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PREVENTIVE MEDICINE
PREDICTIVE TESTING
YUSUF (JP) SALEEBY, MD
PRIORITY HEALTH OF THE CAROLINAS
ZIMETRY
21ST CENTURY PARADIGM
• STEPPING AWAY FROM THE ''PILL FOR THE ILL'' SYSTEM
• STEPPING AWAY FROM AGENCY AND INSURANCE INDUSTRY HURDLES
• STEPPING TOWARD EVIDENCE BASED (EBM) INTEGRATIVE MEDICINE
• STEPPING TOWARD REDUCTION IN POLYPHARMACY
21ST CENTURY PARADIGM
• APPLICATION OF ''NATURAL'' REMEDIES FOR WELLNESS & DISEASE PREVENTION
• APPLICATION OF LIFESTYLE MODIFICATION A TRUE "PRIMARY" PREVENTIVE
MEASURE
• USE OF PREDICTIVE ADVANCED LABORATORY BIOMARKERS AND PREDICTIVE
GENOMICS
• EMBRACING FUNCTIONAL MEDICINE
AWAY WITH THE “PILL FOR THE ILL”
• NON SUSTAINABLE OLD-SCHOOL PHILOSOPHY
• DISEASE BASED – DISEASE CHASING
• LEADS TO POLYPHARMACY
• COSTLY
• MONETARILY (EXPENSIVE MODEL)
• QUALITY OF LIFE (QOL) – OVERALL LOWER QUALITY OF LIFE
• DRIVEN BY BIG PHARMA, INSURANCE & GOVERNMENT MANDATES – THE STATUS
QUO
• PROVIDERS AT PRIORITY HEALTH IN MURRELLS INLET, SC
• PROVIDERS AT PRIORITY HEALTH TRIANGLE IN CARY, NC
• PROVIDERS AT CHARLESTON HOLISTIC MEDICINE IN MT. PLEASANT, SC
WWW.PHC365.COM
WWW.GETMYTHYROIDFIXED.COM
WWW.PRIORITYHEALTHSC.COM WWW.PHTRIANGLE.COM
WWW.CHARLESTONHOLISTICMEDICINE.COM
(800) 965-8482
DIRECT PAY… WAY TO GO
• INSURANCE INDUSTRY
• ICD-9 AND ICD-10 DISEASE BASED TEMPLATE
• INABILITY TO UNDERSTAND PREVENTIVE & PREDICTIVE MEDICINE ALGORISMS
• GOVERNMENT OVERSIGHT
• CMS – BUREAUCRATIC, CUMBERSOME, CORE MEASURES AND MEANINGFUL USE =
FAILURES
• LIMITING, OBSTRUCTIVE & RESTRICTIVE
• HAS NOT MET HEALTHCARE IMPROVEMENT FOR ALL
EBM
• EVIDENCE BASED MEDICINE (EBM)
• STANDARD OF CARE
• DRIVES PRACTICE “GUIDELINES”
• SOMETIMES USED TO SANCTION AND DISCIPLINE
FORWARD THINKING/VISIONARY PRACTITIONERS
WHO STRAY FROM THE “NORM”
EBM
• CAVEAT:
• WHOSE EVIDENCE ?
• SPONSORED STUDIES, AGENDAS, BIG-PHARMA INFLUENCE, GREED,
AVARICE, EGOS
• SEVERAL STUDIES – YIELD DIFFERENT OUTCOMES
• WHO TO BELIEVE
• REDACTIONS AND RETRACTIONS AND OVERTURNS
• IN THE USA:
• COSTS: $2,197 PER CAPITA/YEAR MORE THAN EXPECTED
• YIELDS: 3.1 LIFE YEARS LESS THAN EXPECTED
POLYPHARMACY
• POLYPHARMACY
• DEF: TOO MANY MEDICATIONS (A RELATIVE PROPOSITION)
• ISSUES:
• COST
• DRUG-DRUG INTERACTIONS, (PGX)
• DRUGS TO TX OTHER DRUG SIDE EFFECTS
• TOXICITY
• SIDE EFFECTS
• UNTOWARD EFFECTS
POLYPHARMACY
• POLYPHARMACY
• A STAGGERING PROBLEM OBSERVED IN THE PAST 5-DECADES IN
AMERICA
• NON-MEDICAL USE – ESCALATING PROBLEM
• FROM (2009-2012) 21.8 % OF PERSONS USING THREE OR MORE PRESCRIPTION
DRUGS
• NUMBER OF DRUGS ORDERED OR PROVIDED BY PHYSICIANS AT TIME OF OFFICE
VISIT: 2.6 BILLION RX / YR
• 75.1% OF OFFICE VISITS INVOLVING DRUG THERAPY
• NEARLY 70% OF AMERICANS ARE ON AT LEAST ONE PRESCRIPTION DRUG, AND
MORE THAN HALF RECEIVE AT LEAST TWO PRESCRIPTIONS
• (SOURCE: WWW.DRUGABUSE.GOV / WWW.CDC.GOV/NCHS)
• CAN BE SAID FOR SUPPLEMENTS TOO.
NATURAL / ORTHOMOLECULAR MEDICINE
• FUNCTIONAL MEDICINE
• INTEGRATIVE - WEST MEETS EAST
• IDENTIFY AND ADDRESS NUTRIENT DEFICIENCIES
• NUTRIGENOMICS (GENE EXPRESSION AND EPI-GENETICS)
• RELIANCE ON SAFER, FEWER SIDE EFFECTS AND SUBSTANCES NOT FOREIGN TO
OUR BODIES
• PHARMACEUTICALS – SYNTHETIC, LIVER HAS NO NATURAL WAY TO DETOXIFY
• HERBALS – EXPOSED TO OUR SYSTEM AND LIVER OVER THE MILLENNIA;
EVOLUTIONARILY ADAPTED
LIFESTYLE MODIFICATION
• CHIEF AND MOST IMPORTANT IN CHANGING TO A WELL AND FIT PERSON
• PRIMARY PREVENTION IS LIFESTYLE MODIFICATION – MOST IMPORTANT!
• THE MOST SIMPLE AND LEAST EXPENSIVE
• THE MOST DIFFICULT TO REMAIN ADHERENT AND COMPLIANT
• EXERCISE
• SLEEP
• DIET & NUTRITION
• STRESS REDUCTION
• AVOIDANCE OF ENVIRONMENTAL TOXINS AND HORMONE DISRUPTORS
• SAFETY AND SMART LIVING
Q: DOES ANNUAL BLOOD WORK IN AN ASYMPTOMATIC PATIENT PROVE WORTHWHILE ?
PREDICTIVE TESTING
• USUAL ANNUAL LAB TESTS ARE OF NO VALUE.
• (SOURCE: WWW.NCBI.NLM.NIH.GOV/NBK82767)
• READ DR. H. GILBERT WELSH’S BOOK “LESS MEDICINE, MORE HEALTH”
• PREDICTIVE GENOMICS & PHARMACOGENOMICS, SPECIALIZED ADVANCED
BIOMARKERS
• NUTRIGENOMICS
PREDICTIVE TESTING
• GOING AFTER WHAT “HURTS OR KILLS” MOST AMERICANS
• CARDIOVASCULAR DISEASE (HEART ATTACKS & STROKES)
• CANCER
• DIABETES AND OBESITY (DIABESITY)
• T2DM, T1.5DM & T3DM
PREDICTIVE TESTING
• ADVENT OF PREDICTIVE AND ADVANCE LABORATORY TESTING AND DIAGNOSTICS
• ADVANCED LIPID ANALYSIS
• INFLAMMATORY BIOMARKERS (HS-CRP, FIBRINOGEN, LP-PLA2, IL-6, …)
• BIOMARKERS FOR BONE TURNOVER, TELOMERE LENGTH, HORMONES
• GENOMICS (APO-E; MTHFR; COMT, FACTOR II AND FACTOR V LEIDEN, …)
• CANCER BIOMARKERS FOR SCREENING (LIQUID BX)
• NON-INVASIVE (COLONSENTRY; EARLY CDT-LUNG, …)
• LESS OR NO IONIZING RADIATION
SPECIALIZED LABS
• CUTTING EDGE TECHNOLOGIES/ADVANCED LIPID ANALYSIS/RISK
STRATIFICATION AND RELATIVE RISK FOR CVD, CVA, CANCERS, …
• GENOMIC TESTING TO DETERMINE “ACHILLES HEEL”
• 3-DIMENSIONAL DIABETES AND GLUCOSE METABOLISM SCREENING
• COMPREHENSIVE H-P-A HORMONE ANALYSIS
• PITUITARY, THYROID, ADRENAL AND GONADAL
SPECIALIZED LABS
• TESTS TO TAKE PLACE OF INVASIVE AND RELATIVELY DANGEROUS
AND EXPENSIVE CURRENT SOC TESTS
• COLONSENTRY VS FIBEROPTIC COLONOSCOPY
• CARDIODX LABS CORUS-CAD VS HEART CATHERIZATION
• NEW BIOMARKER FOR BREAST CANCER VS ANNUAL SCREENING
MAMMOGRAPHY
• EARLY CDT-LUNG GENE EXPRESSION TESTING VS CT CHEST OR CHEST-
XRAY
SPECIALIZED DEVICES
• EXAMPLES:
• I-RHYTM’S ZIO-XT
• TAKE HOME WEARABLE DEVICE FOR SLEEP APNEA TESTING
• SLEEPIMAGE CPC/ECG AND BODY POSITION MONITOR
• FDA APPROVED / CLINICAL STUDIES SUPPORT
• WEARABLE APNEA DETECTION DEVICE (WADD)
• IN CLINICAL TRIAL IN THE UK
Q: HOW LONG ON AVERAGE DOES A DOCTOR IN AMERICA SPEND WITH HIS/HER
PATIENTS?
PATIENT – PHYSICIAN PARTNERSHIPS
• PHYSICIAN’S ROLE AS EDUCATOR AND CONSULTANT
• NOT AS PRESCRIBER
• NO LONGER DEMANDING COMPLIANCE BY FIAT
• WHO TO CONSULT?
• HOLISTIC / INTEGRATIVE / FUNCTIONAL MEDICINE
• ONE WHO SPENDS TIME LISTENING
• ONE WHO IS NOT DISMISSIVE (COLLABORATIVE EFFORT TO MANAGE
HEALTH)
• ONE WHO IS OPEN MINDED
• COST: NOTHING GOOD IN LIFE IS FREE. CONSIDER IT AN
INVESTMENT IN YOUR HEALTH AND WELL BEING.
MURRELLS INLET STAFF
• J.P. SALEEBY, MD (MEDICAL DIRECTOR)
• KRISTIN RICHARDSON, PA-C
• A. CHERYL MASSIE, FNP-BC
• FOCUS ON:
• BHRT
• THYROID
• CHRONIC LYME DISEASE
• PREVENTIVE MEDICINE
• PREDICTIVE TESTING; FUNCTIONAL MEDICINE
Mr. Michael Goulding, MSW, LCSW
Cary, NC Staff
Dr. Priscilla Evans, ND
Andrea Saffer, FNP (DNP)
Charleston Office
Family Nurse Practitioner
Doctorate in Nursing (PhD)
• Focus on Preventive Medicine• Predictive Testing• bHRT
Will be team leader in Charleston (Mt. Pleasant) office.
www.CharlestonHolisticMedicine
ZIMETRY.COM LAUNCHED SEP 2015
• PATIENT DRIVEN
• SELF-TESTING
• SELF-MONITORING
• PATIENT/CLIENT CENTERED
• TAKING HEALTHCARE INTO YOUR OWN HANDS
• COST CONTAINMENT
• EFFICIENT
• SELF GUIDED
• DIRECT TO CONSUMER
MY THREE SUPPLEMENTSYOU SHOULD NOT DO WITHOUT
• OMEGA-3 FATTY ACIDS (FISH OIL)
• CURCUMIN (BCM-95 IN PARTICULAR)
• ADAPTOGEN HERB –SEVERAL TO CHOOSE FROM, MAKE ONE A
DAILY
• VITAMIN D3 (NOT ACTUALLY A VITAMIN)
• L-METHYL-FOLATE • (WHEN MTHFR-PHENOTYPE / METHYLATION PATHWAY CORRUPTION IS FOUND)
• PROVIDERS AT PRIORITY HEALTH IN MURRELLS INLET, SC
• PROVIDERS AT PRIORITY HEALTH TRIANGLE IN CARY, NC
• PROVIDERS AT CHARLESTON HOLISTIC MEDICINE IN MT. PLEASANT, SC
WWW.PHC365.COM
WWW.GETMYTHYROIDFIXED.COM
WWW.PRIORITYHEALTHSC.COM WWW.PHTRIANGLE.COM
WWW.CHARLESTONHOLISTICMEDICINE.COM
(800) 965-8482
STAFF
• ROXANNE ALTMAN, RN - HEAD NURSE
• SHELLEY FEGETT, LPN - NURSE IN CHARGE OF SATELLITE OFFICES/HOUSE CALLS
• DAMA BLACK - RECEPTIONIST
• LINDA DEIGHAN - OFFICE / PRACTICE MANAGER
• MID-LEVEL PROVIDERS: KRISTIN RICHARDSON, PA-C; ANDREA SAFFER, FNP
(PHD)
• DOCTORS: JP SALEEBY, MD; PRISCILLA EVANS, ND
• HEALERS: MICHAEL GOULDING, MSW (PRANIC HEALER)
Q & A