31 - Rehumanizing Primary Care with Dr. Chad Krisel

In this episode of the Be Well Asheville Podcast, host Travis Richardson sits down with Dr. Chad Krisel, board-certified family physician and co-founder of Integrative Family Medicine of Asheville (IFMA). Travis is also a longtime patient of the practice, which makes this conversation especially personal. Together they unpack why traditional insurance-based primary care is structurally broken — and how the direct primary care model IFMA pioneered fifteen years ago realigns the incentives between patient, doctor, and business.

Dr. Krisel traces his path from an environmental science major at the University of Florida to family medicine residency in Asheville, where he and co-founder Brian Lewis built a membership-based practice designed around time, trust, and root-cause care. They discuss the RVU system that rewards doctors for doing more rather than doing right, the CDC statistic that 85% of healthcare spending goes toward preventable or reversible conditions, and how near-zero-cost health coaching has become one of the clinic's highest-leverage tools.

The conversation then turns to longevity science: why cardiorespiratory fitness (VO2 max) may predict lifespan better than quitting smoking, why one minute of vigorous activity can outperform 90 minutes of walking, and why protecting lean muscle mass is central to avoiding frailty and sarcopenia. Dr. Krisel closes with Andrew Weil's concept of "compression of morbidity" — the idea that proactive care can't promise more years, but it can compress the years of decline, helping people live better, age better, and die better.

Key Takeaways:

• How the direct primary care membership model removes the financial incentive to over-test, over-refer, and over-treat
• Why RVU-based compensation in insurance medicine is linked to iatrogenic (system-caused) harm
• The CDC finding that 85% of healthcare dollars go toward preventable or reversible conditions
• Why near-zero-cost health coaching may be the single highest-leverage intervention in primary care
• Why VO2 max and cardiorespiratory fitness may be a stronger predictor of longevity than quitting smoking
• The outsized benefit of vigorous activity over light activity for reducing all-cause mortality
• Why protecting lean muscle mass and grip strength guards against sarcopenia, frailty, and cognitive decline
• Andrew Weil's concept of "compression of morbidity" — living, aging, and dying better through proactive care

Timestamps:

00:00 – 01:30 | Introduction: the case for rehumanizing primary care 

01:30 – 04:53 | Meet Dr. Chad Krisel and his path from environmental science to family medicine 

04:53 – 11:30 | How insurance incentives (RVUs) drive unnecessary care and patient harm 

11:30 – 16:15 | Inside IFMA: transparent, near-cost pricing on labs and supplements

 16:15 – 23:30 | Why direct primary care produces better outcomes than the 7-minute visit 

23:30 – 30:00 | Health coaching, personalization, and removing barriers to care

 30:00 – 41:00 | VO2 max, METs, and why cardio fitness outpredicts quitting smoking 

41:00 – 46:00 | Grip strength, sarcopenia, and protecting lean muscle mass with age 

46:00 – 52:00 | Compression of morbidity: living, aging, and dying better 52:00 – 

59:40 | Daily happiness, mindfulness, and lessons from Brian Johnson's routines 

59:40 – 1:04:56 | How to become a patient, book recommendations, and closing thoughts

Episode Links:

• Integrative Family Medicine of Asheville
• Instagram: @integrative__asheville
• Facebook: facebook.com/integrativeasheville

The Wellness in Asheville podcast is produced by Be Well Asheville, your local news source covering health + wellness news + events in Asheville. Get the latest at bewellasheville.com or follow @bewellasheville.

Transcript

travis (00:00)
All right. So today's guest is someone who is doing something both rare and radical. And he's doing it right here in our community. He's a physician who looked at the way primary care actually works in America and decided it was fundamentally broken and built something completely different. We're talking about a doctor who started a clinic that gives patients time, real time, deep relationships, root.

Cause conversations. And best of all, I am a patient. in this episode, we will talk a lot about how why things are broken in healthcare and the progress being made, as well as the new models being used to fix it. Long story short, reduce or remove insurance when possible. Dr. Chad Cressell is a board certified family physician and the co-founder of Integrative Family Medicine of Asheville.

An integrative primary care clinic focused on personalized prevention-centered health care. He blends evidence-based medicine with lifestyle, nutrition, and root cause approaches to help patients move beyond symptom management and toward long-term vitality. Dr. Chad is passionate about rehumanizing medicine, creating the time and space for deep relationships, meaningful conversations, and

truly individualized care. let's jump right in.

Travis Richardson (01:30)
Okay, on the show today, really excited because we have Dr. Chad Chrisel with Integrative Family Medicine and actually for me, it's extra special because I'm also a patient. So I have quite a bit of interest here in you Dr. Chad. So welcome to the show.

Chad (01:48)
Thank you so much. I'm excited to be here and I'm excited about what you're doing and bringing to the Asheville community. This is great.

Travis Richardson (01:55)
Yeah, thanks. Well, as you know, this is we're discussing longevity today and kind of also the intersection between the model that you have that you practice at the clinic there being direct primary care and how that intersects with longevity. We'll cover some other topics too, before we do, just give us the quick version of how your life story, your path and how you.

We're a part of starting Integrative Family Medicine of Asheville.

Chad (02:27)
Yeah, good question. gosh, I guess it goes back to college. was, an environmental science major and I was really interested in how we can make the world a better place. And, as I got further into it, I realized, well, you know, if people don't understand the connections between the choices that they're making and how that manifests in their own health and wellbeing.

then how can we expect folks to extend their sense of self to the environment and others around them? And so that got me interested in medicine. And the more I dove in, the more it just became a deeper and deeper interest. went to undergrad at University of Florida, went to medical school at Florida State University. And in medical school,

I was seeking out a community with folks who were like-minded in terms of taking a more holistic perspective on health and healing. And I ended up finding that community more nationally than locally and became very involved in a group called the American Medical Association. And in particular, a subset of that called a HUMED, which stood for humanistic medicine. And got deeply involved with that, ended up

joining the national leadership. And I was a part of creating national retreats for medical students to join with physician mentors. And we did retreats out in Santa Cruz, California and in North Florida. And really learning as very young, soon to be physicians from folks who are walking the talk and seeing that they're

is something outside of the traditional kind of sick care system that the medical insurance industrial complex is. And so that was really illuminating and inspiring for me. And I actually met my business and medical partner, Brian Lewis, in that group.

called humanistic medicine. And we ended up doing residency here in Asheville at Mayhack.

Travis Richardson (04:53)
That sounds really interesting. I've never heard of this.

Chad (04:55)
Yeah.

And I think it goes by a different name now, but when I was in medical school and a part of AMSA, which is the American Medical Students Association, that's the name for, it was a group of young medical students who were interested in bringing humanism and humanity into medicine. And that's how they came up with that word. So that was a group that brought all of us young, hippie, soon to be doctors together so that we could

Travis Richardson (05:23)
Nice, nice.

Chad (05:24)
have community with each other. yeah, as one of my mentors in life said, get it together, together. And so, you doing things in isolation is much harder than doing it in community. And so that group was really about coming together in community to try to figure out how we can pave a better way, at least through medical school initially and making it through that.

that crazy time period.

Brian and I, we went to the same residency and then when residency was concluding, we were trying to figure out, okay, how can we bring this holistic humanistic medicine to our community here in Asheville? And it was crystal clear that we could not do that under the insurance model, which I can talk at length about as to why that does not support a productive.

physician-patient relationship. And so we really just some good fortune and luck, we found ourselves at a conference where we heard about this idea of membership-based healthcare, which is really a capitated, a form of capitated healthcare where patients are paying the same amount no matter what. So it reduces or even eliminates the incentive of

trying to do more and make care more expensive, even at the expense of patient's health, which is really what ends up happening in insurance-based medicine, fee-for-service type medicine. know, one of, from the late and great Charlie Munger, Warren Buffett's life partner at Berkshire Hathaway, he had...

He had this great great quote. had lots of great quotes, but one of his quotes was show me the incentive and I'll show you the outcome. And in healthcare system where literally as you know, if, if care is made more expensive, the doctors are paid more money and the hospital systems and medical systems make more money. The incentive needs to be, I mean, we all took the Hippocratic oath of do no harm and

If the incentive for a monetary gain is to make the care more expensive, then that's exactly what's gonna happen. And that's why our country's healthcare system is the most expensive in the entire world. Last I checked, at least seven to eight times greater than the next most expensive healthcare

Travis Richardson (08:03)
you

Chad (08:04)
system in the world, yet we rank, according to the WHO, something like 37th worldwide in...

Travis Richardson (08:12)
Yeah.

Chad (08:13)
in the level of healthcare that we provide. you know, patients, they want to get better. Doctors, they want to help patients get better. But if the business is not in the same boat as the patient and the doctor, then it's just not going to happen. And, know, a dirty little secret in healthcare that no one talks about, but that's widespread and kind of the standard of care everywhere is that

Doctors are incentivized with bonuses or even their base pay on something called RVUs, which stands for relative value units. And what that means is for everything that's done in the healthcare system, there's an assignment of this unit called an RVU associated with it. And what that, so what that means boots on the ground is I'm working at the ER or I'm working in a family medicine clinic or urgent care or wherever it is. And

They tell you at the end of each month, okay, you build this many RVUs, so you get this amount of money. And, but what that means is that if you do more x-rays, more procedures, more laboratory tests, then you get more RVUs and you get thousands more dollars. And so unfortunately doing more, doing more tests and more procedures oftentimes leads to patient harm. I there's some studies showing that the number one cause of death

in the United States is iatrogenic causes of death. Scratch that, I might have that stat wrong. That might be the, I believe the stat is the third leading cause of death is iatrogenic. Iatrogenic meaning physician or system caused from hospital acquired infections, know, routine procedure, patient went in for whatever fill in the blank procedure and it went okay. But then they got a hospital acquired infection and then they die of that infection or

the procedures done on the wrong part of the body, or giving a medication that the pharmaceutical representative was just breathing down my neck that I need to prescribe this for every patient with fill in the blank and you prescribe this brand new medication and they have a side effect from the medication. And so there's so many systemic,

Travis Richardson (10:23)
Mm-hmm.

Chad (10:28)
there's so much systemic illness in our provision of healthcare in this country that

from a primary care perspective, Brian and I were thinking, okay, how can we insulate ourselves from that or even extricate ourselves from that altogether? And we came upon this idea, it wasn't really proven yet. We knew of one person doing it. Maybe there were five to 10 across the country doing this idea of patient pays an affordable monthly amount and then we're able to provide them as much primary care as they need throughout the year.

And if you think about where the incentive is there, our medical system at Integrated Family Medicine or at any direct primary care, since we started this 15 years ago, this model has grown like wildfire and there's many thousands of practices around the country. And now it has this name, direct primary care. Under this model, patients are paying the same amount, whether they're coming in 150 times or they're coming in 10 times.

they're paying the same amount, whether they're very sick or very healthy. And if you think about it, the medical system itself is highly incentivized to try and promote and actualize the health of their patient being as optimal as possible. Because, you know, if a patient comes in on day one and I work really hard and I help them get healthy and I'm continuing to have regular touch points in their life,

and we're working with our health coach to help them achieve their optimal health, then the business actually does better and we're very transparent about that. So then what that creates is this wonderful triad where the patient wants to be as healthy as possible. The doctors want to be as

Travis Richardson (12:20)
Mm-hmm.

Chad (12:21)
healthy, want the patients to be as healthy as possible. And the business also wants the patients to be as healthy as possible. And so there's no...

disincentive, there's no misalignment. And then we can be fully transparent with our patients that, yes, we do sell supplements in our office, but we're not making money off of them. We donate the proceeds. We mark them up just a little bit to make sure we don't lose money. Sometimes we do. Last year, we actually literally lost money after selling, I think, $20,000 worth of supplements.

Travis Richardson (12:53)
Ha ha.

Chad (12:54)
Because we intentionally don't want to mark them up more than we need to. But we mark them up just a little bit, and then we donate the

the profits to a nonprofit each month. And similar with medications, we're not making any money off of medications that we're prescribing or laboratory tests. have extremely nominal fees for like basic blood tests that we're doing all the time. We charge $5 per blood test. The same exact blood test in an ER would cost $400. Some of our clients were able to save many, many thousands of dollars just on labs alone.

Travis Richardson (13:30)
Yeah.

Chad (13:31)
And so, yeah.

Travis Richardson (13:31)
Well, I want

to step in real quick because I would just say from my experience, the fundamental difference as a consumer of your services is that for me, I feel like when I go in or if I have a consult online or phone call with a coach, I've always felt like there's this, like I'm going to go get healthier. I'm going there to get healthy. There's this fundamental

difference. Whereas if I go to a traditional doctor, it's like, man, something's really wrong with me. there's no idea of like, I'm going there to like, get healthy, if that makes any sense. It's the only way I can describe

Chad (14:13)
Yeah.

Travis Richardson (14:14)
it. And you go in the, if you go down, go to your clinic and you're sitting and you're seeing the person next to you and you're looking around and you're seeing books about health. You're seeing signs of wellness around you. And you think,

And there's just this feeling. don't know if it's an energetic feeling, but there for me, there's this feeling is that we're in a place where we're, they're trying to actually make us healthy here. Like that, that they're, they're really are trying to do that. That's what they number one want to do. That's what it feels like when I'm there. And, you know, when you go to a doctor's, a traditional doctor's office, it is often the feeling of, we're here just to do our job. we just want to get you pretty much in and out with a standard protocol.

to call as quickly as we can. And it doesn't feel like there's this interest in making me actually a healthier, happier human being. And I think that is, now, even if you keep the procedures the same, let's say, your clinic and some other clinic, and you're offering.

procedurally the same things. To me as a consumer, I'm not going for a procedure. I'm going because I want to know that somebody cares about me enough to want to help me get healthier and better. And I just wanted to say that that's my experience and I'm pretty passionate about the feeling that a doctor or a healthcare provider can instill in a patient so that when they walk out of there, they feel like that's what they want to go home and go do.

They want to go home and go do the thing that you've encouraged them to go try out, whether it's a diet or a supplement or whatever it might be. And I feel like that the outcomes have to be much, much better. And that way, it's in the adherence to a protocol would be much, way better in the model that you're providing.

Chad (16:15)
Hmm. That's, that's incredibly meaningful for me to hear because ultimately everything I just mentioned is the setup for what we're passionate about, which is providing authentic human connection in the healthcare that we're providing. Authentic relationships where we're sitting down, looking people in the eye, having a heartfelt connection with people that we can, we have, we don't have to worry about.

needing a seven minute time limit, right? We can get in there and we have the time to get into the really deep stuff that's most important and most impactful toward patients achieving their health goals and their optimal health outcomes. And yeah, it almost brings tears to my eyes, honestly, hearing stories like that and having the...

felt sense that we're making a meaningful difference in our patients lives because that's ultimately what we're going after. And one person kept out of the hospital, one person's heart attack that never happened, one person coming through the other side of depression. Just one of those makes it all worth it. And we get to have, we have the luxury and the good fortune to have so many of these experiences over and over again, each day, each week and month and year.

So, and it's also, it's

Travis Richardson (17:45)
All right.

Chad (17:46)
exciting to see that this model that we helped to pioneer almost by happenstance has grown such that there's some stats showing 10 % of family physicians are now practicing under this model. And some are going

Travis Richardson (17:59)
Wow.

Chad (18:00)
as far as to say that this will be the model that all primary care is provided through in due time

Travis Richardson (18:06)
Hmm.

Chad (18:07)
because

Because the other model is, is, it's not working. It's impractical is producing poor health outcomes. It's, it's insolvent, you know, and, and yeah.

Travis Richardson (18:17)
Can

you talk about that here too? I want to understand why the model itself lends itself to better health outcomes. Not

Chad (18:29)
Yeah.

Travis Richardson (18:30)
the interventions or the techniques, but the model I'm curious about.

Chad (18:33)
Yeah.

Well, I mean, one reason is what I've already

Travis Richardson (18:36)
As.

Chad (18:38)
mentioned with, you know, there's, there's just hands down more iatrogenic causes of harm when you only have seven minutes with a patient. Study after study has shown the less time a doctor has with their patient, the more likely the patient is to get a referral. The more likely the patient is to get a prescription, the more likely that something is getting done that

was really a result of lack of time. I mean, big hospital systems are literally buying up primary care for the sole reason, and many of these primary carers, they are literally insolvent. in, actually in the market, they would go out of business, but the hospital systems buy them up because they see them as a loss leader that they become a referral machine so that...

you fill in the blank, ologist gets more patients, right? So the cardiologist getting more patients and the orthopedist and the dermatologist and urologist, et cetera, much of which we can handle under primary care. Not to say that we don't work with cardiologists and urologists. We have wonderful relationships with the specialists in our community. And we're very lucky to have a great set of physicians and medical expertise in our community. And we

you know, we don't have to send out those referrals as much. So that's one big reason that you have a better health outcomes. The other is that there's this great statistic from the CDC that, or really sad statistic from the CDC, that 85 % of healthcare dollars in our country are spent on medical conditions that are preventable and or reversible if caught early enough, right?

Travis Richardson (20:22)
Holy

cow. 85 % goes to things that we could be doing to where we wouldn't have to spend that much money. That's an incredible amount of money. That's shocking.

Chad (20:35)
It's incredible. And, and keep in mind,

we spend seven times more than the next most expensive healthcare system in the world. And, yeah, it really is overwhelming to even think about. And so if these conditions are, are preventable or reversible, so why aren't we doing that? And I believe it boils down to the seven minute office visit that if we have time,

to sit with our patients. We're working in a system that is set up to promote their health. And we can then use our innovation and creativity to come up with ways that are gonna work for patients to fit into their lives and their unique situations so that they can get to the outcome that they're wanting, the physician's wanting, and now ideally the system wants as well. And so,

Travis Richardson (21:31)
Right.

Chad (21:32)
Like in our, in our clinic, initially we, it was, it was just us, medical providers and the patients. And then it hit us, you know, like a, like a brick in the head that, wow, most of these, conditions that we're talking about that are preventable and reversible are oftentimes products of poor lifestyle, right? Poor lifestyle decisions with like, I mean, we could, we could talk about this for an hour on its own, but from the food that we're eating.

from the sedentary lifestyle that we're living, from the super high stress life that we're living, from the poor quality sleep, that we realize we have to figure out a system to really get underneath what we now consider the pillars to how we are approaching healthcare, which is the opposite of all that. How do we optimize the food that we're eating, the movement that we're getting, the quality of sleep that we're getting, reduce stress in meaningful ways? And so in our...

I want to say second or third year in practice, decided at no, or I should say minimal extra charge to our patients. They get to see a health coach for, I think we charged $20 a session. Our employee clients pay zero.

Travis Richardson (22:46)
That's phenomenal. That's phenomenal. I just want to say to the listeners, if you haven't had health coaching, you can pay, well, honestly, you can pay as much as you want to pay. There's not a lot of

Chad (22:58)
Yeah.

Travis Richardson (22:59)
limit. I've seen that and I've had, I've used the health coach. I forget her name, but it was,

Chad (23:07)
or Ariana.

Travis Richardson (23:08)
yeah. And I was, I felt it was very helpful. And sometimes you just need accountability from

someone who like knows your unique situation and for the cost of that, and by the way, I want to say one more thing. Just this also kind of goes with your...

This is a more general observation and it also draws upon a story I had heard and that is that the more we can personalize care for people and free the hands of our healthcare providers to do.

what they think is best and not be so corralled into particular protocols or systems of intervention, standards of care that are maybe the standard of care, but it might be 20 years outdated. And this is a problem because for instance, there was a story I'd heard and I don't remember the exact context, but the thing was is that there was an observation that a population of people were not being helped in the way that they wanted to be helped,

they were, that was very effective. So I think it was a diabetic population and the standard model, they were having really horrible outcomes, guess. People were, blindness was rising like super, super fast. There's all these super costly,

metrics that they were seeing, right? So there was an experiment, said, all right, well, let's just give you free rein, as an experiment, and free, we're gonna give you this amount of money and free rein to do what you think is best. Come up and let's see if you can change the situation of this diabetic population. And what they found was the most effective thing to do was, this is the craziest thing, was to pay for transportation

to go see their doctor.

That was the

Chad (25:16)
Mm-hmm.

Travis Richardson (25:16)
main hurdle in their health outcome was that they found it challenging to figure out how to afford to get there. was a big city or

Chad (25:25)
Incredible.

Travis Richardson (25:26)
urban population. And all of a sudden things started changing and that would have never been done because in the standard model, healthcare, health insurance doesn't reimburse you get into your doctor. That's not part of the

Chad (25:41)
Yeah.

Travis Richardson (25:41)
treatment, but that was, that was the treatment actually. That was an,

Chad (25:44)
Yeah.

Travis Richardson (25:45)
an

intervention that was known but

Chad (25:47)
I believe it.

Travis Richardson (25:48)
right and so that happened at a very local hyper personalized level because the doctor had the money and the time to go spend how they knew best for their population and anyway it's a shout out to what y'all are doing which I'll let you continue on because this health care the health coaching is is like that

Chad (26:02)
Thank you. I'll say,

my sister-in-law works for the American Cancer Society for their international work. And she does work exactly along that subject in Africa of getting

Travis Richardson (26:15)
Hmm.

Chad (26:16)
people to get transportation, as an example, to be able to get their chemotherapy. And it makes a tremendous impact on their health outcomes. so that sort of thing, know, applied

across the country and across the world, it's creative solutions like that. Sometimes, Occam's razor, sometimes the simplest answer is the best answer, but

Travis Richardson (26:38)
Right. Right.

Chad (26:42)
we have to sometimes take a step back to see the forest from the trees.

Travis Richardson (26:46)
Yeah, and

I brought that up because the, because, offering health coaching at such a super low cost is in those same lines as saying that will move the needle more than a lot than most things, in my opinion, that moves the needle quite a bit. That's a huge, that's a, that's a

Chad (27:04)
Yeah. Yeah.

Travis Richardson (27:07)
lever that you can pull that has a lot of strength behind it.

Chad (27:10)
And it's so true. And that's why we made it near zero cost, as close to near zero cost as we could, because it's probably the most impactful thing we do, honestly, is if we can get folks to be working with a health coach. And sometimes it takes a little bit of arm wrestling to convince people to do it. But what I oftentimes describe is I'm like, look, if you think the best athletes in the world, you know, whether that was that's an Olympic athlete or

world champion boxer or whatever it is, they all have a coach in their corner. There's a reason for that. Right? So are

Travis Richardson (27:44)
Mm-hmm. Mm-hmm. Mm-hmm.

Chad (27:47)
you telling me that you are, you know, you're set apart from the most

Travis Richardson (27:51)
you

Chad (27:52)
elite athletes in the world that you don't need one.

Travis Richardson (27:55)
Right, right, right, right. Yeah. One of the most successful people I've, I know actually, as a business woman, who I took business coaching from and learned some things from her from that. And she told me that she herself has four coaches. Now it's because she can afford to have four coaches, but she had a relationship coach, a business coach,

Chad (28:11)
Mm. Love it.

Travis Richardson (28:17)
you know, all these things. I'm like, and you know, you see her talking and, and, but there's a reason why it's like she's willing.

to say I don't have all the answers and I'm coachable. I want to learn.

Chad (28:29)
Yeah.

Travis Richardson (28:29)
want to get better at whatever it is. that's a

Chad (28:33)
And so

then we can through health coaching and through unhurried meetings and connections with your medical provider, we can make this meaningful impact. I mean, the data is super clear. Like, you know, I know we were going to talk a little bit about VO2 max, right? And another way of describing that is in METS, which is technically stands for the metabolic equivalent of task, but it's essentially saying

This much effort is equivalent to one unit of a met, right? One unit of a met is sitting quietly. Above, you between two, and I might be getting these brackets a little bit off, but between two and five is light exercise, and between six and eight, moderate exercise, greater than, and so it goes like that. For every one met that a person is able to achieve,

higher than they were previously able to achieve. And so for many people, that just means simply, like if their normal life and their normal ability prior to working with a coach or a personal trainer is that they get winded from walking from their car into their house. And that's a reality for many people. If you can improve the cardio respiratory fitness for that person such that now they can take

a walk around the block without difficulty, then you have just decreased that person's chance of death by 13 % for every one met increase. so, and it's logarithmic, you know, as you go up, it's, mean, increasing cardiorespiratory fitness has been shown in huge studies and published in the most prestigious journals to have a higher impact on

a person's longevity than quitting smoking, than not having diabetes, than not having high blood pressure. And of course, it's crazy.

Travis Richardson (30:35)
Yeah, I saw that same one. That's crazy to think, isn't it? I mean,

just to put it to underline and to highlight what you just said, again, for the listener out there, what was just said is that quitting. having a peak level or a very high level of cardio fitness is. I hate to even say it, I won't say more important. That's not the right word.

is statistically a better predictor of your longevity than quitting smoking is the right way to say it. But if you

Chad (31:10)
Right, yeah.

Travis Richardson (31:11)
had to choose, so what's crazy to me is to think is that if I had to choose two things, which would be the stronger impact on my longevity, it would be to increase my cardio over quitting smoking, which is like, it blows your mind. But to say that

Chad (31:23)
That's right. It's crazy.

Travis Richardson (31:25)
out loud, you think to yourself, no way, that's not possible, but that is what we're saying here. That's what the studies say.

Chad (31:30)
Yeah. And I have people in

my personal life that they are elite athletes and they've actually exercised their whole life and they use tobacco. And,

Travis Richardson (31:38)
Yeah.

Chad (31:39)
you know, that exercise piece is

Travis Richardson (31:42)
you

Chad (31:42)
making a major impact on at least to some degree balancing out the risk of the tobacco.

Travis Richardson (31:48)
There.

I gotta say, I gotta

say, yeah, yeah, and I gotta, I gotta remember, I remember this too on the, there was a Blue Zones, Dan Butener, I think his name is, they did the Blue Zones, where people live the longest spots in the world. And there was a episode on that where I believe it was Sardinia, and it was interesting.

Chad (32:10)
Yeah.

Travis Richardson (32:11)
when we're talking about these things, these are all, there's so many variables, right? So it's really hard to pinpoint a lot of these things, why they're happening, but I was

in Sardinia, they were showing that the men, don't quote me on this, but the men I believe I think was outlived the women in this particular area in Sardinia and the men smoked and the women didn't.

Chad (32:33)
Hmm, interesting.

Travis Richardson (32:33)
And it was,

yeah, so, cause you got two things there. First of all, women always outlive men. We all know that, that to be a thing.

Chad (32:37)
Right. That's right.

Travis Richardson (32:40)
And certainly non-smokers outlive smokers. And we all know that to be a truth. in this case, I want to say, and I can go back and fact check myself, make sure I'm accurate on it, is that they thought though, was that the men did a lot more walking and the terrain was really

Chad (32:58)
Mmm.

Travis Richardson (32:58)
steep often. There was never any flat and they were always walking up and down these hills.

I'm not convoluting the story here, but

Chad (33:06)
Yeah.

Travis Richardson (33:07)
there's some protective measure there that even despite that they were smoking and all this, that they were still

Chad (33:13)
Right.

Travis Richardson (33:14)
often in better shape. anyways, will

Chad (33:16)
What?

Travis Richardson (33:17)
fact check myself, put that in the show notes whether that's true or not.

Chad (33:23)
One pearl I gleaned from that is, and to piggyback on what I was talking about a second ago, is that yes, the stat is that if you're in the upper quartile, so beyond the 75th percent or up, that's where you get that it's a greater protective benefit as compared to quitting tobacco. But having said that, for us mere mortals who are not necessarily in the upper quartile,

Travis Richardson (33:48)
Yeah

Chad (33:49)
For most folks, the biggest gains are really gonna come from being sedentary to being non-sedentary. And yes, we can biohack and get super geeky into exercise physiology. I'm admittedly an exercise addict to some degree. But

Travis Richardson (34:12)
Yeah, yeah, me too, me too.

Chad (34:14)
for the vast majority of people,

just going from non-sedentary to sedentary is going to make the most dramatic difference. And if they want to take it beyond that, which they might want to, because then you start to experience just the runner's high and the euphoric feelings of being non-sedentary, and you get to feel them like that and you want more of it.

Travis Richardson (34:40)
Yeah, And speaking

of that, there's just being like lots of regular movement, think office work, I just being able to move during the day is such a huge profound

Chad (34:52)
Yeah.

Travis Richardson (34:53)
thing you can do. I also heard this really interesting thing. There's an influencer, Dr. Rhonda Patrick, her claim to fame is she's got this found my fitness website and she's very influential. One

Chad (35:07)
Prolific, yeah.

Travis Richardson (35:08)
of the things I heard her say, I don't know if you

have heard this study or seen this, but she was saying that in a recent study, they showed that for every, a profound difference between just walking and vigorous activity. So they used to think

Chad (35:27)
Hmm.

Travis Richardson (35:28)
that walking would be protective and is enough for most people, like we're built to walk. So.

there wasn't

Chad (35:36)
Yeah.

Travis Richardson (35:36)
this gap between the difference between how good it is for you to walk versus vigorous exercise. And at least with cardio protective effects, I believe she said that one minute of vigorous activity, you would have to get, it was something around like.

some ridiculous number of walking to get the same equivalent was like 90 minutes or something. It a crazy amount of

Chad (35:59)
Mm-hmm. Nice.

Travis Richardson (36:01)
walking to achieve that same benefit. I'll have to, we're getting research. Part of this is I hear so many things and I'm always like,

Chad (36:10)
Yeah.

Travis Richardson (36:10)
what's the context? But there is a dramatic difference and so the idea is if you can at least get some bit of vigorous activity, it's very helpful. Even

Chad (36:18)
vigorous activity.

Travis Richardson (36:18)
one minute, one minute is very helpful.

Chad (36:22)
And I don't think that's untrue. think that so much of the art of medicine, of what we are doing when we're in the room with patients is trying to figure out who's sitting in front of me, right? I have some people who no matter what I or the health coach does or says or encourages or begs, they're not doing any physical activity and they come in for a condition and

I'm like, hey, well, you could very possibly avoid a medication if you do X, Y, and Z. And they say, I just want the medication. So for that patient,

Travis Richardson (36:59)
Yeah.

Chad (37:02)
the medication is going to be best. If the reality for this patient is that for whatever reason, there's 0 % chance that they're gonna make the changes, the medication is better than nothing. And for many patients, especially in a relatively

active area, like we live in Asheville with lots of folks interested in movement. We also have tons of patients who are interested, hey, how do I dial in the exercise program that is going to give me the optimal chance that I'm going to be able to continue backpacking or cycling when

Travis Richardson (37:41)
Right.

Chad (37:42)
I'm 75 years old. And

Travis Richardson (37:44)
Right.

Chad (37:45)
for them, yeah, we're going to be talking about

vigorous physical activity, how often, resistance training and the benefits of that unique to aerobic training. And even getting into moderate intensity aerobic training, such as zone two or vigorous intensity, such as high intensity interval training and the unique benefits and all of these different things do confer unique benefits. But two steps back from that is who's sitting in front of me and

what's the next increment of change that they are ready for? Because if you go five increments ahead of where that person is, then you've already lost them. that's part of it. It's not sustainable. It's part of the trust

Travis Richardson (38:28)
It's not sustainable. Yeah.

Chad (38:32)
building and working with reality and not the ideal per se.

Travis Richardson (38:40)
Right,

right. I think it's really important for people to feel two things. One is confident and two is successful. If you have,

Chad (38:49)
You're here.

Travis Richardson (38:50)
you need both, right? And if you take away either of those things, you're not going to have a good outcome. I'm going to read this really quick because I just Googled it I wanted it because I this is just so fascinating. And then we'll get on to some next topic here. And it says,

Chad (39:03)
Yeah, sure.

Travis Richardson (39:03)
I Googled up said according to Dr. Rhonda Patrick, citing a large scale study of over 70,000 adults, one

minute of vigorous activity provides a health benefit equivalent to 53 to 94 minutes of light activity like casual strolling. And this is for

Chad (39:21)
Mm-hmm.

Travis Richardson (39:21)
reducing all cause mortality.

And it says standard guidelines used to use a one to, or do use a one to two ratio, which was that one minute of vigorous equals two minutes of moderate. And so according to this large scale study, it's basically what she's saying is that it's a 10X difference, not two X. So it's a, then you can extrapolate that on a lot of other metrics in cardiovascular.

mortality risk for type 2 diabetes. We won't go into all that, but anyways, I just was wanting to clarify

Chad (39:54)
Yeah.

Travis Richardson (39:55)
that that is the real numbers there.

Chad (39:58)
Thanks for that. And the reason for that is that vigorous physical activity is more potent, apparently 10 times more potent at improving your VO2 max or your peak met level.

Travis Richardson (40:12)
Yeah.

Chad (40:13)
And it's that VO2 max, which, to use English here, that's how much oxygen your body is able to consume.

at any level of exercise, well, your VO2. VO2 max is the maximum amount of oxygen your body is able to consume. After that point, then aerobic respiration does not increase anymore. And so then you start building up lactic acid, you get winded and you have to dial it back or stop. And it's that number, the

Travis Richardson (40:45)
it

Chad (40:47)
peak met or the VO2 max that's associated with such a dramatic

improvement in decreasing all-cause mortality and that's the one that's comparing it to quitting smoking.

Travis Richardson (41:00)
Yeah, that makes sense. And if you think about other things like the mitochondria, the energy producers in our muscles, probably if you were to go and say, if you were looked at somebody who had a high VO2 max or a high grip strength, all these measures that we use to show indicators of longevity, you probably under the hood would also find that you've got the mitochondria are very healthy and very,

there's

a lot of them, right?

Chad (41:32)
Yeah.

Travis Richardson (41:32)
And doing their thing, because we know that, like one of things I know is that as we age, we lose some of that capacity, like fast-twitch muscle fibers, for instance, are one of the first to go. Well, if

Chad (41:43)
Hmm.

Travis Richardson (41:43)
you're somebody who's working on some of these factors, you're going to be improving your odds of being able to still run when you're after age 50 or 60, right? Because a lot of people can't, we

Chad (41:57)
That's right.

Travis Richardson (41:58)
lose those simple things we used to do when we

young as we age. So

Chad (42:02)
Yeah.

Travis Richardson (42:03)
let's talk about that grip strength and the importance, I guess, preventing things like sarcopenia. Let's talk about muscles

Chad (42:16)
Mm-hmm.

Travis Richardson (42:16)
because I think that frailty, we have a lot of, in the population that follow me, folks that are worried about osteopenia, osteoporosis, sarcopenia. Let's just talk about how that whole thing can

alleviated through exercise, guess a little bit more.

Chad (42:34)
Yeah, sure. So yeah,

you're exactly right that as we age, we expect to lose lean muscle mass. And included along with the lean muscle mass is everything that the organ of the muscle helps us with, producing anti-inflammatory molecules, producing something called BDNF, which is...

brain-derived neurotropic factor, which helps with the neuroplasticity of our brain, the lower that is, the higher odds of Alzheimer's. Muscle itself is, it sucks up the glucose in our body, so it helps with glucose regulation. As we age, we lose about three to 8 % of our lean muscle mass per decade, and that compounds in a way that we're...

that's not ideal. So that by the time we're 75 or 80, we've lost 30 to 40 % of our muscle mass as compared to our younger selves. And so if we're not working on that, and we're not genetically well endowed, some people are genetically better off than others. That could mean the difference between by the time you're 75, by the time you're 75, not being able to

join your family for, for the Thanksgiving walk or pick up your grandkids, when it's their birthday and, and they're, and they're climbing all over you. you know, on the contrary, if we are trading it our whole lives and, you know, I think of, I'm a big backpacker and, you know, in the Appalachian trail, everyone gets a trail name. And, there was this guy, Nimble Will Nomad who hiked the entire Appalachian trail at age 83.

2,200 miles of, you know,

Travis Richardson (44:30)
Whoa, whoa.

Chad (44:32)
and anyone who's done that backpacking, I mean, it's climbing 3000 foot climbs just to descend 3000 feet and just to do it again. And, so people who, who are continuing to keep up their conditioning, no one, you know, I mean, maybe AI changes this, I don't know, but right now I'm not banking on anyone not dying and no one's promising that. Right. I mean, we're all going to die one day.

And accepting that and not putting that, know, brushing that to the side, I think is really important for many reasons that we can talk about. And so all of this work, it's not to ignore the fact that we are mortal beings. And at the same time, simultaneously, it's also a reality that people who are keeping up their conditioning, whether it's through

keeping up their lean muscle mass or all of the aerobic stuff that we're talking about, it can mean a very real difference between the last decade of your life being very functional or very not functional. And so that's something to keep in mind. Again, as a physician, I'm working with a patient in front of me and...

I'm gonna talk about some of this, but if it's something that they're not interested in hearing, then there's plenty of other things that we can talk about as well. But on the subject of longevity, if you're ignoring these aspects of physical training, whether it's resistance training to keep up the lean muscle mass or the aerobic, then you're simultaneously ignoring the number one factor that's actually under our control to help enable

how do I say, a longevity that you're gonna wanna be in, right? Because an interesting

Travis Richardson (46:24)
All right. All right.

Chad (46:25)
point is that modern medicine actually does a very good job of keeping people alive for a long time, right? And we all know people who don't do any of this and they live to be 85 or 90, but for too many of those people, the last five, 10, 20 years of their life,

can be fairly uncomfortable and fairly non-functional. And by taking these proactive measures, it can mean the difference between needing an aid to get to the bathroom or not, right? Between being able to transport yourself from your house. I mean, I'm talking about the, I was gonna say the extreme ages, but not necessarily. For too many people,

There is such a stark difference. sometimes say the decade between 70 and 80, and especially 75 and 85, can be as profound a difference as the decade between ages 10 and 20, which is obviously when we go through puberty and we go from being a kid to being an adult. And

Travis Richardson (47:38)
Great.

Chad (47:39)
taking these proactive measures, oftentimes,

That's where it has the most dramatic effect is that between 75 and 85, it could be the difference that you're in a nursing facility for five years or you're hiking the Appalachian Trail at 83. And again, it's incredible. It's incredible.

Travis Richardson (47:56)
Yeah, isn't that incredible?

If you think about that, that's just so, and these are, you could even say that there are two people that don't have any current diseases, but one who has...

One who's been maybe completely sedentary, not activated in any of these, you talked about BDNF and all these other factors that can help preserve muscle, and somebody else who is, has been active, one person can just slow down to the point where they need a walker, or they can barely walk anymore without getting out of breath. And the only thing that they did wrong was they really didn't do much mobility

much activity, much physical activity their whole life. And so I guess I've seen these curves. Maybe you're also familiar with these. well, we can take VO2 max since we're still on that topic. Reference that earlier or strength or strength could be another one. Is that, hey, everybody's declining. You just said yourself three to 8 % per decade decline. Okay, so everybody's declining. The question is, is what do you want your curve

to

look like? What's

Chad (49:14)
That's right.

Travis Richardson (49:15)
the drop off that you want to experience? You could say that the goal is to not think that you're going to have any drop off. It's just that you want to have more of gradual drop off as opposed to a roller coaster that slams you down. And that is what happens. So I guess my

Chad (49:34)
That's right.

Travis Richardson (49:35)
thing is that at age 75, if I'm

as above average as I can be for myself, guess is the only way to say that. If I'm above, if my curve is a little higher up, as high as I can get it, then my drop off, I'll be better off at 85 than if I hadn't done anything at all, I guess is how I'm thinking of it. Yeah.

Chad (49:56)
That's right. You got it. Yeah.

What one phrase that comes to mind, which I first heard from arguably the father of integrated medicine, Andrew Weil, who when I was in medical school and early on was one of my heroes. He uses this term called compression morbidity, which is the idea that we're all going to have, unless we

have the good fortune, whether you believe that or not, to die in our sleep at a nice old age of a heart attack, right? We're 90 and we just go off peacefully. But the statistics show that greater than 50 % of Americans will spend a year or more in a nursing home. And many of us will have a period of our life that we have so-called comorbid conditions, right? And that could be anything from

I mean, fill in the blank, osteoarthritis, an autoimmune condition, cardiovascular disease, a heart attack that didn't kill us, but we have some heart failure. I mean, these things happen, right? If you don't believe it, look at your dogs, right? We have our dogs, we all know our dogs in the last few years of their life. They're not what they were when they were four five. We're no different, but we are different in that,

We can take these proactive measures and this idea of compression morbidity is taking that comorbid period of our life and squelching it down to as short a period as possible. So that ideally we're functional. Yeah, we might not be doing the things that we were doing when we were 25, but we can still make it to the card game with our friends or take a walk or take a gentle bike ride.

And then we have a relatively short period of our life that things are going wrong and then we eventually pass.

Yeah. I, you know, and emphasizing we're not trying to put off this idea that we're going to, going to die, but I was thinking of this phrase the other day, you know, can we, can we be proactive so that we can increase the odds? And that's all this is. There's no promises with any of this, right? But we can statistically say that we can increase the odds that we can live better, that we can age better, and that we can die better.

through taking proactive measures. Live better by increasing the chance that just my quality of life today is gonna be better because of the actions I've taken, that I'm gonna be more likely, not guaranteed, but more likely to be in a positive mind state. More likely to be able to get a solid night's sleep. Not guaranteed, but more likely. So then tomorrow I feel more refreshed. Age better, such that as the years pass,

I have a less steep decline. It's not that there's not going to be a decline, but that is less steep. And that the dying better piece that you know, being proactive and interested. Yeah. I remember reading a book by, I can't remember. Was it think Pema Chodron? that was called How We Live Is How We Die. And it's the idea that, you know, if we're, if we're

putting off all the shit that we need to deal with, right? And the I'm sorry's that I need to say, the realities of our life, then that's gonna hit us like a truck at some point. And for many people, that means dying very poorly, right? Because we're sitting with the heaviness of this. mean, even on just functional level, just the estate planning and figuring out, you you wouldn't believe how many people who passed didn't give their partner

all their logins to their bank accounts and their insurance accounts and all this stuff. And then their family members are left with this nightmare to comb through. And then here in Nashville, just to give a shout out to Emberlite CCLD, which is the Center for Conscious Living and Dying, that's really taking such a proactive step in this dying piece and helping people die with dignity and making

that passage onto whatever's next so much, just to whatever degree we can easier. And so there's a whole world along that lines that thankfully is coming to fruition.

Travis Richardson (54:45)
And that would be a whole separate, I should have them on a podcast. That's like a whole topic that deserves a lot of attention. It's not talked about, it

Chad (54:50)
Yeah, for sure. Agreed.

Travis Richardson (54:53)
should be more. Great, yeah, well, there's, I mean, we could probably, there's so much that we've covered and could cover. I think the main message that my takeaway is that, know, living,

if I have longevity in mind, what you were just saying is that I agree, is that we actually can live a better life today. It's not that those two things are separate. I actually think about, thought about this guy, Brian Johnson, a lot of people have heard of him in the longevity community. He's the guy that spends countless amounts of money on testing things on himself and he's aging like a baby, I guess. His

Chad (55:33)
Yeah.

Travis Richardson (55:34)
rate of aging is that of a two year old.

Chad (55:37)
Yeah.

Travis Richardson (55:38)
but, somebody asked him, said, you know, you have, you live such a strict lifestyle and, and, and, that must be really like, I would never want to do that. And there's this pushback against him. And I look at that a little bit curious because, because I've seen him, I've asked him, or not asked him. I've heard him talk about his, his, his protocols, the things that he does. And he says, you know what, actually I'm as happy as I've ever been. I used to be depressed. I was depressed for 10 years. I'm now not depressed at all. sleep eight.

hours a day and feel very good when I wake up. So it's not really, I don't know why we have this idea that if we do these things that feel like they're, I don't know, strict, that somehow those make us unhappy. And sometimes what the body really does love actually is routines and protocols. mean, going to sleep is such a thing, right? We, we, the body loves it if you go to bed at the same time every night. So

Chad (56:32)
Mm-hmm.

Travis Richardson (56:33)
I don't find this to be a problem to say that I like to

work out at the same time every day I should be eating at a certain time I should sleep at a certain time the Sun rises and sets at a certain time my gosh why who am I to think I shouldn't be similar

Chad (56:49)
Yeah, man, I could not agree more that,

and that's the live better piece, right? If all we're thinking

Travis Richardson (56:55)
Yeah.

Chad (56:56)
is about the future at the expense of the now, then that's not an endeavor that I would find worthwhile. you know,

Travis Richardson (57:03)
Yeah, totally.

Chad (57:04)
ultimately, you know, again, nothing is promised, right? And our last day could be today. We have no idea what tomorrow will bring and people...

I remember the show on HBO called Six Feet Under. I don't know if you ever saw that. was

Travis Richardson (57:22)
Yeah, yeah, yeah.

Chad (57:23)
a great show. But at the very beginning of each show, the storyline for your listeners was it followed this family that ran a funeral home. And it was just kind of their story. But at the very beginning of each show, it showed a person who would die. And then the rest of the show was them kind of caretaking for this person. But the way that it would show people die in the first three minutes of the show,

was the most random of events, right? From a beasting at a picnic to stepping off a ledge to hiking and a mountain lion attacks or all kinds of

Travis Richardson (58:00)
you

Chad (58:00)
things. This stuff happens. And when you work

Travis Richardson (58:03)
Right.

Chad (58:03)
in an ER, it's front and center for you. And so all that, but what's so cool is that everything we're talking about, and we just scratched the surface. We mainly have spoken about the physical activity piece.

But when we're eating better and when we are sleeping better and when we're taking proactive measures to reduce our stress, there's things we can do that are tried and true to do this. Just a walk in the woods or sitting meditation or spending time with friends, dancing, some unique things, right? Like riding a horse or painting or you see my guitar in the background here for playing music.

Travis Richardson (58:42)
Yeah, yeah, yeah.

Chad (58:45)
So reducing stress in a meaningful way, all these things, yes, they help with the longevity piece, but they help with also the daily happiness piece. And there's a whole, whole, whole world out there, a whole specialty of positive psychology, which is the psychology of what are endeavors we can take just to increase our daily happiness. And it's a lot of these same measures.

keeping the body moving and just all of this stuff. And so, yeah, all that said, think that working for the future at the expense of the now is not worth it. But thankfully, the very same interventions help us increase the chance that today is gonna be a good day.

Travis Richardson (59:40)
Yeah, well,

I just want to say thanks for your contribution to the medical profession and what you're doing.

And starting up, you know, at a time when this wasn't really a model that that many were, you you're really a frontiersman in this way, you and your partner. I really think that Asheville as a community has such amazing healers and practitioners and doctors. And I absolutely feel that integrative family medicine of Asheville is part of that. you guys have a legacy.

especially here in Asheville, that I'm particularly proud of. I just think it's...

I'm really, I really enjoy doing these, these podcasts episodes because I love sharing people doing amazing things. And, I'm really excited to continue to share with the audience. so I guess my question to you is how do you, if I'm a listener, how do I get involved? is there a way I can, you know, if I'm listening and saying, I'd like to go check out, the clinic, what's the best way for someone to find out more, to come potentially even maybe be a patient? there a.

Way to do that.

Chad (1:00:57)
Yeah, I mean, probably the best way is to visit our website at integrativeashville.org and our phone number, you can call us. It's on there as 828-575-9600, but definitely the website is super informative and we've got a location down in Arden as well as in the River Arch District on Depot Street. And yeah, I appreciate that. And I appreciate your kind words. It's a...

It makes it, again, I know I said it earlier, but it makes it all worth it hearing words of appreciation. it's, we feel

Travis Richardson (1:01:33)
Yeah.

Chad (1:01:34)
incredibly privileged to play the role that we're playing. So thank you.

Travis Richardson (1:01:38)
Yeah,

you're very welcome.

So OK, so last question. I always do a rapid fire question at the end. You mentioned a couple of books. You're obviously

some form of an avid book reader or have been, what would be the number one book that's influenced how you see health, wellness, life, can be

Chad (1:02:03)
Hmm.

Travis Richardson (1:02:04)
anything? What's the most,

Chad (1:02:06)
Hmm.

Travis Richardson (1:02:07)
yeah, what's your favorite book in that way?

Chad (1:02:09)
Yeah, that's

a good question. God, I have so many. would say, I mean, early on, again, any of the Andrew Weill books, some of them might be a bit outdated now. For daily quality of life, I'm a big believer in the power of a mindfulness meditation practice. And so, you know, from John Kabat-Zinn to Thich Nhat Hanh and...

Jack Kornfield, know, any of those authors, you can pick up any book and it'll blow your mind and help illuminate a perspective on reality that can be life-shifting. Yeah, and I'm a big fan of Michael Pollan and just, you again, the Occam's razor perspective of the simplicity of eat food, mostly plants, not too much. I would add on to that.

that he doesn't have, make sure you get enough protein.

Travis Richardson (1:03:09)
Mm.

Chad (1:03:11)
But yeah, his books have also been mind blowing for me, from the omnivorous dilemma to food rules, to how to change your mind. I mean, he's been instrumental in helping spread the knowledge of the benefits that psychedelics are bringing to folks from the studies from Hopkins and UCLA and NYU and London and

And then I'm actually reading his current book, which is called, A World Appears, A Journey into Consciousness. I think that's the subtitle, but a world appears and it's super interesting. that's what comes to the top of mind.

Travis Richardson (1:03:55)
that's plenty. think if any one of those authors themselves has have so much to offer. I know

Chad (1:04:02)
so much.

Travis Richardson (1:04:03)
Tic Na Ton has influenced me quite a bit. So did Dr. Weil back in the day. Like he was one of the first names I remember even reading about many years ago. So

Chad (1:04:13)
Mm-hmm. Yeah.

Travis Richardson (1:04:15)
yeah, awesome. Well, and then yeah, the contemplative part of things. I think that is a whole separate topic of wellness unto itself that is probably one

the most important and most needed especially right now. We live in such a

Chad (1:04:29)
Yeah.

Travis Richardson (1:04:29)
chaotic, crazy, crazy time. appreciate your, yeah.

Chad (1:04:32)
I concur.

Travis Richardson (1:04:35)
Well, I will let you go. I know you probably have a busy day. Thanks for your time. Do appreciate it and we'll get some things into the show notes and hopefully you have a blessed day.

Chad (1:04:45)
All right. Sounds great. And thank you for the work that you're doing for our Asheville community. I love that you started this Be Well podcast and yeah, good luck as it, as it expands

travis (1:04:56)
That was Dr. Chad Chrysell. And I'll be honest, this conversation hit me somewhere important. The idea that we've organized primary care in this country has quietly been stealing years from people's lives. And that someone here in Asheville is actually doing something real about it, that matters. And the reminder that none of us get out of here alive. So we'd better start treating our time like the non renewable resource it is. That one I'm carrying with me.

If you want to learn more about Dr. Cassell's practice, head to integrativeashville.org. You can also follow the clinic on Instagram at integrative underscore Asheville and on Facebook at facebook.com slash integrativeasheville. Most importantly, please share this with somebody who is overdue for a doctor that actually listens. Until next time, be well, Asheville.