What's Wrong with Our Medical System?

The next generation of women's health care emerges

For 20 years I have been practicing medicine and I have never been more baffled over how mainstream medicine misses the boat on the very foundation of good health: nutrition, physical fitness, and mental health. The frustration rings loud when I see patients and clients talk about how their healthcare provider “just doesn’t get it”. Midlife women experiencing menopausal symptoms are constantly dismissed with the “shrug" and “you’re getting older” with the undertone that screams “Just deal with it” and neglecting the very simple nutrition and movement strategies that can be game-changers.

The other frustration I hear is from the competitive athletes. These are the women who meet the American Heart Association guidelines for “150 minutes of moderate-intensity exercise per week” by Wednesday and are told by their providers that they should “slow down” and “avoid intensity”. For the record, only 20% of the population actually meets those AHA guidelines, which underscores the abysmal job the medical community is doing to promote physical activity in the general population. But somehow, despite these well-known recommendations from the AHA, the 50-year-old competitive female athlete who is meeting and exceeding these guidelines is met with apprehension and in some cases contempt.

We haven’t even broached the subject of the barbell. More and more data in the medical literature supports resistance training for bone health, but squats, deadlifts, cleans, and bench presses are met with “you don’t need to do that crazy stuff - walking is just fine”. Now, I’m not demonizing walking. Everyone can benefit from walking, but it only scratches the surface of the benefits compared to what can be achieved with weight training.

It’s no wonder women are intimidated by the barbell - the negative messaging is everywhere despite the mountain of evidence for the long list of benefits of doing these types of lifts - not just for bone health, but for muscle health, metabolism, and joint health, to name a few. And these lifts are safe when you learn to do them correctly! Just like any other athletic endeavor -once you learn the proper mechanics and safety considerations, these activities can be enjoyed for the long term.

How did we get here?

So why does this “abyss” between the worlds of medicine and wellness exist? My personal opinion is that it is a matter of not having enough time to be good at everything. As knowledge in medicine and fitness advances, it can become overwhelming for any one provider to keep up with everything. As a result, providers become more specialized and focus their expertise in a more limited area. An example of this is the field of Obstetrics and Gynecology (OBGYN). Generations ago, the OBGYN doc did it all. They delivered babies, served as primary care physicians, dealt with infertility, incontinence, and menopause. Today, there is a separate subspecialty for every one of these areas: the obstetrical hospitalist who delivers babies, the urogynogolist specializing in incontinence, the Certified Menopause Practitioner, the infertility specialist - and the list goes on.

We can extend this idea to the “specialty” of nutrition, fitness, and wellness. In defense of my medical colleagues, they just don’t have the time or expertise to even begin to gain the proficiency of a personal trainer, nutritionist, strength, or triathlon coach. So what we have, are these medical and wellness “specialties” living in their own “silos”, isolated from one another. What’s missing is the means to integrate these “silos” into a functional, interdisciplinary team approach to optimal health for females.

A New Medical Model Emerges

Over the last decade, the need for an integrative approach to healthcare has been appreciated by some medical providers and wellness professionals. Functional Medicine providers are ahead of the curve as compared to their Allopathic counterparts in placing more emphasis on lifestyle and environmental factors as the foundation of care, as compared to a “pill to solve every ill”.

The fitness industry has also moved toward breaking down the walls of the silos. In 2017, Greg Glassman, the Founder and former CEO of CrossFit recruited physicians who are part of CrossFit communities from all over the world to come together to create an entity with the mission of “curing chronic disease” with the foundational principles of sound nutrition and physical fitness rooted in “constantly varied functional movement at high intensity” and eating “meat and vegetables, nuts and seeds, some fruit, little starch, and no sugar”.

As one of the physicians who was recruited, this experience was one of the most inspirational things I have ever done in my career. As part of this recruitment, physicians participated in a weekend-long training for the CrossFit Level 1 trainer credential at “The Ranch” in Aromas, California - where the CrossFit “movement” was started in the early 2000s. We trained with some of the most elite trainers in the industry and shared our passions as physicians who wanted to make a difference off the beaten path of the “pill for every ill”.

I met physicians who were already integrating wellness and medicine into their medical practice by having their medical “office” as part of their gym or facility. We created a “network” of providers with their locations and contact information as a referral base so that fitness professionals and providers have a resource to refer their clients for this more comprehensive approach to good health. Sadly, we need more of these practices to meet the needs of our patients and clients who are continually let down by “mainstream medicine”.

The biggest shout-out, however, goes to my colleagues at Wild Health, where they have this integration down to a science! The keystones of the Wild Health model are precision medicine with an extensive genetic assessment to help personalize care. Every client has a lead physician and a health coach with access to various specialty consultants, such as myself, for more specialized care in hormonal issues, immunology, and the like. This model is a true representation of the integrated approach so sorely needed in medicine and wellness today.

Now it’s my turn

It is with great excitement that I announce the upcoming launch of my medical practice in the fall of 2024 specializing in “Reproductive endocrine care for active and high-performing women from puberty through menopause”. This is the first Women’s tele-healthcare specialty concierge practice of its kind that integrates cutting-edge medical practice with individualized fitness and wellness resources through the Health and Wellness Concierge (HWC).

The HWC is composed of a team of “Concierges” who are highly credentialed and experienced in coaching active women and elite female athletes of all ages and athletic backgrounds. Every patient chooses a “Concierge” who helps connect them to the resources they need to achieve their health, wellness, and performance goals. The HWC program also provides clients with exclusive discounts on products and services from some of the most esteemed names in the fitness and wellness industry.

To start, I will be accepting patients for medical consultation who reside in Massachusetts, New York, New Jersey, Ohio, and Florida, with additional states to be added as demand increases. If you do not live in these states but need help, I also offer non-medical and performance consultations to provide guidance and suggestions that you can take to your healthcare providers, coaches, and trainers for further discussion. There will also be “membership access” to the HWC for non-medical clients.

The Future

Despite the challenges that Women’s healthcare faces, there is a clear trend in the right direction. As the Title IX generation is entering a stage of life with years of wisdom and experience behind them, the trailblazing continues. We are more aware. We ask questions. We question what doesn’t make sense and empower ourselves with the resources we need to thrive and leave the “status quo” of past generations behind us. Just like Title IX changed the landscape of women’s sport forever, this same generation will also change women’s healthcare forever! Game on!

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Now Hiring….

Coaches and trainers!!!!! I am looking for a Coach/Trainer who resides in the New York /New Jersey metro area to be a member of my HWC Concierge Team! I am looking for experienced individuals who:

• Are passionate about helping women thrive

• Have experience coaching/training women of all ages

• Ideally have some special training/experience with mid-life women

Some details about the opportunity:

• Independent contractor relationship

• Connect HWC Clients to the resources they need to achieve their wellness goals with an opportunity to promote your own services if they meet the needs of the client.

• Promotion on the Carla DiGirolamo, MD medical practice website as a member of the Concierge Team with opportunities to promote (for FREE) your profile/business, podcasts, and the like.

• Bonus opportunities for performance excellence and client satisfaction

• Become a part of this growing and collaborative Concierge Team! We have 3 amazing Coaches from Massachusetts, Florida, and Ohio already on board!

If you are interested in learning more about this opportunity, please email me at julygirl00719@gmail.com