Is Our Healthcare System Really "Health Care" or Illness Care?

s our healthcare system actually helping people get healthy, or are most of us only getting care once something is already wrong? In this episode of The Hoel Truth Podcast, Emily sits down with Stephanie Owen, a family nurse practitioner, psychiatric mental health nurse practitioner, and integrative practitioner, to talk about functional medicine, lab testing, supplements, and what it can look like to focus on optimizing health instead of only treating illness.

Stephanie shares her journey from massage therapy to nursing, palliative care, functional medicine, and opening her own practice. She explains why she believes deeper testing, education, lifestyle changes, supplements, and personalized care can help people better understand what is going on in their bodies. The conversation also covers vitamin deficiencies, methylated vitamins, vitamin D, thyroid markers, cholesterol, mental health, hydration, sleep, walking after meals, and why supplements should be reviewed by someone qualified before taking them.

This conversation is not medical advice, but it may help you think through better questions to ask about your health, your labs, and your long-term quality of life. If you are feeling tired, not like yourself, or just want a better understanding of your baseline health, this episode gives you a helpful starting point.

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Transcript

Stephanie, what do you think about our current health care system? 

I don't think it's health care. It's actually, I would call it something else because people don't go to the doctor to get healthy anymore. We only go when we're ill, right?

Is it health care or is it illness care?

Hey, guys. Welcome back to another episode of the Hoel Truth podcast. Today we have a local nurse practitioner, Stephanie, with us, and she's just going to be answering some questions and telling us a little bit about herself. So I guess I'll get started. Just introduce yourself and tell us a little bit about your background.

I'm Stephanie Owen, I'm a family nurse practitioner as well as a psychiatric mental health nurse practitioner.

Then I got certified in functional medicine. So I'm considered an integrative practitioner, which means that we have all of the options available so we can prescribe medication of course, but also supplements, lifestyle modifications and do quite a bit of deep prescribing. So getting people off of prescriptions that they don't like the side effect panel, for instance. Now I know that you back when you were first starting, you were into massage therapy.

So what made you go down the path of being a nurse and then becoming a nurse practitioner?

So I started out as a massage therapist back in 1996. I opened my office in Milroy in 97 called Healthy Habits Massage Therapy. I worked quite a bit in the Amish community at that time, and ended up delivering quite a few babies before I found out that I wasn't really supposed to be doing that as a massage therapist.

So I decided to go back to school, and I got my license as a registered nurse to begin with, and then went on to become a nurse practitioner with full prescriptive authority, then decided that I definitely needed that psychiatric mental health piece as well, because of the connection between the mind and the body. Now, what would you say like was your determining factor of I just want to work for the hospital, being a nurse and then going out and taking that risk of doing it on your own.

So after I was double board certified as a nurse practitioner, at that time, I was working as a palliative nurse practitioner in one of the large Indianapolis hospitals. And I used to say that my job was the one that no one wanted. So as a palliative nurse practitioner, I would review cases and then go in to speak with the family as well as the patient, if they were able about whether or not there was any chance of this being beneficial care.

And oftentimes we would have to remove life support, and I would have to write orders to keep that patient comfortable as they passed. So that role for seven years was very stressful and took a toll on my own health. Of course, psychologically, it was just devastating to watch that many people die. And so often going through traditional medicine routes to try to fix my own health, and going from one practice to another, as well as other providers at the hospital.

That's what motivated me to look into functional medicine. And finally, I, I got healthier and I wanted to get involved quicker. So we all went to live longer. But I think the big problem is we also need a better quality of life. So if we get involved much, much earlier in look to optimize health, then we get both, we get a longer lifespan and we get a much better quality of life.

And I just couldn't keep that to myself. So my husband tells me that I would make a terrible employee at this point because of all the hoops you have to jump through for insurance, all the quotas, the very limited time that you get with patients when you work in most offices. So

I decided we would just do it our own way and open our own practice.

That's great. There's several people in our office that see you now, and I know that we've been seeing you for over a year, and it was really surprising that the labs that came back, that the vitamins, just that you would think not normal people would consume through their diet would be there and then how low they are. So just doing those simple labs and then adjusting those vitamins and nutrients that we are getting like that made a huge difference for us.

So I know that a lot of people don't take that into account. They just think I'm tired. I feel just not my not myself every day when I wake up. But is there's something that they could shift just one little tweak that they could make like instantly that might make them feel better or just some guidance on that.

It's it's really different for everyone. Emily, as you know, and and your crew here at the company, they're really amazing the the changes that they've made. It's been so much fun this past year to watch. Just the journey that not only you and Bob, but your employees have made. It's been remarkable and we've been really honored to be a part of that.

So thank you so much.

As far as just the public in general, one thing that everyone can do is check their multivitamin if they're taking one and see if they're methylated vitamins. The statistics vary depending on which source you refer to, but most say that about 40% of the population can have trouble methylated. So if you look at your vitamin, for instance, and it says folic acid, it should say folate, that's the sign of a better vitamin.

If it says cyano cobalamin for the B12, you want that to be methyl mean. You want it to be pre methylated. Along the same lines, people tend to think that enriched grains, fortified cereals, that those are healthy. But that same percentage of the population that has trouble methylated, those fortified and enriched products can actually make them irritable or moody.

So those are general things that people can look at and, and watch for. Okay.

Now, if somebody wanted to look into this for their health to optimize it or just check like, hey, I want a second opinion, how would they go about getting your information or getting a hold of you to set up an appointment to maybe just go over check labs and go over stuff like that?

Great question. We have not been online whatsoever. Actually, we we don't even have a sign out yet and we've been open for 30 months. We've been too busy and we weren't trained in logos or marketing. We're really great at health care and that's about it. But our our phone number is widely available. I do believe we're on Google Maps at this point.

Maybe we can have the phone number posted below this for people's convenience, but basically our office works mostly through text messaging. When they text, we ask for their email and we send them an intake form. As soon as they have that intake form done, we set up an appointment to review with them and offer various tests. You referred to the testing, and our testing really is a key part of our practice.

I spent probably 3 or 4 months before we opened our doors at all, negotiating the cheapest prices that we've been able to find, and we charge our customers the same that we pay ourselves to do any of our testing. So we draw our own labs. We also do the more functional testing, which consists of other bodily fluids other than blood, and those kits get mailed back.

And then as soon as the results come in, we do a review of findings appointment. So those appointments reveal so, so much. And I tell people that even if they feel great, it's a good time to get a baseline assessment because typical ranges are so broad. They're made for millions of people. So if you think you're feeling good, that's a great time to have things checked so that when you start not feeling so well, you have something that you can refer back to.

Here's the target for me. This is what I need to feel good, but even more so for optimal ranges. Those are much, much smaller. And that's what we look at as functional and integrative providers, is whether or not the person is within a range that isn't going to mess up some of their other values. For instance, when people find they have high cholesterol, they're told to go home and eat a healthy diet - that never works, not because they don't do it, but because it's typically the thyroid that's affecting that cholesterol panel.

But as providers, we're not usually trained to look at that. So we try to get to the root cause of what's going on. And that's how we're able to order so many less prescriptions do so much with supplements, which, as you know, I've worked with also for 30 years, along with my massage therapy practice and get people feeling better in months instead of years.

Yes.

Well, and you mentioned the price and the cost, and I feel like a lot of people shy away from going to get testing because even if they have insurance, like there's probably going to be something billing wise put back on them. And if they are feeling some quote unquote normal or healthy, they're not going to go and spend that money if they think nothing's wrong.

So I feel like that is a great opportunity that you guys are presenting for people. If they just want to get tested just to see, then it's not going to cost them a fortune just to get checked out. And a lot of people, hospitals, I know that they won't even test for certain things if they don't see a reason for doing that.

So I know you guys are doing your due diligence and doing more educational research in regards to that, and it's different for everybody. And you know that those or those parameters that they have on lab results now are for, you know, like you said, millions of people. So I think that's great that there's that opportunity that people can you know what, I'm not feeling great or I just wanted to get double.

I want to get tested just to check, just to double check. So I really think that's a great opportunity for people around us that they can they have that option. Now, I know that you and Jim work together in like me and Bob work together. How how what are the some of the difficulties that you present itself, but also like the positives and the great experiences you guys have working together day in and day out?

So as a couple, of course, we we're both family nurse practitioners, I should say that. But any of the psychiatric realm, that's really my world. So he did not go on to get that additional training, and he prefers to be left out of it, which is fine. On the other hand, while I was trained to do all of the the sticking and the needle skills, I don't like that part at all.

So Jim does our urgent care appointments and he also does all of the lab draws. So I'm always grateful for that. I'm kind of the the mind behind the labs. So I do all of the ordering, most of the interpretation just for our patients comfort. He tends to take care of the men's hormonal optimization, although he does quite a bit of the women's as well.

It just depends on who's available, how quickly they want to be seen. And in my experience, I think also a lot has to do with how long they've been coming to the office. Once someone's been there for a while, as you know, the customers tend to be comfortable with either one of us. It's just whoever's available. And also it's very common for either one of us to call the other and kind of do phone a friend, put it on speakerphone so that we can do collaboration right there with the patient, and we can all chat together.

Yeah. We had actually that you mentioned that Jim came in yesterday and looked at Riley's finger and did an urgent care in here. So that was pretty nice. And it it's nice that you don't have to go to the E.R. and sit there for, you know, however long and if it's, you know, not something too serious and. Whoa.

Should I get it looked at? What do you think? So it's nice to have providers that actually care. And like you said, they're not trying to hit that quota and push you out or just go down there to see them just so they can hit their numbers. So it's really nice to have people that actually care and want to see your health better and take care of you.

And you're not just the next number and not just the next patient. So I'm really grateful for that. It's excuse me, Emily, it's actually a lot of fun because we do get texts and phone calls now. Sometimes it is round the clock, interesting hours, so it's not always fun. But last night, we received a call around 9:00 from one of our Amish patients, and there was a toddler who had a cut that needed to be sutured.

So they were very appreciative, especially being Amish, to have someone willing to drive out to the house at 9:00, take a look at a toddler's chin, and have the supplies and do what needed to be done. Yeah, that's nice. And just you guys being able to offer that to them because obviously they they needed to go to the doctor or something.

They got to catch a ride and that's just a whole nother stress level for them. So that's a nice opportunity that you offer for them to and it's nice that you and Jim can work together on like what his strengths are versus like what you like to do. And then you can collaborate together. So that's very helpful.

And to have kind of have each other's back so you can work, work together. So now if you weren't in the nurse practitioner realm, what what do you think that you would be doing career wise? Oh, that's a hard one. I've been down this path for so long now.

Goodness, you've almost got me stumped. I will say when-when I first started, I guess I started with the supplements and then received my massage therapy training because I noticed that a friend of mine, when we would be together and we would run across someone and I would say, how are you doing? And they'd say, oh, I'm fine.

And she would say, yeah, how you been feeling? And they would tell her all of their aches and pains. And I thought, oh, I want that information. So I got my massage therapy training and then just kept going as we discussed. So I was so young when all of that started. I guess prior to that, I actually was looking at going to school for for pharmacy.

I thought about being a pharmacist, which I haven't thought about now in a long, long time, because when I started working bedside in the ICU as an RN, I knew so much more about supplements than I did medication at that point. And luckily now as a nurse practitioner, of course, that's much more balanced.

But if we go back further than that, I was always told in junior high I would either be a doctor or an English teacher.

Would you like to be an English teacher? No, no, I wouldn't like to be an English teacher. My my text. I try to be grammatically correct, but other than that, no. Now, I think those days are long over. Well, you're sort of like a teacher now because you're teaching people about their health. So, I mean, I guess it ties into each other.

There you go. I hadn't thought about that, but you're so right. When we started the office, we would go to Mexico a couple times a year for some of the functional medicine masterminds and conferences, and we quit going for one. We didn't have time. But also we don't do functional medicine the way that it's recommended. If you look on different websites, the people who have websites, you never have more than a half hour appointment once you have your initial intake.

And we accommodate people if their schedules are busy. But education is a key part of what we do. I think that there is enough pain and suffering and exhaustion to go around, so I don't need to have a patient who depends on me forever. Yes, I put the time in up front so that after their program is over.

They pretty much know what supplements they need, what they would do if they were to get sick down the road. We, we tend to look at what kind of check in program they want, if they want to come in quarterly, if they do want to come in monthly because they have ongoing chronic issues that they're trying to maintain.

But education is just so important. So you're right, I hadn't thought that through, but that that rings true. And I mean, like any profession or like teacher wise, like some patients, tend to catch on quicker and absorb the information and want to run with it. And with any kind of general area in your life, like there are people that will give you pushback.

Is is there anything that presents itself as a challenge when you're trying to explain to them, like why it's important to change that part of their lifestyle or what they're eating? Like, how do you try to make that shift and like, educate them to really hone in on the importance of doing that? Or do you just sometimes like, you have to, like, kind of release them and let them figure it out on their own?

Like, how does that work?

So that's a big part of why we do our intake the way that we do. We try to get a feel for what the patient's goals are. So while we love to be able to give people information and do that review of findings and explain their labs and tell them more about their health before it becomes apparent in symptoms, we also like to respect that we all have the right to make the choices that we're making.

So sometimes it's a season where our health is a huge priority and we want to optimize everything, and those people will sometimes have very extensive testing. I already referred to the methylation issues. That's one of the advanced areas that we can do. Micronutrient panels is another one. Most people have their hormones checked to have hormonal optimization. Many, many people are interested in weight loss.

So but if they're not and some aren't. We've had couples come in where one is very depressed, the other is in a lot of pain. Neither of them mention weight, but in order to get them healthy enough to address the issues that they're asking about, they just naturally lose quite a bit of weight. So we really try to follow whatever the patient comes in saying that they want help with, because that's what they're going to be most open to receiving.

We might introduce them to more avenues, but you hit the nail on the head when you said, do we have to release them to their own desires? And we've learned the hard way that we can't want it for them more than they want it for themselves? Yes, but we can provide the education or be a resource that they at least know they can come back to if they decide it's something that they want to address later.

And that is a harder part. The other component to that, I will say, is I think the magic is the behavioral aspect of it, and that is why a lot of the ongoing sessions Jim leaves to me because I do counseling on the side, but I also do a lot of behavioral intervention just within the follow up appointments.

That's just interwoven, where most patients probably wouldn't say that they had received counseling even though they really had. And I think that's what makes it stick is figuring out what appeals to that patient, what their goals are, and aligning what those changes need to be to what their goals are, and also what their lifestyle will already accommodate, making it more so it's baby steps instead of huge interventions that seem overwhelming.

Yes. And to me, taking getting your labs drawn, seeing what is low and then taking the needed supplements like to me that's a no brainer. Like that's something super simple that you can do to shift some of those numbers to feel better. And they might be a little bit, you know, if they're out of pocket, more pricey than a prescription, however, you're going to feel better and you can not go out to eat a couple times a month to pay for those, and then you're going to feel better anyways.

So to me, that's a no brainer to do that. And I get it. Everybody's different, and some people like to give excuses of why they don't, why they can't take it or why they don't want to take it. But even my vitamin D was low and I was just as low as it was felt, quote unquote fine.

But just taking that dose of vitamin D, it just gives you that boost of energy. You feel better. You have, just that more positive outlook, I guess, because it's kind of like, I don't know if you call it like the happy vitamin or something like it makes you your mood better to, just as something as simple as that.

And I was talking to one of our other guys that got put on it, too, and he was like, I was really surprised at how much better I felt just by taking the vitamin D.

You also have an employee who started on a license that has B vitamins, and he was able to wean himself off of his energy.

Drinks like that to me, is like, I mean, energy drinks aren't good for you anyways. And then that's making you feel better, giving you energy and it's not damaging your body. So something as simple as that. Yeah. You mentioned the vitamin D, which here in Indiana. Of course, with the lack of sunshine, especially with the winner, we just had even days that were sunny.

How much skin did we have exposed? As little as possible. So almost everyone that we've checked in the last several months has been incredibly low in vitamin D, but that's a great example where traditional labs, they say they want it over 30, but we know that to be optimal, the bare minimum is 50 and really 60 to 80.

If you have an autoimmune issue, you want it. You want to shoot for about 70. But you're so right. Vitamin D affects your mental health. It affects your metabolism, your hormones. As a matter of fact, when vitamin D gets activated, which happens through magnesium, it's considered then a hormone. I did not know that. Yeah. So there's a lot of interesting things like that.

And vitamin D is not routinely checked in most practices. A lot of the the lab markers that we checked check are not routinely checked in a typical primary care visit. So we recently reached out to some local hospitals, as well as one of the labs in Indianapolis that's considered low cost in the Greenwood area. And when we made a comparison between what we draw, when people come in for an initial appointment and what it would cost there, our panel that runs around $200 costs close to 5000.

Oh my gosh. Yeah. And people aren't they're not going to sign up to go spend that money on getting their blood drawn if they because people have them back of their mind like, well, what if nothing's wrong? And then it's that's a waste of their money. So if they go and get that, I mean, I that's to me that's feasible.

Yeah. We understand high price. The, the last lady who came in who said exactly what you were saying. She had been to three providers. They said everything was fine. She'd had labs drawn and she brought in a copy of her labs, and I. I actually told her, let us draw more labs. If we don't find something, I will cover these, because it was so obvious.

Something was very wrong and we found out she had lupus. Oh, wow. Yeah, she's had quite a journey with us. So I'm I'm just. And she had Hashimoto's thyroiditis to boot, which had been undiagnosed. But most people don't check thyroid antibodies. They don't check an A and a an anti-nuclear antibody. And without those, how would you know. Yeah, I mean that's and if she went to three different providers and they're telling her nothing's wrong, then you feel defeated because you're like they are the professional and they are literally telling me there's nothing wrong.

But that's when you have to step in and be like, this is my body, and I know something is off. And I feel like that that is more common than people kind of talk about because they go to a hospital and they doctor who's done this for how long? It's telling them, no, nothing's wrong, it's fine. The problem is we don't really have a health care system anymore.

We have an illness care system, and that's why people don't go until they're sick is instinctively we recognize what's happened. No one's looking to optimize anymore. Yeah, they're just looking to treat disease, and that's what they do. So if you want to actually optimize, you have to go somewhere outside the traditional so-called health care system. But unfortunately, I think that because we look around and everyone around us is not optimized, we think, oh, this is just part of life.

This is part of aging. Of course, I'm more tired. Of course I'm achy. I don't feel great, but I'm over X amount of years old and that's just not the case. Well, in like treating illness with, you know, they give you a pill for this. Pill for that. I was listening to, I think it was a podcast or something the other day, and a ad popped up and it was for some drug, and I didn't even catch what name it was, but they were listing all the side effects on there, and I'm like, well, heck, I would rather live with what I'm dealing with than all the side effects.

And I feel like that's just like they just want to push pills at you. But like, like with statins, for example, for cholesterol, like there's a ton of side effects for those. And if you're not like digging into like the actual levels of those and you're taking a satin, there's, you know, you're sometimes you're worse off taking those than you were just living with it.

And, you know, not knowing because, you got high cholesterol. I mean, you really don't know, I guess. So it's like, here's, here's a pill for that. But you could be worse off taking that pill.

Absolutely, absolutely. And we like to use evidence based resources. The Mayo Clinic has a wonderful free tool online, Mayo Decision Clinic, I believe it's called where you can put in your own lab values, your blood pressure, your age, whether or not you've had a prior cardiac event.

And it will tell you statistically whether you're taking a low dose or a high dose statin. And if you're not, you can put in there. What would that change as far as prediction on whether or not I would have a cardiac event in the next ten years if I took one, if I didn't, if I took a high dose.

So we like to utilize tools like that to help people make informed decisions. There are some medications, of course, as providers that we think there are definitely better options. A lot of those also include lifestyle modifications, but sitting down and deciding what is non-negotiable for that particular patient, sometimes there are things they don't want to give up. And in that case, sometimes medication is the best route, or there's things they don't want to do, and we will work with them and find baby steps where they can get more active without necessarily working out.

And we've worked with people who have a brace on their legs or walk with a cane. Sometimes it is tricky. They come in and we understand why they're not doing some of the things that we typically think of for for better health. But having someone who can sit down, go through that with you, figure out your priorities, your personal limitations, what improves quality of life for you specifically.

And then we say, okay, to lower your cortisol. Here's a video that will help you with the breathing pattern that will lower it without a medication or a supplement. Here's an eating plan that will help you lower your inflammation for your joint pain or your autoimmune condition. Or here's a supplement if you don't want to do that or you can't make time for that, everyone's in a different season of life, and maybe right now they don't have time.

But once we present the options, they know that they can always get back in touch. If they decide that they're in a different season and their preferences change. And we expect that to happen.

Yes, because where I'm at now, it's a lot easier to get up and work out versus, you know, five, six, seven years ago when the kids were little.

So I understand that, like your priorities shift and your time shifts. So I totally get that. What would you. I know you said everyone's different, but if you had to give, like, a tip trick, word of advice, like something that they could do today just for the general population like that would improve their lifestyle. Drinking more water, taking a walk.

Like what would you suggest? I think you know all of them, Emily. Definitely. Water is huge. A lot of people have symptoms pain, headaches, fatigue, constipation. That water alone would help significantly with walking, especially right after your meal. That helps so much. Helps your metabolism. Trying to get consistent sleep that's super beneficial. And then actually one that you may not have heard of is if you're going to take supplements, make sure you have those reviewed by someone who knows what they're recommending, because there are things such as zinc.

People say, oh, I have a cold, I'll take some zinc, look at zinc and how that impacts copper, and then how both of those impact mental health. Sometimes we have just enough information to be dangerous. So when we start self-medicating, even when it's with supplements, we can mess some things up. So if you're going to take something, make sure you know what you're taking.

And if you need something else to drive it into the part of the body where it needs to go, like the vitamin D, we talk about vitamin D, but yesterday we did a review with an Amish couple, and the vitamin D had no K1 or K2, and some of his other labs revealed, yes, he's forming kidney stones. He had no idea that at that level of vitamin D, you have to have K1 or K2 with it so it doesn't set up in soft tissue.

So that would be, I guess the lesser known tip would be before you take supplements, have that reviewed by someone who knows what they're doing well. And it's so hard because and I've done it with you like sent you over something. You're like, yeah, I'll look into that. You just see so much information out there and it says, it's good for this and good for that.

And you just don't know, like you think you're doing something positive. And then like, I, I wouldn't know that you need for that high a dose that you need that to go with it. So I feel like that's where people get confused too is because there's so much information out there. So, you're trying to do a good thing for your body and you're, like, counteracting it.

So you're exactly right. And they don't teach most of this in, in traditional programs. So I was double board certified. And a lot of this I've learned since then, because none of this is necessary to work in a hospital. Well, I feel like that is some useful information that I, I learned something today, so I appreciate you coming on and just talking with us and giving us some of your tips and tricks and information that you've learned and that, you know, we will have her contact information if anybody is interested in that.

I know that you have done a great job with our team and with me and Bob personally, so just optimizing your health and feeling better can make a world of difference. So if you guys are interested, we'll put that contact information down on the screen below. But I appreciate you coming and taking the time to talk to us today.

Appreciate you asking. Thank you so much, Emily. Always a pleasure.