Why Functional Medicine Doctors Are Burning Out and Retiring Early

So, I have a great experience I want to share with you. Maybe it’s bragging a little bit, I don’t know, but I have a friend, a functional medicine doctor. We’re not really close, but we’ve worked together a little bit. And I said, “I want you to see this software, I want you to see Espre and what it does. And showed it to him, basically did a demo, sort of a baby demo. And he walked into my office, tossed his wallet on the desk, he said, whatever you need. And he wasn’t joking. He was totally desperate because his EHR was horrible. He tried them all. Built for diagnosis codes, insurance billing, and none of them could even begin to understand, let alone do, interpretation of a patient’s story. Or suggest protocols based on that. Or look at what a functional medicine workflow is about. I’m Dr. J, founder of Espre Health. I spent years watching functional medicine docs trapped by software not built for them. And the cost isn’t just time. Actually, there’s a new stat that just came outthat doctors are, on average, retiring nine years earlier than they did 15 years ago. EMRs a ton of them. That’s the reason why. Their EMR,Thousands of dollars lost per week. Complete loss of joy. This is just no fun at all. In fact, I had an experience. I was at a doctor’s office, and I was walking down the hall. We had crossing hallways. And I was whistling, literally, zippity-doo-dah. And the doctor, she was so unhappy that she said, stop being so happy. that’s what Esprē is for, t’s to restore zippity-doo-dah. It gets you back to the place where you’re having fun.The problem is the EMR doesn’t treat you like a healer. It treats you like a data entry clerk. So you’ve got to reframe the problem. Most providers assume all the EHRs are basically the same.They’re just different versions of a workflow tool, but they’re not. Big companies, like Epic, they’ve really built their systems to solve different problems. Their answer, basically, to you is, you know, we are the billing code people. And you’re asking, what’s happening across the whole body’s activity and systems? It’s like, they’re completely different worlds.So the gap is structural. And it’s costing 10 or 20 hours a week. Thousands of dollars in lost revenue. Really, if you stick with the bad EMR, it’s years of clinical burnout. So instead of optimized workflow conversation, we’re going to look at the real mismatch between legacy and functional medicine systems, and what it’s costing you. Epic is a server to solve a problem you don’t have, those big guys. They answer the question, what is the diagnosis X? What is the billing code? A lot of Xs. Functional medicine has something different. And it’s hard. What’s happening across the entire system, The legacy workflow is super linear. It’s a silver bullet, Chief complaint, single diagnosis, billing code, submission. It doesn’t always work like that. If you’re working in a legacy EHR, you’re trying to make that all work within that system, But everything flows from the billing. And functional medicine is not linear that way. It’s multidimensional, It’s relationally interconnected. Skin, gut, and hormones, the immune system, health risks, genetics, they’re all communicating. Epigenetics, all of that. Legacy EHRs don’t begin to understand that. They separate everything. One box goes to another box. And then there’s this other group of boxes in separate silos. No relationships, no synthesis, no story, So the doctor, in a system like that, has to integrate all that information. I’m looking at all these different data points, and I’ve got to, which I did for years, crunch all that in my head, which gave me a headache. So you’re carrying the whole story in your head, Or you’re writing it down on paper, sheets and sheets of legal paper, And then you’ve got to reenter it into your system later.You’re reconstructing the visit. And I used to do that. I’d miss things during a visit, and I would go back and look at the lab and think, in that situation, what would I have done? Oh, yeah, that’s what I did, I remember. And then I’d write it down,That’s not a feature problem. It’s a philosophy problem. And the system is built, those large systems, on reductionism. Ours is built on systems thinking. One asks, what diagnosis fits that I can build? The other asks, what story is this telling? And if you’ve been blaming yourself, you should just stop, because you’re not the bottleneck, the system is. And you can’t retrofit that, You’re putting a horsey harness on a rocket ship. It doesn’t work. It’s never going to work, The architecture won’t allow it. So which means the solution is not going to be optimization. You want a system that’s aligned with the way you think, You’re not slow, your system is. Most functional medicine days look like, depending on you, a follow-up is 15 to 30 minutes, and maybe an hour of documentation after. Maybe you’re really good and it’s only a half hour. So maybe it’s a one-to-one or one-to-two ratio. A little bit of patient time, a little bit more screen time, or worse. 15 patients are seen, 25 hours of visits, 10 hours of total work. The system doesn’t capture the story in real time. It forces after-hours reconstruction, and there you are.Meaningful use is a great example. Absolutely no value, except for getting paid by some faraway entity. Checkbox medicine, it has nothing to do with patient care. Ask every patient who comes in, people you’ve known for years about domestic abuse. They came in for a sore throat, for God’s sake. That’s ridiculous. That’s not medicine. That’s administrative compliance. But it costs you every day, and that means that you’re seeing less patients, you’re making less revenue, and you have less capacity in every part of your life. It doesn’t slow you down. It wears you down. You open the chart and you feel it every time. You start working later, you see your family less, you’re falling behind, and that’s why they’re burning out and retiring, not because they’re weak, which, by the way, what else are you going to assume? I mean, you know how we’re trained. We can’t get beat up so bad that only the strong survive, and we have survived, and that’s the way these systems treat you too. We’ll just beat you up. You’re fine. You’re used to getting beat up. It shouldn’t be that way. The system is not sustainable, because you don’t have to. You could retire. I’m going to give you possibly, depending on you and your ability to work and your willingness, a $10,000 a week hidden cost. Why? That’s expensive software, baby. It’s not the software. It’s your capacity to think, to create relationship, to work. If you’re losing 20 hours a week, you’re at least 10 patients that you’re not seeing. If you’re $1,000 for an hour or two a year in time, that’s $10,000.Over a year, easily $500,000, that’s half a million dollars. That’s a whole practice right there that you’re losing. And really what’s happening is these are guarantees. This is going to happen. It’s guaranteed by the structure. You have less time and less revenue, less staff, more burden, less capacity, and you’re going to stagnate, and you’re going to burn out, and if you don’t quit, you’ll wish you did. I just know so many docs. I read the feeds all the time, and they’re saying, ah, my EMR, I hate it, and insurance, I hate it. It’s like, don’t do it. Get something new. Not only that, your ability to care for patients and love them and work through a problem, do you know how sick I am right now from this? I don’t even want to talk to anybody, let alone pour myself out. It’s not because you’ve become a hard, calloused, horrible person, it’s because you’re overloaded.So if it’s costing you $10,000 a week, that’s possible. The real question is, why are you even questioning whether or not you should switch? You should. Customization’s never going to work.You can’t customize your way out of bad architecture. You try to do a bunch of templates, or you get a consultant to come in and tell you how dumb you are, and how smart they are, and pay them a lot of money, and you make some workarounds, and it’s still the same, because the structure’s not right. And things get more complicated, not less.Building systems need codes and structure that do that. And that’s a single diagnosis logic. Functional medicine requires the story, and there’s so many data points. I mean, you don’t have a diagnosis, you have multiple points, and you need to be able to interconnect them. And if software does that for you, the value to the patient is inestimable. You know how good functional medicine is. So why use a system that’s designed to create that incredible reductionistic condition, when you can have one that builds the whole patient’s story out, and provides the care that we know is the best, that gives them that opportunity.I’ll give you an example. Intake data is collected and never interpreted. You know, you fill out the form,, that big multi-page thing. Symptoms are completely isolated and not connected. You don’t have time. So we know that if somebody has a skin issue, it could be their gut, it could be toxicity, it could be so many things, But not in that system. You’ve got one box now, stick with the box, build a box. It can’t express that. So you have to do it manually. So you’ve got to write all that out, and then you’ve got to squeeze it back into the box. Billing has to come from the story. That’s how it works. And if you can’t fix that with customization, you have to replace it. What functional medicine software actually does is it interprets data. Our system is an interpretive health record. So it actually takes the story in a really cool way, you know, basically a patient does it online, and they answer questions, and if they answer questions a certain way, it gives them different further questions, and it’s great. Then it takes that data and doesn’t just sayhere’s a big long list of all the answers. It actually interprets that data and puts it together in a graphic format,So it builds a story, not a checklist. It builds a visual narrative, So all of that comes together to create a clinical conversation. So once you have that data, that’s not the end. You don’t say, okay, this is the answer, and you check it off. You actually look at that and say, based on this, let me chat with Bob and have the conversation. And it’s a real clinical conversation because you know that patient. I mean, you know their story. So they don’t say, I don’t quite understand. You know me. It’s really great. I mean, if you’ve never had the opportunity, you really need to do a demo. It’ll blow your mind. Legacy systems, they frag everything. There’s fragmentation everywhere. Everything’s separated, and then you have to do that manually. But good software, functional medicine software that connects the patterns and relationships works. So let’s say you have a sleep problem We know that there’s a ton of things that can cause that. There’s a hormonal imbalance, and there’s silent reflux, and the stress of your horrible job, but you can see them together. I’m going to give you a great example. I have a patient who came in just the other day. He’s a builder. He’s a 40-year-old guy, and he thinks he has a sleep problem. That’s his sleep. My job is so stressful. I have two little kids. By the way, that’s true. It’s really super stressful. It’s bad. So the builder comes in, and he’s got this problem. The software asks him questions, and it asks him about his hormonal questions and his psych questions, and they’re fairly normal, but he’s got this screaming prostate score. His prostate score is like 70, 80% likelihood that that’s causing a problem, but he never brought it up, and he never would bring it up. He’s a 40-year-old guy. He should never be talking about his prostate. That’s at least what he thinks. Well, the reason he’s not sleeping is because he’s getting up to pee all night.It never occurred to him that that was the problem, but because Espre interpreted the data and presented it, and that’s a super simple case. That guy’s better tomorrow. I’m not giving him a bunch of magnesium or melatonin or Lunesta or something else. I’m not giving him that. I’m giving him the solution to the problem because I’m looking at his entire system. And I don’t have to hold that all in my head to figure it out, and I don’t have to go through the whole questionnaire bit by bit by bit by bit. He does that in a way that he’s completely relaxed about. He doesn’t have to look me in the eye and go, yeah, Doc, I dribble on myself. He doesn’t have to do that. So it’s an amazing way to do it. The system puts everything together, and then I validate it. I ask the question and say, so how many times do you get up? And oh, you don’t have the ability to pee like you used to? Okay, great. So everything’s faster, and believe it or not, it’s way more accurate, and data shows that patients who do online stuff will do it much more accurately because they’re more honest with a computer. I don’t know why, but they are. So it’s clear. So then I’m confident when I’m making decisions because I’m asking the patient. I look at that, and instead of asking each question and wearing everybody out, I’m getting to the…cutting to the chase right away.And I’m not sitting behind a screen. We’re sharing that data together. We look at the screen together. As opposed to somebody who’s on a laptop blocking their view of the patient or with their back to the patient at a desk, those situations, they create separation. Ours creates alignment.So legacy workflow is clicks, compliance, documentation, and the patient experiences, this sucks. Functional workflow, it’s actually showing the patient the story, sharing with them the graphs that show their story, kind of show the trends, validate their experience, and the patient’s experience is, this is awesome. I understand what’s going on. You listen to me. It builds trust, and patients will partner with you, they’ll follow through, and patients will actually do what you ask. And when patients see over time, as you continue to apply the same principles, they see things change and their symptoms improve and that they’re really progressing. They completely change in terms of their engagement. Most people, I think they’ll tell you, honestly, I hate doctors. It’s like, what am I? Well, I’m not your typical doctor because I use systems that actually create relationship, right? So you’ll find all this sounds amazing, but you’re going to have to switch.. It’s easier than you think. Most of the stuff that you need to switch is automatic. All the demographics and everything out, contact info, the basics, they’reall, easy. All those big, long stories that you get in hundreds and hundreds of pages of data that doesn’t connect, believe it or not, they’re useless in the past and they’re useless now. So that’s really not a big deal, and the system’s really easy to learn. It matches your workflow. Almost everyone who’s become an Espre customer said, oh my God, I should have done this years ago. And your fear, which is justified, is I’ve tried this before and every one of them is the same. Not true. It’s not the same. They’re a completely different category of tool. One’s billing infrastructure, ours is a clinical interpretation system that’s designed for functional medicine. Different architecture, different outcome. Cost of delay, money, money, money, money, horrible. The revenue that you’re going to lose, it’s unbelievable. You’re going to hate your job more than you should, and ultimately, and it’d be horrible if it got to this level, you’re burned out. And you’re not good anymore. You’re just not good at your job. The cost of switching, it depends who you are. Some people get it done in a day or two, they’re really, really good. Others take a month or two. So it’s pretty simple to figure out. So here’s how you know you’re ready to switch, you ready? I’m done with medicine. Okay, that’s a good reason. Just switch, try it. What do you got to lose? You’re going to walk away from your career, right? Number two, I’ve tried everything and nothing works, okay? You haven’t triedEspre, please do. This is one that’s really super sad, but your family doesn’t expect you to be around anymore. They stop noticing that you’re absent. You’re not at games, you’re not at dinner. You’re kind of expected to be gone. You need to switch. You think about cracking your computer open and you’re just full of anger, that is a really good reason you might want to switch, right? And I think that resentment is a data point that you can’t deny, right? And it’s not your personality.  You’re not the only one in the world who’s experiencing that The system’s just crushing you under the weight of it. And there’s no optimization you’re going to do that’s going to fix that. You’re going to hit a ceiling and you’re going to burn out. Either way, the system’s a bottleneck. So how long are you going to stay with that? That’s up to you. Basically the average person takes about a week to get set up, a week to migrate and they’re ready to go. They’re learning in two or three weeks and they’re going. The week four is that, oh my gosh, this is the greatest thing I’ve ever done. And you’ll be super relieved. All the things that you used to do every day that took you so much time, the system does effortlessly and it becomes pretty much invisible except for the fact that you’re so thankful that it’s there. And if it’s possible, and I’ve seen some data that shows that there’s some decrease in burnout throughout the industry. So burnout can decrease. But if you use a Espre, it will almost guaranteed to decrease, right? And you become present to your patients and to your staff and it becomes fun. And you become a doctor instead of a data entry clerk. The fear of switching, it’s way bigger than the reality. You can do it. So it’s a simple math. If you want to gain back 10, 20 hours a week and you want to make a couple hundred thousand dollars more each year, you want to spare some psychiatry visits, oh well, no, maybe not that. Maybe it’s not that bad. But maybe it is. It’s simple. Just switch. You know, the cost of staying is years of life and revenue and health and the cost of switching is a month or two tota. So the goal isn’t a perfect EHR, it’s just an amazing one. The goal is a system that supports the way you actually practice medicine. And if you want to see what that looks like, the mystery, that you can uncover for free. That’s what a Espre was built for. Thanks for watching. We’ll see you in the next episode.