Episode #14: What Support Is Going To Make This Patient Relationship Successful? With Dr. Lauren Munsch Dal Farra

Much of our healthcare is built upon the transactional framework – the patient comes to the hospital, gets admitted, and is subjected to medication and medical procedures to cure whatever ails them. At PALM Health, an integrative medicine and wellness center in St. Louis, Missouri, clients get to have a whole new experience with its patient-centered philosophy and personalized care that is based on a deep understanding of what the patient needs. Dr. Lauren Munsch Dal Farra, founder, CEO, and a physician at the center, joins Betsy Westhafer and Tony Bodoh on the show to talk about the way PALM Health conducts its operations – from its navigator program for patient experience optimization to its varied services that combine the best of boutique medicine and integrative lifestyle medicine. Join in as she shares the center’s approach to healthcare and how it has successfully shifted its services in response to the COVID-19 crisis.

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What Support Is Going To Make This Patient Relationship Successful? With Dr. Lauren Munsch Dal Farra

Knowing The Patient Means Having The Time To Listen

Our guest is Dr. Lauren Dal Farra. I’m excited about this interview because Dr. Lauren is going to take us through how she has built a holistic practice that focuses on understanding healthcare from a relationship perspective as opposed to a transactional perspective.

I’m excited for this interview, Tony. It’s such a time of evaluating one’s health with everything that’s been going on. I’ve been digging into a lot more detail. What her organization offers is so exciting and the approach they take. I’m looking forward to diving into this one.

I love that we have this opportunity to look at healthcare as we’re going through the COVID-19 crisis, a pandemic, because there’s been a lot of changes very quickly in a lot of businesses and healthcare is at the forefront of that. I know we’re going to dive into some of those topics as well.

Without further ado, Lauren, welcome to the show. We’re glad you’re here.

Thank you for having me.

Lauren, to let our audience know, you are a Cardiologist and the CEO of PALM Health, which we’re going to get into a discussion about what you do there and how you do it more importantly. Tell us more about your career path and how you as a medical doctor have now become a CEO.

My background is similar to most physicians. I went to medical school here in St. Louis, where I grew up. I went on to do an internal medicine residency at Washington University School of Medicine here in St. Louis. I went on to do a cardiology fellowship at New York in Mount Sinai Hospital. Along that path of my traditional medical training, one of the things that stood out to me was that patients would come in again and again, with the same symptom, the same problem and that our system didn’t have a means of being able to address the root cause of that problem. Nor did we have a real comprehensive platform to not only give patients the tools and resources to change their lifestyle in a meaningful way, or to develop an elevated level of consciousness that helped them change their behaviors. We also didn’t have a platform to build relationships truly with our patients. That is what led me into creating PALM Health, which is the outcome of something that I wanted to provide patients as a physician and something I would want to experience as a patient as well.

Tell us at a high-level about PALM Health and why it’s different?

The medical system only allows 10-15 minutes with the patient. That was not enough time to connect with my patients.CLICK TO TWEET

PALM is an integrative medicine and wellness center where under one roof we combine a multi-specialty medical practice. The backbone of that practice is our primary care physicians. What is unique about those primary care physicians is that they are also trained in functional medicine, which helps us develop skills and tools to get to know our patients at a genetic level, behavioral level, how their mind is working together with their body, look for root causes of different disorders and illnesses, and then put together comprehensive treatment programs. Within PALM, we have a comprehensive component of experts in fitness, nutrition, coaching, counseling, as well as the lifestyle platform of a personal training gym, a fitness studio, movement studios, we have a number of different wellness therapies and then a healthy cafe to help support people in their nutrition.

It’s truly a lifestyle approach to it, which I love that idea because one of the biggest challenges that I’ve seen when I’ve worked with other medical practices, is that being able to go from one specialty to another means I typically have to leave the building, set up appointments, go through the whole process again and again. It could be in different areas of the same city. It could be in different cities, depending on what I need to get to. What you’re providing is so revolutionary in the medical space. When we say revolutionary today, it will be evolutionary from the perspective that a lot of other companies and organizations are going to move that way. Talk to us a little bit about this idea. It was one of the things that moved you also in this direction, which was healthcare is often like transactional and you were sharing with us how, in your mind, it’s about a relationship with the patient.

Much of the different illnesses and conditions that our patients are dealing with now, the root of those problems are lifestyle and stress. To get to the root of those problems and help address them and help people make meaningful changes in their lifestyle, we need to know our patient at a deeper level and part of that knowing our patient piece comes simply into the fact of having the time to spend with them, to listen to their stories, hear where have been the obstacles in their ability to make substantial and sustainable changes in their lives. Our medical system and the way that I was practicing allowed for no more than 10 to 15 minutes with a patient.

That wasn’t enough time to help me understand, not only why do they have high blood pressure, but why weren’t they able to consistently take their medications or change the way that they were eating or address all the different mixed messages that they were getting in the community about how they should be eating and how they should be exercising. Not only was there a lack of ability to connect with my patient, but the fragmentation in the lifestyle and wellness space of all the different messages ranging from you should fast for eighteen hours a day to you should eat every two hours to keep your metabolism going was so fragmented. I went in to put together a team of experts across nutrition, fitness, coaching and counseling and mental health that allowed us to comprehensively be an expert in that space. We customize our recommendations to the individual so that they were getting the best plan that met their needs based on their individual circumstances and to not have so much noise and confusion amongst the different recommendations that my patients were getting.

That’s key. There are many messages. With the internet, Dr. Google can mess people up as far as being able to access so much of this information that may be completely irrelevant to their own healthcare. What strikes me is in our vocabulary, we talk about patients, but you’re a CEO and these are your customers. That’s why it’s exciting to hear you talk about really knowing your patients because the equivalent in the business side is knowing your customers. Talk to us about your mindset as a CEO and how you have a big commitment to your patients, but how tactically you get to know your patients at a deep level.

Our process is unique for a medical practice in that first encounter with PALM Health starts with somebody who’s called the navigator. Most of our navigators are trained as well-being coaches. Their background is understanding how to look at, talk to a person, develop that relationship and understand what their needs are. Why did they walk through the door? Are they looking for a proactive approach to prevent a problem? Did they get hit with a major life diagnosis and they’re looking for all the tools and resources to address that and improve the quality of their life and the quality of their condition?

Our first interaction starts with a navigator that works to identify our client’s goals and what it is that is motivating them to come into a place like PALM Health. Are they more interested in the lifestyle components or the access to a medical team that will call them back for all their acute needs in a timely basis and help them put together a personalized plan? Once our navigators go through that process and identify our client’s goals, they help match them with the medical provider if that’s something that they’re interested in that would be best suited for them. Often, they do a meet and greet with that medical provider, which is like a mini consultation, to make sure that each side feels like they’re a fit for each other.

Oftentimes, someone might come in and initially based on what they’ve said, they might fit in one box, but when you get to know them, and we understand that they are busy in their life and they need to have appointments that are outside of the traditional clinic time and have someone available for them on Saturdays or after hours that may be a different provider. Everyone’s needs are varied. It starts with understanding what’s going to be the support that will make this relationship successful. Those navigators need to know our different providers so they can make that best match. Once that match happens, that navigator is there for helping optimize the experience for the patient or the client. They are making sure that if there are issues that come up along the way, that they feel supported and that they always have a place to turn to through each step of their path with us.

Patient Relationship: We need to know our patients at a deeper level to get to the root of their health problems and help them make meaningful changes in their lifestyle.

I love that approach because it’s like having an account manager for a patient where you’ve got somebody quarterbacking, all the services, looking for red flags and all those kinds of things. I love that approach, especially, as somebody who’s been there trying to do the navigation myself. To have somebody that understands the infrastructure, the network and the ins and outs would be a tremendous asset for your patients.

It’s the number one thing that we hear over and over again from patients is how important that navigator relationship is to them. Our patients also form strong connections with our physicians, their personal trainers, their massage therapists and with their counselors but knowing that there is a single point person for them to contact and help keep a pulse on all those different recommendations and “navigate the system” so to speak is a tremendous benefit.

One of the things that allows you to do this is the way you’re set up. You’re not just a practice that has a lot of different specialties, but you are a membership-based organization. Talk a little bit about why you decided to go that way and how that’s benefited your members?

We decided to take a membership-based approach because of two factors. One, it allows us to keep the level of quality at the level we would want to deliver for patient care. How it does that is it allows us to take all these services that insurance doesn’t reimburse for, including that coordination piece, really understanding the wellness recommendations that are coming through, helping people follow through with their plan, being a point person to hold people accountable. All of those soft skills that are not transactional in patient care, that’s what that program is there for.

Our physicians want to make sure that they’re in a relationship that is two-way. This is not about our physicians giving recommendations, but they’re giving recommendations to people who want to make substantial lifestyle changes or have made substantial lifestyle changes and want to maintain them or who are already living very healthy and want to keep that health safeguarded or who want to understand what is the best way to maintain comfort and quality through a significant new diagnosis or an old diagnosis that’s come back. That spectrum is so varied across our patients, that the skills that are necessary and the support that’s necessary to be there for our patients in all those different ways requires a substantial team of people to take care of them.

When they’re committing to something like a membership program, whether it’s a one-year commitment, they’re also making that investment into their own health. There’s a motivation for them to also give to that relationship. It becomes something that they want to be accountable toward. You see that often with people who take a personal trainer. It might not necessarily need to be because they need the same trainer to show them the same exercise for the 100th time in a row. They take that appointment because it holds them accountable to showing up to an appointment in the middle of their busy life. It holds them accountable to following through with a goal that they’ve set out for themselves.

In the same way, that’s often the type of infrastructure and support that a membership program provides is you’ve inscribed, you’ve committed to following through with something. Now, you have an accountability partner. You have a community. You have a connection and that connection might vary throughout the course of your experience with PALM. You might feel more connected at one point in time to your personal trainer and your nutritionists, and another time to your doctor and another time to your coach. You know you have that entire support system that’s going to rotate around you, depending on what your need is at any particular moment.

You hit on something important about that human connection. As we record this we’re right in the throes of COVID, isolation, locked down and all of those things. People are craving that human connection. That’s a key component, but talk to us about how you’re doing business with the inability for people to come in and out back in the old days and how you’ve adjusted your business to more of a virtual model.

When you’re in a crisis, it’s amazing how much people can accomplish in a very short amount of time.CLICK TO TWEET

It has been an interesting time and one of the things that COVID has prompted is the drastic switch into a more telemedicine and telewellness service platform. In a matter of just a couple of weeks, we had launched over 80% of our services onto a digital platform, which not only included our medical visits, but also included our personal training, our nutrition counseling, our wellbeing coaching, counseling as well and mental health component. We’re all experiencing the technical glitches that come along with that. The fact of the matter is that people wanted to keep that connection, that relationship, hold themselves accountable to the appointments, whether they were personal training or medical follow-up visits.

We’ve been able to adapt quickly. I’ve been extremely impressed with our team and all the different ways that they’ve been able to roll this out including getting meaningful engaging content. We have an on-demand class library that we launched. We have on-demand classes for people to go in live within a structure so that they can experienced that sense of community, of all being logged into one place at one time, doing different components of their lifestyle, whether it’s meditation or fitness. I think a number of these practices will stick with us.

It’s also been interesting because certain people were traveling when this started and stayed out of town. Now these virtual options, we will continue them moving forward into the future to give people more connection points. We’ve launched entire programs like our stress management program virtually that has enabled us to expand outside of our local St. Louis area and be a pillar of support to people. Members have family members in other states that they’ve said, “Can this person join and start on this program?” It’s been pretty remarkable to watch, not just how our own community has come together and decided that this is something they want to continue their commitment and it’s part of their daily lifestyle, but how they’ve also now folded their families into that process as well.

Was that part of your initial strategy to get to a virtual model or was this born out of necessity?

It was an ideal that probably would have taken us a lot longer to accomplish as we started putting these pieces in place. When you have a crisis, it’s amazing what people are able to accomplish in a short amount of time. I’m very proud of our team.

It’s been interesting as we’ve talked in various conversations, hearing how the company has evolved because you’re not that old of a company, and yet you’ve come a long way. This talk about the telehealth and what you’ve done there has been impressive. As we were prepping for this, you were telling us about how you’ve amped up the patient feedback side of things and understanding that service excellence part. I’m wondering if you can talk a little bit about maybe where it was a few years ago, where you are now, and how that’s helped you understand what your patients want and need? How you innovate and bring new services to the table and maybe phase out some things that are no longer as needed?

When we opened a huge part of what we saw in the industry was that two models were emerging. One was that concierge, boutique medicine, ability to access your doctor by cell phone when you want, get a quick call back. That access point was important for clients. The other component that was important and starting to emerge was this strong desire to have a whole person functional medicine and integrative medicine approach that brought in traditional allopathic, Western medicine, as well as other forms of complimentary alternative medical therapies and endless resources and offerings. Neither of those offerings were together under one place. What’s been interesting for us as a company over the last four years is to see how people, depending on their external environment, are often sometimes favoring one over another.

Sometimes the access point whether it’s to any provider is more important. Sometimes people are focused on that whole person plan and getting the support needed to sustain that plan. Finding the balance points of being able to deliver quality, personalized care with a lot of high touch, accessible, convenient points of access for people has been a balancing act for our company. In certain times, like within COVID, now more than ever people are looking for the ability to know that they have an access point to their provider in the event that they get sick or a family member gets sick.

Patient Relationship: COVID-19 has prompted a drastic switch to tele-medicine and tele-wellness.

That sense of security, we’re always vulnerable to illness and we’re always vulnerable to unexpected life circumstances. In the middle of the pandemic, you’re aware of how vulnerable you are and how many people count on you, whether that’s your kids, your wife, your husband, your business, your employees, your dog or cat that’s at home. All of a sudden, your sense of accountability to other people becomes a lot more paramount. Both that need for access and that need to be healthy and proactive are prominent right now. What’s unique about PALM is that we’ve constantly been balancing how do we provide both and how do we give people all the access points that they want within a timely prompt fashion and as the pillars of support, but how are we also pushing people to be proactive about their health and to take control of it? That’s been the balance point we’ve been working with since we opened and improving on and it’s the constant dialogue. It comes back to that each and every time is how can we improve on those two points simultaneously to deliver the best healthcare possible?

When you talk about the balance between those things and I love your insight on this, how do you balance that fine line that we’re all walking between being proactive, but not so much out of fear? That whole fear thing adds so much stress, which obviously is not great for your body, but you have to have some element of what’s real and what’s going on here. How do you work with your patients to manage stress while at the same time saying, “This is something you need to be paying attention to and be proactive on?”

That’s a great point because any time that we make huge life changes or life decisions out of fear often they are, first, not sustainable when that fear wears off. Secondly, that fear is a stress component. The most important piece about that is maintaining perspective. That was the first piece that we went out with to our patients is keeping the perspective in a time like COVID of, yes, we are in a pandemic and we have a highly contagious and infectious virus, but certain people will be more susceptible or more prone to the adverse effects of it.

Here are the things that you can do to prevent getting it. Here are the things that you can do too if you do get it to prevent having as severe acute symptoms as you might have. Keeping in mind that although there are a lot of deaths, we forget that the reason that we isolate in this way is to not overwhelm our healthcare system, our hospitals, our ICU beds, because we do have a largely vulnerable population of elderly and immunocompromised people. First and foremost, it’s about helping people maintain perspective and helping people understand that if they do the things that helps their bodies in all the ways that they can, they’re going to be in a less vulnerable position if they are to become infected with the coronavirus.

We also like to share stories of hope to keep that fear and stress down. My 90-year-old great uncle had coronavirus and a number of residents in his building and unit. He immediately started taking supplements and he said he turned a corner. Right away, he could feel a difference with his energy levels. He is someone who has always practiced a healthy lifestyle, taking walks and eating healthy. That is important to keep down the overall levels of inflammation in your body. Whether it’s this virus or something else that comes through diet, through exercise, through meditation and mindfulness and become resilient. It’s about cultivating that perspective is be resilient through healthy practices versus being reactionary.

I’m intrigued as we talk about this and I’ll play off the last point you made there about not being reactionary. The culture of your organization has been amazing to watch how it’s developed. I’ve known you for several months now. As we’ve gone through different conversations, seeing how it’s evolved and the thing that fascinates me most is you’re always on this side of learning, growing and understanding how you can do things better.

One of the pieces that stands out is that early this year, you went from this model of understanding, getting feedback from everyone in the organization, maybe on a monthly basis to structuring that so you’re getting it more like a weekly basis right now and using that to craft where do we go next? How do we handle the next thing that comes up? This was before COVID-19 and all the other things. It’s like, you’ve got yourself in a position as an organization to respond to what’s happening now. That’s going to make you stronger going forward. Talk a little bit about what was the logic or the reasoning behind moving from this, maybe a monthly review cycle that may be less formal, to something that’s formal and structured?

The most important impetus for that is that service is at the heart of what we do. As physicians, as nurses, as medical assistants, as personal trainers or a reception staff or a cafe team, at the heart of what we do is service. Striving for service excellence is critical to our mission and to making sure that those relationships that are there are trusted relationships and that our patients and our clients can count on us for their needs. Keeping that value in mind, it’s important to me that that value is at the forefront of our team leads, our managers and our staff.

What people need now is a balance between having easy access to healthcare and being proactive with their own health and wellness.CLICK TO TWEET

It’s very easy in an organization and especially in a time of a pandemic to get distracted. There’s a lot of noise. There are a lot of worries and concerns so it was very important. It was prior to COVID, we set this up and I’m glad that we did, because it’s allowed us to stay very focused during this time. We have a service excellence team that’s comprised of our different department managers, team leads, and then some of our navigators and various other staff who keep a tight pulse because they have frequent client interaction. We meet every week. It’s an opportunity for them to bring to the table any things that have been going well, any new trends and any complaints.

Our clients are vocal and we give them a lot of avenues to give us feedback. It’s important that we stay on the top of that feedback because if there’s a small glitch that we don’t know about that only someone in a back office is hearing about because it has to do with an app or something, we don’t know about it. We also don’t know how the rest of the company is addressing it. For us to all be on the same page, what stood out in my observations of our company is that at the heart of service excellence was communication. It was important that as long as we were communicating with our clients, that we know something, we’re taking care of it, here’s how we’re handling it, that then we had a trusted relationship. That goes in two directions.

This is a platform for us to hear about anything new in terms of what’s going well because that’s motivating and it makes people happy, what’s not going well. For our managers to update the different teams so that they can bring that back to their departments on here’s an issue that we’ve identified and here’s how we’re handling it so that anybody is empowered in the company to be able to communicate that to a client who brings that feedback or has that question or concern. These meetings are the tool of keeping us on the same page, keeping us communicating with our whole company and communicating with our clients, which at the end of the day is the most important ingredient I see for service excellence.

I love everything about what you said for multiple reasons but the internal alignment, making sure that everybody on your team is flying in formation on behalf of your patients, is critical. One of the things that we work on in the business that I’m in with customer advisory boards, we don’t want our executive team clients going out in front of their customers and not singing from the same song book. That makes them vulnerable and also erodes that trust to your point. That’s such a great model. The fact that you are listening and incorporating the customer feedback, the patient feedback, is one of the most important things a leader can do. Kudos for that.

As we wrap up, one of the things we’d like to do is give our guests an opportunity to give a shout out to a nonprofit or a community organization that you may be involved in. We understand that you started a nonprofit yourself. Why don’t you tell us a little bit about that organization?

Thank you. I’m always happy to have an opportunity to talk about Anthropedia. It’s a nonprofit organization that I cofounded back in 2004. It focuses on wellbeing education. That nonprofit has a very robust training program that is available to a number of different helping professionals, whether they be coaches, counselors, social workers, people who have interest in medical education or mental health education. Now we’re opening up that platform through different levels of training into college undergrads who have an interest in becoming wellbeing coaches. That coaching program not only focuses on basic lifestyle components of health coaching, which is in coactive coaching techniques, but we really focus on helping people cultivate elevated levels of mindfulness, consciousness and understanding their thoughts and their outlook, which is an important component of behavioral change. We train trainers all over the world. Those people work with clients on a mind, body, spirit approach to cultivating better lives and increased life satisfaction and fulfillment.

What’s the best way to find you and PALM Health?

The best way to locate PALM Health is through our website, which is www.PALMHealth.com. From there, there are different access points to connect with a navigator. That’s always the best place to start with PALM.

Dr. Lauren, it’s great to have you on the show. The things you’ve shared, we’re going to take away from this, and Betsy and I are going to talk about because there’s some key elements here that we need to be able to bring to other medical professionals and practices. Things that you have mastered. I find that awesome and inspiring because of you being a visionary. We love having visionaries on our show and you definitely hit that category for us. Thank you.

Patient Relationship: PALM Health delivers personalized care by utilizing the best aspect both the concierge, boutique medicine approach, and the integrative medicine approach.

Thank you for having me. For all the guidance in the sphere of customer relations and customer service that you’ve been able to provide throughout the time we’ve been working together so thank you.

Thank you, Dr. Lauren. Thank you, readers, for being here again. We hope you were able to get as much value out of this conversation as Tony and I did. This was very enlightening and inspiring. I hope so much that this is the wave of the future because we do need to be a healthier country. I’m excited that these kinds of things are happening in the healthcare profession.

I absolutely love having Dr. Lauren on the show because she took us to this place that I don’t think we’ve been yet. We’ve talked to other people in the healthcare and benefits space, but not like this. She is revolutionary. She’s on the edge of what’s happening. From the start of the organization, listening to what is it that patients want? What is it that they need? How does she create a model that supports that? It’s been fascinating to listen to this whole conversation and take away. One of the biggest pieces that stand out to me, I want to go back to that is for them, it’s all about the relationship. It’s not about the medical transactions, not even about necessarily the disease or the sickness. It’s the relationship, it’s the human person that matters. When you talk about really knowing your customer, that’s what it’s about.

I love people like Dr. Lauren that are so visionary and not willing to accept the status quo and shaking up a model that’s been around for a million years. I personally get excited about this because something’s got to change with the way we’re all living our lives in terms of our health. I’m hoping that the combination of the pandemic plus these new models for healthcare delivery will get us to a much better place. I feel certain that there’s somebody out there that heard this show that is going to get something that could be life changing for them. That’s exciting. Thank you, readers, for being here. We’ll see you next time.

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About Dr. Lauren Munsch Dal Farra, M.D.

Inspiring an upward spiral of change to ignite growth and improve quality of life is the invisible thread connecting CEO Lauren Munsch Dal Farra’s visionary leadership across multiple business ventures.

Lauren knows that while everyone wants optimal well-being, cultivating the awareness and behaviors that contribute to sustainable health is hard to do. Enter PALM Health, innovative home of a multidisciplinary team of experts in wellness and medicine that she founded in 2016. PALM addresses the problem of the current healthcare crisis by diagnosing and treating the whole person- body, spirit, and thought- in the context of their environment. At the core of the PALM model is highly accessible, personalized support and meaningful relationships with a wealth of providers. Over four years, innumerable PALM clients have shared stories of the kind of transformation Lauren has always known was possible.

As a leader, Lauren has cultivated an environment of collaboration, innovation, and commitment to service excellence in which staff and clients thrive together as a community. She has been featured in numerous articles and podcasts highlighting her vision of and dedication to empowering individuals and communities to grow in well-being. In 2018, she was named as one of St. Louis Business Journal’s 40 Under 40 Top Business Leaders.

In addition to taking PALM Health from concept to reality, Lauren’s entrepreneurial success includes co-launching two business ventures in other fields: BCDF Pictures, an independent film production company, and Statement Advertising, which creates trailers and posters for film and television. She is also a Board Certified Internal Medicine Physician who completed medical school at Saint Louis University and her Internal Medicine training at Washington University, then excelled as a Cardiology Fellow at Mount Sinai Hospital. During medical school, Lauren co-founded The Anthropedia Foundation, an educational organization that teaches individuals, professionals, and non-profits ways to cultivate mental health and well-being in order to decrease rates of lifestyle- and stress-related illness. Anthropedia has built partnerships with Saint Louis University and numerous national non-profits and has developed training centers in France, Sweden, and New York in addition to St. Louis.

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