Peptides 101 for Cash Practices | Ethical Peptide Therapy, GLP-1s, Outcomes & the Right EMR

Hello. Welcome to the Catch Practice Solution podcast. I am your host, Dr J. And this week we’re talking about peptides in clinical practice. Consider this your peptides 101 we’re gonna look at this topic from our unique cash practice perspective.

Peptides are everywhere right now.

Patients are not only asking for them, but they’re driving me crazy sometimes. Looking around, I don’t know that there’s a place I can look in the medical sphere that clinicians aren’t marketing them. Practices are being built around them all by themselves. And we’re dealing with a lot of practices in our software business. That’s what the practice is. It’s telehealth peptides. But the real risk for you is not missing out. The real risk is using these really powerful, amazing tools without really knowing what you’re doing. And the bad part of that is you’re going to pay in terms of the outcomes.   Not only that, you get there are great, but the outcomes that you miss and then the trust that people have in you is going to get a hit, and then your reputation will crash.

So how do we use peptides to support better outcomes without joining the hype and doing things that are ethically questionable or practice damaging? Or worse yet, indulging in the well, they have an online service. I could just order them there. A big practice somewhere, I think was Florida just got in trouble, prosecuted for using something that they got online and they’re actually giving it to patients instead of going through a pharmacist, which is the only way to go if you really want to get verifiable, high quality peptides. And they’re so good, you don’t want to miss that opportunity. So peptides aren’t new science. But in a lot of places they’re being marketed kind of like magic. I think the GLP-1’s kind of look like that. And to me, they’re such a huge breakthrough. It almost feels like they are magic. In a cash practice, that really matters, because your credibility is what you’re trading on. People come to you because you have a reputation. I’ve been doing my practice for thirty years, and we’re super busy because people know if you see Dr J, you’re going to get a good outcome. So let’s break it down. Peptides are not a hype. They’re not a magical tool. They’re a precision tool. Shortcuts are not going to work.

Peptides are short chain amino acid groups that are linked together. Proteins are multi-dimensional. Peptides are kind of flat and linear. The first peptide that was ever discovered was glutathione before 1900. And then the first one that was really commercially available to be used was insulin. And everybody knows insulin, so there’s nothing new about it, right? The thing about the peptides is they’re targeted messengers. They bind really quick. They signal quickly, they turn off quickly. Unlike hormones, which can have a real long lasting effect, they can just go on and on and on and they can linger and have huge, huge impacts. I call testosterone and the sex hormones, the big switch.

With peptides you can do little whispers into the system. And they can be subtle, but they can be incredibly effective. Let’s talk about some things that you can do with peptides that you might not think of just off the top of your head.

The brain. What can you do if somebody has a memory problem, you can use acetylcarnitine. You can do Bresson’s work, which is brilliant. But on top of that, BPC-157, KPV, TB-500 Semax, Selank I’ve used some nasal spray, some injectable. But, if the person’s not really doing the deep work and really getting the diet right and the other things, peptides are still going to be helpful, but not nearly as much as they will if you are doing the whole program. So if you want to support cognition, sleep and neuro recovery, Semax, Selank, DSIP, Cerebrolysin, people will do better, they’ll heal faster, they’ll sleep better, they’ll think clearer. They’ll do all the things that you’re trying to get them to do, only a little bit better or a whole lot better.

There are some patients that are just amazing responders. With GLP-1’s you have 10% or 15% of people that don’t respond, they just don’t, I’m not really clear why.

We can get some modifications made that we haven’t maybe seen subclinical hypothyroidism, maybe a little bit of a reverse T3, maybe, I don’t know, something else that the peptide isn’t designed to do. Or they’re just not responders. People who do respond, on the other hand, they’re not just going to feel better. They’re going to look at you like you are the knowledgeable resource. You are the one who’s got the goods, who knows what’s going on. Because everybody, in the PTA and in the local coffee shop are talking about peptides, EVERYBODY . So you need to know about them.

So how does this impact your cash practice? Well, when your patients recover faster when you have an athlete who goes back to the game next week because of the BPC you gave him that’s going to count. When someone who hasn’t been able to sleep for a month suddenly can sleep. That’s going to matter. So when you are offering people premium care, you have to offer peptides. And it’s not about selling, it’s about being an expert. At first peptides 101, you can get started with this kind of stuff, and eventually you’ll get to the point where you’ll become as adept with peptides as you are with hormone therapy.

This episode is brought to you by Esprē Health, the game changing platform for cash practices that are ready to level up with smart, intuitive AI tools that sharpen your clinical insight and streamline your business. Esprē Health helps you run a practice that’s not just efficient, it’s enjoyable. So if you’re ready to break up with that cranky old EMR and finally experience tech that makes your life easier. Come on over to EsprēHealth.com and see how thoughtful technology can transform your practice. And hey, don’t forget to subscribe so you never miss an episode that delivers the freedom to choose. And the power to heal. Now let’s get back to the show.

Why does knowledge matter? Well, GLP-1 agonists like semaglutide, they’re everywhere and they work. But what’s the caveat? Well, everybody knows the big huge wave of success, all these great things that were happening and then all the warnings that came out right. Ozempic face. Muscle loss. That can be easily avoided. Proper discussion with the patient about the need to be exercising. You need to make sure you’re getting adequate protein. You want to focus more on protein even in people who have a tendency to like protein a little less, you really want to reinforce that and offer them at least 60g a day, maybe a little bit more, because they’re under stress.

It’s also mitochondrialy. If that’s a word. That’s probably a word. Mitochondrialy stressful. So your mitochondria is going to be stressed because you’re going to deprive it of its normal fuel, its normal rate. All those things are going to change. So you can cause metabolic damage. And without strength training during that time of GLP-1 activation, you’re going to have that risk. So you want to use it thoughtfully. And lately we have been super successful dropping the once a week dose in half and giving it twice a week. This reduces problems of constipation, reflux, all of the side effects that we’re used to having, some people just don’t do well on the full dose weekly. So you cut it in half and you can even go less than that.

When you have short term wins that look really, really good. And then in your community, that long term failure is really going to show up and your cash practice is going to be impacted by that, because as we talked about early on in this whole podcast series, your outcomes affect your income. If your outcomes are awesome, which peptides will absolutely support, you’re going to get great results. If you have a quick fix, like an urgent care kind of response, that patient loses weight and has a weight control program, and for three months they lose 15 pounds. And it’s so exciting. And then six months later they gain their weight back and they’ve lost a lot of strength. That’s going to really hurt your practice. You’re going to have an amazing amount of churn but it really always comes back to, do you care about the patient.

Is that the essence of your practice? Are you caring for the patient? Peptide therapy is unbelievably powerful. You know, I guess with the ozempic stuff everybody knows it’s powerful and everybody knows that there are things that can be done to mitigate the side effects and make it better. But there’s a whole world of peptides outside of the weight loss world. So you have to protect your patients against misuse, right.

And there’s some areas where it’s not necessarily dangerous. But it’s a little risky.

The BIG risk, in cancer, it’s downright dangerous. So the ones that you need to be really careful of, and anybody who’s got active cancer or a chance of active cancer and you’re concerned about BPC-157 because it stimulates healing response. It protects cancer cells, sometimes two KPV do the same thing.

MOTS-C it’s a mitochondrial product. And what it does is it lets the mitochondria be a little bit more effective. It improves insulin resistance. Cancer loves sugar. Right. So when insulin resistance is decreased, the sugar comes in easier. And the cancer just loves that. That’s a beautiful thing for cancer. So you need to be careful on that. Not everybody understands that.  They’ll order stuff online and they’ll do peptides. It’ll live up the dose and they’ll do it. And they never really hurt themselves. So you’re in a position where you can really change that dynamic dramatically. And boy, if you really want to create a problem, cross any ethical lines, you might get away with it.

With a few patients, you want to do things a little cheaper or a little quicker or a little. But if you ever get involved in those kinds of things with online products or any of that stuff, you’re going to get in trouble and eventually it’s going to hurt patients, and it could destroy your reputation and your practice.

So at the Cash Practice Solution, we believe that growth is going to come to your practice from making better decisions. And not necessarily the trendiest protocol. And peptides are absolutely going to elevate your outcomes when the foundation is solid. When you pick the right patient, a patient who’s going to understand how to comply, like, you know, some, peptide, you got to do them twice a week and more is not necessarily better.

So if there’s a sensitizing problem and you can’t take a peptide every day, you need to make sure that if a patient is compliant and they’re going to get the benefit of it, and you’re educating them and they’re going to say, I understand and you know that they will and monitor them.

You don’t give them a half of your prescription and say, have a good time.

And the timing is really critical. And that’s the difference between precision medicine and chasing a trend. Right. And you can get in the business of trend chasing. And in the cash practice world, man, I see a ton of it. There’s a ton of opportunity to make quick money, but it will not be a great practice. And I’ve been in this practice for 30 years and it continues to do well because people know that I’m looking out for them.

My outcomes are what supports my income, not because I have a trend. You build a practice instead of burn it down.

But I want to tell you about a really specific case. It’s really amazing. A patient, young girl, 22 years old, had seen several doctors for her GLP-1 problems. She had taken enough to help one to lose weight and done really well, 50 or 60 pound weight loss. Really good over six months.

But she developed gastroparesis and severe constipation to the point where she stopped having any bowel movements at all. So, she came to see us for her management of her peptide side effects. It was really very, very serious complications at this point. Because we understand the mechanism of GLP-1 and how it works. And we also understand how to reverse that.

We understand how to look at the patient’s entire story, listen to the patient, learn their stories and care about them. Love them with all your heart because we have that capability to listen to the patient. We use the software, the Esprē software, to investigate all of the aspects of her function. So we looked at her bowel function, of course, but also emotionally, her sleep pattern, her hormones, every bit of it.

And then we addressed all of them in a single visit with acupuncture, osteopathic treatment, some nutritional support, digestive enzymes, and some magnesium to have her bowels move better. So a comprehensive approach and GLP-1s are unbelievably effective. They are not a single therapy. It is part of an orchestra, part of a symphony of care that you provide your patients.

If you’re going to provide care like that, you need to have tools to do it properly. The Esprē software is unbelievable. You’ll be able to get a patient involved in your practice and know everything about them before they hit the door, because they’ll actually be able to provide you with an interview and an output that will tell you all about all the systems in their body and how they’re performing.

Once you’ve got that information, you can address the problems in a way that is comprehensive, symphonic, and really, really effective. So GLP-1 or whatever else you have, if you want to treat a patient comprehensively, start with the right tools and comprehensively care for them. When I say love them with all your heart, you have to use your head too.

If you have a question, or you want more tangible steps about this stuff, and you really are interested in cash practice because that’s really the passion, right? You can go to esprehealth.com/podcast.

In the upcoming episodes next week, we’re going to continue to break down how to grow cash practice, especially without compromising outcomes, including when to say no. Like I tell people all the time, that’s hype. Peptides are not hype. It’s pure juice baby. I mean, it’s powerful. And if you get it right, you’re going to be absolutely thrilled with the results that you’re getting.

I’m seeing an amazing transition in my patient population from what used to be really difficult stuff to treat, but it’s amazing what BPC and KPV will do. Unbelievable. And it kind of has changed. Well, ulcerative colitis serious stuff I mean and you get people well I’ve got their five R, four R program. Replace, re-inoculate, restore all that.

That’s right. So when I add that peptide on top of it I get dramatic results when it works. And like I said, some people are non-responders. Don’t let that get to you. Just keep at it and learn and become an expert at this. Your practice will grow, your practice will continue to do better and better.

Thanks for tuning into the Catch Practice Solution podcast. I’m Dr J. I’m here to remind you a fulfilling practice is this close. It’s within reach. We can help you get there. We’ve done it for lots and lots of practices. If you want to optimize your current cash practice or start out a new cash practice on the right foot, check out all of our resources at esprehealth.com.

So until next time, our mantra. Listen to your patients, learn their stories and love them with all your heart. You will be unstoppable.

Thanks for joining us. And if you have enjoyed today’s conversation, be sure to hit subscribe so you don’t miss out on future episodes packed with insights to help your cash based practice thrive. And don’t forget to check out all the tools and resources available at esprehealth.com. They’re free to you and we’re always adding more. Keep raising the bar in patient care.

We’ll reconnect in the next episode with more ways to help you succeed.