159: Community Approach to Getting Your Health in Line | James Maskell

on today's episode of The Real Fudalgy Podcast. Is there a way that someone could be held, validated, understood, listened to, and go through a process of then building new muscles to do new healthy things? And could that whole process happen without a doctor's time? And the truth is it absolutely can and is happening. Hi friends! Welcome back to another episode of The Real Fudalgy Podcast. Today's guest, I started following back in 2020 on Instagram when, you know, the whole world kind of exploded and not a lot of people were talking about prevention and talking about our broken healthcare system and speaking out about the way that our public officials were dealing with everything and I was very appreciative of people speaking out about and criticizing the fact that we were not having a conversation with people about their health and about their immunity and giving them tips and tricks on how to take care of their health and boost their immune system. So I have been following him ever since I really love his work. He wrote a book called The Evolution of Medicine and Dr. Mark Hyman was quoted saying this book might change the world which I loved and in this book James gives a step-by-step guide for health professionals to build the practices of the future. And this model that he talks about in his book really helps to address a lot of the issues that we're seeing in our modern healthcare system like the rise of chronic disease, physician shortages, escalating costs, care access and affordability, physician burnout. And it's a community-based model that has been compared to similarly the way that AA operates. So it was a really fascinating conversation. We talk a lot about the importance of community and the role that it plays in your overall health and it was a really fascinating conversation. I am so grateful to have been connected with James Maskle and I just want to get to the episode. So I hope you guys love it and hope that you are inspired by it. If you are, please write me a message on Instagram DM me or if you want to post about it tag at Real Fudology on Instagram. I always seal your posts and I really, really appreciate them a lot. So yeah, and as always, if you guys could leave a rating and review, it means so much to me and it really helps the show. So thanks a lot. I hope you guys enjoy the episode. Love you. Do you struggle with sleep like I do? Well, let me tell you about by optimizers because their products change the sleep game for me. And I can actually tell you from personal anecdotal experience after reading my aura ring for the last year and just seeing the improvement in my REM sleep and my deep sleep that it really does work. I also had a founder of by optimizers on the podcast, a couple months back. So if you guys want to look that up, he divulged some amazing tips for getting better sleep. 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Life is really hard and regardless if you have a clinical mental health issue like depression or anxiety or if you're just a human who lives in this world who's going through a hard time or maybe you've been through something traumatic like me, therapy can give you the tools to approach your life in a very different way. Throughout the years it's helped me to really see my role that I play in my own suffering and it's helped me to get out of my own way. It's helped me to see different things in a different light and of course it's helped me to process and deal with the trauma that I went through as a kid. But again I really just want to reiterate that you don't even have to have any trauma in your past to have therapy help you. I honestly think everyone could benefit from being in therapy. I think it's an amazing thing that we have access to and this is why I really love better help. 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That's better help as an h-e-l-p.com slash real-foodology. Clicking that link helps support this channel and it also gives you 10% off your first month of better help so you can connect with a therapist and see if it helps you. I hope this helps you. James, I'm so excited to have you on the podcast today. It has been a long time coming. I actually, I don't know if I told you this, but I originally found you during 2020 because I was really inspired by what you were talking about. You were one of the only accounts that I found on Instagram that was talking about preventative medicine and root cause treatment and you were trying to sound the alarm for people saying, like, you know, what are we doing right now? Why are we not telling people to take better care of their health and be conscious of the foods that they're eating and get outside and get sunlight? And, you know, there was really no public conversation about that and I was really excited to find your account because you were very vocal about it during that time. Yeah, absolutely. It's interesting. I think there's been a lot of historians that have talked about as a need for a sort of a transformational moment for a new concept to take hold. And I just recognized straight away that COVID could be that for the movement that you're involved with and that I'm involved with, which is, you know, preventive health. Now, it was interesting, you know, as soon as people, like, I can remember April of 2020 being part of a webinar with, you know, some of the preeminent people in functional medicine. And even then at that point, they knew this is the kind of person that's going to have a really tough time with COVID. This is the kind of person that's going to have a pretty easy journey through it. And it was proven to be, right, now how is that possible? Like, there are some unique characteristics of COVID but ultimately there is a vast understanding of, you know, how each of our own terrain essentially, like the way that we, the function of our body, the whole of functional medicine is built around understanding how your body functions. And there were key parts of how the body functions that were determined, you know, your pathway in that, in that, in that journey. And there's an opportunity for everyone at every time to move in the right direction. And so I just thought, like, this is an amazing opportunity. This is a great, a great moment where we could move to sort of immovable metal towards health. And yeah, it didn't, it didn't go that well. I know, I know. And I share your frustrations because I remember, so, you know, I got my masters in nutrition. And a lot of what we studied was the immune system and the connection to the foods that you put in your body and how healthy you are is going to determine your outcome for many diseases. And it's going to determine how well your immune system works. And so when we first started learning about all this, I remember, you know, simultaneously I had two messages where I was like, okay, we obviously, this is a novel thing. So we don't know, there's like some strange things happening with it. So we don't know everything. But we also do know we've been studying coronavirus this for a long time. And also like, I knew how the immune system worked. And I was like, okay, like, we got to get this stuff in line. And I, at the time, I was excited because I was like, yes, like there's going to be a large conversation about this. So many people in our, in our nation are really sick. Why don't we start talking about prevention? And then it just went the total opposite. And I was so frustrated. I will say though, like now, in 2023, I do think that it helped open a lot of people's eyes up to realize one, how corrupt our system is, two, how they're, they're really not taking any sort of action in trying to educate the general public on how we can get healthy and how we can prevent all these chronic diseases. So I do think that there, there was a bit of a turning point, but there was a huge missed opportunity as well. Yeah, I think, I think there was definitely progress as far as the general public seeing it. I think where there's, again, a frustrating lack of progress is in the development and delivery of healthcare, which is what I spend my time working on. And I think that's probably just been the same forever, really, if you think about it, like, you know, supplements have taken off in the last 20 years, but you'd still quite hard press to find a doctor who'd prescribe you a supplement, right? So, you know, it's happening in a sort of a consumer first evolution. And I think that's just because podcasts like this and the way that the word has got out has happened in a, you know, one to many kind of conversation. I still find myself in the trenches, shifting healthcare. And it's exciting to see what opportunities are popping up because they're finding their way to me, which is great. But in general, we've still got a ton of work to do. And, you know, I would say the theme of what I say to people when I speak to people is that ultimately, even when that system is created, right, where there's predictive, preventive, participatory medicine for everyone in the country, it's still going to be down to each individual to go on and activate that. Like, if you really want a kind of medicine that will reverse chronic illness or prevent it before it starts, part of that paradigm shift is that it requires full participation from the person whose health it is. And so, you know, the empowering part about that is that you could, you know, you can start today. You can start today. You probably have started already, but that's an opportunity for everyone at any time. You know, that's a great point that you brought up because, you know, often I think people have this mentality, not everyone, but a lot of people generally have this mentality that they go to the doctor and they're like, the doctor's going to fix me. Please fix me. Like, how can you fix me? And the reality of the situation is it's like, ultimately, no one can fix us if we're not willing to put in the effort ourselves. And this is what I really love about your message. And I want my audience to hear what your approach is as far as this like this community approach to getting your health in line. I know recently I listened to you on a podcast and you guys were talking about how if you are in a community of friends or even family who are, you know, overweight or really sick, you are way more likely to be overweight yourself. So what is that community basis for health care that really could help a lot of people? Like, what is your approach? I'd love to talk about that. I should just go one step back to something you just said. The idea that the doctor can fix you is a reasonable way to think about things in 1950 or in 1930, right? Because the diseases of that day, if you look at like, you know, you're in an accident or you get infection or you're dealing with some acute issue, it's reasonable that medicines came along that had an incredible effect, right? So that was a reasonable way of thinking. It didn't shift that way of thinking didn't shift even though the types of diseases that affect people changed 180 degrees, right? So the biggest killers are all lifestyle driven chronic illness and the doctor can't fix those. Patients can fix those. A doctor can manage those and manage the symptoms of those, but really it's up to the patient to participate. So it's not that it's wrong to think in that way. It's just outdated based on what we're facing, you know, facing here today. You know, ultimately, I've been on an 18 year now, journey to understand where chronic disease comes from, what's driving it, is it reversible? And then the last question is, is it reversible at the scale that it exists? And so for the first, you know, 10 years, I would say, in the last 18 years, I was really just trying to learn as much as I could and particularly learn about what kind of doctors are doing things differently. How are they doing it differently? And then more recently trying to get other doctors to buy in, you know, some of those ideas. And ultimately, through that journey, I learned that chronic disease is indeed reversible. The vast majority of chronic illnesses follow actually a very predictable path of pathogenesis or moving towards disease. And then there's a journey back. You know, many of your listeners have probably been on some part of that journey. You know, many people who do what you do have come to it because they've been on that journey. They've learned so much and they want to share with other people. So, you know, that's really exciting. Along that journey, what I recognize is that chronic disease is extremely isolating. You know, good, most likely, if you're dealing with an autoimmune condition or you have type to diabetes or you are dealing with some, you know, other mental or physical health challenge, you're probably the only person that you know that is dealing with that. And that can become very tricky because one, no one knows what it's like to be you. And second, you can't participate in the kinds of things that most people participate in. If you look at the things that most people co-participate in in America, those have become unhealthy things. So, you know, the alcohol and drugs and even eating a fast food and all that kind of stuff that you've spoken about. Most of those things are unhealthy. If you go back 50 years when it was church and community service and you know, working with each other, most of those things were profoundly healthy. So, you know, in order to get healthy, you have to sort of like almost isolate yourself from those things. Because if you come to understand that those things made you unhealthy, you have to isolate yourself from that. And then you end up isolated. And loneliness is actually the biggest driverable cause mortality, more than food, more than alcohol, more than smoking. And so, you know, that not only exacerbates the problem and makes it worse, but it makes it difficult to start your journey back to health. And so, in 2019, I wrote a book called The Community Cure, really looking at how these new ways of doing medicine, which we could call functional medicine, you know, we could call preventive health, we could call whole food nutrition, like there's a lot of things that go into it, does different factors. When you can deploy that in a sort of a community environment, it's almost exponentially more effective. And so, you know, that's been about eight years of like learning research, trying to understand them, and then trying to create models that are scalable, affordable, accessible. And that's been sort of my work for the last four years, particularly. Yeah, it's amazing. Yeah, I mean, you and I both are in the same page, you know, we, well, many people agree that, you know, the current alopathic model, it works really great for acute care, but our current health care model is not equipped to handle the astronomical rise of chronic disease that we're facing. And you're right, there needs to be this social shift where people realize, okay, I need to go to my doctor, you know, if I need a surgery, or, you know, I was in an accident, but I need to be looking for different types of doctors that are specifically practicing preventative medicine, because otherwise, like they're not, they're, they're, there's not trained help you in that way. And, you know, this is one of our biggest hurdles right now, and I'm so grateful for people like you that are really trying to tackle this problem is that there's this accessibility piece that people are really struggling with, you know, like everyone, you know, that wants to seek out an integrative functional naturopathic doctor, if you don't have a huge budget, it's generally not covered by insurance. And so this is a huge problem that we're facing. How do we fix this and, or are there other ways for people that are maybe, you know, really on a strong budget to approach their health in a different way, if they're not able to find, you know, just an integrative or an apathetic doctor. Yeah, so there's a number of things I would say on that. So, you know, first of all, my work has been to try and introduce new models of care that can make that kind of care more affordable to take certain elements of that and bring it into conventional care. You know, the biggest barrier to that happening is time. And, you know, one of the things that's, that's common if you go to see one of those types of practitioners is that you spend a lot of time with them. And you have to eventually pay for that time one way or another. And that's the reason why it's not available on insurance is because insurance won't pay if you just spend that long with someone. But what I came to realize having like, you know, done the research and spent so much time in this area that, you know, the attention of a doctor's time is not the only thing that can provide time. And I came to really understand that, you know, if, if, is there a way that someone could be held, validated, understood, listened to, and go through a process of then building new muscles to do new healthy things. And could that whole process happen without a doctor's time? And the truth is it absolutely can and is happening. And so, you know, just to give you an example that would be resonant to your, to your listeners. When I, in 2014, I started something called the functional forum and it became the biggest like functional medicine conference for doctors. And in part of the reason it took off is that in the fourth ever episode, the first time this, the live streaming worked in May 2014, Dr. Mark Hyman came and announced that there was going to be the Cleveland Clinic Center for functional medicine, right? So it was a huge moment in the industry because it was like a big credible institution saying, we're going to battle this. So five years later, having built the center and now deployed it, we learn in the Journal of American Medicine that functional medicine outperforms conventional medicine and not just any conventional medicine, like Cleveland Clinic level conventional medicine. And great moment, right? But again, like what's actually happening at the Cleveland Clinic at that moment, the demand is like this, the supply of doctors is like this. And there's, they're looking to see the fact that like they can't scale to meet the level of demand that's being created by the fact that now there's an institution doing this. So what do they do? They end up delivering this functional medicine and group model. And in this group, it's an extended period of time. I think there's was 10 weeks. There's no doctors involved at all. It's being driven by health coaches who are, you know, typically people who have had an experience of chronic disease, I've got over it themselves, feel energized to get into helping other people and end up in this sort of like half-peer, half-health professional role, right? But there's also dieticians and other providers involved who are really there for like the nutrition piece, but also to make the whole thing insurance billable and make it so that, you know, people with conventional insurance can do it for free. And what do they learn from doing that? Well, one, that model of functional medicine with no doctor time involved is even better than one-on-one functional medicine. So the outcomes are better and the cost is almost exponentially lower, right? Because it's one, one dietitian or one health coach working with a group of people as opposed to a doctor spending a long time with one person. So when I heard that data, this was 2019, early 2019, I heard that at a conference, I was like, this is it, right? As a health economist in me recognized that we could never solve the sort of resource allocation in medicine as long as everything was built on the foundation of what the most expensive person spending the longest time with each person. And so I wrote a book called The Community Cure and, you know, I wrote it in 2019. I brought it out January 2020 and then COVID happened, an all-group medicine was destroyed, right? And that was really interesting too. And now what's interesting is even today, as I'm speaking to you, it's coming, coming round again, where like this Monday, I am flying to South Carolina, or I am being flown to South Carolina by a $5 billion dollar health system that serves one and a half million patients, where my book is required reading and I'm going to go and tell them what to do. And this is incredible for so many. One, I've never been to a hospital in the US, right? I've kept myself out of the hospital. I went once in the birth of my second daughter, because the home birth went a little bit sideways and we needed a bit of support and it was all fine, but I was there for a few hours. That's the only time I've been in an American hospital and here I am coming to like talk about the community cure and talk about how they can deploy these new health measures in groups in an interesting way. And for the last three years, I've been involved in doing that same thing virtually and I've learned a lot about how you create cohesion and connection and community without the opportunity to sit in a room together. Yeah, that's really fascinating. And you know what I was thinking as you were talking about this is that I'm sure a lot of my audience is, you know, health coaches and practitioners and maybe there's ways in which they can create these little communities in their own community with their clients where they can encourage them all to help each other out because, yeah, I mean, it sounds like this is something that's really missing in our current approach to health care. And you're the first person I've ever really heard talk about it in this way. You know, obviously we hear communities really healthy for you. Loneliness can cause a lot of diseases, but I've never actually heard about a community of like holding people accountable in this way from a health care approach. Yeah, it's really interesting. I mean, my viewpoint on it has been shifted even since I wrote the book. I mean, I've been part of a men's group for the last four years. It's not a health group. Health is tangential to it. It's really like a emotional intelligence accountability structure for a group of emotionally mature men to be with each other and help each other in their goals and to have that space. I've seen incredible health outcomes in that group in the other men quitting smoking, losing weight, getting sober, all these things like I've seen that happen, but it's not even a medical group. Now, if you were to take that structure of trust and accountability and infuse it with new healthy behaviors and, you know, someone in there who understood what reversing chronic illness looked like, you now have something, you know, extremely powerful. And so, yeah, I think that opportunity is really available to almost anyone. And the advice that I would give to people who this is resonant for is, you can use online tools to create in-person offline connections, right? There are tools today that can alert you to the existence of people who are like you. And I think that probably the healthiest thing that any person could do if they're struggling with a chronic illness is to try and find a way to either join a local community of people that are struggling with a similar thing or to start something like that. And, you know, we've seen in the work that we've done, you know, if you do something healthy by yourself, that's great. If you do something healthy in community, it sort of supercharges it and creates ongoing support and accountability and friendship around it. One of the things that I'm certain of is that the stickiest force to really create long-term healthcare transformation is friendship. And, you know, you see it in their examples all over of where, you know, in the healthiest places that exist on the planet, there's a structure of community that really is, you know, that is, you know, that it's just woven in as part of society. And we've lost a lot of that. So, rebuilding that, I think, is critical to, you know, transforming chronic disease and health outcomes. Yeah, absolutely. I mean, you know, I moved to the west side of LA a year ago. I used to live on the east side and I found myself in this new community of friends that I had met through mutual friends. And I was immediately blown away by the fact that the majority of my friends in this group do not drink alcohol at all. And they're also really good about getting everyone together and creating different events. Like, for example, you know, we get a crew together to go to the beach and do cold plunges once a week. And everyone brings their dinner and they eat wheat dinner on the beach in the sunset after we've like done a cold plunge in the water. Or like, whenever we get together and one of our friends does a shabbat dinner like once a month. And I've always loved so much about this community that at this shabbat dinner, there will literally be one bottle of wine. And there's like 30 people there. So, like, maybe someone will have a glass, people will have like a couple of sips. But my point in this is that like, if you desire a community of people that are healthier and are doing healthier things, if you don't have that, like you said, you can create that. And I've been so inspired by this group of friends of mine because like I said, they're constantly like getting crews together to go hiking. Like, what are what are things that you really love to do in your life? And how can you find people that share that similar interest? And I've found it personally for me as someone who, you know, I love to drink a glass of wine. And I'm very influenced in that. Like, if I'm around a bunch of people that are drinking wine, I'm going to have a couple glasses of wine every night. But I love being in this community where when I go to shabbat dinner, there's not even wine to be drink. And I don't even miss it. I don't feel like I need it. And I just feel like that's a great point as far as like, if you really want to create a healthy community like that for yourself, you can make that happen for you. Yeah. I mean, I think you're going to find more concentrations of people who care about those kind of things in certain areas. But I do think there is. It is becoming a social movement. And I think that there are more and more people who are interested in it. And yeah, I'm grateful to hear that that's possible and happening. And yeah, I agree with that as well. You know, it's certainly changed my experience. I mean, I grew up in England where drinking is just a part of everyday culture. And it's so built in to society that it's much more difficult to pull out. And I know some of that definitely, you know, exists everywhere. But I do think that, you know, that offline, online tools do exist to create those kind of offline connections. And I think you'd be surprised if you started something like that, how it would spread quickly because I think people are really searching for that sort of community. I want to take a second to talk about some of my favorite organifi products and why I love them. When I first started getting into health, I was an avid juicer. 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So you guys can claim a free element sample pack when you make a purchase through the link. The link is drink element that's LMNT.com slash real foodology and in the element sample pack you're going to get one packet of every flavor so that you can try all of them and see which one is your favorite. I hope you guys enjoyed as much as I do. Again it's drink element.com slash real foodology that's drink LMNT.com slash real foodology. So in regards to what you do as far as some healthcare approach, how would someone go about finding if they want to find like a hospital or a doctor that is practicing this or do you have hospitals and doctors that are doing that in the US or is this one you just talked about in South Carolina the first one doing that. So yeah we you know so at the beginning of the pandemic I started a company called Peel Community or One Word and it was to deliver virtual groups paid for by insurance in partnership with clinics and hospitals. You know it's not a consumer business so it's not like you can go on and and and sign up I mean we partner with hospitals and then if you're in if you if you're seeing those doctors you can you can sign up for it so it's like a B2B effort. So I know it's disappointing and everyone kind of expects that anything that exists they should be able to have access to because we're very familiar with apps and so forth. I mean there are certainly other things like this I know there are consumer facing group technologies not exactly the same because they don't really have the the sort of health focus it's more just the the community focus but yeah we we're we're working on deploying this like the goal is within five years that every insurance would be you know that you would be able to you know you'd be able to have this on whatever insurance you have Medicare and Medicaid we have to be able to go out and prove out that if a group of people comes together and works together to improve healthy behaviors that their cost of care their total cost of care goes down and we're in the process approving that right now so that's the big prize right the big prize is you know transforming healthcare in such a way that major medical entities that are now incentivized to reduce the cost of care can do that to facilitate that and that's what I spend my day doing and this is just me going on that trip is just an example of me being slightly ahead of the curve seeing what needed to happen and now hopefully health systems catching up to it and then executing yeah yeah me what you just described I feel like is is part of them it's a very multifaceted issue that we're having right now they're failing healthcare system and what's cool is seeing all these different people from different angles trying to implement this new approach I know you and I talked about this one on one recently but I had Kelly means on my podcast and I love what he's doing is true med where he's essentially getting these like healthier foods healthier like tech devices getting covered by essentially by food stamps through his company and incentivizing people to to go after these like healthier foods and lifestyle choices and it's so cool to just see all these different people trying to tackle this goliath of a healthcare system that we're dealing with right now I mean what do you what do you believe are are the biggest problems that we're dealing with like what's that the root of our failing healthcare system right now well that the root of it all is is chronic illness because ultimately chronic illness is driving cost and is driving the overuse of the system and the overuse of the system has all the sort of downstream effects you know if you have a society where a small fraction of the population are chronically ill then and then there's like a small you know a certain number of normal acute issues that have to be dealt with that's what the system was built for but you see the same sort of number of acute kinds of issues but then you see this huge growth in chronic illness and that means that there's just going to be way more pressure put on to the system in every part where that pressure can be deployed right so in primary care and your average doctor they have to go faster to you know meet in a barn you know hospitals you know everywhere so that's that's really the root cause but it you know it just really depends on on how how you see it I mean I'm I'm getting a little bit more engaged politically than I've ever been in the last few months and I've been involved in some conversations where like listening to the needs of voters in New Hampshire and South Carolina and for those people it's a lot of um access rural hospitals you know the cost of medication the cost of care how do you fit insurance premiums and how do you are you even within an hours drive of a of a hospital like there's meta things and not and bigger things that happening at that level ultimately it is a huge behemoth I don't think it can change overnight I think there's some really exciting things that are happening because so many people are putting their you know their mind towards this and even people that have done really incredible things historically are now starting to put their eyes towards healthcare um and you know I think that it hopefully what you're going to see is a is a renaissance right a renaissance where um at the same time many people are coming to a real understanding of where health comes from where disease comes from that we have to go upstream you have to go towards more preventive approaches and um it's exciting to just be in the mix of all of that uh because you know because ultimately that's you know that's what needs to happen I'm just picking spots I mean it's uh the problem is so pervasive and so huge that there's an unlimited number of places where people could make an impact if they so desired and they could conjure up the capital expertise and and assets to to go after solving one little piece of that yeah absolutely I mean thank god there's so many of us trying to tackle this and you know I I saw post of yours on Instagram um the other day that you know on on one hand I get really excited when you and I are having this conversation right now and I talk to people like you similar like minds that are are really trying to tackle this issue I get so much hope because I know there's a lot of people um waking up and realizing this is not the way to do it and then I see things like you posted about this on your Instagram how the industry is basically perpetuating these chronic diseases in the way that their the science basically is corrupt now and you posted this thing that basically said something like these scientists are attempting to build a healthy dietary pattern using processed foods and your caption was spot on basically calling out the the current state of corruption in science and how basically what's happening is they're they're paying for these studies and then they're getting the desired outcomes that they want because they you know I haven't have invested interest in the outcome of these studies and they're completely funded by the industry and so when I see stuff like this I get so discouraged because I'm like how how are we going to change this like how do we how do we fix this and how do we how do we get rid of this corruption yeah man well I mean yeah look at I mean it is it is happening I mean I've been aware of this all the way through when I was a university um there was suddenly a burger king on campus right all of a sudden from nowhere from like my second year to my third year there was suddenly a burger king on campus and as as we kind of looked into it and why it was there they had given a bunch of money to like the food sciences division of the university and part of the benefit was now that there was a burger king on campus and so at that moment I was sort of well aware of like well what you think science is is not really necessarily what science is and eventually you know that yeah so I mean I see that and you see it all the way through look the best the best thing that you can do is to do you know do your best to avoid interacting with the health care system almost altogether I mean I think there there is value to understanding your labs and really understanding where your function is right part of the part of the re-education that I I'm in process of facilitating is really an understanding that you know one of the things that's frustrating to people with chronic illnesses is in their mind and in the way that they communicate to the doctor it's like healthy healthy healthy healthy healthy healthy lupus and that didn't go down like that it just seemed like it did because only when your labs hit a certain number are you now classified for lupus but there was a journey if you could if you could listen to the whispers internally and like track some of those symptoms and look back you could see how it was coming and there were some signs it's just that the doctor didn't know you well enough or wasn't attuned to you well enough or you didn't have the right kind of information to see that it was happening and so you know ultimately the journey for each one of us is to understand ourselves well enough to know when something's coming and then to get ahead of it and do something about it and unfortunately that's not something the doctors are really taught to do it's not part of made you know the conventional medical education but there are you know plenty of people out there talking about these types of things and the good news is is that over the last 10 years in every tiny niche of health there is now an abundance of information on on any particular topic so whatever thing that you're struggling with or you're starting to feel with that there's incredible books and podcasts and summits and all that information so it's all there but what's necessary is the implementation of that information taking it from the podcast and that implementation and my recommendation to everyone is that ultimately what that what it's going to take for long term implementation is a community structure around it that reinforces and that healthy behavior so if you know if you can go out understand what you need to do and then try and find a supported group by which to at least weekly be in accountability with if not daily I've told this story a number of times but at one point about a decade ago my mother-in-law lost 110 pounds through over each is anonymous and the only thing that was different is that she had to call her mentor partner to or text them once a day to say what she'd eaten that day that was it that was the only homework and even that like point of accountability where it would have been kind of embarrassing to say I lost it and I went through McDonald's you was powerful enough to facilitate a dramatic change in behavior so that's just one example and we took that actually into heal community and we call it a progress partner where you're paired up with someone else in the group and you're encouraged to connect regularly about what's going on and build that friendship and so yeah we're testing things out we think can really work at scale and we're learning how to make that work but it's it's it's a journey and it's it's progress and you're really you know rebuilding something that used to be part of society right you know you were you were you were almost you were accountable to a lot more people in a much more connected physically and and geographically connected society and we've lost that through technology for sure oh yeah for sure I mean what you just described is essentially why AA is so successful is because they have an accountability partner you know they have that I'm blanking on what they call them right now the yes exactly the sponsor who they have to be accountable to and yeah you're way more likely to hold yourself accountable when you have to also share it with someone else yeah I mean I've found that too when I used to have clients I would have them text me once a day just to kind of check in and everything just to give them accountability and also get to give them reassurance or you know validation or even just like a simple like you can do this you've got this the reminder of like why of why you're actually doing this is also really helpful you know your why is what is going to get you through it yeah so I'm so I'm curious you know because we hear all the time like America really struggles with this and our nations so sick and our healthcare is messed up are you do you guys struggle with this in the UK as well absolutely UK is actually a breaking point you know and has been for the last few years because you have you have the NHS which is the National Health Service started in the 50s and is free for everyone in the country to use and is you know if you go back to when I was getting my education and I was doing health economics like it was held up as an example in the world of best access best affordability you know because essentially you could go and use it for free at any moment right and that was that was where it was 20 years ago but again in the last 20 years you have such a growth of chronic illness that all of the places where then you can like access the care get plugged up right so too much pressure on GPs which are the primary care doctors too much pressure on accident emergency in hospitals because there are just way more people coming in that ever came in because of the state of health add in stress add in you know all the other things that can contribute to it and you have a big issue I want to so yes that is true and even though it's you know a lot of people think in America well if if it was just paid for differently if we had Medicare for all it would solve all this problems and the truth is I think England is a great counterpoint to that but it's not just the way that it's paid for we have to have a way of keeping people healthy at scale right that and facilitating health and I want to give you an example of something in the UK that is sort of meta enough to give you an idea of what's possible but there is a town in the UK called Froome F-R-O-M-E and in Froome two doctors who I've had on my podcast and you know I've spoken to and I've like developed a lot of my thinking on this they realized that they had a lot of lonely people in their community and they got a grant to try something else so they five health coaches because there's five clinics serving about 110,000 people in these you know four towns that this sort of one area and they have those coaches spent half their time in the office like speaking to patients who were who were lonely and then they sent them half the time to go and sit in what they called these talking cafes which were like coffee shops essentially like around the town and then they started to recruit regular people as well who would participate and wear this like green lanyard and the goal was could you take people who are lonely and put them into some sort of structure where they weekly connection on a whole range of topics so they in a year they sourced 2,000 clubs sport staff social staff anything could be anything as long as it was meeting regularly they paired it down to 400 and they created a website so there were 400 different groups church sports everything and essentially the role of those coaches and the role of the people with the lanyards was to engage people who they saw in society and say hey you know how's it going for you hey if you need this and push them towards the website essentially onto one of the coaches of talking cafes and ultimately in a period of four years that they executed that while the numbers on emergency run visits and so forth went up everywhere else in the country in a pretty exponential way in that area it went down the savings just for that city were like I think 20 or 30 billion pounds and you know it's not that much in a in a bigger quick peer review but what it showed was that if you could you know the thing that I like about that story is that not everyone got involved in the town it was optional it wasn't forced on anyone but what you saw is people come out of the woodwork to be of service to each other and what you saw was that the way to solve it was actually in through the health care system because lonely people end up in the health care system and also there's sort of budget assigned to help people in in health care and that's essentially the thesis in my book which is that we need to rebuild community through health care because ultimately lonely people will end up overusing and using health care services but that ultimately it's going to take other people to participate it's not just the sick and the people in health care other people need to stand up and participate and you know when I had the opportunity to connect with you I just felt like you're the kind of person that I think that connects to kind of people through their podcasts that are those kind of people that are ready to make a difference in some way and you know my hope is that through this conversation you know people feel inspired to want to participate in some ways and maybe some of the ideas that have come up today will be the way and maybe it'll be something else that you see in your community that's needed but ultimately the theme is healthy behaviors in the way that disease is either created or destroyed and that's you know what you eat how you sleep how you deal with your stress you know how you move and how you deal with like environment and relationships and then the community structure and the community can be as small as two and as many as you know tens of thousands I mean I got examples in my book of you know ten thousand lonely men eating a plant-based diet in Detroit to try and avoid heart disease so you know there's all kinds of different examples sometimes it's free you know the other thing I would say is one strong advantage if you're looking at where to start look at where community already exists where you could just add a little bit of a healthy curriculum on top because then you're not trying to create both things from scratch right and so I think that there's examples in the book of of churches um you know other community style settings where it's been a lot easier where people were already getting together if we can just add some healthy behaviors and curriculum into it the impact can be transformational yeah well and I think part of what you touched on that's so important is that you know generally speaking humans want to help other humans you know and when we get together in community like that and we see each other struggles our desire is to help the people around us you know and so when when you're in community with with people and maybe you're struggling one time and then you know they're they're all there for you and then you get to be there for them and they're struggling um there's a real power in that and you mentioned this earlier with your men's group that you have my dad has been telling me about this my entire life is that he has had this men's group that he has met with for probably 30 plus years now they've been through deaths they've been through you know disease and lot like you know loss like I said like everything that they could possibly imagine you know quitting smoking divorce and they've been able to my I mean my dad literally told me this maybe a month ago he goes you know something along the lines of I don't know that I would have like survived some of the stuff that I've been through without this community of men that I had in my life and similar to yours this wasn't even like a health care based community it was just general it was just a you know a place for them to all be there for each other and again I just think that's a great um reminder for all of us and for everyone listening that how incredibly important it is for us to be in community absolutely yeah no it's critical and you know some of those things exist and you know if you're listening to this I mean the group that I'm part of is called mankind project there's like chapters all over the country all over the world actually and they have weekends and so forth but I know these things exist for women um I've heard of other you know I know that there are those kind of groups so sometimes those groups can just happen um sometimes those groups have built around particular disease states so I talk about in the book there's a group called healing strong which has hundreds of chapters all over the world and it's for people going through cancer who want to do healthy things alongside whatever treatment they're going through and a support group for people who are all committed to being as healthy as possible so yeah like I I think um you can either find it through a disease that you get to or you can try and get ahead of it and try and avoid that altogether and I think you know it's none of no answers are wrong it's all about it's all about progress and um you know finding finding a group that resonates for you long term yeah for sure and just start seeking out different um maybe activities or places that you will be exposed more to people that you would probably have something in common with I mean I think about there's this natural food store that I love and they have a little bulletin board and it just has all these like events and support groups and you know just all this different information on there and I think that's a great way I also think if you just go on Facebook and just search for groups in your area you might find something you know something that you're into or I know when I first moved to the west side I started going to dog parks more and meeting people there and then another great way is like I mean pickleball everyone's freaking out about pickleball right now and I know that there's little groups popping up everywhere so I think there's there's so many different ways and I just really wanted to give people some tangible examples because I think this is something that a lot of people really struggle with is finding their community yeah I mean you might you mentioned pickleball that I played pickleball on Thursday nights with a bunch of guys too and one of the things about it is that it's kind of so new that no one's that good at it or you know it's just like it's easy to just kind of be part of and it's easy to pick up and I think you know doing something like that can also you know help avoid this sort of sticky early parts of conversations when you know an introvert doesn't want to be with other people when you're doing something that like you can concentrate on whether that be hiking or pickleball or whatever else it might be so I think you know building something around existing healthy behaviors or existing social groups is where it's at yeah there's a hiking club in LA that I love to go to and I made a lot of my friends through that way as well like every week we meet up and we hike I actually haven't been in a couple months but that was how I met a lot of my friends exactly so you're you're based in California too right you're just in the north yeah I used to live in Venice too actually now I live in Northern California you know the healthiest thing that I ever did for my nervous system was to live in the countryside so having lived in New York for nine years and lived in London for that and lived in LA now I have two kids and I live in the countryside and my life is very different but I get the excitement and exhilaration of being involved in you know my day-to-day work and then I can have the calm and and off of you know hearing birds tweet and you know having silence at night oh my god I'm really honestly craving that and I think it's so funny I've been thinking about this a lot recently how for the longest time it was vilified like moving to the country and having land and now all of a sudden there's this switch where everyone wants land and they want to move outside of the city and have more space and more quiet and it's just interesting to see the shift that's been happening and now I've got Starlink so I can now get internet and I live in the country that's amazing Elon Musk he's doing a lot of cool things so I want to ask you a personal question that I ask all my my guests what are your personal health non-negotiable so these are things either that you do daily weekly both that are just non-negotiables for you and taking care of your health so one is we have family dinner so my own family every night and then the extended family we have once a month here at the house so that's you know eating food that we've we've cooked ourselves and eating you know that generally and then my men's group you know and a lot of other healthy things flow from that but it varies depending on what I'm focused on but those two things are mission critical I love that you know you're the first guest that has answered that that family dinners are non-negotiable and that was non-negotiable in my family growing up and I think it was a really important part of of my childhood that I think a lot of people I think it's really discounted now so I'm so glad that you brought that up because I think it's really important when I have kids that's going to be something where it's like a non-negotiable like sorry guys like Monday through Thursday dinners at home we've got to eat as a family that's cool yeah it's healthy yeah it's very healthy well please let everyone know where they can find you where they can find your work your book yeah actually so you know I retain the rights to my book the community cure so that I could give it away on audio book for free so you can get it on audible but and other places but if you go to the community cure.com slash audio book you can download the audio for free on an MP3 and you can listen to the smooth sounds of James Maskell whenever you want and that's you know it's written for like my goal with that book was actually written for health professionals and and actually health systems to adopt this type of type of care but yeah Instagram is mr. James Maskell and I you know if you just I'm James Maskell.com you can see all the different things that I'm involved with I've got I've got quite a few different areas that I'm involved with really because it's not a single solution right there's not one single solution and I like to keep myself a little bit involved in working with doctors who are delivering new models of care because I learned a lot from that and then I can take those learnings into when I'm talking to health systems so I have quite a few different things going on but yeah you can find out all about it changemaskell.com. Awesome thank you James this is a really fascinating conversation I haven't really had a conversation about community from this lens and I think it's really important and will hopefully be super inspiring for people to hear this so thank you for your time. I hope so too thank you. Thank you so much for listening to this week's episode of the Real Footballogy podcast. If you liked the episode please leave a review in your podcast app to let me know. This is a resonant media production produced by Drake Peterson and edited by Mike Fry. The theme song is called Heaven by the amazing singer Georgie Georgie is spelled with a J. For more amazing podcasts produced by my team go to resonantmediagroup.com. I love you guys so much see you next week. The content of this show is for educational and informational purposes only. It is not a substitute for individual medical and mental health advice and doesn't constitute a provider patient relationship. I am a nutritionist but I am not your nutritionist as always talk to your doctor or your health team first. Looking to build a more robust foundation in your health and well-being. From the producer of the Real Foodology podcast comes one of the most popular alternative health shows on Apple podcasts. The Dr. Tina show. 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