What we need is a food revolution, a total overhaul of our food system where subsidized and commoditized monocrops like soy and corn become a thing of the past while industrialized food producers are forced to the sidelines so that government “nutrition” guidelines are not as biased as they are today. One of the reasons for our obesity epidemic is the perverse incentives farmers have to produce these crops that then become ingredients for high-calorie low-nutritional-density fast-foods and Franken-foods. High fructose corn syrup is not just “empty calories.” It’s liver toxic, and it’s found in so many processed foods and drinks. We have kids currently suffering from non-alcoholic fatty liver disease which is a result of high-fructose corn syrup and is similar to what alcoholics suffer from! I think the increasingly high demand for our unique approach is evidence that this revolution is gaining traction — and that’s good news.
I had the pleasure to interview Julia Getzelman, M.D. Dr. Getzelman founded GetzWell Pediatrics in 2008 with a commitment to bring pediatric functional medicine to San Francisco. Dr. Getzelman graduated with a bachelor’s degree in Psychology from Stanford University with Distinction and Phi Beta Kappa. She later earned her medical degree from Yale University and completed her residency at Children’s Hospital Oakland. Thereafter, she was an attending physician in the neonatal intensive care unit (NICU) and pediatric clinic at Highland, Oakland’s county hospital, and also worked at After Hour Pediatrics in San Mateo. In the 5 years before founding GetzWell, she practiced at Sutter-Saint Luke’s Health Care Center in San Francisco’s Mission District where she provided whole kid care to thousands of patients. She is board certified in pediatrics and is a member of the American Academy of Pediatrics. In 2007, she completed the core curriculum of the Institute for Functional Medicine and has additional training in homeopathy and applied nutritional biochemistry/food as medicine as well as in using genetic polymorphisms as a foundation for treating a variety of chronic health problems like ADHD, anxiety, behavior issues and autoimmunity.
Thank you so much for joining us Dr. Getzelman. Can you tell us a bit about your “backstory”?
Over the dozen years since I established GetzWell Pediatrics in San Francisco, we have developed a highly successful and fundamentally different kind of medical approach, empowering parents with the information necessary to prevent disease — and even cure illness — largely by raising their awareness of food’s powerful impact on their children and its potential to both harm and to heal. But it really all started with a garden in the middle of Los Angeles in the 1960s.
There are so many things my parents said and did during my childhood that I look back at as life-long gifts that have taught me more than I could have ever imagined: insisting on piano lessons starting at age five, teaching me to navigate the LA public transportation system (such as it was), and “strongly suggesting” I spend a fair bit of my precious summer break learning to sew with my great aunt — just to name a few.
I’m immensely grateful for those opportunities. But, in the end, the warp and woof of me were most influenced by my father’s garden and the chickens we raised in the foothills of Los Angeles, in full view of the crowded 134 freeway. I was fortunate to grow up in a family with a fundamental belief in food’s ability to make you sick or keep you well. “You are what you eat” was the family mantra.
I can still see the coffee tin that sat near the kitchen sink, slightly the worse for wear, overflowing with food scraps and eggshells. At the end of each day, its contents were added to the compost pile — which Dad rigorously tended for use as fertilizer for the vegetable garden and fruit trees — or were offered to our lucky, egg-producing chickens. Most evenings, Mom would ask one of us to go out and pick a head of lettuce — our modest contribution to the night’s fresh nutritious salad — a dinner staple.
Granted, I just wanted to eat warmed-up Swanson TV-dinners like “normal” families — how I longed for those shiny trays with individual compartments neatly dividing the steaming peas from the breaded chicken pucks and perfectly sculpted mashed potatoes. But, when a teen from our neighborhood was diagnosed with cancer, my mother was convinced it was due to all the preservatives in the processed food and soda the young girl had lived on. Forevermore, we read labels, avoided Red Dye #2 and all other additives that Mom intuited were unnatural and harmful. We shopped mostly at the local “health food” store. This was just how our family did things and, at the time, I had no idea what an indelible mark this would leave on me.
Today, I’m a pediatrician with a unique practice focused on applied nutritional science — aka functional medicine. When I first learned from credible sources that food is more than just calories, and that it delivers information able to impact us at the level of our DNA, I just about did cartwheels. The science supported what Mom and Dad had said all along — that the most powerful medicine we had access to was already on our dinner plates!
Take Daniel, a morbidly obese and volatile 3-year-old, who could barely bend over far enough to reach his feet in order to put his shoes on. His former pediatrician had referred him to a hospital dietician with a six month wait-list who recommended little more than simply counting calories. This yielded no improvement in Daniel’s weight, nor did it reduce his severe tantrums.
Desperate for help, Daniel’s mother and grandmother sought me out for advice. We discussed, among other things, why the number of calories Daniel consumed was only one part of the equation; the carbohydrates and juices (provided with the best of healthful intentions) in his diet, not the fat, were the likely culprits.
When Daniel returned three months later, I was ecstatic to see incredible improvements in his weight and mood. He was lighter and moved with greater ease. And his mother was convinced that he liked his new way of eating. “He feels better because his moods are more stable. He’s happy now,” she told me. Daniel’s life will now likely unfold in a profoundly different way, both physically and social-emotionally.
I’ve enjoyed so many similarly fulfilling experiences with children who have benefited from this “food-as-medicine” approach to their care. Sean was two years old when I met him, the son of a very bright and successful couple. He could only speak three words, a serious delay in speech development. Sean also suffered from chronic nasal congestion, and his worried parents explained, “it just seems like the lights are always on dim.”
Sean’s parents were resistant to the idea that something as simple as food could be both the problem and the solution. It took some time to convince them to commit to significant changes in their way of eating. But, once they did, in the matter of a few short weeks Sean was speaking in full sentences. “For the first time in his life, his nose isn’t running!” his mother rejoiced. Fast forward three years to one of Sean’s wellness visits, with me trying hard to re-establish a rapport as we now only have annual visits. Sean, now an articulate and funny five-year-old, quipped, “is this a check-up or a chat-up?” I was barely able to stifle a burst of laughter.
Our national medical model is still two generations behind the science. So many chronic ills that fundamentally impact the quality of life of millions go unaided — in fact are exacerbated — by our “one-ill-one-pill” construct of care, dictated largely by pharmaceutical and insurance companies. Fatigue, joint pains, headaches/migraines, ADHD, anxiety and skin rashes — these are all examples of ailments that most people (and their doctors) would never imagine have anything to do with what they put in their mouths.
Can you share an interesting story that happened to you since you started your career?
When I was in my thirties, after finishing my medical training and working as a “mainstream pediatrician” prior to founding GetzWell, I went on a medical-mission-type trip. I worked for a month in a hospital clinic in Antigua, Guatemala. Families with children in need of medical and surgical interventions — and even some adults who had lived their entire lives with facial deformities — traveled for many miles to the clinic, lining up for hours in order to get help. It was a tremendously moving and transformative experience.
I witnessed the literal fall-out of babies not receiving proper nutrition in utero. Among the many patterns I witnessed first-hand, I was particularly struck by the prevalence of folate deficiency which produces midline defects like cleft lips and palates. Also evident was the poor nutrition children received after they were born, which we describe as “failure to thrive.”
While serving on the medical team in Guatemala, I became sick with what seemed like the flu. After experiencing some relief, I believed I had recovered. But I ended up with a gut problem that followed me home and haunted me for years. No traditional medical doctor I sought out in California was able to help me. I suffered with chronic abdominal pain and hormonal issues for years. I believe the persistence of the condition was due to small intestinal bacterial overgrowth, or SIBO. It wasn’t until I discovered functional medicine and began to address my complaints through that lens that I finally found relief.
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?
I was a one woman show. I started my practice from scratch and was motivated to try new — and sometimes unorthodox — ways of doing things. I was inspired by the appealing promises of the new “share economy.” I had this grand idea that I could be environmentally conscious and save some money by using City Car Share for everything from getting office supplies to doing house calls. So, I sold my car.
At the same time, I had committed that every newborn entering my practice would have their first visit at home. What started as a great idea ended up with me schlepping a baby scale and other necessities for newborn house calls to the nearest City Car. But it turned out that cars which seemed so close on my phone’s tiny screen weren’t that close after all (especially with all the stuff I had to carry.)
Sweaty and harried, I would finally arrive at the often-dirty car, running late and needing to race off to the next appointment. I suffered through this self-inflicted hellscape for a couple of months until it became clear that, in addition to the severe inconvenience, it would have cost me far less to lease my own luxury auto! I drive my own car now and take a Lyft in a pinch.
Are you working on any new or exciting projects now?
The newest of my clinical tools are resources like 23andMe which allow me to use individual genetic data to personalize care and treatment plans for kids and adults with chronic issues such as ADHD, anxiety, and autoimmune illness (alopecia, rheumatoid arthritis, lupus, Hashimoto’s, psoriasis, etc.) The application of this invaluable information is producing fantastic outcomes for children and adult patients at GetzWell.
None of us is able to achieve success without some help along the way. Is there anyone in particular to whom you are grateful that helped get you to where you are? Can you share a story about that?
First, my father, who was a small business owner and professional. He was a dentist in our community and was my first role model and a true inspiration. Second, as I was considering what it would mean to leave the insurance based model of care, a dear friend who is a wizard with spreadsheets did his magic, ran the numbers and gave me the confidence that having a direct-pay fee-for-service practice could work. Third, Amy Hecht, MD, another great doc with a small adult practice in San Francisco, was so generous with her advice and time; she showed me first-hand how she did it, making it real for me. And finally, my husband Jon — my biggest fan — has been the invisible support structure behind GetzWell from the get-go.
Can you share your top three “lifestyle tweaks” that will help people feel great?
Magnesium: Clients tell me again and again, “magnesium changed my life.” Magnesium is the relaxation mineral and is a co-factor in over 300 enzymatic processes in the body. It helps with insomnia, anxiety/worry, constipation, headaches, migraines and so many other basic functions. Most of us don’t get enough magnesium in our diets, even if we eat well. Our food is only as magnesium rich as our soil, and our soil is severely mineral depleted from over-farming.
Probiotics/prebiotics: The bugs in us and on us co-evolved with us, and we need them. We’ve spent the last fifty years at war with these single-celled organisms, and most of them are our friends — we depend on them to keep us healthy. We walk around with about 4lbs of these critters in our guts and we have them to thank for everything from keeping our immune systems in tip-top shape to producing certain vitamins for us to maintain our calm. Prebiotics are the plant fibers that we eat but can’t digest that feed our belly bugs.
Breathing like a navy seal: Proper breathing reduces stress and helps relieve the many ailments to which stress can contribute. And it only takes five minutes.
Is there a particular book that has made an impact on you? Can you share a story?
In God’s Hotel, Dr. Victoria Sweet discusses her experiences at Laguna Honda Hospital in San Francisco back when it functioned much like an almshouse for those who had fallen on hard times. She describes practicing a kind of “slow medicine” that has basically vanished in today’s version of medical care.
Slow medicine. That’s what I decided I wanted to be able to provide for families and especially for kids. I tell people GetzWell Pediatrics is like your old-fashioned neighborhood doctor armed with all the best modern tools. We provide first-week well baby house calls, support for breastfeeding and hour-long wellness visits. In short, we really get to know our families. The national average for a pediatric visit is twelve minutes — this results in a lot of doctor burn-out and even more unhappy patients. Sharing critical and often complex information takes time. At GetzWell, nobody is rushed. I could never go back.
If you could start a movement that would bring the most amount of wellness to the most amount of people, what would that be?
I don’t know about starting a movement, but as Dr. Mark Hyman, functional medicine doc extraordinaire, says, “the most powerful medicine we have is at the end of our fork.” What we need is a food revolution, a total overhaul of our food system where subsidized and commoditized monocrops like soy and corn become a thing of the past while industrialized food producers are forced to the sidelines so that government “nutrition” guidelines are not as biased as they are today.
One of the reasons for our obesity epidemic is the perverse incentives farmers have to produce these crops that then become ingredients for high-calorie low-nutritional-density fast-foods and Franken-foods. High fructose corn syrup is not just “empty calories.” It’s liver toxic, and it’s found in so many processed foods and drinks. We have kids currently suffering from non-alcoholic fatty liver disease which is a result of high-fructose corn syrup and is similar to what alcoholics suffer from!
I think the increasingly high demand for our unique approach is evidence that this revolution is gaining traction — and that’s good news. Our influence has already grown beyond the boundaries of the Bay Area, with GetzWell serving patients and families across the US and as far away as the Philippines.
How have you used your success to bring goodness to the world?
My hope is that, at GetzWell Pediatrics, our growing team of expert functional health practitioners has not only influenced a generation’s good health with the slow medicine that we’ve provided — emphasizing microbiome/gut health and nutrition — but also that we’ve had an impact on several generations via epigenetic programming. We know from the field of epigenetics that vitamins, nutrition, exercise, stress, love — in short, our environments in the largest sense — impact how our DNA is expressed (without actually changing our basic genetic code.)
This is extremely powerful. Some of these epigenetic changes endure for generations. Others may not present for another generation or two. For example, trauma or extreme calorie deprivation during pregnancy may impact not only the developing fetus’s stress resilience and risk for metabolic syndrome, but also the risk for that fetus’s children and grandchildren. Conversely, a predictable and relatively peaceful home environment, and a pregnancy diet rich in micronutrients such as choline and folate, have a higher likelihood of producing children with greater stress resilience through their lifetimes and, in turn, their offspring’s lives.
What are your “5 Things I Wish Someone Told Me Before I Started” and why? (Please share a story or example for each.)
- Be careful what you wish for. The work never ends. No one told me that starting and growing a successful small business and medical practice would be like having a newborn — for 12 years and counting! Early mornings and middle of the night wake-ups are the norm. The nurturing never ends. I’m everything from the Chief Medical Officer and CEO to the Chief Doorknob Sanitizer. In addition, I’m the GetzWell community leader, wisdom sharer, parenting coach, sleep consultant, child behavior expert, therapist, microbiome specialist and more. And, I should add, I wouldn’t have it any other way.
- The sheer grit and resilience required to stick with it when you have to wear so many hats… and talk down the worried parents of a baby with her first fever at 3AM… and write articles… and give talks… and continue studying… and provide leadership to the team… and make marketing decisions… and… and… and…
- I wish someone had been able to predict that we were opening the practice at the start of the great recession of 2008. Fortunately, we still grew month over month, year over year — and have continued to do so in order to meet the growing demand for our services. I might have made some different hiring decisions at the beginning had I known about the impending economic downturn. On the other hand, I was blissfully unaware as we were building out the office and I was fleshing out my dream. So maybe that was a good thing as it didn’t put a crimp in my creative process or drive.
- The need for the flexibility and creativity required to be able to flow through the numerous, inevitable and often unanticipated hurdles — such as the challenges that present themselves in terms of staff and HR management — can’t be over-emphasized.
- I wanted to have a 21st Century business that was horizontal and nimble, not hierarchical and rigid like so many of the clinic and office settings I’d worked in. But what I discovered is that most people/staff want clarity of roles, boundaries and structure. I had to learn this the hard way.
Can you please give us your favorite “Life Lesson Quote”?
“Bravery means doing something scary.” Elizabeth Gilbert
Some of the biggest names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world, or in the US whom you would love to have a private breakfast or lunch with, and why? He or she might just see this if we tag them 🙂
- Mark Hyman, MD. So smart. So influential in the functional medicine community. Such a trailblazer. So charismatic. I’ve followed him for years.
- Elizabeth Gilbert, writer: The manner and grace with which she has followed her creative path while moving others to follow theirs is such an inspiration to me. She’s a great speaker and motivator with such a talent for expression and the use of words to inspire and transform.
What is the best way to follow you on Social Media?
Facebook: @ GetzWell Personalized Pediatrics
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