The annual physical needs to be completely overhauled to include a focus on prevention rather than merely identifying what’s already broken. Studies have shown the annual physical, as is currently done, has no impact on mortality. We need to include more predictive biomarkers that can lead to proactive lifestyle or medication changes which can help to prevent serious problems down the road.
Asa part of my interview series with leaders in healthcare, I had the pleasure to interview Dr. Myles Spar. Dr. Spar is founder of the Tack180 Integrative Health Program and is now the Chief Medical Officer for Vault Health, an optimal health program for men. He is also the director of the Integrative Medicine program at the Simms-Mann Health and Wellness Center at Venice Family Clinic. He is a Clinical faculty member of the UCLA and University of Arizona Schools of Medicine. Dr Spar has served as a consultant to the NBA, working with many NBA teams on optimal health and Integrative Medicine issues. He co-edited Integrative Men’s Health from Oxford University Press and his book, Optimal Men’s Health: Your guide to being healthy in order to win! comes out in February 2020. Dr. Spar is the recipient of the Bravewell Award for Leadership in Integrative Medicine in 2013. Born in Charleston, South Carolina, Dr. Spar attended the University of Michigan Medical School and worked as a humanitarian for Medecins sans Frontieres/Doctors without Borders, which triggered his appreciation for the role of health in each person’s ability to achieve their goals.
Thank you so much for doing this with us Dr. Spar! Can you tell us a story about what brought you to this specific career path?
Ifinished my medical training in Internal Medicine feeling wholly unprepared to really address a good 50% of what my patients needed — help with preventing disease, being proactive or incorporating simple lifestyle changes in order to help manage chronic conditions. I was taught how to prescribe medications. So, I figured if I was only really trained to treat acute disease I might as well go where acute disease is really bad — so I joined Doctors without Borders. It was when I was working abroad with that amazing organization that I saw the power of non-western interventions on the ability to stay healthy. I saw people who were eating relatively healthy and engaging in regular activity with tight family and community structures — elements that were clearly contributing substantially to health. So, I came back to the U.S. committed to learning what else was science-based that I could include in my Doctor’s tool-kit besides a prescription pad.
Can you share the most interesting story that happened to you since you began leading your company?
I’m always asked why I can’t include women in my men’s health program. I think many women also appreciate a goal-oriented, direct, “here’s what to do next” approach to health, yet most practitioners talk a lot about general ideas of wellness and prevention without specific plans.
Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?
One of the funniest mistakes I made early on was to use the language of Integrative Medicine that I had learned — focusing on “holistic” practice and “wellness.” This was funny because I was trying to reach men, and I was having a very hard time getting my business going. It took me a while to realize that men aren’t ever going to miss eating a hotdog in the name of “wellness.” But tell him that eating hotdogs will impact his ability to get erections, and he’ll never eat a hotdog again. I learned how to engage men in their health — by focusing on their goals — not just sexual goals, but what goals mattered to them beyond abstract ideas of wellness.
What do you think makes your company stand out? Can you share a story?
We offer men specific strategies to achieve their goals and see health as a tool to achieve those goals — not as the goal itself. I had a patient who had high blood pressure that he was trying to get under control. Every time he went to his doctor, they reviewed his blood pressure log and tweaked his medications. He came to me and I asked about his goals — why did it matter to him whether or not his blood pressure was under control — and he was floored. No one had ever asked him that . Once we identified that his goal was to play tennis without getting as winded or worrying about his heart, he was much more engaged in changing his diet and working on stress — things that made a big difference in his blood pressure.
We focus on what matters to the patient — not what’s the matter with the patient — and offer a strategy to optimize health so that he can achieve his goals. That’s unlike most medical encounters.
What advice would you give to other healthcare leaders to help their team to thrive?
Keep the patient front and center and treat each one like you’d want to be treated — or like you’d want your Mom to be treated.
Ok, thank you for that. Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?
1 — Social determinants of health weigh heavily on outcomes. Your zip code is a stronger predictor of when you will die than anything else. That speaks volumes.
2 — Many people in the U.S. would rather eat poorly, avoid exercise and sleep minimally — and take a pill to deal with the repercussions — rather than change their lifestyle.
3 — Our training as doctors is all about treatment of acute illness, so that remains our focus. We don’t learn about prevention or lifestyle approaches to staying healthy.
You are a “healthcare insider”. If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
1 — Focus on goals rather than chief complaints. If we started each visit asking patients what they wanted their health for, it would frame all encounters differently — making it about what the patient wants and needs, rather than simply what is wrong that needs fixing. It’s a very different dynamic that gets created, with practitioner as guide and facilitator rather than purveyor of medications.
2 — The annual physical needs to be completely overhauled to include a focus on prevention rather than merely identifying what’s already broken. Studies have shown the annual physical, as is currently done, has no impact on mortality. We need to include more predictive biomarkers that can lead to proactive lifestyle or medication changes which can help to prevent serious problems down the road.
3 — At Vault, we will equip every member with a wearable device and a dashboard, enabling men to track their outcomes of interest and learn what health interventions really impact the aspects of their health that matters to them. That helps gain real insight into which lifestyle habits make the biggest impacts for each individual.
4 — We need to make it easier for men to want to learn how to get healthier — making it macho to seek care when needed.
5 — We need a single payer system for primary health care. When profit is the goal, quality of care becomes secondary and access to care becomes tiered in unfair ways
Ok, its very nice to suggest changes, but what concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?
1 — Practitioners can learn more about the healthiest diets, ways to exercise and manage stress and ways to help patients with sleep — focusing more on lifestyle recommendations than medication prescribing.
2 — Communities can strive to be like the Blue Zones, incorporating schools, health departments, city planners and local restaurants in initiatives that make it easier to move, interact and eat in healthier ways.
3 — Male professional athletes and other male role models can encourage men to take better care of themselves and to reach out for help when needed.
4 — We need to change our industrial agriculture policy such that nonorganic GMO crops are not subsidized and organic fruits and vegetables are, so that there can be cheaper good quality food available across all populations.
I’m interested in the interplay between the general healthcare system and the mental health system. Right now, we have two parallel tracks, mental/behavioral health and general health. What are your thoughts about this status quo? What would you suggest to improve this?
1 — Life expectancy is dropping, largely from drug-related deaths and suicides. There needs to be less of a stigma for men to admit to feeling anxious or stressed or depressed and to seek help when needed. Professional athletes like Kevin Love and Demar Derozan have gone public with their mental health issues, opening up this door for men to seek help when needed. We need to make more of an effort to make it comfortable for men to get help.
How would you define an “excellent healthcare provider”?
One who meets the patient where they are at and focuses on what matters to the patient, not what’s the matter with the patient.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
Assume a virtue if you have it not.
I often tell patients who don’t think they can change their diet or start to exercise, that they should act as if they eat healthier or are an avid exerciser, and by, God, they will become that which they pretend to be.
Are you working on any exciting new projects now? How do you think that will help people?
I just started as Chief Medical Officer of Vault Health — a corporation dedicated to bringing performance and prevention-oriented health tools to men. I think we will engage men in caring for their health such that we will shrink the difference in life expectancy between men and women.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
I love the podcasts The Drive by Peter Attia and the Rich Roll Podcast. Peter is a brilliant doctor who covers in-depth information about cutting edge health topics related to aging and prevention. Rich is an ultra-triathlete who is plant powered — he is also brilliant and a terrific interviewer.
I am excited by the work of David Perlmutter and Dale Bredesen regarding neurologic health, so I am an avid reader and listener to anything they write or say.
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger.
I aim to inspire a movement for men to engage in being proactive about their health, recognizing that healthy food, regular movement, managing stress, sleeping better and connecting with others are fundamental to achieving their goals.
How can our readers follow you on social media?
Thank you so much for these insights! This was so inspiring!