Shadow Me Next!

From Standard Medical Protocols To Curiosity-Driven Care | Dr. Aaron Hartman, MD

• Ashley Love • Season 1 • Episode 52

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To learn more about Dr. Aaron Hartman, visit: aaronhartmanmd.com

Dr. Aaron Hartman—triple board certified in family, integrative, and functional medicine—walks us through his path from military rounds and high-volume private practice to a more deliberate, patient-first model. 

We unpack how evidence-based medicine lost two of its three legs, why publication bias distorts what we read, and how overlooked data from neuromodulation, nutrition, and environmental health can outpace costly procedures. From a $300 stim device that relaxed spasticity and avoided a $400k surgery, to low-dose naltrexone for neuroinflammation, to butyrate’s modern biochemical validation of an ancient insight, we connect research to real-world wins.

You’ll hear how he rebuilt clinic life around longer visits, smaller panels, and a foundation of sleep, nutrition, movement, relationships, and micronutrient, and then layered in precision labs, peptides, hyperbaric oxygen, and targeted devices when needed. W

e talk candidly about mitochondrial toxicity from common drugs, the gut microbiome’s role in medication metabolism, and the hidden costs of “that’s just how it is."

Virtual shadowing is an important tool to use when planning your medical career. At Shadow Me Next! we want to provide you with the resources you need to find your role in healthcare and secure your place in medicine.

Check out our pre-health resources. Great for pre-med, pre-PA, pre-nursing, pre-therapy students or anyone else with an upcoming interview!
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Ashley :

Hello and welcome to Shadow Me Next, a podcast where I take you into and behind the scenes of the medical world to provide you with a deeper understanding of the human side of medicine. I'm Ashley, a physician assistant, medical editor, clinical preceptor, and the creator of Shadow Me Next. It is my pleasure to introduce you to incredible members of the healthcare field and uncover their unique stories, the joys and challenges they face, and what drives them in their careers. It's access you want and stories you need. Whether you're a pre-health student or simply curious about the healthcare field, I invite you to join me as we take a conversational and personal look into the lives and minds of leaders in medicine. I don't want you to miss a single one of these conversations. So make sure that you subscribe to this podcast, which will automatically notify you when new episodes are dropped. And follow us on Instagram and Facebook at Shadow Me Next, where we will review highlights from this conversation and where I'll give you sneak previews of our upcoming guests. Today on Shadow Me Next, we're diving into a story that challenges so much of what we assume about medicine, expertise, and the limits of what's possible. I am pleased to welcome Dr. Aaron Hartman, a triple board certified physician in functional, integrative, holistic, family, and regenerative medicine. But the thing that stands out most about him isn't his credentials. It's the way he thinks and the courage that one little girl named Anna gave him to rethink medicine entirely. You'll hear how his path was pretty traditional at first: medical school, residency, military medicine, private practice. And then one moment with one patient, a little girl, that he and his wife brought into their home changed everything he thought he knew about standard of care. That moment pushed him into a decade-long search for answers the system wasn't offering and opened a door into functional and integrative medicine he never expected to walk through. What I love about this conversation is how honest he is about the limits of expertise, the blind spots in evidence-based medicine, and the importance of staying curious, even when your training tells you to stop asking questions. And he brings so much clarity to what it actually looks like to build a meaningful, flexible, ever-evolving career in medicine, one that grows like you do. This is a powerful episode for anyone who's ever felt that internal nudge that says, there's more here. I'm supposed to go deeper. Please keep in mind that the content of this podcast is intended for informational and entertainment purposes only and should not be considered as professional medical advice. The views and opinions expressed in this podcast are those of the host and guests and do not necessarily reflect the official policy or position of any other agency, organization, employer, or company. This is Shadow Me Next with Dr. Aaron Hartman. Dr. Hartman, thank you so much for joining us today on Shadow Me Next. You are triple board certified in functional medicine, integrative and holistic medicine, family medicine, and anti-aging regenerative medicine. You I like there's so many titles. And the the amazing thing is, I think your journey goes well beyond those titles. Um I cannot wait to talk to you about this.

Aaron Hartman:

I'm excited to be here and share stuff with your community and take a deep dive.

Ashley :

Yeah, a deep dive for sure. Um and you are also an associate clinical professor of medicine. So, you know, you have a lot of knowledge when it comes to talking to not just patients, not just, you know, the average Joe, but also students interested in medicine as well. So we're gonna approach this kind of from all angles today. Um, but let's let's go back. Did you always know you wanted to be a doctor? That's always a fun question.

Aaron Hartman:

You know what? It's funny. I remember being maybe in second or third grade, walking through the park with my parents, saying I want to be a doctor, I was gonna do this, that, that. And you know, at that stage, parents were like, yeah, that's that's cute. Um, I remember, you know, I grew up in Harrisonburg, which is a small town in the mountains, the valley in Sandra Valley, Virginia. And our dot family doctor was a country doctor, and you go to the visit, drive out of the city, the massive city of you know 20,000 people, right? And go his little office. And he talked to my mom, listen to her lungs, and then give us some pills. And I remember as a kid being like, I can do that, that seems pretty easy. So um, that was kind of where I realized I want to be a doctor because I'm like, well, looks pretty easy, talks to my mom, helps us out, you know. Um, and at super simple beginning, but that's kind of how it started.

Ashley :

I love that. And you know, I think that we'll we'll learn throughout our conversation that um obviously you achieved that, but then it took a major shift. And again, it was from personal experience, and and we'll definitely talk about that. But tell us about your medical education journey. So you graduate high school, you go to college, what does it look like after that?

Aaron Hartman:

I was very focused. You know, the purpose of high school was to go to college. I mean, ultimately it was to get become a physician. So, like most students, um, went to um Virginia Commonwealth University and graduated Sumo Cum Lada um from there, very focused out of scholarship. So it was I was fortunate to get out of college with no debt. And then I was like, what's next? And um go to medical school. And again, I was kind of raised no debt. So I got an Air Force scholarship and went into um the Medical College of Virginia and then did my residency there as well. Because those of your listeners who go to do residency, I mean, you don't really have a life. And so I realized that you know, MCD was great, um, great, great reputation, great clinical experience. And so I had a social network, so I stayed local and it actually had a pretty difficult internship. Their internship year was a medical surge internship, which is 100% hospital-based. So it's like it was one step below a surgery internship is difficulty, but harder than internal medicine. So it was you learned a lot in a year, and um, and then did my about the additional two years in family medicine, and then did the military for four years. And military was awesome because every six months my job changed. So I got deployed overseas, um, helped run a clinic in Germany, um, um uh came back, ran a clinic in McDill Air Force Base, realized there was no one doing dermatology on the base. So um did start doing some dermatology training at USF and ended up running the dermatology through our clinic there. Um, they didn't have anybody doing stress testing, so I picked that up as well. And my thing was always to learn a new procedure every year. Got out, came back to Virginia, joined a private practice, and this might resonate with some of your people. Like that was back before when it was uncool for doctors to advertise. And so I realized for our practice to grow, we need to set up the first website in 2007, which was like a one-page sheet. And um, that was before other businesses started buying, like health grade started buying websites. So we were actually in the head of that. So now if you come to the local community and you're an individual, you won't be able to make web presence because it's owned by different organizations, which is another topic, and then built that practice up to 10 practitioners. The busiest that practice was, we were seeing like 60,000 people a year come through it. So it's busier than the ERA across the street. During that, I decided to start a research company. So I started Virginia Research Center, and we ended up running over 70 clinical trials through the center over 12 years, and um started studying functional medicine, integrated medicine. And some somewhere in that whole mess, I decided to get a seminary degree as well. So when I was in the military, I went to seminary and took me seven years to finish that because it was a part-time gig. So so it took longer than usual. But um just, you know, if you learn something new every year and the open the doors open, you walk through them and you do that for 25 years and you look back, you're like, wow, like where's everybody else? And this is cool. And that's been kind of my journey.

Ashley :

It's incredible. And I'm so glad that you have had this experience that you can share because I think there is this common misconception right now that if you want to become a physician, MD DO, if you want to become a physician, you're gonna be pigeonholed for the rest of your life. You know, I talk to so many PA students and they say, or pre-PA students, and they say, well, Ashley, I want to be a PA because I want job flexibility and I don't know if I want to stay working in the same field for my whole life. And I think, unfortunately for you, you're gonna have to revisit that thought because that is not true. And Dr. Hartman, you're living proof of this. I mean, you've had a very varied career when it comes to your career in medicine. Do you think that's I mean, is that is that normal? Is this something that you've obviously had to work really hard to seek out?

Aaron Hartman:

My philosophy was to walk through doors as they open. I'm not like a go-getter, like I'm gonna like run, like I remember saying, I'm never gonna do research, I'm never gonna write a book, I'm never gonna own my own business, like because I don't want to do that stuff. I just want to be a doctor and help people and you know, travel and have fun and all that kind of stuff. But if you if opportunities show themselves, you take them. If it and if it's not hard, it's probably not worth doing. So you need to do hard things, you know, and it's amazing. You know, there's this thing called the 80-20 rule, the paretal rule. And it's basically basically the idea is 20% people do 80% of the work. Um, and that includes 20% of the people have 80% of the knowledge or however you want to frame it. The ratios change based on the what you're looking at, but it's roughly true. So all of a sudden, with doctors, 80% of people are following the herd or doing the status quo, and 20% will do things a little different. And then it's the 20% of the 20% of the 20%, which is the 1%, and those are the innovators, those are people who are thinking outside the box. And so you have to go from this 20% to that 20%, that 20%, realizing that by the time you get there, you're gonna look around and it's gonna be like you'll be alone. But a lot of people will be looking to you, and so it's one of those things that um you have to be willing to do hard things, you have to keep on learning. But I think just realizing that a prepay, a pre-PA student, or you know, pre-med, whatever the level is, you know, just be open to new things, be willing to do hard things, be be curious, be curious. Um, be the first one there, the last one to go home. You know, I did more when I was doing my OBG WAN, did more deliveries, did more fiducial scalp electrodes. When I was doing my um my um ICU, I did more intubations because I was first one there, last I wasn't the smartest. Um, I wasn't the the person with photographic memory who could quote stuff, but I just worked hard and that's worth a lot more than being the smart person in the room. And so just be willing to do hard things, be curious, don't stop working, and you'll be amazed by where it takes you.

Ashley :

Be curious. I love that. I think that's fantastic, especially nowadays in a world where you know we're able to just search up information immediately in our hand or online right there. You know, it's all instant the curiosity factor is fading. And I think if we maintain that, like you said, doors are gonna just start flying open and we're gonna have to walk through. Dr. Hartman, let's let's talk about this. I'm very, very excited to talk about this. So many guests on the show, like you just did, share a personal experience that led them to medicine, right? In your case, a personal experience actually opened your eyes to the realities of medicine, the realities of your profession. And I think it took you on a pretty big pivot. Can you tell us a little bit about this?

Aaron Hartman:

So, this was during my third, going my fourth year at McDill Air Force Base while I was in the Air Force. I was a captain during a major at that point in time. And my wife, who um is a pediatric occupational therapist who worked with kids with special needs. So she'd have all these rare cases. We'd have interesting conversations about the things I heard about in textbooks that she was seeing every day in the clinic clinic and where she was working. One of the little girls, Anna, um, her foster home was closing. She was 12 months old, and she asked me if we'd be willing to foster her, bring her in. And I said, sure, you know, because of my personal belief system, part of that is to take care of the vulnerable, take care of people who can't take care of themselves. And I'm like, I say I believe these things, and I should be willing to do that. So for me, it was very mechanical, to be honest with you. But in the process, I did fall in love with Anna and we started the whole adoption process. And what happened was really interesting. You know, she was a failure to thrive. Her her birth mother did crystal meth the entire pregnancy. She had a stroke before she was born. Um, she was born in a drug coma, and usually kids are there for about six or so. She didn't interact with the world for six months, and she was small, she was less than fifth percentile. So the GI doctor was like, hey, she's not growing. Let's put a tube in her because that's standard of care. Cut a hole, put formula in. And my wife and I had conversations about speech development, about crawling, about neurological development. Chewing and swallowing changes facial structure development. I mean, we have more, if you don't chew and swallow, it can set you up for sleep apnea in adulthood, for example, right? So all of a sudden it's like, no, we're not doing that. Like we have high hopes and dreams, we have aspirations, like all parents do, or future parents do. So we said no to the tube. And we were reported to child protective services.

Ashley :

Oh my gosh.

Aaron Hartman:

Or for child neglect, yeah, because we refused to do it to the doctor. Said now, my wife, it's so funny because I was, I'm a doctor, my wife's an OT. And we got investigated. The nurse who investigated us, my wife actually shared patients with. And so they kind of joked about it, like, uh, this doctor puts tubes in all the kids. And they kind of joked about it. And we had to like meet with the nutritionist. The nutritionist was like, Yeah, you're doing the right stuff. So it went away, but that was my first inflection point. The system does not like it when you say no, when you question the system. And in the special needs world with kids with special needs, this actually happens a lot where kids are actually taken away because they have rare diagnoses that the system doesn't understand. And the parents literally not just fighting for the kids, but they actually lose them and have to fight to get it's it's horrible that to see if it's even is possible, but it does happen. And so I was kind of watching that from the outside, kind of sort of not quite from the inside. But here's the major inflection point. Um, six months later, my industrious wife found a growth chart for kids with cerebral palsy. And Anna was in the middle. So the expert didn't know this existed. And so that was like the aha moment for me. Like the experts don't know. What else don't they know? What are the blind spots that people think to be true that's wrong? People know not to be true that's actually not true. And so it put a weight on my back because all of a sudden I realized I had to figure it out. I had to be the person who'd get up at four o'clock in the morning and pull up articles on nutritional therapies, gene-based cell therapies, um, things based on SNPs, which are small, they're basically myth typos in your genes and how that can affect so um drug exposure, crystal methyl policy. So that ended up being a 10 to 12 year journey of me getting up ridiculously early, reading articles, reading books, finding experts, traveling out of the country to meet these experts, and realize there's it's like it's like Alice in Wonderland, right? You go there and you go from black and white to a color world. And once you go there, you realize, oh my gosh, there is so much stuff out there that we're never told about, we're never taught about, that we ignore, we say is witchcraft hooey. It's actually cutting edge in Germany and Russia and Switzerland and and China. And all of a sudden, that became my practice of medicine, is doing that stuff, not just my daughter, but with other people as well. And that is what led to me starting my practice, Richmond Engravement Functional Medicine. So taking everything I'd learned with her and starting an entirely new practice with a totally different um economic basis of, you know, you have to make money, obviously, to practice medicine. And that's been a journey as well, figuring out the economics of actually enabled me to practice the best medicine that I can learn in a system that says, you know, one widget and one dollar. Um, so that was another journey as well.

Ashley :

Incredible. That is an absolutely incredible story. And I can't wait to unpack some things in there. Um, but before we talk about how your day looks a little bit different now from what you were doing to what you're doing now, you mentioned something that I think is really important that we touch on, and that's called standard of care or evidence-based medicine. And my two questions for you about this are number one, what does that generally mean in the medical world? Like if you walked into a hospital and you hear people talking about standard of care, what does that mean? And then what does that mean to you? Because I have a feeling that it might perhaps be two separate things. Now, Dr. Hartman and I did not have a chance to discuss a quality question. Quality questions is a segment on the show where we review interview questions for you, a pre-health student, looking towards your next interview. But something Dr. Hartman is about to talk about would make an excellent question. When someone defines the standard of care, what happens when that standard does not apply to your daughter suffering from a muscular issue? It begs the question: how do you define standard of care? If you're asked this on an interview, admissions committees want to see your ability to think beyond what's handed to you, to notice nuance, to challenge assumptions, and to advocate for better care. Your action step this week is going to be to identify a moment where you did not settle for the first explanation or the easy path. Reflect on what that says about how you'll show up in medicine. Keep in mind that there's more interview prep, such as mock interviews and personal statement review, over on ShadowMeNext.com. There you'll find amazing resources to help you as you prepare to answer your own quality questions.

Aaron Hartman:

So standard of care is just the basic concept that whatever's done in the local community, and standard of care can be different in Mississippi versus New York versus California. It's basically an unstated consensus. Like what's going on in your area that people do? Now, sometimes they become standardized. Like when I did my OBGYN training, they had the ACOG have a big book and they actually every year put it out and it's got like the protocols for absolutely everything. So they have their own stated standard of care. And it's basically consensus. If you get a room full of experts, what's the consensus on diabetes treatment and management, post-concussive syndrome treatment, chronic fatigue, whatever it is? And so it's a consensus-based treatment. We're following a herd. Um, and so that's kind of what standard of care is. The issue with standard of care is that if you're outside of it, there's really no room for that. And there's so many things, people forget that, like with kids, up to 60% of medications used with pediatrics are not FDA approved. 30 to 40% of drug use in adults is not FDA approved. So it's like you get a drug out there, like metformin or aspirin or um COZAR, I'm low Sartan, and you find out, hey, it lowers uric acid. You can use it for gout patients, it lowers TGF beta. It can, it's an anti-inflammatory. I mean, that's that's part of how it helps blood pressure. You're right. And so all of a sudden now medications get a wider, broader usage that might fall outside the quote-unquote standard of care, but that's kind of how the practice of medicine works. So it's consensus basically. Um, and typically you have you know room, a bunch of smart people, and what can you agree on? The lowest common denominator. So it's not cutting edge care. It's okay, what can we all agree about? Agree in. So that's something to think about. Evidence-based medicine is not what it used to be. It was supposed to be, there was an article that came out, it was either 89 or 91, I believe, in um British Medical Journal, uh maybe, or JAMA. Um, think of which one that actually defined evidence-based medicine. And it was three legs. It was um the you know, up to date, accurate um clinical evidence, so research articles, etc. Patient preference and clinician experience. So the fact that I've had over 100,000 patient encounters in seven countries and four continents means meant something, meant something. I've taken care of malaria in Ecuador, I've taken care of diabetic wounds in Honduras, like I've seen a flesh-eating disease in Morocco and North Africa. So it's like I have a toolkit that's a little unique, right? The problem is now it means solely randomized, double-blind, placebo-controlled trials. So now when you when you're room with experts, like what's the evidence for that? They mean what's the RTC? And then people don't realize this whole thing about publication bias, where just like the standard of care to get in a journal, an editorial board has to say, yes, we think that is true. Let's put it in. And so there's a publication bias bias. And then according to Dr. Ioannis and PLOS, which is the largest um journal, online journal in the world, 50% of all research findings are later found to be false. So all of a sudden, the evidence we're looking at, half of it's wrong. And when I was in medical school, I was told half of what I read in a textbook was wrong. So all of a sudden, we've gone to this technocratic practice based on research articles that, you know, batting 500 maybe, you know, batting 500 is great for baseball and horrible for flying planes. And so, and so I think, you know, that's where it's that's where I think we've kind of got off the rails a little bit with the evidence-based medicine thing. And evidence-based medicine ignores population data, it ignores um meta-analysis, ignores healing traditions. You know, um, I could give you so many examples. One example in ancient Ayurvedic medicine, they believed ghee could use, could be used to treat neurological issues. When I first heard that, I'm like ghee treating neural. That's stupid, that's dumb. Well, fast forward, there's actually now a FDA-proved drug, phenyl butyrate, in combination with phosphylcholine, that's being used to treat symptoms of ALS. What we now know is that butyrate acts like a chaperone to clear to clear out um lipid debris in our bodies. Now, butyrate's made in your gut naturally by bacteria. So if you have a good diet, fiber, um, you actually make your own butyrate. But nature's best source of butyrate is clarified butter or ghee. So then it's like, how did people 4,000 years ago connect some dots to figure out what just now in the last three to five years, evidence is showing there's evidence for that? And so that's where what I love what I do, it's a lot of times it's connecting those dots, sometimes 10, 20, 30 years before the evidence does, and then taking evidence that's published and accelerating it, right? Like using the ponds, it's a portable oral neurostimulation device that was used to trade kids with CP in Russia. It was available in Canada. So I went to Canada to get it, and it's only approved here in the United States to treat balance issues with MS. Oh, why can't I use why are they using it in Russia and Canada? So sometimes this evidence-based journey is also kind of you gotta you gotta you gotta look at all the evidence, all the data, and then use your clinical expertise to figure out is this true or false? Because sometimes evidence says things that are false, and you how are you gonna know the difference?

Ashley :

I'm blown away. I'm actually blown away right now. That is so interesting. Dr. Harmon, do you think so? For functional medicine, do you have to be a medical doctor? Do you have to be an MD or a DO in order to enter functional? I'm just the reason I ask is because I'm imagining the fact that your view of this is so incredibly well-rounded because conventional medicine, you have that education there, but then you also have this functional medicine education as well. So what does every functional medicine doctor have the same uh background you do?

Aaron Hartman:

No, um, no, it just depends on how deep you go. And obviously, I'm someone who goes pretty, pretty deep. Um I I think the basic principles are that with functional medicine, the foundations are foundational. You know, diet, exercise, sleep, uh, meaningful relationships, um, nutrient deficiencies. Like if you do the basics, that hits 80% of everything. So you can have, you know, nutritionists that are are trained in functional medicine. You can have acupuncturists, chiropractors that are trained in it, that can do the 80%, that can say, hey, you're eating processed foods. And oh, by the way, if you have post-concussive syndrome, omega-3 and healthy omega-6s can actually help your brain heal. Don't eat trans fats, don't eat, you know, rancid orals. Like that, you don't have to be a triple board certified clinical researcher doctor to give that kind of advice. So that's the beauty of functional medicine is that at the basic foundational level, it's really accessible. But then you get to the nuances, the weeds where it's like, okay, you get past the 80%, and um you still have post-concussive syndrome or long COVID or post-Lyme, you got to take illness or something else, the flu, and you've been feeling crappy and hurting for years. Well, then it's like, what's the literature say? And you can use low-dose naltrexone, which has been around forever, to remodulate microglia in your brain. Okay, cool. I use that with a lot of my autistic kids, my pandas kids, and it helps calm the inflammation down your brain. Um, a lot of all all chronic pain actually has a has a centralization process to it. And low-dose naltrexone works great for that. So all of a sudden, as a medical doctor in the string, I can actually take some of that data and translate it. With my daughter, for example, she had really bad tone in her legs. And the standard of care for her at DuPont, which is one of the top, the top pediatric places in the world, was to put a bacclefin pump in her back, to put bacclefin into her spine. Locally, here it was to do on the spinal surgery, cut her hamstrings, or send her to Texas for a selective dorsal rhizotomy, super fancy test. They cut little nerves to release the tone. That was that was the cutting edge stuff. But then I knew from functional neurology studies that you can remodulate the brain with peripheral nerve stimulation. And I was looking for a neuromuscular stimulation device and I found one called Revitative. FDA approved, by the way, to treat circulation issues in the legs. And within six months, her tone in her lower extremities was gone. Wow. And so she went from hunching over. So that $300 device is probably saved a $400,000 procedure. And when you realize this happens all the time, you know, when we talk about electrical stimulation, there are devices FDA-approved to treat migraines, hitting your V1, part of your trigeminal. There are ones used for treating different pain syndromes, um, muscle spasms. You know, professional athletes use this to help build muscle mass. And the question is, how can I translate these data points to this chronic fatigue fiber? There's actually an interesting device called Quell, Q-U-E-L-L, and it actually activates your peripheral, and this might be getting a little nerdy here, but hopefully your people get this here.

Ashley :

You can nerd out.

Aaron Hartman:

Okay. It activates your peripheral um alpha fibers, which go into your rubrospin, the rubrospinal, the red tract in your brain. The way your brain works in the midbrain is actually sends inhibition down to inhibit pain. When that gets dysregulated, now shingles, my arm hurts, a phantom limb syndrome, the arm that's not there hurts. Well, this device actually helps remodulate that. And I've had patients with profaneuropathy and chronic fibro pain, have it go away over three or four months with a little buzzy thing that buzzes your leg for 12 hours a day. So part of what I would do is take these data points that there's data here, diet here, and diet to here, and then fill the gaps in. And that's unfortunately where a lot of our conventional stuff doesn't do is that we'll take this data point for the physiatrist and this data point for the neurologist migraine person, but it won't connect those dots and fill in the gaps for your typical average person that I see in my clinic.

Ashley :

That is so cool. And actually it leads really nicely into my next question. So, how, in your opinion, how has your day in clinic, for example, how has that changed from when you were practicing conventional medicine to what you're practicing now? You're describing a little bit of it, but really getting down to nitty-gritty specifics. Is it is it vastly different for you? Is it vastly different for your relationship with your patients?

Aaron Hartman:

So it my day used to be when I was in the the heat of it, when I was seeing my my busiest year, I saw um just slightly below 6,000 patients um in a year. So for those people out there, you know, that's a lot of people. I was getting to the hospital. Um the I think the standard physician sees maybe three, 4,500 is considered a lot, right? So um I got to the hospital at six o'clock in the morning. I did rounds on my admissions um overnight, followed with my my my existing patients, would then go to the clinic at eight, um, eight till five in the clinic seeing people, hospital follow-ups. Um, if needed to go back to the hospital, see someone in the ICU, I either go during lunch break or at the end of the day. I typically get back home about six, six o'clock. And I did that um five days a week. And then the every fourth um weekend I was on call. So I was working through the weekend. And every Tuesday night, I was on call, so I did it eight to eight. So um so I did that for you know from 2007 until about 20 um 22. So that's and that's a stay, that's a standard good old-fashioned family medicine kind of practice, right? On top of that, I was doing my reading and research, and and actually in 2016 is when I started my functional practice. So that's when I was doing that as well at that time. What's it look like now? Um now at that point in time, I was also getting up at four o'clock in the morning to read these stuff. Now I get up at 6, 6:30 in the morning, um, have my coffee, read a little bit, um, go to the gym. Clink starts at 8:30. Um, I go 8:30 to 12. I have a two-hour break between 12 and 2, and then see patients from 2 to 4. So, you know, a pretty light, not big, busy day. Um, I have Wednesdays and tries off for admin time. So when I read that's when I research my patients now. I'm not still not stealing from my sleep anymore because sleep is the super drug. And so when I was young, I was I was told and believed that I'll sleep when I die. And now that I'm older and know more, I'm like, uh not sleeping will kill me. So increase my risk for cancer and diabetes and all kinds of stuff. Don't listen to that residents out there. You gotta work hard, you gotta not sleep. But um, and so it's totally different now. Um I I currently I used to take my patient impalement at one point in time was right at 2800 patients. Now it's 300. Um, an intake for me is two hours.

unknown:

Wow.

Aaron Hartman:

So I will do an intake two hours, um, order a bunch of fancy labs, et cetera. FOP is an hour and 15 minutes, and a routine visit is 45 minutes. So instead of being 10 to 12 minutes, I have 45 minutes routinely with a patient. Sometimes short, sometimes a really short 30 minutes, you know. So it's vastly different. But it's interesting. I have patients I've been working with for years, and it's and I did this in primary care because I was intentive and I listened to people and you see them a lot, but you you get to know people's story a lot better. And I can give you a story about my wife, actually. Um it's funny what you learned. She was an OT and she um developed really bad um anxiety in grad school, almost dropped out, got anxious, depressed, just felt super off. Ended up graduating, got straight at ACE like all the years, and grad school did well. When I met her, I was kind of like, you know, I remember hearing her story and be like, suck it up. Like that's just what we do. We work hard. Um, she's ended up developing a couple of health issues, mast cell issues, chronic fatigue, fibro, had really bad chronic fatigue for five years. 15 years into our marriage. Because I'm a very attentive husband. I'm glad you're laughing, not scowling. Realized her trigger for this health crisis was an anatomy lab in grad school where she was exposed to formaldehyde for six months straight. Whoa. Fromaldehyde is a neurotoxin. It binds to your proteins and changes the conformation. That's how it preserves stuff. And it was, it took me 15 years to figure that out. But part of the functional medicine thing is realizing how the environment affects her health. So that one data point led to her health issues for 15 plus years. And that was just one thing that my my this alternative medicine, functional medicine, has helped me realize that environment is just as important as the food you eat. It's just as important as the people you're around, just as important the medications you do and don't take. 30% of all pharmaceutical drugs are mitochondrial toxicants. Whoa. Just think about that. And half of all drugs are actually detoxified or processed out of our bodies by our gut microbiome. So it's two basic functional medicine foundational things. The idea of mitochondrial toxicity and gut microbiome that comes together with traditional medicine is ignored by the system, a blind spot, if you will.

Ashley :

Wow. Again, mind blown. It's like like fireworks over here, like the one one thing and then the next. That is, I'm glad you mentioned some of these things because you have a blog that we can find on Aaron Hartman MD.com, amongst a bunch of other things that we're going to talk about in a second. And you you dive into some of these things that people might not know about. Um, formaldehyde. Obviously, we know not to drink it, but we didn't really know what else we need not to do with it. Um, mold. You talk a lot about mold and some of the things maybe people need to start thinking about. Um, that can be found in your blog, which we're gonna talk about in a second. But as our as our last question before we wrap up, especially as a parent physician, you've refused to accept that's just how it is. You know, that phrase, that's just how it is. That you that's unacceptable to you as an answer. If patients or clinicians are feeling this way right now, with their own health challenges or with the health challenges in their patients, what should their next step be?

Aaron Hartman:

Um, you need to research, don't give up, don't accept the status quo. Um, answers were if you look for the answers, you will find them, you know, or they sometimes they actually, if they find you, to be honest with you, it's don't give up. And so I actually was on a podcast with a an ultra-marathon runner in New Zealand.

unknown:

Wow.

Aaron Hartman:

Who like was the first woman to like run 150 miles in some random desert somewhere. So like super motivated, super mindset oriented, not a um doctor, not a clinician, just a super athlete. And her mother had a stroke, and her mother later got lymphoma. And her mother should have her mother's still alive now. She should have been dead 15 years ago. And she did not accept what New Zealand told her that we can't help your mom's stroke, figured out about hyperbaric mess and got a hyperbaric chamber, figured out peptides. And her mom, within three years, 100% recovered from her stroke. She should have passed away from. Five years later, um, they had lesions in her brain. They actually happened to be um an intro cranial lymphoma. Again, she figured out some stuff, um, hyperbaric um ketogenic diets. It's a lot of interesting literature on cancer is a metabolic disease. There's a whole book on it. And so she found this information, and her mom's 15 years into it, thriving, doing well. And so, and this was someone who's not medical. So, part of her story that was just impactful to me is you might feel like, how do you do this? You can do it too. And so I wouldn't give up. And the reality is just research, find stuff. It's amazing. One path leads to another. I started my functional medicine training, and then one of the one of the lecturers was Tatis Karazian, probably the top functional neurologist in the world, him and Dr. Brock. And I spent a year studying functional neurology, which is how you can look at a patient, how they walk, and figure out which part of the brain's messed up, and then how you can actually get the brain to cell phenol repair using physical and electrical modalities, the whole field of medicine out there. And so once you start looking at things, you'll find you gut microbiome stuff, hormones, environmental toxins. You know, I have a textbook of clinical environmental medicine sitting right there. It's a book about how the environment can affect your health. And so when you find those things, get your library together and put them in your books to read. It might not be anytime soon because you're in in school or whatnot, but start collecting the books you want to read. And it's amazing. One thing leads to another, leads to another. Um, unfortunately, in our board certification um siloed training training world, we take the inquisitive inquisitiveness and the curiosity of students, and we kind of like eliminate it when you finish. I remember, haha, you'll appreciate this. I remember the last semester of my residency training, my first one, talking to my cousin. I read all the textbooks. I I got like 97% on my board search. So it's like I was a top three percentile. I remember saying to him, I've learned everything, I've mastered medicine. And he looked at me and it's like, Hartman, like what's your no? And he, you know, and I remember thinking, you just don't know, young lad, how smart and brilliant I am. And um, in hindsight, I was an idiot. Like now I'm like, I don't I tell people, I'll you know, Ashley, I don't know what I'm doing. Like, I'm still practicing, I'm still figuring stuff out. And so it's interesting how the system kind of beats that out of us. Don't let it beat it out of you. Stay, stay curious, um, keep learning, never and never, ever, ever give up on yourself or your loved ones because the system will.

Ashley :

That's so true. Dr. Aaron Hartman of Aaron Hartman MD.com. Uh, we mentioned your blog on there. There's a whole bunch of awesome, really, really awesome things. Your podcast, which is made for health, definitely check it out. You links to your YouTube videos are there. Um, and then your book, Uncurable, from hopeless diagnosis to defying all odds. And that's uncurable. And this is going to be a great next step if this conversation is really resonating with you right now. Um, it's an amazing book. It's available on his website, it's also available on Amazon. Please check it out, Dr. Hartman. It has been the most fun talking to you today. Thank you so much.

Aaron Hartman:

So I appreciate it. Hopefully, this was helpful to your audience.

Ashley :

Thank you so very much for listening to this episode of Shadow Me Next. If you liked this episode, or if you think it could be useful for a friend, please subscribe and invite them to join us next Monday. As always, if you have any questions, let me know on Facebook or Instagram. Access you want, stories you need, you're always invited to Shadow Me Next.

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Ashley Love

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