I love LinkedIn and use it daily. It’s my favorite go-to social platform. Incredibly effective, it has consistently driven business for FON and my personal brand over the last decade. I currently enjoy over 10,000 first level connections and 9500 followers.

Every practitioner, educator, executive, researcher, influencer—pretty much every working individual—should create and optimize a comprehensive, on-brand LinkedIn profile. This is especially important if you do not have a personal brand website.

But… how many times a week are you invited to connect with someone you don’t know on LinkedIn?

No sooner have you lightly vetted and accepted an invitation, their boilerplate sales pitch arrives with the ubiquitous ask: ‘let’s hop on a short call to discuss’.  Or more inventive, though no less annoying, scribes like this gem:

I don’t want to become one of “those people” on LinkedIn… you know the kind that just keeps pestering you until you tell them to go kick rocks. I get it. I get tons of messages like that too and I don’t want to be that guy. But I did want to check back in as I didn’t hear back from my last message. I would love to grab a virtual cup of coffee and chat. Open to a virtual meeting? ~ Anonymous

And I’m not talking just about the myriad vendor sales calls for social media help, web development, app programmers, and virtual assistant pitches from around the world—these days we all get those never-ending spam lobs from LinkedIn. Nor am I describing the now-numerous LinkedIn automated marketing lead tools. I’m mostly referring to representatives focusing on business-to-business sales of products, services, or affiliate sales programs, all under the larger umbrella of the integrative health ecosystem. Organizations within the tribe—those who should know better—along with the general medicine and wellness sectors hawking EMRs, supplements, medical devices, apps, conferences, medical journal paper submissions, courses….

Accepting New Connections on LinkedIn 

As a rule of thumb, I don’t need to know you or be connected to scores of people you are connected with in order to accept your invitation to link. If you are immersed in the health and wellness field and provide goods or services or quality-directed work that might be of potential value for me or my clients, I will accept your invitation. If you take the time to preface your invite with a meaningful note about why you would like to connect, that is appreciated.

I apply this same criteria to those within the marketing, legal, technology, content, and media fields because, as a business development and marketing consultant, each of these industries connects to the work I do.

If you are a wealth management advisor, real estate broker, MLM representative, medical conference organizer, I will take a quick peek but may not accept the connection. 

Effective Selling on LinkedIn 

LinkedIn is an amazing tool for reaching executives and developing and nurturing substantive relationships. You can successfully ‘sell’ and influence on LinkedIn.

Successful influencing through LinkedIn takes time. You need to know what behavior to avoid and how your energies should best be directed. You need a plan.

I know first-hand that the link-and-pitch strategy—one deployed by too many folks—is both annoying and wholly ineffective. As such, Linkedin has not done enough to monitor and address this growing problem, even while its users write about the problem and how best to deal with it in articles like this one.

The Do’s and Don’ts of LinkedIn Selling and Engagement

• Don’t: Transfer your LinkedIn connections’ email addresses to an email marketing platform. That is called spam and it will turn off new connections.
• Instead… Do: Engage through LinkedIn, the network where proper permission was granted from the receiving party. If they connect with your work and mission, and you meaningfully engage, at some point they will cleanly opt-in to your list. Use the platform to communicate and develop the relationship.

• Don’t: Throw up a LinkedIn profile with no picture (avatar) or sparse information about yourself and your background, and immediately start attempting to build your connections.
• Instead … Do: Take your time. An incomplete placeholder profile that is ‘live’ may be worse than a comprehensive profile that is not properly fashioned to position your personal brand, business brand, and goals for success. Be sure to populate every appropriate section of your profile. Make sure to include a professional image. Follow best practices for optimizing a strong, compelling profile… and pay attention to spelling and grammar. If you want to be taken seriously, don’t skimp or rush any aspect when creating your LinkedIn profile.

• Don’t: Send invites without an accompanying note, especially if you do not have an existing relationship with the person you hope to link to. Sure, they may connect anyway, but you are reducing that possibility—and you have missed the opportunity for an initial spark.
• Instead… Do: Study your invitee’s profile, their website(s) and writings, and the groups they participate in, to get a clear idea of who they are; this will give you something interesting to comment on when asking for the connection.

• Don’t: Immediately pitch your newly linked contact, four minutes after your invite is accepted, with your verbose biography (or shorter biosketch) and business interests.
• Instead… Do: Allow the new ‘relationship’ some breathing room. The mention of an impressive article by someone else, in an abbreviated, well composed—read: genuine—note will impress more. Provide value. Be helpful. After all, isn’t that what you’d prefer?

• Don’t: Send ubiquitous hard pitches and clichés. If the invitee is someone new to you, or you otherwise don’t know a lot about their work, goals, and priorities, resist these disingenuous one-liners: ‘How are you doing in these challenging times?’ or ‘I really care about getting to know each of my connections here on LinkedIn’ or ‘What are you working on these days?’ People see right through this crap. I go into my profile and immediately remove these connections.
• Instead… Do: Take the time to understand your new connection, the work they do, and your common networks. Engage positively from a position of knowledge based on an actual understanding you gained from this person’s profile, company website, and other external links.

• Don’t: Create group message threads with folks who you barely know, or those you are looking to directly sell to in this fashion.
• Instead … Do: Create energy and momentum through collaboration. If you absolutely know each person in your selected group, and the subject matter is germane to their interests, by all means see if you can create a connection through what is essentially a group email via the LinkedIn platform. Or better yet, create and/or participate in a LinkedIn group that is germane to your area or business of interest. Engage folks around posts—those that you create as a thought leader or budding neophyte—or comment on posts authored by others. Get to know people within your group and message them directly to connect. Group conversations can then be considered amongst a collection of individuals with similar professional interests—interests you have already shared and engaged around.

In Conclusion

Utilizing LinkedIn for marketing and sales can be very effective because it’s the most powerful B2B social platform. But no one likes a pushy, ill-informed salesperson. Aim to have conversations that lead to authentic connections, and take the time to learn about whom you are ‘pitching’ to and what their real world needs may be instead of shoving your integrative health products and services, and videos and webinars at them.

You are (hopefully) in this for the long-term. Slow and steady creates genuine connections, meaningful, professional relationships and, over time, a much stronger pipeline of high-quality sales leads and referral sources via the powerful LinkedIn ecosystem. 

Are you on LinkedIn? You should be. You can send me an invitation here.

FON also has a group page and a company page.

About FON

FON is a leading integrative health and medicine business development and strategy consulting firm. FON specializes in custom solutions for growing patient volume, developing programs, and increasing product sales. Our practical business models are driven by innovative marketing, clear messaging, and customer engagement via branded storytelling.

Photo credit: bigstock.com/tashatuvango

Here in the U.S., the Federal Trade Commission (FTC) has been clamping down on bad actors, and those well-intentioned but under-informed about the current, and sometimes opaque, rules of the road.

Federal responses have been accelerated by a perniciously persistent pandemic that lacks an approved drug-based prophylactic therapy, a vaccine, or treatment, other than one repurposed COVID-19 treatment therapy, Remdesivir.

We are all in pursuit of reasonable solutions to prevent, manage, and overcome this virus. Traditional therapies across cultures and provider disciplines are being explored and observed clinically, if not studied in large randomized placebo-controlled trials.

Back to the Basics: Know the Law

If you are an integrative health practitioner or your organization markets and sells natural products of any kind, now is the ideal time to revisit how to best communicate the benefits of your goods and services to existing and prospective patients and clients.

Proactivity begins with returning to the basics of focusing on structural and functional characteristics.

Put simply:

Any discussion of COVID-19 mitigation, prevention or cure using dietary ingredients or herbs, connected to the sale of those products, is a direct violation of the prohibition against disease claims for dietary supplements.  ~AANP Fact Sheet on Regulatory Agency Warning Letters During COVID-19 Pandemic

Serious consequences can result upon receiving a warning letter from the FTC and other regulatory agencies. There is a risk of fines, censure, negative publicity, and other punitive actions, including those from:

• State Investigations
• Federal Actions
• Medical Licensing Boards
• Bank/Merchant/Processing Gateways
• Potential Challenges from Malpractice Insurers

Limited Science is Merely Observational and Anecdotal

For example:

Natural products and infusions such as high-dose Vitamin C may be incredibly useful to help develop a stronger immune system response, reducing the cytokines storm, or increasing antiviral activities through other unknown mechanisms at various stages of infection.

Though vitamin D deficiency was recently shown to be prevalent among those with COVID-19, this does not prove that dosing vitamin D and reaching a specific blood serum level will prevent the virus. 

Until ‘if and when’ natural agents, or combinations thereof, are tested under large and rigorous randomized control trials to prove their efficacy and become approved as a drug, no medical claims can be made.

[Handpicked Related Content: Integrative Health Must Lead on COVID-19 and Immune Resiliency]

AANP Offers Valuable Resource for Integrative Health and Functional Medicine Community

The leadership of The American Association of Naturopathic Physicians (AANP), in coordination with integrative health professionals, dietary supplement manufacturers, and longtime industry attorney Alan Dumoff, has created an important and prescient Fact Sheet on Regulatory Agency Warning Letters During COVID-19 Pandemic.

Whether you are a credentialed health provider, manage a supplement company or retail operation, manufacture natural products—or otherwise make recommendations, market/sell supplements, IV nutrients, or functional foods—this Fact Sheet is comprehensive and timely; it is required reading for your practice, company, or organization.

Access the Fact Sheet to learn about:

• Avoiding “direct” or “implied” claims regarding a nutrient ingredient supplement.
• Allowable immune claims for dietary supplements in the context of COVID-19.
• Areas where the law is unclear, such as advertising intravenous vitamin C—which typically requires a clinical evaluation to ensure appropriate care delivery.
• Legal risk versus benefits of sharing information, especially in the context of COVID-19 support and the importance of not overstating the evidence.
• Specific disclaimers to incorporate immediately.

You do not have to be a naturopathic physician to find solid, actionable value from the guidance provided by AANP’s Fact Sheet on Regulatory Agency Warning Letters During COVID-19 Pandemic.

Currently, more than ever, there is a responsibility and an opportunity for those in the integrative health and functional medicine community to positively impact population health. As a member, your role is critical in the education and support of patients and clients specific to lifestyle and natural products that strengthen host immune resiliency.

Let’s ensure we step forward and participate in a responsible, safe way with a heightened understanding of the legal and regulatory constructs in place. Full stop.

About FON

FON is a leading integrative health and medicine business development and strategy consulting firm. FON specializes in custom solutions for growing patient volume, developing programs, and increasing product sales. Our practical business models are driven by innovative marketing, clear messaging, and customer engagement via branded storytelling.

Image credit: BigStockPhoto.com/nature78

“Unfortunately, the American population is a very diverse… a population with significant unhealthy comorbidities… minority communities particularly at risk here because of significant underlying disease health disparities… an unfortunate legacy in our health care system that we certainly do need to address.” Alex Azar, U.S. Secretary of Health and Human Services 

COVID-19 has ripped the scab off health inequity in the U.S., exposing highly variable levels of healthcare access. It’s a way of life, an existence for too many, in an environment that systematically promotes weakened immune resiliency, thus affecting the collective human condition. 

This health (and economic) crisis will force a recalibration and rethinking of priorities. The critical question is before us: what should value-based disease prevention and health care now look like in service of health creation?

In the 50+ year history of integrative health, this is our moment to influence what comes next. Because…

In the face of COVID-19, and the virulent viruses sure to follow—with untold additional costs—we in the integrative health community have a critical role to play: specifically, the consistent promotion and teachings of robust immunity and resiliency.

COVID-19 Is Our Movement’s Opportunity to Lead

No matter the branch of integrative health your business, clinical practice, or organization is rooted—integrative, functional, regenerative, lifestyle, holistic, antiaging, Traditional Chinese Medicine, or Ayurvedic—no area of medicine does a better job of fortifying immune function and resiliency than integrative health.

This is Your Moment

This unparalleled time, with the challenges ahead, delivers a defining opportunity to sow the guiding principles of integrative health across the land.

Regardless of whether your products, programs, or services are generalized or specific to various conditions and chronic pathologies, this is the clarion call for your attention.

Health creation, as an ideal and driving framework, has the potential to turn our current chronic disease Band-Aid model on its head.

Focusing on immune resiliency will help prevent or mitigate the very morbidities that make this first-world country unnecessarily vulnerable to SARS-CoV-2 and future outbreaks.

Before I dig further into immune function and resiliency support—the foundational principals of integrative health and lifestyle-directed medicine—let’s set the table.

An Emerging Picture of Those Most at Risk

Americans hosting the top morbidities and comorbidities are those at the highest risk of infection and death: diabetes, obesity, heart disease, lung impairments such as COPD, and patients undergoing cancer treatment are only a few examples.

We also know that close-quartered living incubates and feeds a highly virulent virus.  Vulnerable Americans include:  the elderly in nursing homes and assisted living centers; individuals who are incarcerated; people living in food deserts and areas of stark health inequality where support is nonexistent and services are under-delivered—primarily African American and Latino minorities; Indigenous populations living on Native American lands; folks living in the greatest socioeconomically impacted areas; essential workers who come in direct contact with the public every day.

As of May 2020:

• There is no vaccine for COVID-19.
• Some models suggest the majority of us will be infected by COVID-19, at some level, within the next 24 months.
• A safe, efficacious vaccine may come in six months (unlikely), 12-24 months, or never. After all, the common cold is also a coronavirus… and we know how preventatives for that have turned out. An effective vaccine may, like the seasonal flu vaccine, only help a percentage of those who contract Covid-19.
• Some predict COVID-19 is here to stay, at some level, for a long time, much like the common cold, AIDS, measles, and chickenpox are endemic viruses that have not been eradicated.
• It is not known if it is possible to be re-infected after recovery from a first infection.
• A highly accurate antibody test is lacking. Once we have one, it remains unclear if antibodies are fully protective, or for how long.
• We remain in the dark regarding the long-term or permanent, deleterious effects of COVID-19 on major organs such as the heart, kidneys, liver, and lungs.
• The number of outlier groups of children and adults experiencing heart and other life-threatening symptoms, with some inducing death, is unclear.
• No effective national strategy is in place—or materials and committed human resources—to deliver mass testing, implement contact tracing, or provide requisite isolation on a scale to test and re-test 320M Americans.

Treatment and Vaccine Development Silver Linings?

On the brighter side, we have one FDA approved broad spectrum antiviral treatment in Gilead’s Remdesivir. But this drug is not a cure. Newly published data reveals it had limited benefit for patients who were severely ill.

With an average shortening of recovery time by 30%, Remdesivir is a solid start toward investigating the potential of repurposing existing drugs for off-label use—as we move full bore into the discovery of new, potentially effective treatment agents. Over 100 are being studied.

Moderna’s innovative vaccine development approach suggests—in a small phase 1 study focused on safety—that enough antibodies, even at lower doses, may potentially protect the host from infection. There are also a number of critics who say Moderna’s trial design, and the early data (not peer reviewed or published) it has provided to date, is incomplete.

While this rapid progress could mean a significantly shortened timeline to get to market, a long road of investigation remains. Because of the quantity of vaccines needed, there would likely be a requirement for several vaccines and multiple manufacturers—and it is known that a vaccine is not a one-size-fits-all product.

Integrative Health Must Lead Now on COVID-19 and Immune Resiliency

This is not a trendy window with a short shelf life; it is a crucial, long-term responsibility to seize in this moment and continue indefinitely. Integrative health companies and organizations will be best served building trust with their customers and prospects via the consistent delivery of actionable, educational information on immune resiliency, and the invaluable addition of how to create it.

Since the onslaught of COVID-19, I have spent an enormous amount of time strategizing for FON clients, specific to immune support and resiliency. As health consumers—because we all are—your inboxes and feeds are likely brimming with messages, promotions, and content that speaks to increasing immune function.

Tread carefully and deliberately by building your brand steeped in education, value, and trust. No one wants to be hard-sold on specific purchases and programs, especially during a raging pandemic and economic calamity affecting so many. Be the intelligent, calm leader.

Laying out heavy discounts in this climate will result in a race-to-the-bottom that will only serve to cheapen your brand.

Your Expertise Matters

You are already authorities on immune function and resiliency via nutrition, hydration, movement, stress reduction, well-placed nutraceuticals (see: vitamin D serum levels and correlation to COVID-19), limiting toxins, environmental awareness.

By extension, you and your company or organization are most probably better positioned to deliver this information than most others in your community right now.

Leverage your knowledge by clearly and consistently articulating the critical importance of creating strong immune function and resiliency, therefore making our community less susceptible to contracting viruses (and myriad chronic conditions).

Restate The Meaning Of Integrative Health

Consumers are easily confused, and bad actors still exist—they are prolific in this unique period. It’s our job to remind folks what ‘integrative’ versus alternative means in the context of COVID-19. That’s because:

Proven vaccines, treatments, and efforts to strengthen immune function and resiliency are not mutually exclusive. It will be wonderful when we have safe and effective vaccine(s) and treatments but, in the here and now, we have no biopharma standard of care for prevention or treatment (notwithstanding Remdesivir) for COVID-19.

Educating about immune resiliency, and the positioning of products and services focused on building immune function, may be the most powerful tools we have to improve the health of our communities, while also improving the fiscal health of your integrative health company or organization.

 So Much Unmet Need: YOU are the Solution

Fill the vacuum or someone else will. Become the immune resiliency specialist for your current and prospective clients, members, and constituents.

Ready? Start Now

Media is a good place to begin. It is one powerful tactic to leverage as part of an overarching business development strategy.

Follow these 4 steps to amplify your expertise on all that comprises immune resiliency:

1. Understand the difference between earned, paid, owned, and contributed media. Start here.
2. Specific to ‘earned media’:

• Create a database of media outlets to which you want to deliver your message—local, regional, and/or national.
• Set up a staffer or hire a virtual assistant to populate a spreadsheet with core information. Include the name of outlet, health writers/editors, name of recurring health column/segment, assignment editors, email addresses, circulation, geographic reach (if local).
• Be sure to include radio, TV (cable/broadcast), newspapers, monthly publications (local, regional, national), and influential web sites and bloggers.
• Create a short press release specific to you/your organization and your position on COVID-19 and immune resiliency. Include your efforts, public activities, products, and services that support this theme.
• Create a pithy introductory email, attach the press release, and proactively follow up within 48 hours by phone.

3. Specific to ‘contributed media’, many outlets on your media database from whom you are looking to ‘earn’ media coverage will be amenable to receiving media contribution from your organization. That may be in the form of an article, a recurring column on immune resiliency, or hosting a piece on radio or local television. Explainer: guest = earned media, and host = contributed. Think of earned and contributed media as being interviewed to extract your intellectual content versus you creating and driving your own content to be utilized (distributed and promoted) by the outlet.
4. Be prepared. Role play with a colleague or coach. Anticipate questions. Have your responses ready so that they are not reactions.

To the extent possible and practical, always make sure there is a clear call-to-action (ex., ‘To learn more, please visit our website.’) in any earned or contributed media activities so that folks can easily contact your organization.

Takeaways

• This is the time for your expertise to shine.
• There is no current vaccine, and approved drug treatments for COVID-19 are incredibly limited.
• Educating on how to strengthen immune function and resiliency through lifestyle behavioral changes, via myriad tools available through integrative health experts, should be leading the charge across the U.S., and around the globe.
• Two aspects of media, specifically ‘earned’ and ‘contributed’, should be featured in your efforts to engage a larger community through which to educate about the current limitations of COVID-19 therapeutics and the profound protective power of immune resiliency.

About FON

FON is a leading integrative health and medicine business development and strategy consulting firm. FON specializes in custom solutions for growing patient volume, developing programs, and increasing product sales. Our practical business models are driven by innovative marketing, clear messaging, and customer engagement via branded storytelling.

Image Credit: Bigstock.com/Sid10

In addition to us all doing our personal and professional best to lift our communities above crisis, we attend online sessions, keep up with a torrent of emails, and consider the troubling question about our economic future. Solely on that subject, one thing is clear: out of crises profound business opportunity is often born.

This is a rare moment in time to strengthen your market position within the specific area of integrative health space you serve.

Only by taking a couple steps back—not to be confused with retreating—will the full picture emerge as to what is possible moving forward.

Only by pivoting from a defensive posture to an offensive stance is sustainable success possible.

Only then can you commence the charting of ‘what comes next’ for the health-directed organization to which you are fully committed.

There are no guarantees of what things will look like over the next three, six, or 18 months. Many small businesses and organizations will not survive, even with government assistance—especially those that were floundering before COVID-19 struck. As history shows us, legacy firms disappear, and new organizations emerge in the wake of crisis.

No one can accurately predict the human and fiscal impact of an unprepared government in the face of a silent killer. Apparently the U.S.—in the here and now—is not as adept, organized, or nimble enough to quickly mobilize as smaller countries have (read: South Korea).

The ‘program’ to address population health preparedness, in response to this viral crisis, has been at best at the level of an undeveloped nation. The depth and breadth of this health and fiscal crisis could have been greatly mitigated had delayed and poor policy decisions not failed us. Yes, it will be ‘fixed’. We will catch up. We will eventually get out in front of this monster. After all, $2 trillion dollars, with more in reserve, can impact recovery.

Objects Are Closer Than They Appear

We can heed the words of the expert economists and their advanced modeling techniques, yet it’s deep speculation against a backdrop of fog. While we don’t know the final effects, we can push now to advance our market position within our competitive set.

While it is true that unparalleled health crises can trigger economic disasters, the fundamentals of the economy in the U.S. were strong before COVID-19. It’s the fear of the unknown—coupled with the closing of a large chunk of the economy, and our collective hunkering down (and not spending money outside of necessities)—that drives our newfound economic woes and uncertainty.

However, the absolute core of health creation, and all that falls under the rubric of integrative health, remains intact as we absorb the physical and mental health challenges of self-isolation, change exercise and movement patterns, establish a new normal in the way we purchase food, and deal with financial stress on top of it all.

The question becomes: When the dust starts to settle and the economy begins its ascent, what will you have done to prepare your business, organization, or personal brand for this moment?

Without taking immediate control of critical decisions now, you will fail to capture economic recovery for yourself, your employees, and those stakeholders you represent. Preparedness, strength, positioning, and vitality is only possible with advance, pragmatic strategic planning.

Do Not Press Pause

Some of the largest and most successful brands today were launched during deep recessions, including:

Apple: 2001

General Electric: 1890

IBM: 1896

General Motors: 1908

Disney: 1923

Microsoft: 1975

CNN: 1980

In 2009, at the height of the great recession, half of the Fortune 500 companies were recognized to have been founded during a previous recession or bear market. From crises come innovation, improvement, promise, and financial gain.

Innovators—not the majority—go to work now to help ensure a larger slice of customer attention and market share later.  In which camp will you and your team live?

I realize integrative health does not generate many blue chip firms (yet). Still, the premise holds true: there is no better time than right now to take a long, measured look at what it will take to secure not only the survival of business, but to ensure an incredibly well-positioned spot for the next phase of its life… think post-COVID-19 relief.

This is the critical window in which to act—to examine and to imagine what is possible and what comes next in the evolution of your integrative health and wellness enterprise or organization. It is the ideal time to reassess gaps in your brand platform and unique market positioning—and to assess how your firm engages current and prospective clients and investors.

Put simply, today’s unique challenges present an extraordinary opportunity for business leaders to think forward, and work on their companies, not just in them both operationally and administratively.  

You cannot control when your business may reopen (if you work within a nonessential sector). Nor can you control the inevitable human resource challenges and decisions ahead—both short and longer-term. However, you can emerge in a much stronger position through a proper assessment to inform strategy.

Many companies and entrepreneurs intentionally launch at the beginning of a recession. Furthermore, other forward-thinkers see value in existing top-tier quality brands and companies that are teetering—on the brink of dissolving or going into bankruptcy—and make smart acquisitions or form partnerships to their financial advantage. Prudent and swift action often pays off for them over time.

In this moment in time, we have been forced into an almost entirely virtual landscape. Conferences are moving rapidly to virtual platforms. Private physicians, hospitals, and health systems are fully tapping the power of telemedicine. Government is loosening regulations to support this dire time of unmet patient need.

Now, as you hunker down—literally and figuratively—look inward as you also look outward at strategic planning for an exceptional future.

This hunkering provides opportunity: before the disruption of COVID-19, you didn’t have time to strengthen core elements of business platform or personal brand.  What’s holding you back from making decisive moves now?

Are you ready to seize this moment?  Contact us today for a discovery call with FON’s founder, Glenn Sabin.

About FON

FON is a leading integrative health and medicine business development and strategy consulting firm. FON specializes in custom solutions for growing patient volume, developing programs, and increasing product sales. Our practical business models are driven by innovative marketing, clear messaging, and customer engagement via branded storytelling.

A difficult decision-making process made even more challenging to pull together so many options.

To address this void, the folks at Integrative Practitioner, led by editor Katherine Rushlau, have released a FREE 160-page guide to the multitude of integrative healthcare credentials and certifications currently available.

[ACCESS GUIDE]

I’m often asked what fellowships and certifications are the best for a particular clinician discipline and area of expertise. Now, finally, there is a comprehensive resource to greatly inform this process—Integrative Practitioner’s Guide to Integrative Healthcare Credentials & Certifications.

From the publisher:

In this guide, you will find our research focused on six categories for each entry:

1. What the credential certifies
2. Certification standards and requirements
3. Scope of practice
4. Accreditation and governance
5. Continuing education
6. Any relevant additional information

We also listed background information on the license or certification, including:

• Where its headquarters is located
• What type of organization it is
• When it was founded
• Its mission
• The minimum education level required to obtain the license or certification
• Its website

In addition, we understand the lengthy list of acronyms does not end with credentials and certifications. In our glossary of terms, we lay out several medical boards, credentialing agencies, and certification entities as well as common industry terms allowing you to use this guide with confidence.

With this terminology in hand, our profiles can easily be digested, even by those with a passing interest in a credential or certification.

[ACCESS GUIDE]

Word-of-mouth referrals and the activation of fanatical brand-ambassadors remain the holy grail of any organization.

The above is absolute for integrative and functional medicine enterprises. But how does this low-spend, or no-spend, word-of-mouth phenomena take flight? Can one just create an amazing product or service, or deliver exceptional medical care, and simply expect unending momentum and success to happen magically? In select cases, sure, but for most of us… not so much.

It’s said that ‘luck’ is the intersection of hard work and opportunity. From the outside looking in, many envious onlookers mistakenly believe that a successful person or organization was built solely on some sort of secret sauce: seemingly instant success rooted in pure good fortune and incredible timing.

It’s not that easy. If there existed a one-size-fits-all formula for business or brand development… there would be a lot more thriving enterprises out there in the integrative health ecosystem—thousands of flourishing integrative clinics and hospital programs, scores of technology platforms, and innumerable top-tier supplement manufacturers killing it on quality, trust, customer engagement… and sales.

Build It and They Will Come

This adage is mostly outdated; a misnomer in this age of hyper-competiveness. Sure, what you provide in terms of products or services is, hopefully, highly-differentiated in the market, but the ‘build it and they will come’ approach is a risky and failing primary business strategy.

The Crossroads of Success

If luck is found at the intersection of hard work and opportunity, then success happens at the same crossroads. Inevitably, the work must get done. But determining the key tasks on which to focus and execute—and phased in to ensure traction—is critical.

Because, let’s face it: whether you run a company solo (today) or are a critical player in team management, you cannot waste time focused on disparate tactics that will never provide a substantive return on your expended resources and energy.

I’m not suggesting best practices don’t exist for your business category or model. Study these, as they may exist and be applicable to your situation. And I’m not saying that structured, canned learning modules or hybrid online business/practice development programs do not provide some level of actionable guidance and accountability. They can, especially for the dogged, overachieving DIYer.

You Do You

What I posit is that you are different: your brand ethos is different; your personal narrative is different; your goals and aspirations are different.  And how you engage your target customers around your products or services must be highly differentiated to break through the noise and chatter in this ever-increasingly contested marketplace we call integrative health.

The following set of foundational reading material—a comprehensive primer, if you will—provides actionable guidance for a newly launched organization, or otherwise provides required information for how you can accelerate your business growth.

FON’s Essential Reading List for Non-Formulaic Thinkers + Integrative Health Builders

I’ve combed through scores of FON articles over the last few years to cherry-pick 14 that I believe are the most foundational and essential for any integrative health entrepreneur or business/clinic development person to explore. Each article includes actionable insights (and a prevailing mindset) you can put into practice immediately.

Is Functional Medicine Becoming a Commodity?

Functional medicine should never be considered indistinguishable—its various products, services and providers are unique, with specific expertise, attributes and features that help differentiate brands in a crowded market. Functional (and integrative) medicine should be widely accessible, yes, but never indistinguishable from the competition.

Read more>>>

Your Integrative Health Brand and Platform: Invest or Fail

Your brand positioning matters. If you do not budget and invest in the core aspects of your brand and platform, in unison, and upfront, you are ultimately impeding your cash-flow and disadvantaging your enterprise right out of the gate.

Read more>>>

The Integrative Health Business: ‘Administrators’ Versus ‘Builders’

Integrative and functional medicine business and organization leaders are often burdened with the weight of managing day-to-day operations, which allows neither adequate time nor sufficient resources for the strategic business development and execution efforts required to ensure long-term success.

Read more>>>

Becoming an Integrative Health Thought Leader: 7 Part Series

This 7-part series aims to provide the basic framework under which you can begin focusing on becoming a thought leader by creating a platform from which to spread your message with more impact, enlarge your community of followers, and achieve your professional goals.

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Establishing Prices for Integrative Health Products and Services

As an integrative functional medicine business owner or executive, you may serve a local, national, international clientele, or a group of constituents comprised of varying demographics and psychographics. So how do you best decide fair market value for what you offer?

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We’re All in Sales: Advancing Integrative Health

You don’t have to be part of a formal sales team to be ‘in sales’. We are all in sales. Yes, including you. You just may not have realized it yet.

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The Power of Effective Copywriting to Engage and Sell

You may pen exceptional prose, do a bang-up job on crafting business reports and/or blogs, or churn out scientific papers with ease—but are you the best person to write the content for your website, collateral, advertisements, or any number of key copy and messaging areas organization-wide? Or even for your small business?

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Customer Service in the Age of Integrative and Functional Medicine

Does the end-to-end customer experience your integrative health organization delivers align with a service ethos that drives retention, ensures loyalty, and creates fervent word-of-mouth referrals? If you want to serve demanding Boomers, and even pickier Generation Xers, Millennials, and Generation Zers to come, this article is a must read.

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Ultimate Guide: Using Community Events to Gain More Patients

Nothing touches people like an ‘in-person, living, breathing, experience’. Whether it’s sports, music or … yes, even health and medical information—LIVE (done well) will always engage more than books, television programs, or websites. Here’s how to make it happen.

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SEO Magic: 7 Ways for New Clients to Find Your Integrative Health Practice

Whether yours is an established practice, or you are relatively new on the scene, it’s critical to take ‘ownership’ of your local market. And for that, you need to make it easy for people to find you.

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7 Critical Steps to Mastering Your Integrative and Functional Medicine Sales Funnel

Unless, through other means, you’ve created powerful word-of-mouth referrals to keep you booked for months in advance, you need a well-oiled sales pipeline—a funnel—that collects leads and converts prospects to customers.

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9 Ways to Earn Your Patient’s Lifetime Value

According to Wikipedia, customer lifetime value—what we’ll refer to as patient lifetime value (PLV)—predicts net profit attributed to the entire future relationship with a customer. Though extraordinarily important, it’s often overlooked by most integrative and functional medicine practices.

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Testimonials: How to get them. How to Promote them.

Given that testimonials significantly influence a prospective customer or patient’s proclivity for your brand, it is incumbent upon you to play an active role in what is said, and where it appears. Don’t sing your own praises… leave this to your happy customers (or patients).

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Grow Your ‘List’ to Grow Your Integrative Health Business

There’s no single magic silver bullet approach for growing integrative health and medicine practices today. It requires comprehensive strategy featuring a range of digital and non-digital communication tactics, of which growing a list for email marketing is incredibly important.

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The Right Information is Power…

However, information without execution results in subject matter knowledge. This is important, but the work still must be done. Let’s discuss what you are working on during a complimentary 30 minute strategy call.

About FON

FON is a leading integrative health and medicine business development and strategy consulting firm. FON specializes in custom solutions for growing patient volume, developing programs, and increasing product sales. Our practical business models are driven by innovative marketing, clear messaging, and customer engagement via branded storytelling.

Photo Credit: bigstock.com/ra2studio

Medscape followed up on the assertions in the published commentary by polling its physician and nurse readers for feedback—results strongly evidenced agreement from those over 55 years old.

[Note: Free registration to Medscape required to access article.]

Caplan, a renowned and influential bioethicist whose work I highly respect, especially in the area of organ transplantation, wholeheartedly agreed with the Hastings authors’ viewpoint that patients are not, and should not be, consumers. He extended his perspective by suggesting doctors not be referred to as ‘providers’, only as ‘physicians’. His remarks are quoted throughout this piece.

At 69, Dr. Caplan embodies an old guard of thinkers who have not come to terms with where patient care is headed—perhaps not fully considering the growing participation and purchasing power of patients.

This accelerating participatory shift is made possible through the rapid growth of readily accessible, high-quality medical content, tools, and evolving technology, allowing patients to make more informed decisions based on the medical literature and their specific disease state. Progress is also happening on the legislative front to force easy, transparent access and accurate estimations of medical costs, before services are engaged.

The Nouns At Hand

Patient, originally defined as ‘one who suffers’, from the Latin patiens, meaning ‘I am suffering’.

A modern definition is ‘an individual awaiting or under medical care and treatment’.

Consumer is a term used for someone who purchases goods and services, from providers, for personal use.

Patients Are Consumers. Doctors are Providers.

(This is a Good Thing.)

Doctors are providers because, simply stated, they provide various services to consumers. Effective and empathetic physicians who nonjudgmentally listen to a patient’s narrative, and do not rush out the door, earn respect and loyalty for the highly personal work they ‘provide’. They establish a standard and deliver care within a market place. Full stop.

We have Medicare and Medicaid, and the VA—Veterans Affairs. Medicare covers about 80% of medical costs, requiring gap insurance for the balance. Everyone else uses the government insurance exchange, or purchases their coverage on the open market. Currently, we have the option, without tax penalty, to forego insurance altogether—forcing out-of-pocket costs for all medical services consumed.

The choices and costs are variable. That is the core of consumerism.

Many healthcare providers and consumers choose to cut insurance providers out of the mix altogether. Consumers maintain high-deductible plans to cover potential medical catastrophes only. Physicians opt out of accepting Medicare. This allows the provider to work directly with patients on a cash-based, direct-pay membership model, or per encounter fee schedule. It removes the opacity of working through a complex insurance billing process, and allows providers to set fees that permit spending more time with patients.

Many of us, this writer included, have high deductible insurance plans. We are paying thousands of out-of-pocket dollars before insurance ever kicks in to assist. Those deductibles themselves are chosen—as products—based on each consumer’s thoughts about affordability, timing, needs, and experience. In other words, they are purchasing decisions.

Speaking of single payer: if that was instituted across the land, patients would still be consumers because they would pay for medical services through taxes.

Patients are consumers. Their choices have already influenced a market, and continue to contribute to change.

Doctors are providers: ‘Payment is due at the time services are rendered. Thank you’. Who hasn’t seen this sign in most doctors’ offices?

A new era, formed by a collaboration of commerce between medical providers and consumer patients is inevitable. And that change—all that power—can be used for good.

Change is Inexorable

While I’ve made my point that doctors are providers and patients are consumers, I agree with Caplan about the challenges in doctor patient encounters.

“In our healthcare system, more and more, the language of business is shaping and changing descriptions of what doctor-patient encounters are all about.”

We’ve gotten to a point where most physicians working within a conventional reimbursement model (specifically, commercial insurance and Medicare) are pressured to keep patient engagements incredibly short. The average appointment lasts 17 minutes. Too much of that time is spent with the ‘provider’ staring at a computer screen, and ends with a prescription pad—or another electronic entry with directives for the closest drugstore.

Seventeen minutes is rarely enough time to thoroughly assess a patient and make highly informed recommendations for care. Absolutely not enough time to really listen to a patient and meaningfully engage about overarching health and how to improve it.

With a consumer’s demand for more time and a provider’s ability to service the consumer, the importance of a doctor-patient visit is highlighted.

This is more about a systemic failure of a (healthcare) system. It’s not an issue of names and nomenclature—it’s just a broken business and care delivery model. Perhaps it’s that way because it was ‘not allowed’ to evolve productively—and now it’s time to catch up.

Patient Engagement and Immersion

“The Hastings scholars said that talking about patients as consumers implies choice and activity that patients and would-be patients don’t engage in.”

But they do, Dr. Caplan. Contrary to the beliefs of the Hastings Center’s research scholars contained in the aforementioned published paper, patients are engaging as consumers in profound ways. Many consult PubMed and reputable consumer health sites.

Patients read reviews. So do would-be patients. They utilize Yelp, Healthgrades, Google My Business… scores of ratings sites and publications. Patients are constantly rating physicians. Word-of-mouth ‘powers’ and social media communities consistently exploit these phenomena. Even in smaller markets—there are choices.

Physicians are in this loop, fueling word-of-mouth ‘professional referrals’.

There are exceptions. Those with ‘closed’ end-to-end insurance providers like Kaiser Permanente may have fewer choices if, say, they would be best served getting a second opinion from an outside specialist for a specific condition.

Educated consumer patients will often make the best choices about their care. Those not positioned to do proper research on their specific condition, or not willing to get additional opinions, will take what they are given. But that doesn’t mean they’re not consumers. There is a plethora of information available to them in myriad forms.

Information is highly accessible; technology continues to simplify that access for input and extraction. Consumer patients are able to play an active role in their own care and the decision-making process.

Now, in a utopian existence, disease would no longer exist—effectively prevented along the journey of life.

In a perfect world, high-quality, no-cost medical treatment would be available to all, and every practitioner would use the most up-t0-date treatment options—therefore other avenues would never need to be considered, and a competitive market wouldn’t exist. But is that true?

Patients would still find themselves ‘shopping for providers’ based on logistics, geography, institutions, bedside manner, belief systems, recommendations from family and friends, and even intuition.

Choice necessitates the reason for ‘consumerism’ and ‘consumer/provider’ relationships. We have the right to choose, and many of us consistently exercise our rights.

Even in Emergencies

“The emergency room you wind up in is not something you shopped for online.”

Consumer patients—depending where they live—typically have more than one hospital emergency room to choose from. And while it is true that an ambulance will transport people in acute distress to the closest facility, once stabilized, the patient can be transported, if they choose, to a different hospital.

Upgrades Are More Than Room Service

“I know everybody is very excited these days about bringing in practices from industries, such as the hotel industry, where we try to get patient satisfaction by having better meals or nicer sheets.”

Successful endeavors require excellence at their metaphorical entrance. All providers require a concierge. And it’s not necessarily for the benefit of a financial bottom line; it’s a step toward improving standards which, in turn, improves recovery. It’s not about ‘nicer sheets’ it’s about those nicer sheets affecting a healing process. That might seem like a stretch for those with decades in hospital clinical care settings; I understand how such things could seem like frills.

However, opportunity—think: progress—arrives when people demand better and more. Better food, less clinically cold surroundings, more natural light, less noise, warmer furnishings and paint colors. This is why new hospitals and renovated facilities often feature atriums and greenspaces.

The boomer generation may put up with it, but hospitals and health systems (and small clinics and centers alike) that fail to make substantive changes to evolve their physical environments with ‘hospitality best practices’ and consumer engagement and customer service top-of-mind will not be utilized by Gen X, Gen Z, and most definitely will not be considered by millennials.

Patient satisfaction is one measurement CMS (Centers for Medicare and Medicaid) uses to pay providers for value-based care service ‘bundles’. So it makes sense for hospitals who participate in these fledgling models to make their institutions a bit more comfortable and visually appealing.

Dr. Caplan is concerned that hospitals will become hotels.

“They should become places where infections are low, treatment is efficient, and people are comfortable, given what we have to do there. I’m bothered about that kind of marketing push.”

I posit they need to become both. Not the Ritz Carlton, per se, but for healing’s sake, they need to be overtly hospitable and highly efficient. There is an expression that hospitals are terrible places for sick people. It’s said tongue-in-cheek, but true nonetheless. It’s long been inferred: stabilize me and get me the hell out so I can heal in an environment actually conducive to healing.

It’s not just a marketing push that drives the higher comfort standards of hospitals; it’s that these amenities promote a positive state of mind which, in turn, supports recovery and deep healing. At the end of the day it is consumer demand that drives these sea changes. Why would an organization not message these attributes and areas of differentiation to leverage a competitive edge?

Today’s consumer patients and medical providers are progressive. They understand, through prior collaboration, that healing advantages come in a variety of packages.

Common Ground

It is clear Caplan wants the best for all. No one is arguing he doesn’t, but limited views and 20^th century thinking does not play well in today’s fast-evolving healthcare marketplace.

“Overall, I don’t want to replace medical ethics and medical professionalism with business jargon and business ethics… it starts to make them [physicians] feel more like pawns or agents, without professional standing and without the respect and authority that go with the profession.”

These things are not mutually exclusive. Physician providers will retain their ethical standing and professionalism if they are able to authentically connect with their consumer patients and help them get well.

Patients as savvy health consumers, doctors as engaging medical services providers = collaboration over pure consultation.

We cannot stop change. As each day unfolds, medicine delivery evolves organically. It always has. Ultimately, doctors take care of patients. Patients are cared for by doctors. The way this is executed today is completely different than one-hundred years ago, fifty years ago, ten years ago, and last month.

The patients of the future—and many in the here and now—are in control of their health creation powers and healthcare services. The tools are here and are becoming more robust. Cost transparency is on its way. Progress need not be an enemy of professionalism or ethics. Neither does collaboration weaken a structure.

The doctors of the future—and many in the here and now—are opening doors to new delivery systems. Their ‘call to serve’ and their ‘drive to heal’ will continue to be informed by technology and be supported by establishing the needs of both the patient as savvy consumers and physician as engaging and collaborative medical professional.

This shift is happening right before our eyes. Blink and you’ll miss the subtle changes that mark the continuous evolution of a system.

Image Credit: Bigstock.com/Fascinadora

Given former vice president Joe Biden is currently atop the polls of democratic hopefuls in the hunt for the 2020 nomination, the announcement that the Biden Cancer Initiative (BCI) suspended operations—after a mere two years of existence—was no real surprise.

According to bioethicist Arthur Caplan, it needed to shutter because a “Biden administration would give favorable treatment for anyone who supported his foundation in the past.”

This naturally leaves one to wonder about:

• Biden’s original dream to positively impact the cancer burden, if or how that will fit into his future, and from what perch Biden can be most effective thwarting cancer’s insidious breadth and reach?
• Biden’s ability to leverage his personal brand and energy—after losing his party’s nomination or even after winning a White House bid—in service to cancer patients and those wishing to prevent it.
• The funding he took in to support his initiative—and the good work of many to build its infrastructure and influence. Does this momentum just evaporate?

That’s a lot to wonder about in regard to Biden’s future as a champion for those affected by cancer’s sinister grip.

Let’s dig in and review what happened shortly after Biden launched BCI and I responded.

What We Need is a Cancer ‘Prevention’ Moonshot was the title of an open letter I wrote to Biden when the Cancer Moonshot was announced. I strongly posited the obvious:

A focus on the comprehensive prevention of cancer would have the most impact at the lowest cost.

Though comprehensive prevention does not appear as sexy or innovative as, say, developing magic bullet immunotherapies such as genetic modification of T-cells, the massive financial benefit from potential health gains can no longer be ignored: improved quality of life, healthcare savings, increased productivity in the workplace, gains from a healthy workforce, higher earnings, are powerful arguments.

I’ll wait here while you catch up by reading the open letter.

Cancer’s complexity does not need to overpower the fact that there is more than one way to reduce its burden. Reduction is accomplished through innovative cancer treatment and common sense cancer prevention strategies to protect the population.

I said then, and it remains so: we need a serious, executable plan for the latter so that the two approaches can be mutually supportive because, otherwise, when prevention is not given the same support as treatment … cancer wins.

The Genesis of Biden Cancer Initiative

When Biden decided not to run for president in 2016—shortly after losing his son, Beau, to glioblastoma metforme—he announced to the world that running for office would keep him from his dream of leading a revolution in cancer treatment.  What began as the Cancer Moonshot under the Obama administration was rebranded as Biden Cancer Initiative in 2017, and it focused its mission to discover immunotherapies to treat cancer.

BCI endeavored to pool and share the resources of leading pharma, biotech, academic centers, and oncologists to fast-track the exploration of scores of novel agents and combinations of agents in service of the so-called war against cancer. Per BCI’s website, “The Biden Cancer Initiative is a response to the lack of a cohesive, comprehensive and timely approach to cancer prevention, detection, diagnosis, research, and care.” (Note: the emphasis is mine.)

To lead BCI, Biden hired seasoned industry veteran Greg Simon who is a cancer survivor and the first president of FasterCures. Biden also engaged the Michael Miliken think tank dedicated to fast-tracking medical solutions.

Within a week of my open letter to Biden appearing on my websites and social media, I heard from a senior staffer at BCI. She asked if I would be interested in visiting BCI and meeting with their team to discuss integrative oncology and the impact of lifestyle on cancer prevention, treatment, and survival. After agreeing to meet, I never heard back. I will leave it to others to measure the impact and accomplishments of BCI over such a short—two-year—lifetime.

Apparently, cancer prevention was never a substantive focus of BCI—a lost opportunity for Biden and BCI to have a significant impact nationwide.

The Impact of Closing BCI

I am not convinced the shuttering of BCI will ultimately represent a substantive loss to cancer drug discovery or the speed with which novel agents are investigated and brought to market. After all, there remains plenty of commercial incentive, and support from well-intentioned non-profit organizations and government alike, to keep the innovation train running.

Lack of Access or Lack of Innovation?

When it comes to the delivery of quality cancer care and the few magic bullet cancer ‘cures’, is it primarily an access issue, a shortage of innovation, or both, that accounts for disparities in overall survival? Lack of access for some, and lack of education for many on how to best navigate a cancer diagnosis in a complex health environment, is an ongoing problem.

While constant, expeditious innovation is crucial, we have yet to respond intelligently to what we already know—where the literature is clear and building: a high-quality diet and regular exercise resulting in a healthy body mass index can help prevent many types of cancer. Adequate sleep, social interaction, hydration via unadulterated water, and reduced toxins in our everyday environment… can all support a strong immune function and help create a terrain inhospitable to cancer.

Smoking and alcohol cessation programs, vaccines, colonoscopies, and other early detection procedures and tests are critical to early treatment when cancer is most treatable, but we should be preventing more cancer occurrences altogether.

When we are fully engaged in a complete prevention plan we can prevent more cancers than are currently caught in early stages of development.

These things—smoking cessation et al—are vital to prevention, but offered alone and often in silos, do not make for a truly comprehensive cancer prevention strategy. Sadly, these are the limited approaches that tend to currently comprise the definition of ‘cancer prevention’.

We are ‘feeding’ a pro-cancer environment largely of our own making because our priorities and politics are compromised. This happens when:

• …the volume of healthcare delivered, and consumption of medications, are commercially incentivized, whereas prevention is not;
• …agriculture is driven by volume, aided by chemicals that should be banned but remain unregulated;
• …we subsidize crops, many genetically modified, to support a vast ultra-processed foodstuffs industry;
• …food deserts and lack of nutrition education deny the opportunity for wellness by keeping millions of people from accessing healthful, real food;
• …environmental regulations are gutted and the EPA runs amok—especially these last couple of years—but in reality, unlike most of Europe, we’ve been swimming in under-tested chemicals for decades; they’re in our food supply, household cleaning agents, and cosmetics and toiletries.

New drug discovery is critical, but for the most part this process is a commercial endeavor to address existing disease and its many deleterious side effects. This is why we need people such as Joe Biden to better understand the drivers—especially political drivers—of a most malignant disease, and how mostly low-tech, high-touch, affordable approaches are critical to true cancer prevention, health creation, and education.

How Joe Biden Can Still Make a Difference

Biden has, so-far, missed his opportunity to reduce the cancer burden in the U.S. However, should he decide to revisit his mission, it is paramount he look at the lowest hanging fruit to make impact where he can be most effective: prevention via education and legislation… by leveraging and expending significant political capital.

C’mon man—we need you, Joe.

I was recently interviewed by Stacey Richter for the Relentless Health Value podcast on the topic of integrative oncology in hospital settings.

During our spirited discussion we covered lots of ground, including the growing science supporting integrative oncology and the profound opportunity for hospitals and cancer centers to engage and educate their communities on true cancer prevention focused on smart lifestyle—read: beyond vaccines, colonoscopies, mammograms and early detection.

ACCESS PODCAST

Relentless Health Value is one of the oldest and largest podcasts dedicated to healthcare industry decision-makers. Its mission is to “help transform health care by fostering collaboration and breaking down silos”. So when asked to participate, I seized the opportunity to reach a wider group of influencers to discuss both the health and economic value of integrative oncology within hospital and health system settings.

I’m excited to share our conversation. You can access the podcast here—or read the entire transcript just below.

ACCESS PODCAST

Stacey Richter: 00:00
Episode 233, Integrative Oncology Is A Clinically Proven Approach. Here’s to hoping that news gets out to payers and patients.

Stacey Richter: 00:10
Today I speak with Glenn Sabin, an integrative oncology consultant at FON Consulting.

Announcer: 00:24
American healthcare entrepreneurs and executives who want to know. Talking. Relentlessly seeking value.

Stacey Richter: 00:32
The Society for Integrative Oncology recently completed a systematic evaluation of peer reviewed randomized clinical trials for patients with breast cancer. The researchers assigned letter grades to therapies based on the strength of the evidence. Meditation got an A. It had the strongest evidence supporting its use. Music therapy, yoga, and massage received a B grade. Hypnosis got a C. By the way, the letter grade varied, depending on the symptoms that were involved. You can go on the website of the society if you want to look up the trial itself.

Stacey Richter: 01:11
Here’s my question. Are insurance carriers paying for music therapy, meditation, and yoga? How about cooking classes? Some are, generally, if it’s part of the services provided by the cancer center. It’s striking, though, that every single insurance carrier will pay for the downstream costs of unfettered anxiety, stress, poor nutrition. You get the idea. Things that an integrative oncology focus would aim to attenuate.

Stacey Richter: 01:42
Do employers know about integrative oncology? I think I’d rather have an employee on a cocktail of music therapy and yoga than a cocktail of pretty much anything else. I’m thinking about this, because if these therapies are not covered benefits, then I’m going to doubt that the middle of the bell curve employees or patients can afford them. Whose going to “splurge” on meditation classes when GoFundMe has a whole section to help people pay for their traditional cancer care?

Stacey Richter: 02:09
Today I speak with Glenn Sabin, an integrative oncology consultant at FON Consulting. Glenn is a nationally recognized thought leader with a reputation for successfully positioning integrative health organizations for sustainable growth. My name is Stacey Richter, and this podcast is sponsored by Aventria Health Group.

Stacey Richter: 02:29
Welcome to Relentless Health Value, Glenn.

Glenn Sabin: 02:33
Good to be with you.

Stacey Richter: 02:33
Just to kick this off and give us all a grounding, what is integrative oncology?

Glenn Sabin: 02:39
The comprehensive definition, which I will read, is, “Integrative oncology is a patient centered, evidence informed field of cancer care that utilizes mind and body practices, natural products, and/or lifestyle modifications from different traditions alongside conventional cancer treatments. Integrative oncology aims to optimize health, quality of life, and clinical outcomes across the cancer care continuum to empower people to prevent cancer and become active participants before, during, and beyond cancer treatment.”

Stacey Richter: 03:14
If I’m going to distill that down, what I’m hearing you say is that cancer care is more than just treating the disease.

Glenn Sabin: 03:21
If not enough attention is given to the host, the person who’s hosting the disease, then it really makes it difficult for many folks to have the same quality outcomes or the same potential positive outcomes. By focusing on the core tenets of lifestyle medicine, for instance, movement, stress reduction, quality diet, and other aspects, it really helps position the patient for success and helps ensure good quality of life during treatment and post-treatment as a survivor. There shouldn’t be any disconnection. They should be one and the same. Just as much focus should be on the host, how they’re feeling emotionally, physically, psychologically, while undergoing a treatment schema for the disease itself.

Stacey Richter: 04:16
I could see how this is starting to gain some traction in that collecting patient reported outcomes will only become more prevalent. The FDA just included patient reported outcomes in their evaluation of new drugs, for example. Maybe the reason for that is because especially with oncology … I can think of a bunch of reasons, but one of them is especially in oncology, it’s like what’s the quality of life that is being led here? Is that an avenue that you’ve been thinking about?

Glenn Sabin: 04:51
When you can help ensure the highest level of quality of life from the point of diagnoses through long-term hopefully survivorship, it helps create value.

Stacey Richter: 05:01
I find it interesting that you called the patient the host, which just seems terribly evocative of things from the disease’s standpoint almost. You know what I mean?

Glenn Sabin: 05:13
Sure. The patient, in theory, doesn’t have a disease. The patient is hosting the disease. So the concept around integrative oncology is how to become an inhospitable host to the disease to create an environment where it’s harder for the disease to manifest.

Stacey Richter: 05:31
It sounds like what you’re saying is that actually by I was going to say integrating integrative oncology … Say that three times fast … there is the potential to actually produce better survivorship, like better quantitative outcomes.

Glenn Sabin: 05:47
Not always, but often it is lifestyle choices that contributes heavily to various types of malignancies, the more lifestyle driven malignancies, such as breast, colon, prostate. So if folks after diagnoses, after they’re diagnosed, if they make certain changes in their lifestyle and continue with these better lifestyle choices through a treatment and into long-term survival, this can help ensure a deeper and more durable remission as opposed to those that don’t make any changes during treatment or post-treatment. That’s a critical really profound opportunity for those that are diagnosed sometimes with life-limiting challenges to be able to impact at some level both their quality of life and potentially their survival long-term.

Stacey Richter: 06:39
Is there evidence to suggest that this is true?

Glenn Sabin: 06:41
There’s certainly a growing body of irrefutable evidence around the core tenets of lifestyle medicine. Stress reduction, physical activity, and nutrition in terms of other areas of integrative oncology, in terms of the guidelines that have been developed for breast cancer treatment, specifically the highest levels of evidence supports meditation, relaxation, yoga, massage, and music therapy. There’s a growing body of evidence, many of which are included in a growing group of clinical guidelines. So it’s really heartening to see this.

Stacey Richter: 07:19
The Society for Integrative Oncology has created guidelines which are to be incorporated in let’s just say the more traditional ASCO pathways. What does this look like?

Glenn Sabin: 07:32
ASCO has supported these guidelines by communicating to their large community about this paper, about these guidelines with the hope, of course, that they will be included and considered for the management of cancer patients.

Stacey Richter: 07:49
Do you feel like at this juncture this is mainstream what we’re talking about here?

Glenn Sabin: 07:52
We’re absolutely getting close to a tipping point, especially when you have the majority of the NCI designated cancer centers and then that subset within that 69 or 70 centers being NCI designated comprehensive cancer centers. The major academic centers—Sloan Kettering, MD Anderson, Dana-Farber, Fred Hutch. All these centers of note, these major institutions have had an integrative oncology program, some going back to the early 2000s.

Stacey Richter: 08:26
Who comprises the Society for Integrative Oncology? Who is that?

Glenn Sabin: 08:31
The Society for Integrative Oncology was founded in 2003 by the leading integrative oncology leaders from Sloan Kettering, Dana Farber, and MD Anderson. So they’re into their 16th year, and this was originally created as a forum for investigators doing research around these different modalities and natural products as a forum to discuss the literature. Over time, it grew and the amount of abstracts and research that is being considered, reviewed, discussed has really grown.

Stacey Richter: 09:06
This society, in other words, is not some industry sponsored coalition led by the vitamin industry. This is a peer…

Glenn Sabin: 09:14
No.

Stacey Richter: 09:14
This is an organization led by NCI designated cancer center researchers who are doing peer review types of studies.

Glenn Sabin: 09:22
Absolutely. Originally, this was formed also because there’s so much confusion. There’s confusion—a lot that remains out there, of course—but this was specifically to help delineate between alternative cancer cure or management claims versus evidence based or minimally evidence informed approaches. It was to really shed light on what this is and how these terms should be differentiated.

Stacey Richter: 09:51
When you say these terms should be differentiated, I’m assuming that what was happening, and maybe this was part of the impetus for beginning this society, is that obviously if I’m anybody but a regulated industry, I can say whatever I want. So people were potentially running around making what could be construed as let’s just say not super well-substantiated claims. Then it becomes really incumbent upon if you’re an NCI designated cancer center dedicated to improving cancer outcomes to be able to separate the modalities that don’t work so well from the ones that might?

Glenn Sabin: 10:28
It’s important for all oncologists, including the academic clinical investigators, to be able to communicate to their patients about what integrative oncology is versus alternative cancer care treatments or products that are some folks will use in lieu of proven conventional therapies that are provided or recommended with curative intent. There still remains a problem communicating what this is. So it’s important for the information to get out there in a meaningful way for consumers to have better access and to understand what these profound differences are as well as oncologists.

Glenn Sabin: 11:09
A lot of oncologists do not take the time to communicate about even the core tenets of the lifestyle approaches. So that remains a problem, even though this is evidence based, even though this is what should be done, because at the end of the day, the health of your patient and to help them create just underlying a healthy body and making them stronger emotionally is going to help them get through active treatment and it’s going to help them in terms of long-term survival.

Stacey Richter: 11:42
You said that around the country there are a subset of the NCI designated cancer centers which consider themselves integrative medicine enabled or maybe they’re integrative medicine centers. What’s the correct term?

Glenn Sabin: 11:55
Most of these major academic centers and even at this point many major health systems and even small just hospitals that even aren’t part of systems, they have either integrative medicine program, an integrative medicine center, an integrative oncology center. These are pretty well established at this point.

Stacey Richter: 12:16
Are they credentialed in any way?

Glenn Sabin: 12:17
The Society for Integrative Oncology, SIO, is not a credentialing body. However, a large portion … I’m not going to say all, but by and large, those that are in leadership positions within an integrative medicine or integrative oncology center or program have gone through either a bona fide fellowship or have otherwise been credentialed for the work that they’re doing.

Stacey Richter: 12:43
Let’s walk through a patient experience. What does it essentially look like? Say that a patient walks in the door of an institution which embraces integrative oncology. When does this kick in? Is it prior to diagnosis when someone is completely stressed out waiting for their biopsy results? Does it come in at a survivorship level? When does this start and what does it look like?

Glenn Sabin: 13:08
That’s a great question. Ideally it would be at the very beginning while a patient perhaps is waiting to get results back and a clear diagnoses is being formed waiting for pathology, etc. But more realistically, it happens at the point of diagnosis. If there is an integrative medicine program within the institution or hospital setting, that’s when at the time of diagnosis that the treating or managing oncologist would communicate. “Hey, by the way, we have an integrative medicine program. This is where you can get one-on-one guidance in terms of different core components of lifestyle.” So it should be as a clinician recognizes, perhaps, the need for psychological support, emotional support.

Stacey Richter: 14:01
So it’s not necessarily something that’s integrated into what I’m going to call the traditional patient journey per se. In other words, the oncologist who tends to be talking to the patient might not necessarily do anything differently. It’s that there’s this affiliated office, maybe, that takes care of the integrative aspects of the patient journey. Maybe they’re working side by side, but it’s kind of like a separate group.

Glenn Sabin: 14:29
There are a lot of silos still, and each system or each institution handles it a bit differently. There’s no bona fide best practices, if you will. Cancer Treatment Centers of America, they pride themselves on an integrative approach that everyone is on board for at the very beginning. Some of these silos are starting to fall downward.

Glenn Sabin: 14:52
For instance, at the Dana Farber Cancer Institute, there is the Zakim Center for Integrative Therapies, which David Rosenthal, past president of American Cancer Society, launched in early 2000s. It was a separate facility, and you had to get a referral from an oncologist. Some referred and some didn’t, so a lot of this has evolved.

Stacey Richter: 15:13
What happens when the patient walks in the door of that department—is it another physician that greets them? Is it a coordinated care group of nurses and coaches? Who’s in there?

Glenn Sabin: 15:24
It depends if it’s an inpatient or outpatient program. If it’s a traditional outpatient program, typically it would be an MD. Often it can be an oncologist within an academic setting, but not necessarily. So they would take lead, and they would then refer further internally for various services, depending on what their challenge may be related to active treatment. If they’re dealing with a lot of anxiety or pain of different types, then they’re making recommendations for massage or acupuncture. Or in some cases, some well-placed dietary supplements or movement. Whatever it may be that can help support the patient in an evidence informed or evidence based way.

Stacey Richter: 16:09
Okay. This probably is a good time to pivot this conversation a little bit into value based care … obviously we’ve got the new oncology medical home model. There’s a lot of stuff that’s happening right now relative to value based care, even in oncology. In more traditional, and I’m going to say not oncology settings, it’s obviously becoming … Social determinants of health, for example, are becoming a very well proven, if you will, factors that drives outcomes just as much as or maybe even more so than what diabetes medicine got prescribed. So it sounds like it’s the same type of general idea that’s happening in oncology, but given how other parts of institutions are pouncing on social determinants of health in order to meet value based care and population health management goals, I would assume that this is a similar paradigm.

Glenn Sabin: 17:08
Integrative oncology approaches tend to be low tech, high touch, and low margin, and heavy on education and engagement as compared to where margins still exist in radiation oncology, systemic care and surgery. So there’s an opportunity to engage patients in this area of integrative oncology, especially around preventing disease, preventing malignancy, and by doing so and engaging in a meaningful way, to create more brand loyalty to the institution, because there’s certainly downstream revenue opportunities for where high margins still exist.

Stacey Richter: 17:56
Obviously there’s different implications of this, but if we’re talking about the guideline driven integrative oncology, is this something where the hospital is basically hosting yoga classes and anybody can go, but someone could be referred there from integrative oncology practice?

Glenn Sabin: 18:13
It kind of slices both ways, but when you mention yoga or yoga therapy within the physical setting, absolutely. There is a number of institutions and programs where it’s heavy on experiential, where they have a kitchen in-house, and they’re showing people how to read labels and purchase foods, healthy food and with cooking demonstrations.

Glenn Sabin: 18:35
There’s certainly therapeutic yoga classes and other discussions and lectures. This is a way to bring community together. Not just for the patient, but the family, caregivers, and even going deeper into the community for those that are looking for prevention opportunities to have influence, the prevention of disease, the prevention of cancer. This goes beyond mammograms and colonoscopies and vaccines and what’s typically attached to the term prevention. This is prevention largely via lifestyle choices.

Glenn Sabin: 19:10
Folks are hungry for this, and so it’s taking an institution that again focuses mostly on acute and emergency care and does that very well and pivoting to engaging around information that will be more attractive to millennials and the younger boomers and the coming generation of folks that are going to be more putting themselves at the center of their own care and looking for more than just a plain clinical setting just to be used for emergency care.

Stacey Richter: 19:42
What I’m understanding here is that there are additional benefits beyond improving patient outcomes of patients that already have cancer. It also follows the consumerism trend and enables the cancer center to put a toe in that water as well.

Glenn Sabin: 19:57
It could be an economic driver, yes.

Stacey Richter: 20:00
It’s an economic driver in the sense that if I’m on a risk based pay for outcomes kind of deal, then I could improve outcomes, which technically if the system is functioning properly, would also increase revenue. But then also because the oncology center is part of the community, it might enable less network leakage maybe or more patients who choose that center for their care?

Glenn Sabin: 20:28
Yes. It supports value based care. It also supports, if it’s done right, downstream revenue for fee-for-service. So as things evolve in how care is delivered and how it’s incentivized, it’s right there. It’s helpful as these models evolve and as these incentives evolve.

Stacey Richter: 20:48
We’ve got obviously these economic incentives. I’m also considering here the recently released Edleman Trust Barometer, which showed that trust in hospitals has nosedived seven points this year. So I would assume that anything like this also probably is a positive in that equation.

Stacey Richter: 21:06
Let me ask you this, Glenn. You mentioned yoga. You mentioned cooking demonstrations. There’s also crystal therapy. You start getting into complementary medicine, if you will, or these alternative therapies. There’s a lot of them. If I am a data driven oncologist and I am looking for ways I want to measurable improve my patient outcomes, if I do a search on the internet for …

Glenn Sabin: 21:34
Sure.

Stacey Richter: 21:35
… things that improve and fill in the blank, how do I know what works better than others? Is there guidelines for that?

Glenn Sabin: 21:43
Well, you stick with the literature. If you look at the guidelines that have been created for during and after breast cancer treatment, you focus on nutrition, stress reduction, which may include mindfulness-based stress reduction. You stick with these core areas. In yoga, the evidence for yoga for reducing anxiety and stress reduction, therapeutic yoga with certified instructors that specialize in this area, this is quite important. Even around body movement, whether it’s tai chi or qi gong or weight training or cardiovascular exercise. These are all important areas. The evidence is there to support these sensible recommendations.

Stacey Richter: 22:27
I actually did take a look at the guidelines that the Society for Integrative Oncology had put out relative to breast cancer. There’s a list of potential integrative therapies, and they all have grades. Yoga gets an A, and then there’s other things on the list that might not fare so well, because there actually were, I’m assuming, some sort of trial that was done that compared outcomes of patients that receive X integrative therapy versus some other ones. I found it fascinating.

Glenn Sabin: 22:56
Even the use of acupuncture, acupressure and acupuncture for reducing chemo induced nausea and vomiting. This is very useful, and I hope that oncologists really read it and incorporate it where they can and share it with patients who are coming in with all kinds of questions about what else they might do to support the conventional treatment. Unfortunately, a lot of patients don’t even communicate with their oncologist about what they’re doing. So that’s an issue as well. The communication is really key.

Stacey Richter: 23:29
Yeah. Considering that side effects management, if a patient is experiencing extensive nausea, that’s a reason why patients fall off or “non-adherence” to their therapy.

Glenn Sabin: 23:42
That’s an important point.

Stacey Richter: 23:43
I can definitely see how by enabling patients to be adherent to the best practice oncology care and drugs and therapies would certainly improve outcomes, because there’s plenty of research that shows that non-adherence significantly reduces outcomes.

Glenn Sabin: 24:01
Yes. Absolutely.

Stacey Richter: 24:02
Is there anything else that you want to mention relative to this, Glenn? Anything I forgot to ask you that you think is an important point?

Glenn Sabin: 24:09

I think that administrators and leadership, hospital and health system leadership that currently don’t have an integrative health program or an integrative oncology program attached to their cancer service line really should take a look at integrative oncology and in general integrative health and how this is an opportunity to engage the population on relentless health creation.

Stacey Richter: 24:34
Glenn Sabin from FON Consulting. That’s F-O-N Consulting. Thank you so much for being on Relentless Health Value today.

Glenn Sabin: 24:41
Thank you. It’s been a pleasure.

Stacey Richter: 24:43
Links to everything discussed on the program today can be found at RelentlessHealthValue.com, where you will also find a complete listing of all of the shows that we have published thus far with leading entrepreneurs and executives in the healthcare space today. Another cool feature is you can subscribe to the show so that every week the episode is automatically sent to you so you don’t have to remember to go to the website to download it.

Stacey Richter: 25:19
Thanks so much for listening.

You possess a powerful tool to enhance your business and expand your influence and goodwill for the good of your patients and customers. It’s called a medical savings account. Are you leveraging this tax-deferred tool?

I have always wondered why integrative healthcare practices and businesses aren’t savvier at promoting the economic attributes of health savings accounts (HSA) and flexible savings accounts (FSA) to their current, and prospective, patients and customers. After all, what consumers would want to spend more than is absolutely necessary for medical care, or other products that would otherwise qualify as a medical expense—and for which pre-tax dollars can be used?

As a practice owner or nutraceutical company, why would we not shout the benefits of medical savings accounts from the rooftops—a bona fide ‘discount’ sponsored by the IRS?

For some, depending on tax bracket, we are talking upwards of 40% in pretax savings. That’s real money. So is the 20% penalty assessed to improperly submitted, non-qualified medical expenses.

Healthcare consumers want to spend less for high quality medical care and products. Medical savings accounts allow service providers and dietary supplement manufacturers across the integrative health ecosystem to benefit—because when their patients and clients are getting more value for their hard-earned money, everyone wins.

[Note: HSA and FSA are popular medical savings accounts that are similar in several ways. But there are some distinct differences. Here is an excellent HSA versus FSA primer.]

Health Savings Accounts 101

HSAs allow individuals and families the opportunity to pay for qualified medical expenses using pretax dollars—essentially tax-free purchases.

The 2019 annual individual contribution limit to an HSA is $3,500. The annual family contribution limit is $7,000. Setting up an HSA is super-easy and inexpensive to maintain, even as an individual (as opposed to an FSA through an employer). I’ve had one for years. Mine costs about $25 per year in service fees.

So why aren’t more U.S. consumers taking advantage of medical savings accounts? And why are direct pay, cash-based integrative and functional medicine practices—and other businesses within the integrative health ecosystem—not more effective at promoting and educating their patients and customers on the tax advantage of using these accounts?

We’ll start with direct pay, and various concierge practice models, then dive into dietary supplements.

Direct Pay/Cash-Based

With à la carte, pay as you go, no-membership models, the tax laws are unambiguous. If you are delivering clinically-indicated care, and charging a fee specific to each patient’s clinical engagement, and properly capturing these details, these services are qualified medical expenses so long as the individual has an HSA-qualified high-deductible health insurance policy.

Concierge Practice Models

This is where things get trickier.

Excerpts below are from the article ‘Are Concierge Physician Fees Payable Tax-Free from Health Savings Accounts and Reimbursable Health Flexible Spending Accounts?’ by Galina P. “Allie” Petrova, JD.

Petrova, an expert in tax-deferred medical spending accounts, is the director of the Petrova Law PLLC, in Greensboro, NC. The full article with numerous citations, originally published by the American Bar Association, appears here.

Characterization of Concierge Physician Fees

While the business model may vary, concierge physicians typically charge a concierge fee ranging from a small monthly membership fee to annual retainers in the thousands. Ordinarily, concierge subscription fees and retainers are charged for access and convenience, regardless of whether medical services are provided.  Yet concierge fees may cover routine medical services, and additional fees may accompany medical services provided à la carte.  

The nature of the service determines whether a concierge fee is a qualified expense for “medical care” and eligible for reimbursement. Only the portion of the fee which is associated with the medical service, and not otherwise covered by insurance, is eligible for coverage. If the fee is only for non-medical services or the right to preferred access to concierge medical care, then the fee is not a qualified medical expense.  

Concierge physician fees encompass the following categories:

Access fees.  In this case, the patient subscribes to a concierge physician practice solely for preferred access to medical care. When medical services are provided, additional fees would apply. While the subscription portion of the fee is paid for preferred access and is ineligible, any amount paid for medical care would be treated as a qualified medical expense.

Retainer fees.  These are charges for special treatment and perks, including 24-hour availability of a physician, special waiting rooms, newsletters with wellness recommendations, minimal or no wait time when scheduling appointments, longer and more comprehensive appointments and house calls. Retainer fees are billed annually and apply whether or not medical services are provided. These fees are paid for non-medical services and convenience and so are not qualified medical expenses.

Membership fees.  Similar to retainer fees, these fees cover special treatment and perks and are payable whether or not medical services are provided.  Unlike retainer fees, membership fees may offset part of the cost of medical services.  Membership fees are billed monthly, in addition to copayments, deductibles, and other charges for office visits. These fees are similar to insurance premiums in that they are paid to cover contingent future expenses, and insurance premiums cannot be covered with HSA or FSA funds. Therefore, neither can membership fees.

Fees for diagnostics, prevention and annual physicals. These fees normally qualify as expenses for medical care and may be paid in advance, on an annual basis, or when the services are actually received. Annual physical exams qualify as medical care, and certain diagnostic and preventive medical services qualify, as well. If the fees are paid in advance, they may become reimbursable once the physical or other medical services have been performed because that is when the medical character of the expenses is established.

Documenting Concierge Fees for Medical Care 

The patient must have supporting documents to prove that medical services were received and payment was made for an eligible medical expense. Ideally, the concierge physician practice would provide details on the fee and indicate whether the patient has received medical services or merely convenience, concierge access, and non-medical services. In addition to the patient’s name and dollar amounts, itemized billing statements should indicate the type of expense and the date of service.  

IRS’s Silence

The IRS has not issued interpretive guidance on the eligibility of concierge fees as medical expenses. In an IRS Information Letter, which is only advisory and has no binding effect, the IRS faced the issue of whether a concierge fee was reimbursable from a Medical Reimbursement Account (MRA) or Healthcare Reimbursement Arrangement, which is very similar to an FSA.  

The patient paid an annual medical concierge fee for “access to physicians, a comprehensive annual physical, minimum half hour doctor visits, and access to dietitians and exercise therapists.” Whether intentionally or not, the IRS did not address the issue of whether the fee would qualify as an expense for medical care. Instead, the IRS letter outlined the tax rules and alluded to an MRA plan’s discretion to set its own rules to determine which expenses are reimbursable and which ones are excluded from coverage.

Restricting Eligibility of Medical Expenses 

All medical expenses under section 213(d) are eligible for payment or reimbursement from HSA funds, and employers cannot restrict the eligibility of medical expenses under an HSA.  However, even if an expense qualifies as for “medical care,” the tax law does not require FSA plans to reimburse. Employers have discretion to limit reimbursement to only a subset of eligible medical expenses listed in the plan and exclude others, whether or not these expenses would otherwise qualify under the Code. 

~~~~~

Dietary Supplements 

In the spirit of transparency, I began drafting this post five months ago, and then put it aside to work on other pieces—because this important subject is complex and rather unclear. There is an incredible amount of nuance and gray area when it comes to qualified medical expenses and IRS tax code guidance on HSAs/FSAs. And the subject of dietary supplements is even more daunting.

Dietary Supplements as Qualified Medical Expense

On the one hand: dietary supplements are not designed to treat, diagnose, prevent, or cure diseases. On the other hand: dietary supplements are designed to give patients the vital substances that the body needs for normal functioning, and as such they may prevent or reduce certain diseases.

Supplements for weight-loss, everyday wellness and health maintenance—such as multivitamins—are not eligible as qualified medical expenses.

Prenatal vitamins are an exception, as they have been proven to prevent birth defects and promote healthy development of the child. However, in general, dietary supplements must be prescribed for a specific medical condition or nutrient deficiency, such as vitamin C for scurvy, or the combination of calcium, vitamin D and potassium for osteoporosis.

Qualified Dietary Supplement ‘Agents’

The actual lists of qualified dietary supplements I was able to find were outdated. Over at www.irs.gov, a search for the latest guidance came back ‘empty’. It’s as if the IRS is playing this one real close to the vest.

I also reached out to an editor at a major trade publication in the nutraceutical space, but did not hear back before putting this post to bed.

[Access this (almost) exhaustive list of qualified and non-qualified over-the-counter products and provider services, including which ones require a prescription.]

Prescriptions and Letters of Medical Necessity

A medically indicated ‘prescription’ on a prescription pad is not enough to ensure compliance with tax law as a qualified medical expense.

Below are some examples, some a bit far afield but instructive nonetheless, to help you start thinking about the utility of having your dietary supplement recommendations backed up with, at minimum, evidence-informed content and citations to support their use for specific conditions and pathologies.

If Nestle and Abbott can create Letters of Medical Necessity language to support their so-called nutritional drinks such as Boost and PediaSure… you can, too.

You can be better positioned to support your patients and clients for coverage through their medical savings plans. The following examples—generic and more specific to nutrition therapy and individual agents connected to specific conditions—can get you started.

Generic Word template #1

Generic Word template #2

Nutrition Management

Kate Farms® Core Essentials Standard Formula

Abbott’s PediaSure

Nestle’s Boost

Improving the Physical and Financial Health of Patients and Customers

It is simply good business to invest the requisite time and energy to identify that the clinical services you deliver, and supportive products you recommend, are tax qualified medical expenses. Doing so supports the financial health of patients and customers, while supporting your practice or business through reduced-cost goods to the end user. It shows you care.

Work with a tax or legal professional with expertise in this area. It will be well worth the investment. Once this is done, the financial benefits of medical savings accounts, and how they specifically apply to your situation, should be overtly and consistently messaged to your patients and customers. Put simply, this is a significant financial opportunity in which ‘all’ can participate.

Takeaways

• Medical savings accounts benefit patients/clients and practices/businesses alike.
• As integrative and functional concierge medicine becomes more popular, and greater out-of-pocket healthcare responsibility leads to higher use of HSA and FSA, understanding these rules to ensure compliance is essential.
• Consider incorporating clinical services into membership programs in ways that also create HSA/FSA-qualified medical expenses.
• Own the responsibility of learning how medical savings accounts work, then apply it to your standard operating procedures, to help guide patients/clients.
• Effectively market and message the attributes of HSAs/FSAs to your patients/clients so that you can save them money using tax-exempt dollars… with the potential of selling higher volumes of useful products and services.

Is your integrative health business or organization positioned to ensure its long-term sustainability and growth? Contact FON for a 30 minute exploratory phone or Skype consult to discuss your specific goals, opportunities, and challenges.  

About FON

FON is a leading integrative health and medicine business development and strategy consulting firm. FON specializes in custom solutions for growing patient volume, developing programs, and increasing product sales. Our practical business models are driven by innovative marketing, clear messaging, and customer engagement via branded storytelling.

Photo credit: www.bigstock.com/Robertindiana