland: 28:22

Thank you. And on the flip side, what's um the sort of most frustrating or complex part of growing lifestyle telemedicine from your perspective?

Anthony Masiello: 28:30

You know, it's I would say it's marketing, it's competing with all the noise that's out there. You know, for better or worse, I think we have one of the most honest transactions in healthcare. You know, a patient pays a doctor $175, the doctor is focused 100% on that patient for that half hour of time and helping that patient. You know, we don't have any behind the thing, behind the scenes pills or procedures or anything that we're trying to encourage that patient to take on. And um so as honest as it is, we don't have anything flashy to uh to lure people in with. You know, we don't have a short promise. We don't say, you know, we don't say, you know, we we can't go out there in the marketing world and say, hey, you know, we have this special tea, and if you drink this tea, all your health problems will go away. Or, you know, we we don't, you know, but we have to compete with that. But we don't have that. You know, we don't have anything that that's kind of simple. And I think it's part of the positives and the negatives, the approach is so individualized that it's hard for us to package it in a way that people can really understand it until they experience it. And that's really challenging.

Dr Andrew Greenland: 29:48

Um, and if you had a magic wand and you could fix one thing in the business tomorrow, what would that be? I mean, perhaps marketing aside, because I think you mentioned that. Is there anything else that you would love to be able to just kind of solve overnight with a magic wand?

Anthony Masiello: 30:01

Um I would love for the insurance companies in the US to reimburse for these services. You know, if we could take away the pay out-of-pocket part, I think we could we could get a lot more people um help. And I do think that it would lower the overall cost on the medical system. Um, you know, if we get people off these medications, if we get people, if we create that environment in the body where the body starts to heal and doesn't become dependent on medical pills and procedures to live for a long time, I think it will save money overall. And we need the insurance companies to believe that people will do it, that patients will do it, and start to invest in that kind of prevention rather than waiting until people have problems and become dependent on conventional medical care.

Dr Andrew Greenland: 30:54

Obviously, you were looking to grow, and I know you want to reach more people, but if you had a sudden influx of new patients next week, um, would anything break? Hopefully, not you and your colleagues.

Anthony Masiello: 31:04

Um no, honestly, it would not. You know, the we were approached. Um, I have a folder on my computer with uh, I think 123 CBs from doctors who would love to collaborate with us and would love to see more patients. Um, I have the upfront conversation with them, with anyone who's interested, to let them know that this is a place to come and to build, you know, to build your practice. This we don't have a lineup of patients waiting to see doctors. If we did that, if we had that lineup of patients, we could very easily bring on enough doctors to scale seamlessly. I don't think anything would would break. And we didn't build the technology ourselves. You know, we're using industry standard technology, you know, with our electronic health record systems, our patient portals, all of that stuff. So I have confidence that that can scale very easily.

Dr Andrew Greenland: 31:56

So where where do you fit into the platform at the moment in terms of where you're spending your time? Is that more sort of clinical, operational, administration, all of the above, none of the above? Where where do you kind of fit into this?

Anthony Masiello: 32:09

It's mostly operational and um administrative. You know, I I feel lucky now sometimes when I get to do uh help the patients. We have a full-time patient care coordinator. Her name is Susan, and she takes amazing care of the patients outside of their medical care, right? But when patients need to get onto the portal where they have questions about which doctor to see, but uh when Susan takes off, I answer the phones, and it's one of the most one of my favorite things to do is talk to uh people who call up on the phone or who are interested or want to learn more about what these doctors do and how it might help them. So um so that's that's fun, and I get to do a little bit of that, but mostly I'm working on the the business stuff, you know, trying to figure out the accounting and the numbers and the and uh you know keep everything afloat, keep everyone else and all the other, you know, the other expenses paid, and then really focused on um what can I do to help these doctors to see more patients? What can I do to help raise awareness so that more people are aware of these doctors and can come and learn about them and um and hopefully make an appointment with them.

Dr Andrew Greenland: 33:26

Thank you. I think scaling um physician-led care is is tough in any sort of sector, but have you ever explored or thought about things like group programs or any digital tools to try and support um patients between consults or your colleagues working with them?

Anthony Masiello: 33:42

Yes, we we've explored, and we haven't been able to implement anything like share medical appointments or group visits. It gets really complicated in the US with the state licensing. In order for a physician to provide care to a patient, the physician must be licensed in the state where the patient is at the time of service. So, what that means is if we set up share medical appointments for, let's say, diabetes, and we had patients particu participate from you know 10 different states, and we don't have any one doctor who's licensed in all states. We have we we can provide uh coverage for patients in all states because the doctors kind of divide and conquer. You know, some of them have eight licenses, some of them have 10. But if I have 10 people participating and they're each coming from a different state, then we have to have uh doctors who are licensed in all those states in that shared medical appointment in order to have it count as a medical visit. And then what we have to do is after the appointment, the doctors have to spend a lot of time then charting for each one of those patients outside the visit. So I think it's more efficient in some ways, in that the patients get, you know, like they get all the information, they get the benefit of learning from each other's questions, they get the benefit of learning from how the doctors are treating each person while they're all together in that community. Um, I think they get the benefit from the social aspects of spending time together. But on the administrative side, we have not figured out how to make it work efficiently to be able to implement something like that. So, what we do is we do do uh live QA chats on social media and YouTube, and we do those twice per month so that people who have general questions can come, and it can be existing patients who have questions in between their appointments, or it can be people who are not patients, they're just part of our community, and they can come there and they can ask questions. Obviously, they can't receive medical care, but they can get general questions answered and they can get pointed to resources and uh different information that they can read and look up on their own and stuff like that. So we do try to balance, we try to provide enough for people who want to help themselves and who, for whatever reason, cannot um book an appointment.

Dr Andrew Greenland: 36:10

Thinking ahead to the future. What's next in the next 12 months for lifestyle telemedicine? Do you have any particular goals or plans for the business?

Anthony Masiello: 36:18

Um I mean, our goal is to grow. And one of the most exciting ways that we've been growing recently, and uh is we've we're putting in a number of partnership programs. Um, there's this company called El Neutra, which which is uh, you know, they have this product, this consumer product called Prolon. Yeah, five-day fast mimicking diet. Yeah, it's it's very popular and it's fantastic. But they also, what people don't know as much about them is they also have a diabetes remission program where they have RD coaches who will run patients through a course of six um five-day fast mimicking diets over six courses of that over a six-month period, so once per month. And the RD coaches will help to monitor the the patients and support them in between uh courses of the fast mimicking diet to specifically to help them put their diabetes into remission. But ElNutra was running the program in Texas and California because that's where they had doctors who could then do the deprescribing and medication adjustments. But um, I worked with their uh medical chief medical officer, Dr. Will Shu, and um we came up with a partnership where our doctors will provide medical care for the patients who were going through their diabetes remission program. So essentially we helped them to overnight to make their program national. So now instead of only being able to see patients in Texas and California, now they could see patients in all 50 states because the medical, the licensed medical care was coming through us. Um, we have a similar arrangement with um the McDougal program, which uh Dr. John McDougal was a you know a um very well-known, well-respected um kind of whole food plant-based um physician who who runs a 12-day program and helps people to you know eliminate all kinds of diseases during this very intensive 12-day period of time. Uh, Dr. McDougal has passed uh this earlier this year, but his daughter is continuing to run the program. And they also wanted doctors who would provide licensed medical care so that they could run the program online virtually for people who weren't coming to California. So we've plugged in our doctors behind that program, and now they can run that program medically supported to patients everywhere. And if someone requires labs or changes in medications, you know, our doctors can handle that part of it while they're going through the health transformation program. And uh, we're also working with a couple of other coaches who are similar. So we can be that back end, we can provide um medical supervision or medical support, you know, whatever people want, as long as it's kind of like-minded medicine, you know, lifestyle medicine, then uh we can help other people to take their non-medical services and to include a medical component so that they can reach, um they can provide like deeper care for the people who they can reach in their communities.

Dr Andrew Greenland: 39:34

And and finally, uh what do you wish more people, whether it's patients, doctors, insurers, understood about lifestyle medicine as a model for care?

Anthony Masiello: 39:42

Yeah, I wish that they understood that it works, that it really, really works. You know, I would love for us to have like a drug commercial, but for lifestyle medicine. You know, we can we can follow that same pattern that that we see on the television all the time. It's like, do you suffer from? Heart disease or type 2 diabetes or metabolic conditions or autoimmune. You know, ask your doctor if lifestyle medicine is right for you. Side effects include weight loss, more energy, um, you know, uh uh feeling better, you know, more better family life, um, you know, career advancement, you know, all of these things that come from really taking good care of yourself. Um, I think that would be huge if we can figure out how to reach the world and help them to know that lifestyle medicine, you know, functional medicine, as you said, there's so much overlap between these things, integrative medicine, that these disciplines of medicine are worth pursuing. And I think that they're worth pursuing first, and then using conventional medicine as a backup when it's necessary.

Dr Andrew Greenland: 40:47

And on that note, Anthony, I'd like to thank you enormously for your time today. It's been really interesting hearing about your personal journey and how you've converted that into something really amazing to help lots of other people restore their health using a lifestyle medicine approach. And thank you very much for sharing that and also the child some of the challenges in running this as an operation. I think it's been really interesting and something people can really learn from. So thank you so much for your time.

Anthony Masiello: 41:10

Yeah, you're very welcome. Thank you so much for having me on. You know, I love that you share these stories out there and these um these conversations, and I really appreciate being part of it. Thank you. Thank you.