Dr Douglas Lucas

Habits & Health episode 84 - Douglas Lucas - Would you like better: Stamina? Ambition? Vitality? Energy? Desire?

Habits & Health episode 84 with Dr Doug Lucas, a board certified orthopaedic surgeon who left the traditional medical model to build a practice on health optimisation. He aims to address the underlying causes of chronic disease to improve both health span and lifespan. 

He has been specialising in metabolic health, hormone optimisation for both men and women, osteoporosis and longevity.
He has pursued additional fellowship training from the American Academy of Anti-Aging Medicine (A4M), The Academy of Preventive and Innovative Medicine and Wild Health. His passion is to work with patients looking to optimise their health through a customised approach based on genetic data, extensive evaluation and in depth lifestyle examination. Armed with this information he can partner with his patients to achieve their health dreams.
In this episode topics we discuss include:
  • Bone health
  • Hormone replacement
  • Health optimisation
  • Lifestyle changes
  • Genetics
  • Looking at the big picture
  • Functional Medicine
  • Health Coaches
  • Lab tests

Favourite Quote

"How you do anything is how you do everything"

Related episode:

84 – Douglas Lucas


[00:00:00] Tony Winyard: Habits Health episode, 84.

[00:00:16] Tony Winyard: Welcome to another edition of Habits. Health. My guest today, Dr. Doug Lucas, who is a board certified orthopedic surgeon Who left the traditional medical model to build a practice on health optimization. Specializing in metabolic health, hormone optimization for both men and women. Osteoporosis, and longevity.

He aims to address the underlying causes of chronic disease to improve both healthspan and lifespan. So we dig in to what does that all mean? and a lot more about. Osteoporosis. About why he stopped being a surgeon about health optimization and longevity and health span and lifespan. And so on.

So that’s all in this week’s episode with Dr. Doug Lucas. If you know anyone who would enjoy this. Please share the episode with them And I hope you enjoy this week’s show.

Habits & Health. My guest today. Douglas Lucas. How are you? Doug?

[00:01:10] Douglas Lucas: I am doing well. Thank you. Great to be here.

and I should have said Dr. Douglas Lucas, cuz you are a board certified orthopedic surgeon.

[00:01:19] Douglas Lucas: That’s right.

[00:01:19] When did Doug become a surgeon?

[00:01:19] Tony Winyard: When did you become a surgeon?

gosh, I started practice in, 2015, so seven years ago, a little over, but made a shift , to really more of, prevention and health optimization practice about two years ago. So about five years in really started making that transit. So I’ll be sitting for my second board certification in, anti-aging and functional medicine here.

next month.

[00:01:44] Tony Winyard: I’m definitely gonna dig into that, but before we get into that, so let’s go back to when you became a surgeon, what seven years ago, I think you said. And what was it that led you into that in the first place?

[00:01:55] Douglas Lucas: Yeah in medical school. I, when I started, I was really thinking something more along the lines of primary care. I’m a do, which is a little bit different country to country, but in the United States, a do or doctor of osteopathy is the legal equivalent of an MD. And the training is almost identical, except that we learn.

Manual manipulation similar to that, of chiropractor in the United States. and so I was thinking primary care with some kind of muscle manual work. and then I really just fell into the rabbit hole of the musculoskeletal system and then recognized, wow. Yeah, I can do manual work with my hands, but wow.

Look, what I can do with these tools. I just fell in love with the operating room and the power that had. so it was really. That power of the surgical experience that drew me into that space.

[00:02:42] Tony Winyard: and you talked about what you could do with your hands. were you working with your hand for a long time then before becoming a surgeon?

[00:02:49] Douglas Lucas: Yeah, my, my path, was, probably a little bit abnormal. So I was very into kind of outdoor athletics endeavors. So I was rock climber and snowboarder and love being in the mountains. And after an injury in undergrad, I, ended up. training myself into the world of fine arts. So I actually worked trained and then eventually worked as a professional ballet dancer.

So I took this really strange, deviation into the world of arts, where I was very physical, not necessarily with my hands,just, very physical with the human body and then art and then wove my way back into science. So a peculiar pathway into being an orthopedic.

[00:03:25] Professional ballet dancer

[00:03:25] Tony Winyard: And so a professional ballet dancer. As a professional ballet dancer, do you need to know, not necessarily you, but do ballet dancers need to have a really good knowledge of their body.

[00:03:36] Douglas Lucas: Absolutely. Whether they know it or not, they have an incredible knowledge and intuition of, what’s happening in their body. They might not be able to put a label on it. but they know it and it’s a really fascinating group of athletes.

[00:03:49] Tony Winyard: And how long did you do that?

[00:03:51] Douglas Lucas: So I started training. I was in my second year of undergrad, so that would’ve been, 1998. and so did four years of undergrad and then, danced professionally with the Richmond ballet in Richmond, Virginia for, two years before heading back to school. So relatively short little JAG in my career.

[00:04:12] Tony Winyard: And because of the knowledge you gained in your body during that time, is that, do you think that was one of the things that kind of led you to the direction that you.

[00:04:20] The musculoskeletal system

[00:04:20] Douglas Lucas: Yeah, I really do. I just, I love the musculoskeletal system. I loved the, just the complexity of it, but also in some ways, the simplicity where, you can lay your eyes on it as opposed to something like the brain and the nerves, which you’re just their mind boggling because you can’t see it, it just looks, it doesn’t look like it’s working and yet it’s doing all these crazy things.

So yeah, that I, went from feeling it to then studying it and understanding.

[00:04:45] Tony Winyard: Do you still dance?.

[00:04:47] Douglas Lucas: And, a little bit, my wife and I like to get out and do different styles of dancing, but not ballet.

[00:04:52] Tony Winyard: Cool. And so you mentioned that so recently you’ve got more into, to functional medicine. So why the change?.

Moving into Functional Medicine

[00:04:59] Douglas Lucas: Yeah. So I started practice in 2015 and, I’ve always had an interest in nutrition and I’ve always had, as a, as an athlete, an interest in performance. And, very quickly I started recognizing that, some of the things that I learned in medical school and training didn’t really seem to pan out with how I was treating my patients, particularly with my diabetic patients, people that we were.

In training just assumed that they just weren’t following what we were telling them to do. And that what we were telling them to do was right. as it turns out what I was trained in is not the right advice in that a lot of these patients actually were doing what we were telling them to do, but not succeeding.

And so I. I started seeing these discrepancies of my patients and my wife who started a nutrition business. She has a PhD in nutrition. She’s a registered dietician and she started changing people’s lives through nutrition and preventive measures. And, in ways that I did not think were possible. This sort of disparity started to grow. and then lots of things occurred, but ultimately I, I wanted to end up being able to help take care of some of the people that she was working with because they weren’t getting the kind of support that they needed in things that I ended up, specializing in, which would be like hormone optimization, thyroid optimization, and, really digging into,functional labs and cut health and all these things where there just isn’t a great place for them to.

[00:06:18] Tony Winyard: So you talked about hormone optimization for anyone who’s listening and maybe has no idea what that is. Could you give a, go a bit deeper on.

[00:06:28] Hormone optimisation

[00:06:28] Douglas Lucas: Yeah. So when we talk about hormone optimization in general, we’re talking about the sex hormones, but obviously other organs have hormones too, but in general, we’re talking about sex hormones. So for men that’s mostly testosterone and for women that’s estrogen, progesterone, and testosterone, We are optimizing and or replacing depending on where they are in the spectrum of need of all those sex hormone.

[00:06:50] Tony Winyard: Are you working with any particular type of client? How do you help people at the.

[00:06:54] Douglas Lucas: Yeah, I have two, I have two offerings essentially for the same business. So I’m now actually completely out of, operating. I haven’t, I haven’t been functioning as an orthopedic surgeon for a while. I run a health optimization practice where we focus on. energy restoring, optimal health, how you feel talking about Habits, which I’m sure we’ll talk about, and supplementation and so forth.

and so really helping people optimize their health and those tend to be, I would call them, younger professional folks that aren’t. Functioning the way that they want to, or used to,just missing the edge, and helping them to restore that, which is that’s a super fun group to work with.

[00:07:30] Douglas Lucas: The other group that we ended up creating a pathway for very specifically are people that are struggling with bone health issues. So people that have osteoporosis because it really. It blends the orthopedic background with the functional holistic approach, which it works great for osteoporosis and reversing osteoporosis without medications.

so I just have a passion for those patients because I’ve been treating those fractures for a long time. and they similar to my wife’s clients. They just have very few options as far as where to go once they have had a fracture or have a diagnosis of osteoporosis.

[00:08:04] Reversing osteoporosis

[00:08:04] Tony Winyard: Are people surprised that you can reverse.

most of the people coming to me feel like they should be able to, But most people don’t, they’re just, they take what they’ve been told, which is you have osteoporosis or you’ve had a fracture and you probably should take this medication. And that’s the end of the conversation.

so unfortunately, most people don’t know that you can reverse osteoporosis. but yeah, we see it very frequently where people can, and even potentially without the use of medications, which, it just is not commonly known outside of the traditional medical model or even inside it for that matter.

[00:08:35] Tony Winyard: I guess it’s different for every patient, but how long might that.

[00:08:39] Douglas Lucas: It takes a while. and if it depends on how you’re looking at it. So if your metrics are the traditional, bone screening study, which is called a DEXA scan, which is a, kind of an x-ray type image, It takes usually a year at minimum to two years or potentially longer to see improvements on Xa, but Xa is not really a great study anyway.

So there are other studies which are more sensitive to change and you could actually see some relatively quick change in three months or six months. but those studies are harder to find, to be able to get. but we do see, the other metrics as far as, is your gut getting better? Are your hormones optimized?

Those things you can see right away. So we know that you’re headed down the right path. and then the other findings are.

[00:09:18] Tony Winyard: Would I be right in assuming that on that path to reversing that there’s many other aspects of their health are being improved as.

[00:09:26] Douglas Lucas: Absolutely. In fact, the bone health program that we’ve developed is actually just a layer on top of our optimization program. Whether they know it or not, they’re actually going through our optimization platform and we’re just layering on the bone health labs and layering on different education components of, all the things that are important from a lifestyle perspective.

So all the Habits associated with, having bad bones and how do you hold yourself and what kinda exercise should you be trying to do and so forth.

[00:09:50] What he enjoys most about his work

[00:09:50] Tony Winyard: What would you say is the most enjoyable aspect of what you’re doing?

I would say, working with patients that are highly motivated to get better,that was always something that I struggle with in the traditional medical model. Patients would come to me, not because they wanted to be there, but because they, they had broken something or they had pain.

[00:10:05] Douglas Lucas: And there’s never a good time, to break a bone. And so it’s always an inconvenience and so they want to get better right away and they want the pill or the surgery that’s gonna make the better. and oftentimes that’s not what I could offer. And so that was, that’s always a very challenging conversation.

Whereas in this. Scenario, this platform patients are seeking me out because they want to get better. They’re motivated to do the behavior change to change the way that they’re eating. and so that’s super fun cuz we see results and they’re happy and and they love the information.

So it’s just, it’s a much more, enjoyable experience all around.

[00:10:38] The damage being done by refined carbs etc

[00:10:38] Tony Winyard: So because of the increase in, people now eating more processed foods, fast foods, refined, carbs, whatever is that weakening the bones? Is there more people suffering from that kind of thing now?

[00:10:49] Douglas Lucas: Absolutely. I was just writing about this. We have a weekly email, and I was just writing about this, the highly processed nature of foods and how easy it is to succumb to the marketing around them. because we, If you’re trying to do something in your diet often, you’re, trying to eat with a certain macronutrients or, plant based or carnivore or paleo or whatever.

and the food companies are, they’re so good about marketing that they’ll create, a process piece of garbage to, to help fit whatever your philosophy or macro bills are. And it’s so easy to fall into that trap, cuz it lets you fall into old behaviors around. You’re like, I want eat this sweet thing.

if I’m on a low carb diet, I don’t wanna eat this sweet thing, but that sweet thing is just absolute garbage. When you consume that type of garbage, your body doesn’t really know what to do with it. the minerals and nutrients that are in it are probably not gonna be well absorbed. and yeah, it will absolutely have an impact on your overall health and depending on what you’re consuming or how you’re consuming, it could certainly have an impact on your bones.

[00:11:42] The importance of habits

[00:11:42] Tony Winyard: And so you talked before, you touched upon the importance of Habits before. So what would you say are some of the. Main behaviors. You try to instill in people or to get them to.

[00:11:54] Douglas Lucas: Yeah. So the first thing we do with somebody is I have our coach sit down with them and they talk for an hour about Habits. So we talk about, what are your Habits around sleep? What are your Habits around exercise? What are your goals around those things? how are you eating. When are you eating to what quantity you’re eating?

Why are you eating? and then same thing with what are you doing with stress in your life? Because we all have a lot of stress in our lives. And what we do with that stress is critically important. So we come up with a list of, okay, these are all the things that we could potentially improve upon and then just tackle them at whatever pace, somebody can tolerate.

I would say the things that I see across the board is that people have terrible. And, it’s just something that we and our society, we’re trying to fit more and more things into our life. So the thing that you don’t understand will go first and we don’t really understand in general why we sleep, why do I need eight hours of sleep?

It’s just such a long time. and it’s such a waste of time, right? And so I’m gonna just shorten my sleep window so that I can get all this other important stuff done. see it all the time. And the first thing I tell people is you’ve got to sleep for that long. there’s a reason. And. We get, we run genetics on everybody.

So we know that some people can sleep a little bit less, but it’s still it’s not eight at seven and a half, it’s not five. And,and so that’s probably the number one thing. As we encourage people to sleep better, to sleep longer, help them with sleep quality in, in Habits, around sleep quantity.

and then I think probably the second thing,either nutrition, depending on what their background is or exercise, because. And our society really focuses on the cardiovascular side of exercise and people love to, get on their Peloton bike or the, the next cool thing,the cardio or whatever.

but what we have lost is just the simplicity of training your body to lift something heavy. And it doesn’t have to be a fancy piece of equipment. It could be a rock. I don’t care what it is, but training your body to lift something heavy in a safe way. So you don’t injure yourself. that simple act can have tremendous impact on maintaining muscle mass.

[00:13:47] Douglas Lucas: As we age building muscle mass, building bone mass year in that group. those two things are really the starting point. and it’s amazing that most people are not doing those two things, even in a very dialed in population.

[00:13:58] Sleep

[00:13:58] Tony Winyard: Some of those behavior changes that you mentioned there about asleep and the nutrition. And so on which ones do you think, do you find that your patients struggle with the most.

[00:14:09] Douglas Lucas: Sleep because it not because they can’t sleep, but because it’s just all of the behaviors around, if you have young children getting them to bed, the Habits that then creep in the evening, as far as, the addictive things like watching TV or,sitting on your phone and scrolling through social media or eating late at night, or, even, the challenging things around, your partner.

if you and. Really need that two to three hours after the kids go to bed. you’re not gonna go to bed till midnight, and if you have to get up at five o’clock for work, or, if you’re getting up at four to go work out, that’s just not enough. And, but it’s, that takes a lot of discipline because nobody’s watching you.

and then also really hard conversations with your partner to say, look. This is a priority for me. This is what I need. and you guys may have different chronotypes, my wife and I are a great example. She’s a night out, I’m a morning person. I would not recommend that in a marriage.

[00:14:57] Douglas Lucas: And, we’ve had to have some very challenging conversations around, okay. this is how we’re gonna go to bed. This is how our evening routine’s gonna look like. and it’s been a year’s process of finding that middle.

[00:15:08] Tony Winyard: But then in that situation that you just described, where there are two different chrono types. And so one person does ask the other one, can you work with me on this? They’re both gonna benefit though. Aren’t they not just a one partner?

[00:15:20] Douglas Lucas: For sure. Yeah. And what we’ve also learned is that my wife, for example, needs more sleep and I need less. And fortunately we can actually find a common ground of bedtime and then I get up earlier and I get the time that I need, which for me is around seven and a half hours. and she gets the time that she needs, which is around eight and a half hours, but we go to bed at the same time.

and we have both become very disciplined around, shaping our evening routine to say, we’re gonna do these things, but at this time we’re done at this time, the computers are closed at this time. the TV goes off if it’s even on, which is less and less off than these days.

[00:15:54] TV in the bedroom!

[00:15:54] Tony Winyard: I think one of, one of the things that’s, surprises my clients the most is when I’m trying to help them with sleep. And when we start talking about the TV in a bedroom and so many people just, they find it. they find it horrific when I suggest they shouldn’t have a TV in the bedroom first of all and trying to get people to understand why that is so detrimental to their sleep.

[00:16:16] Douglas Lucas: Yeah. Yeah. I, fortunately I don’t find that many of my patients do, and again, this is like a select population. but yeah, one of the, we ask that questionnaire, what does your bedroom look like? How cold do you keep it? How dark is it? Do you have any LEDs? Do you have a TV?

And then, and like when people say oh yeah, no, I have a TV in my room. I’m like, why, what are you doing with a TV in your room? cuz I’m so far removed from it. But I know it is extremely. And absolutely, terrible for sleep Habits.

and the worst thing is when they wake up in middle of the night. And so to get back to sleep, they start watching TV.

yeah. Yeah. I work a lot with people who get up that, that two, 3:00 AM wake up with anxiety, and ruminating thoughts. that’s a tough one. And, one of the first things I say is, what do you do? if you get outta bed after 30, 45 minutes, what do you do?

[00:17:02] Douglas Lucas: And if the answer is well, I start reply. To, to emails or I start no, no, you can’t get up at three and work, you can’t get up at three and watch TV cuz then you’re not gonna go back to sleep. You’re gonna feel terrible. So we have go through that whole thing, but yeah, that’s, it is a habit and it’s a bad one.

but it’s really a dependence on the TV.

[00:17:17] Tony Winyard: Our society just conditioned to that is normal and not watching TV in bed is abnormal to many people. It seems.

Yeah. Almost. I love the same, analogy around eating, where if you are selective about what you’re eating, then you’re on a diet. I’m like,no. That’s actually just eating healthy.

[00:17:33] Tony Winyard: Yeah.

Like not eating everything in sight is actually called binging. and being selective about what you eat is actually eating an optimal diet.

[00:17:41] The Functional Medicine approach

[00:17:41] Tony Winyard: So the functional medicine approach that you’re taking. Do you find that it’s been much more accepted in recent years than it was say five years?

I think that now that there is, there are more of us in the. Intermediate ground, between a traditional medical model and what is the functional medicine historically, which was really more, either natural path, depending on the state, which, I don’t know if you guys have natural path in England.

but,a natural path. Who’s an ind, um, in in like Nancy D. Or a chiropractor, who’s done some additional training, that was really what functional medicine was. So now we’re getting more people that are, they’d or dos and bridge the gap and there was some really good additional training.

[00:18:21] Douglas Lucas: Ithe training I went through, was, I don’t know how many hours, but it definitely thousands of hours of meal medicine training. because as an orthopedic surgeon, what did I know about the thyroid? I don’t know, if it’s off you, can you gain weight or it’s too fast, you.

Bone mass. but to understand how to manage those things, it takes a lot of time. And so I think the training’s getting better. The respect from, both patients and physicians is improving. just had an interesting patient interaction where the. The patient was a physician. His wife is an internal medicine physician, and we’re talking about functional testing and hormone replacement.

And she’s very hesitant, but she’s open, she’s at least open to having the conversation. Whereas I think, probably a decade ago would’ve been like, what are you even talking about? stop talking to my husband. so I think, yeah, I think it’s improving. There’s still a long way to go because there are a lot of people in the quote unquote functional medicine space who.

I’d say not well trained because it doesn’t take much or anything for you to be able to say that you’re a functional medicine, whatever. That’s why that word’s kind of, it’s a little dirty.

[00:19:20] Lab tests

[00:19:20] Tony Winyard: And one of the sticks that’s used to beat people in the function, medicine space is about that. They just they’re about, willy-nilly just prescribing, this lab test and that lab test. and so there’s a big misunderstand that seems to me why in, in many cases there are lab tests that are really important.

[00:19:38] Douglas Lucas: Yeah. And that’s the really tough thing,from a business model perspective, cuz I own my business. So I’m both entrepreneur and provider. which again, I wouldn’t wish on most people. but that’s where the margin is, is typically not on services so much as it is on the extra stuff.

And so you are. Monetarily motivated to say, oh, you need these labs. You let’s check your gut for the fifth time. so you really have to work with somebody who has integrity that you believe in, and they can demonstrate that’s one of the reasons why we recently actually changed our model into more of a subscription model so that we’re not.

[00:20:09] Douglas Lucas: Put into a position where we’re like looking for a lab, like, how can we fill this, this lab quota, like we only order them if we really need them. And we have a thorough discussion with the patient prior to ordering them. So the lab technology is amazing and there are so many great things that we can do, but.

You’re never gonna know as a consumer, whether or not they should be ordered or not, or whether or not the results from those labs are gonna help you in your journey or not. And some of them are incredibly expensive. So it really comes down to finding the group or provider that you believe has integrity around their services.

[00:20:42] Tony Winyard: And so how do you help a patient client choose between? Yeah, because there is this massive range of different labs. how can you help them decide which ones are gonna be the most important?

[00:20:53] Douglas Lucas: Yeah, it comes down to understanding your patient, so like I said, we initially right now I meet with all of. Potential patients before they ever sign up with us. So I already know, I know them, I know who they are. I know what their needs are. So I can come up with a list based off of that, as we grow that will develop into more of a, a questionnaire that we’re learning about them.

And then that initial meeting with my coach, who’s gonna, spend an hour with them talking about their history and, looking at previous lab results. that’s gonna really feed into that decision making process. There are some things that I wanna know about every. I want to know everybody’s genetics.

I want know, our lab panels pretty consistent with a few tweaks here or there, depending on what’s going on with them medically, the functional testing layer I want know about everybody’s gut, how well it’s working, how much more I want to know really depends on what’s going on with them. I wanna know about everybody’s HPA access.

how well are their adrenal glands functioning? What does their quarters all look like? So there are some things that I can say across the board I want for everybody. Unfortunately, not everybody can afford that. So we do have to pick and choose, but it’s a conversation with a patient and understanding what their unique needs.

[00:21:57] Tony Winyard: And are there, which are there blood tests that. almost insist on, or is it again just dependent on the.

[00:22:02] Douglas Lucas: Yeah, we have a base panel, we call it our optimization panel and it really hits, it hits well, a lot of things. there’s about 600 plus markers in it. but it really hits. most of the important things that I would want to know, we leave out a few things that are not relevant to some people.

So for example, if you have high blood pressure, we have some extra labs that we add in to help differentiate what type of high blood pressure you have. if you have osteoporosis, we do those lab, but if you don’t, we don’t. but for the most part, we’re doing a micronutrient analysis.

We’re looking at inflammatory markers, cardiovascular markers, a deep dive into lipids, a deep dive. To thyroid, a deep dive into sex hormone function, so that we can come out on the other side of this panel and have a big picture to say, yeah, we got a lot of things we could potentially work on now.

Let’s decide what we wanna work on. and then we follow that and it’s really important that we follow that over time. So we repeat that same panel every six months and we can follow progress or catch something else as it’s starting to.

[00:22:54] Having a proactive attitude towards health

[00:22:54] Tony Winyard: So you mentioned about that. Repeat that every six months. So do you find that you have many patients then who have a, quite a proactive attitude and they may not have anything wrong, but they just come and see you like a couple of times a year to, to stay healthy.

[00:23:08] Douglas Lucas: Yeah, I’ve got some really dialed in patients that have some, remarkably clean looking labs, but. What’s funny about those patients is they’re also the first ones that are gonna want the new lab test or want, the new fancy thing. And, they get grief from either their family or friends and say, oh my God, like, why are you spending all this time and money on you’re so healthy?

Like, why are you doing that? And they’re like, that’s right. I’m so healthy. And yeah, so they just, they want to keep checking and keep checking, because they want to stay that way. They feel great and they see everybody around them falling apart. so yeah, they want to keep checking and the way that we’ve developed our program is that we.

We essentially bring you on and you it’s in a subscription model, So you’re just gonna keep going. we’re gonna get labs every six months and then we’ll get functional testing as needed. and then I see them in a results review every six months. And so we just of keep marching down that pathway and then whatever happens, we have, a, we are ready to react to it rather than,or I guess anticipates a better term.

We’re ready to anticipate rather than react. and so we can be proactive that.

[00:24:05] Insurance companies

[00:24:05] Tony Winyard: can you see a time or maybe it’s already happening where insurance companies, cuz I know how big it is in the states with, medicine and insurance companies much more so than here where they’ll be, they’ll see that the people who are being so proactive in that subscription model that you are talking about.

They should maybe get very different rates to other, to how most people.

[00:24:27] Douglas Lucas: Yeah, it’s it. It’s definitely not shifted that way, And it’s, if anything, it’s gotten worse. and, I, I don’t know that much about the system, that you’re a part of, but my understanding is that, there, the expectations are lower as far as what your insurance will cover or at least the government.

Provided insurance. And that there’s more expectation that if you want to do something outside of the traditional model, then it’s gonna be on you. And whether or not that’s through a different layer of, insurance or private or whatever, in the United States, we’re still very stuck on this idea that insurance should cover everything health.

Which really is relatively new and it doesn’t actually make any sense. and we have gotten to this point now where the expectation is that insurance is, a right in the country, which I agree with. But the downside of that decision is now that everybody gets the same coverage. And our healthcare is extremely expensive.

And so it has become this, like this huge problem of how do we provide people with the quality of care that we have now become accustomed to a lot of my patients, they’ll ask me, why doesn’t my insurance cover this? Or why can’t I submit this to my insurance? And they could submit it to their insurance, but I could I’ll tell them it’s not going to cover it.

and it’s because it’s an additional cost to the insurance company that they don’t wanna bear. And they really are not motivated. From a business perspective to, to care and not to say that in a mean way, it’s just, they are a money driven business, just like any other business and their product is an insurance policy.

[00:25:55] Douglas Lucas: So they don’t actually care if you’re healthy or that you’re optimized. They’re just looking at the bottom line. And if you think about the statistics around how long you’re gonna be. A client of that insurance company, the average is three years. So why would they care if they’re preventing cancer 10 years from now?

Not that they don’t have a heart, just from a business perspective, it doesn’t make sense. So I don’t see that’s ever gonna change. And if anything, I think that the quality of the care is gonna continue to deteriorate from that. Provided right level, as we have seen in other countries, like in Canada and England and other areas where yeah.

You’ll get care and it’s provided for by the government, but the quality of care has declined and correct me if I’m wrong, but that’s my understanding.

[00:26:37] Morning journalling

[00:26:37] Tony Winyard: Yeah, you’re not wrong at all. the NHS is, yeah. Going through some bad times. Yeah. We won’t get into that. So I know one of the things, yeah. We talked about sleep and in Habits around sleep and so on. I know you’ve got something else that you think is important for people is morning journaling.

[00:26:54] Douglas Lucas: Yeah. Yeah. journaling is something that, has really been kinda over the last year that I’ve really started to speak about with my patients and, become a huge advocate for something that I didn’t. I wasn’t exposed to the value of it early on. I was in the meditation mindfulness base, really focusing on meditation and,being mindful throughout the day.

but at what I was missing for myself and also therefore for my patients was the ability to use a tool like a journal to put those thoughts on paper and the value in doing that. And. The way that I do it in the morning is also to help sculpt my day around other Habits like eating. And when am I gonna work out and what am I gonna do?

[00:27:33] Douglas Lucas: All the things that I need to do. I like putting that in my journal because it helps me then to build it into my integrity, my spiritual integrity, and my integrity around,my, my physical integrity and what am I gonna work out? And then I stick to it. and then I actually grade myself at the end of the day, what was my discipline on sticking to my physical integrity today? If it’s on paper. It’s almost like you have an accountability buddy, because you’re gonna look at it later. the other thing I love about journaling too, is I use it as a tool for that same person we talked about earlier that wakes up at 3:00 AM with ruminating thoughts. I think that it is such a powerful tool to journal at night.

I don’t use that personally, but I have a lot of patience that do, and they find it really helpful. So that’s simple and it’s gotta be on paper. It’s gotta be a physical thing, but that simple tool of having that. Book, is really powerful, especially in our digital age where, most people, when they start journaling, they, I’ll just get my note taker out and I’ll dictate.

nah, it doesn’t work that way. It’s gotta be on paper.

[00:28:27] Tony Winyard: Have you got, had any patients who that was really helpful for ’em and I didn’t think that was gonna be, make a difference.

[00:28:35] Douglas Lucas: Yeah. so it’s funny. I, when I ask my patients,do you do any journaling and are you interested? women generally have done journaling in the past or they’re currently doing it. and they’re usually open to it. Whereas men are like, no, man. I don’t journal. And, but they’re usually open to it.

And I would say, I have found that more men have found that it’s very helpful because we are so bad at expressing emotion out, out outwardly. whereas if it’s in a safe place, we can actually put it down, in the notebook. And we can say, Hey, this is how I’m feeling about this thing.

That’s happening in my life. and I, so I think it’s really is powerful for men. Whereas for women, they’re just a. More used to it. And for women, they don’t have as much difficulty speaking emotion out loud. and that’s just, it’s our culture.

[00:29:14] How he sees health changing in the future

we touched upon just now I was asking you about insurance and how that might go in the future. how do you see. Your business and health in general in changing in the next five, 10 years.

[00:29:28] Douglas Lucas: Yeah. we’re young, I’m currently seeing all the patients, so I have a hundred percent of the patient load. the way that I designed my business is really so that I could see patients and I’d want to see patients, but as a platform that others could see patients. So my hope is that we, I will find more physicians who are like-minded, and we will have a funnel to capture more people that are looking for what we provide.

our platform is infinitely scalable. it’s just a matter of, how do we let people know that we’re out there? because I think that as the model of the accepted level of care continues to decline, but people’s expectations continue to go. This gap is gonna get bigger.

[00:30:07] Douglas Lucas: So to fill that disparity, I think a program like ours, and other I’m sure there are others and others will pop up, but the ability to help people to understand the really messy space of Habits and nutrition and supplements and hormone optimization and peptides, having somebody that you trust to help you navigate that, there’s a lot of value there.

[00:30:28] The role of the health coach

And from what I understand in the states, the role of the health coach is getting much more known. Now

[00:30:35] Douglas Lucas: everybody’s a health coach. I’m a health coach. No, I’m not a health coach actually, but,yeah, so a lot of people are getting into this health coaching space. and I like a health coach. The downside in the states is that there’s nobody overseeing, who calls themselves a health coach.

And so anybody can call themselves a health coach. anybody can be a coach of any. and that’s good, and I have a business coach and I have a relationship coach and,I guess I work with a health coach, but I employ her. So I dunno if that counts. So I love coaches, every star athlete has a coach or two or three, so there’s nothing wrong with having a coach.

I think that you, again, you have to really understand what their background is. we see a lot of people coming out of. Other programs or people working with, especially nutrition coaches who are, they’re very stuck in dogma and not recognizing that, Hey, your client’s not getting better.

they’re getting worse. And maybe your approach should change for this person because they, a lot of people will just have their, their one thing. And they’re like, everybody should eat this way and that’s just not true. And yeah, I think understanding who your coach is and what their training is really important.

and the reason I said that, because you, cause I, you did refer to your health coach a few times earlier in the episode. So it, it seems that you do have, when you have a good health coach, it can be of real value,

[00:31:44] Douglas Lucas: Absolutely. Yeah. the coach that we work with in our practice, she has a master’s in nutrition and she’s a registered dietician and a health coach. So she is, she’s a lot of things. she’s also really good at BI building websites, so she’s very multifaceted. but having the background to really dig into some of these more complex problems is really important for us.

When it comes to the amount of time it takes to talk about behaviors and it really, the time it takes to dig into, a meal plan or, go through meal by meal, what you ate last week. That’s not something that I can do in from physician perspective, even with the amount of time that we spend with our patients, which is a lot, it’s still not enough for that.

[00:32:20] Douglas Lucas: So you really need somebody who can spend the time to do that. And. And so we have a layer of coaching where, we have, we can accommodate that. Not everybody wants it, not everybody needs it, but I think for people that have specific goals, particularly around, weight loss or your gut health, it’s our osteoporosis to those are patients that really require some intensive, either nutrition, medical nutrition, therapy, or coaching around their eating.

[00:32:44] Promoting his business

[00:32:44] Tony Winyard: So as a, you are a business and as a business, do you find, you need to be doing a lot of promoting yourself on social media, writing blogs, doing you.

[00:32:56] Douglas Lucas: Yeah, it comes down to how do we get the message out? And so our mission is twofold. One is I want to educate the world. I want to get information out that there is more to your health than what your primary care doctor or your insurance company says. There is nothing against primary care doctors.

They’re doing their job. If you really wanna feel good, you gotta be an advocate for yourself and gotta do more. So to some extent, we are putting out as much information as we can through blogs, through social media. Through all of those accounts to try to help educate people. The second component of that is we need to see patients, we need to see patients just survive as a business.

I wanna see patients because I like seeing patients. So some of that is self-promotion as well. and we try to find that balance. but ultimately, I want to educate people and if somebody wanted to pay me to just do that, then I would potentially just do that. But, that’s not how it works.

[00:33:44] The books which have moved him

okay. we are coming towards the end. So one of the questions I always ask my, my guests and I you’ve already told me this is gonna be a really hard question to answer. So it’s is there a book you can think of? I’ll give you a couple of books. That have moved you for any.

[00:34:00] Douglas Lucas: Yeah. there’s been so many as my life, making that transition from orthopedics into this space was really challenging. So there’s a lot of personal growth that went along there. but I would say, go back. Before he was even a, even on my way to medical school. I think it was that long ago.

Maybe it wasn’t that long ago, but, the book, primal blueprint by mark Sissen. I don’t remember when that was written, but it was really the first time I ever heard an author. Deviate from what I had been told, my whole life growing up of how to eat. I grew up in the, the low fat, the fear of dietary fat and, there’s no issue with carbohydrates, world, which is why my metabolism is so broken.

And, I, I listened to him and it was the first time where it just like common sense, really stuck out. And I was like, wow, that just makes sense. And really changed my, and my wife’s trajectory. forever. so that was a very pivotal book for us, even though it’s, not an incredible piece of writing, but it was just a trajectory changer.

and then I think most recently, from a personal growth perspective, I really like the book. no more Mr. Nice guy. and I forget the author’s name. I think it might be Glover last name, but, basically a look at, As men in our culture. And I’m, I would imagine it’s the same,in England, but the, that we are generations really since world war II that have been raised by women, as opposed to being raised by men and how that has changed, how we as men see other men and how we see women and how we respond.

[00:35:23] Douglas Lucas: And this whole concept that, we were raised to be nice boys. and we’re raised then to be nice guys, but we are. secretly not happy about that. And we get resentful. And so it’s this whole concept of, you don’t wanna be a nice guy. You wanna be a respectful guy, but you wanna stand on your own and you need to be ultimately be a man and understand what that means.

and that’s something that, that I certainly wasn’t taught. And, most of my peers have not been taught. but the nice guy syndrome, I see it all over the place and it’s a bunch of resentful men that have secret lives and it’s not good.

[00:35:55] Tony Winyard: Sounds interesting. I’ve never heard about that. Okay. I’ll I’ll check that

it’s a good one.

[00:35:59] Contact details

[00:35:59] Tony Winyard: So if people wanna find out more about you, where’s the best place to look.

[00:36:03] Douglas Lucas: Yeah, I would say our primary website, which is optimal human health.com. And there we have blogs and, links to our social media platforms. we are changing things right now, so hopefully it’ll look great by the time this goes live. the secondary platform is optimal bone health, so optimal human health and optimal bone health.

And that’s the osteoporosis specific.

[00:36:22] Tony Winyard: And is there any social media you.

[00:36:25] Douglas Lucas: Right now we’re biggest on Instagram. And so we have handles my own private handle, which is Dr. Underscore Doug Lucas. And then we have optimal bone health and optimal human health with underscores between words, depending on which avenue you’re looking for.

[00:36:37] Favourite quote

and finally, Doug, is there a quote that you particularly.

[00:36:41] Douglas Lucas: Yeah, the quote I have written, right beside me is how you do anything is how you do everything. And, I don’t know who to attribute that to, but just a reminder that you really can’t skimp on anything. and there’s always somebody watching and that’s either you or God, your choice. but you can’t get away with anything.

[00:36:59] Tony Winyard: And can you remember how long ago it was you first heard?

[00:37:02] Douglas Lucas: It wasn’t long. I’d say, I think of April this year is probably the first time I heard that, where it really stuck.

Doug’s been a real pleasure speaking to you, sir. Thank you for your time.

[00:37:11] Douglas Lucas: Yeah. Thank you. It’s been great.

[00:37:15] Tony Winyard: Next week is episode 85 with Dr. GQ. And he is a board licensed doctor of chiropractic medicine. Uh, from the Pasadena college of chiropractic. And he’s the founder of the valley time. Fibroid Institute, a functional medicine practice. That specializes in the treatment of various thyroid conditions.

Including Hashimoto’s low thyroid graves’ disease and many others. He upholds the principle to each patient is unique and therefore deserves individualized treatment specific to their needs. So we talk a lot more around thyroid and functional medicine and. Many of these other, um, conditions such as, as she motos on. So on.

So that’s next week. Episode 85 with Dr. Gil Gil Contiki. Hope you enjoyed this week’s episode with, um, Doug Lucas. And if you know anyone who would get some value from listening to that please do share the episode with them and hope you have a great week

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