Update on Dr. Cady's presentation on transition from conventional allopathic to functional and integrated practice. Current state of medicine, socio-economic variables, and demographics reviewed. Mental posture toward how you want to practice reviewed. Presented 8/17/2012 in Salt Lake City for CME lecture of World Link Medical

2. How to Transition from Traditional Allopathic
Practice to a Holistic and Integrated Medical Model
Louis B. Cady, MD – CEO & Founder – Cady Wellness Institute
Adjunct Professor – University of Southern Indiana
Adjunct Clinical Lecturer – Indiana University School of Medicine
Department of Psychiatry
Child, Adolescent, Adult & Forensic Psychiatry – Evansville, Indiana
This presentation is © Louis B. Cady M.D. and may not be reproduced
or used without permission. World Link Medical is authorized to
reprint/duplicate it for 2012 syllabi.
(c) 2012 Louis B. Cady, M.D. - all rights reserved

3. Louis B. Cady, M.D. – historical statement of
support, conflict of interests… [>/=2 years]
• Abbott Laboratories
• Bristol-Myers Squibb (Serzone)
• Celltech (Metadate CD)
• Cephalon (Provigil)
• Elli Lilly (Prozac)
• Forest Pharmaceuticals
(Celexa, Lexapro, Namenda, Viibryd)
• Glaxo-SmithKline (Wellbutrin, Paxil)
• Janssen (Concerta, [Reminyl]/ Razadyne)
• McNeil (Concerta)
• Pfizer-Roerig (Zoloft, Pristiq)
• Sanofi~aventis (Ambien)
• Sepracor (Lunesta)
• Searle Pharmaceutical (Ambien)
• Shire Pharmaceuticals
(Adderall, Daytrana, Vyvanse, Intuniv)
• Shionogi & Co., Ltd. (Kapvay)
• Takeda Pharmaceuticals (Rozerem)
• Wyeth-Ayerst (Effexor, Pristiq) Note: Today’s presentations are CME
and are sponsored by World Link
Medical.

4. “The mind, once
expanded to the
dimensions of larger
ideas, never returns
to its original size.”
- Oliver Wendell Holmes

5. Ethics and financial/logistical
practicalities of these lectures
• Nothing is more important than taking care of the
patient.
• “The needs of the patient come first.” (Dr. Will
Mayo, MD)
• The current “medical model” is at variance with
what is ethical, moral, and factual.
• If the physician is not stable and financially secure,
the system implodes.
– “No margin, no mission.” - Steven R. Covey
• If the system implodes, the patient suffers.

6. Background
• Listen for IDEAS
• MINDSET is important.
• WHY to make the change is more difficult
than HOW to make the change. (Strategy
vs. tactics).
• Listen for personal relevance – if it’s
important to you, it’s important to your
patients.
• Relax for use of COLOR.
• Relax for data – you’re getting access.

7. Attention class!!
www.slideshare.net/lcadym
d

8. www.slideshare.net/lcadymd

9. Tech Rules…. Please turn
your phones ON (just
silenced).
• Shoot photos!
• Tweet! ( @LouisCadyMD )

10. “But my patients don’t know about
this and aren’t asking for it….”
“It’s not the
consumers’
job to know
what they
want.”
- Steve Jobs

11. “Wellness
[integrated]
No Disease = Health
Medicine”
Forestall and
Diagnose and PREVENT Disease –
Treat Disease Optimize
Function
New Drugs Hormone
New Surgical Modulation
Techniques
Diet, Exercise
Nutritional Supplementation

12. Health is a state of
complete physical, mental
and social well-being, and
not merely the absence of
disease or infirmity.
- World Health Organization

13. American Journal of Health Promotion;
November/December, 2002
18.8% 66% 19% of those
“Incompletely healthy” surveyed were
completely
completely
unhealthy, d
healthy with
efined as
high levels of
having low
both physical
levels of health
and mental
with high Two-thirds of the adults health and a
levels of reported some degree low level of
illness. of mental or
illness.
physical illness that
kept them from being
completely healthy.
“Incompletely healthy.”
OPTIMAL
DEAD
HEALTH continuum

14. Outline
• Overview of concepts
• My bias – a practice model
• Current state of allopathic medicine
• Microchip as disruptor and disintermediator
– (“Change or die”)
• Current state of patients and society
• What’s your model? Chloraseptic or PCN?
• How to start changing….

15. The evolution of my practice
• Sidetracked in high school, two degrees in music (’77 and
’79) and learned piano tuning
• 1976 – 1989 – piano tuning (through pre-med and med
school). “fee for service”(Med School finished 1989)
• 1989-1993 – conventional allopathic psychiatry residency
at Mayo Clinic
• 1993 – start practice. 1995 – l-tyrosine and EFA’s
• 2002 – first IFM conference
• 2003 – Cenegenics training
• 2005 – founded Cady Wellness Institute
• 2010 – 2011 – Neil Rouzier, MD & WorldLink
• 2012 – rTMS (Transcranial Magnetic Stimulation)

16. May 2002: 9th Annual IFM Conference

17. The Functional Medicine component
Dead Doctors Don’t Lie - Joel Wallach, DVM, ND

21. Cady Wellness Institute – July 2005
The Reasons:
• Conventional medical practice had failed me twice.
• A lot of “psychiatric cases” WEREN’T “psychiatric.”
• Nobody was integrated.
• Nobody was looking at ALL of the peer-reviewed
literature.

23. Current socioeconomic state and
allopathic (“conventional”) medicine –
DISRUPTIVE NOTIONS
• CONVENTIONAL Allopathic medicine = symptom
focused, reactive, “taught,” unthinking, uncreative,
PRACTICALLY non-informed by peer-reviewed
medical literature.
– Commoditized. No variability. “Providers.”
• Wellness medicine: individualized. Can’t get it
elsewhere. Not a commodity. Scientific. Informed
by peer-reviewed literature.
– Concept of “information brokering” (example:
THYROID)

24. Healthcare “Reform” Today
•Today: Patient Protection and Affordable Care Act (P.L. 111-148) – includes amendments from
the Health Care and Education Reconciliation Act of 2010 (H.R. 4872)
Slide courtesy of John Adams, MBA – CEO, Cenegenics
Available at http://voices.washingtonpost.com/capitol-briefing/2009/07/gop_accuses_democrats_of_censo.html

25. What the feds see & their lust for “cost control”
Example: salaries for Family Medicine
Average
Sweden
Finland
Australia
France
Canada
Switzerland
United Kingdom
United States
$0 $50 $100 $150 $200
US $1000
Adapted from http://economix.blogs.nytimes.com/2009/07/15/how-much-do-doctors-in-other-countries-make/. Accessed April 3, 2010.
Slide courtesy of John Adams, MBA – CEO, Cenegenics

26. Medicare–Workers per Beneficiary
Millions
Year
SOURCE: Kaiser Family Foundation based on the 2009 Annual Report of the Boards of Trustees of the Federal Hospital
Insurance and Federal Supplementary Medical Insurance http://facts.kff.org/chart.aspx?ch=383. Accessed April 3, 2010.
Trust Funds.
Slide courtesy of John Adams, MBA – CEO, Cenegenics

27. The Future of Medicare
“Medicare is going
bankrupt. The Medicare
Trustees estimate that
the program will run
short of money starting
in 2017.”
•Rep. Bobby Scott,
Senators Jim Webb and Mark Warner
http://www.congress.org/congressorg/bio/userletter/?id=3181&letter_id=47
47883751. Accessed April 3, 2010.
Slide courtesy of John Adams, MBA – CEO, Cenegenics

28. http://www.ama-assn.org/amednews/2011/11/21/gvsd1121.htm

29. SOURCE: Mary Meeker, Partner – Kleiner, Perkins Caulfield &
Byers – “Internet Trends” Slide deck – D10 conference, released

30. SOURCE: Mary Meeker, Partner – Kleiner, Perkins Caulfield &
Byers – “Internet Trends” Slide deck – D10 conference, released

31. Healthcare Reform–Physicians Perception of
Medicine Over the Next Few Years
http://www.athenahealth.com/index.php?open=26. Accessed April 3, 2010.
Slide courtesy of John Adams, MBA – CEO, Cenegenics

32. Are the Best and Brightest
Staying in Medicine?
“60% of physicians
would not recommend
medicine as a career
to their children.”
http://www.mayorswellnesscampaign.org/wp-
content/uploads/2009/05/merritt-hawkins-survey.pdf.
• – The Physicians’
Accessed April 3, 2010.
Foundation
Slide courtesy of John Adams, MBA – CEO, Cenegenics

33. “Although American doctors feel stressed, overworked, and
uncertain about the future, they’re generally happy with their
career choices and the state of their lives (???), despite
practicing during one of the greatest periods of tumult in the
modern history of US healthcare.”
“The results also suggest strongly that
physicians wish they had more control of their
http://marketing- careers… and time.”
images.ubmmedica.com/Insights/2011/2011_GAP_Survey.pdf
Accessed 01 21 2012

34. Current US Physicians’ Attitudes
• Mean respondent – 51 yoa
– 43% primary care; 57%
specialty
• 31% owners of private
practice
• 96% - at least somewhat
happy to be docs
• 65% - plan to remain in
practice at least 5 years
• Note – no “n” cited.
Great American Physician Survey – July 31, 2011 – UBM Medica – cf:
http://marketing-images.ubmmedica.com/Insights/2011/2011_GAP_Survey.pdf
referenced 01 21 2012

37. Note: new slide

38. “The Great Crossover” – the microchip
cf: Dan Sullivan www.strategiccoach.com

43. Accessed 1 21 2012

44. CURRENT STATUS OF
PATIENTS AND SOCIETY

45. CURRENT PRACTICE OF MEDICINE:
What a patient had to say about her “specialists”:
“They just monitor my
degeneration.”

47. Consultations with “complementary
and alternative” practitioners
• US, 2004. 36% of US adult >18 yoa
– National Center for Complementary and Alternative
Medicine survey, 2004.
• http://altmedicine.about.com/od/alternativemedicinebasics/a/CA
Muse.htm
• Canada – 1.2 million adults, or 13% of the
population of Ontario. N = 32,598 surveyed.
– Williams, Kitchen, e al. Alternative health care consultations in Ontario,
Canada. BMC Complementary and Alternative Medicine 2011, 11:47

49. What causes oxidative stress?
• Environmental Toxins
– Heavy metals – including Mercury (fillings!)
– Pesticides/herbicides
– Preservatives
– PCB’s, Dioxins, Phthalates
• Toxins produced in the body
– Yeast and bacteria
– Products of cellular metabolism
• Emotional Stress
– Anxiety/Tension
– Fear
– Anger

53. Today’s Medical Practice
Challenges
• Obesity, diabetes, auto-immune, inflammatory and
chronic diseases increasing
• Inflammatory triggers increasing
• Novel viruses and infective organisms
• Unresponsive/resistant infections
• Weakened immune systems
• GI decline/inflammation
• Poor quality /foods/nutritionals

54. A CHANGE FROM THE
ALLOPATHIC MODEL?

55. Socioeconomic/disruptive forces
with two models
Allopathic Wellness/ fxnl med
• Disease and CHANGE
• Integrated and whole
sickness focused AGENTS
person model
• Short appointments • Microchip/inter • Bill for time
• Commoditized net • Non-commoditized
• Compartmentalized • Increase in • Collaborative
• Doctor as priest chronic disease • Informed patients
• Uninformed patient • “boomers” willing to “pay for
• Sicker patients • Job/socio- expertise”
• Either practice economic • Practice per peer-
ignorantly or with reviewed literature;
pressures No crises (pl) of
guilty conscience
• Worry/poor conscience
satisfaction • INTENSE satisfaction

56. Divergence of focus of two models
Wellness/ fxnl med;
“complementary/alternative”
Allopathic
• Relief of symptoms • CAUSE of symptoms, prevention
• Organ specific • SYSTEMS focused
• Aggressive. “magic bullet” • Gentle, methodical.
• Rules, practice guidelines • Creative. What works?
• Patient as uninformed • Patient as integral part of team.
protoplasm. Questions/participation
encouraged.
• Tied to medico-pharmaco- • Focused on health and optimization
industrial complex with natural, bio-identical methods
• Use of synthetic, patented, • Use of PROVEN botanicals and
not-from-nature substances natural hormones (as well as
conventional RX).
Adatped from “Alternative Medicine: Why so popular? By Hans R. Larsen, MSc
ChE. International Health News, Sept 1999, issue 93
http://www.yourhealthbase.com/alternative_medicine.htm accessed 1 21 2012

57. “Slumber not in
the tents of your
fathers.
The world is
advancing.
Advance with it.”
- Giuseppe Mazzine

58. Some interesting thoughts:
• “The war situation has developed not
necessarily to Japan’s advantage..” - Japanese
Emperor Hirohito after the atomic bombing of Hiroshima and Nagasaki,
announcing Japan’s surrender to the Allies
• “A naïve analysis of stability is derived from the
absence of past variations” (or “The Turkey
Problem”)
– Nicholas Taleb, author of The Black Swan

59. What does integrated, holistic
medicine “look like?”
A quick dip in the literature

60. % U.S. Women with inadequate quantities of nutrients
Arab L, Carriquiry A, Steck-Scott S, Gaudet MM. Ethnic differences in the
nutrient intake adequacy of premenopausal US women: results from the
Third National Health Examination Survey. J Am Diet Assoc 2003;
103:1008-14.

61. = 2 apples (fruits) & 3 - 4
vegetables – per CDC

62. 4 – 13 servings of fruits and
vegetables per day, depending
on energy needs

64. % Mineral depletion from the soil
during the past 100 years, by continent
North America 85%
South America 76%
Asia 76%
Africa 74%
Europe 72%
Australia 55%
Source: UN Earth Summit Report 1992

65. Cf: http://www.veganforum.com/forums/showthread.php?t=3532

66. Source: Jerry Brunetti – www.agri-

68. 16,103 people – 1994 – 1996.
ZERO got 100% of all required vitamins and
nutrients
- Highest – B12 =- 82.8% got enough
- 66.8% - had adequate folate
- Lowest – Zinc – only 26.6% got enough.

70. Factors trapping physicians
• “Doing it, doing it, doing it.” (Michael Gerber, The
E-Myth)
• Already time-pressured –
– Minimal time to think or plan
– PROBABLY ADRENALLY DEPLETED ALREADY,
perhaps with suboptimal thyroid and sex hormones
– Tip – GET YOUR LABS CHECKED!!
• Must “make overhead.”
• Can’t “take chances.”
• Trapped by “provider panel” arrangements,
including cut rate fees. (Alcoa story)

71. The Baby Boomers & Their Expectations
The first time the entire
Baby Boom generation
is impacting a single market
ALL at the same time!

73. Let’s look at the logic.
How would you take care of a classic?
“Chronic diseases
affect at least 125
million Americans
& cost more than
$500 billion last
year.”
Centers for DiseaseControl – Dec 2003

74. “Age management” “Conventional
practice”fuel additives
There are No fuel additives should
we can use to keep our be used. They are
cars burning cleaner and unnatural. Gas is all that
preserve engines. is required.
We should use optimal The quality of the gas is
quality of gas. Cheap gas irrelevant. Anything that
causes “pinging” which is the motor will burn is
hard on the engine. adequate.
We should take our car in Preventive maintenance? This
for preventive is silly! Wait until something
breaks, then have the car
maintenance before
towed in so the mechanic can
anything breaks.
really tell what is wrong.

75. Modern Medicine’s Paradigm:
Two Standard Deviations – “if you are not
sick, then you must be well.”
“NORMAL”
OPTIMAL?
OPTIMAL

76. Definition of “normal labs”:
“When your lab
values are as
crappy as
everyone else’s.”
- Neil Rouzier, MD
(World Link Medical Seminar II –
Spring 2011)

77. MAKING THE TRANSITION
• Must DECIDE
– Must have INFO (e.g., this weekend)
– Must INTROSPECT
• Must have something LEGITIMATE to offer
• Start SMALL – both with interventions and
logistics/financial
– E.g, ¼ grain Armour, or Cytomel 5 MICROgrams, or Cortef 5 mg
twice daily, or FDA approved testosterone for guys
– E.g. – ½ day per week – “hormones”
• Get EDUCATION
– Teachers – Rouzier, World Link Medical
– AAMG, A4M
• Find a mentor (s) – start here

79. Marketing & Practice Development
• Maintain excellence in allopathy or (traditional
osteopathy)
– (knowledge base, prescribing, surgery)
– (“Be able to debate the great issues.” – Jim Rohn)
• Know your [new] stuff!
• Do not badmouth the competition. (Chris Lord
example).
• Give CME talks and paper over their objecting
mouths with references. (examples follow next)
• Spiritual and ethical clarity.

80. Quick examples of powering
through objections and
overwhelming with literature
Note – don’t get bogged down.
Get the idea of HOW TO
PRESENT the data.

81. A Scientific (& FUN!!!) Review of Vitamin
Supplementation & Essential Nutrients
Louis B. Cady, MD – CEO & Founder – Cady Wellness Institute
Adjunct Professor – University of Southern Indiana
Adjunct Clinical Lecturer – Indiana University School of Medicine
Department of Psychiatry
Child, Adolescent, Adult & Forensic Psychiatry – Evansville, Indiana
Presented 2 27 2010 – Oliver Headache and Pain
Clinic CME seminar – Evansville, IN

82. Trends in Pharmacological Sciences (2008) Jul; 29(7):351. Epub 2008 Ju

83. • Mitochondrial diseases are due to impairment of
chemical reactions.
• A reasonable theory is oxidative stress.
• Few studies have actually been done on this.
• Glutathione deficiency is known in mitochondrial
disease.
• Biosynthesis of glutathione depends on cysteine
availability.
• “Our findings reinforce the notions that in
mitochondrial disease, oxidative stress is
important and can be reduced by
administration of a cysteine donor.”

84. Zoned, Stoned and Blown: The Emotional
Tsunami of Psychiatric Disorders Coupled
with Pain Disorders & Chemical Dependency
Louis B. Cady, MD – CEO & Founder – Cady Wellness Institute
Adjunct Professor – University of Southern Indiana
Adjunct Clinical Lecturer – Indiana University School of Medicine
Department of Psychiatry
Child, Adolescent, Adult & Forensic Psychiatry – Evansville, Indiana
Also Presented 2 27 2010 – Oliver Headache and
Pain Clinic CME seminar – Evansville, IN

86. Pharmacotherapy Significantly
Reduces Substance Abuse in Adults
with ADHD
40
32
3- P<0.001
% of study population
30
fold!
20
12 10
10
0
Unmedicated Medicated Control
ADHD ADHD (N=137)
(N=19) (N=56)
Biederman J, et al. Pediatrics. 1999;104:e20-e25.

87. …END EXAMPLES…
Business philosophy citations
follow

88. “You can have everything in life
you want, if you just help
enough other people get what
they want.”
- Zig Ziglar
What do patients want?
• To be treated with
respect
• To not have to wait!
• To FEEL BETTER
• To HAVE HOPE.
• To not be doped up.
• To NOT have their
money wasted.

89. $5,000 worth of wisdom on one page
– from Jay Abraham
• Risk reversal
• “USP” – unique selling Focus: “Be able
proposition
to treat your
• Defining the buying
clients (or
criteria
patients) as dear
• Three ways for more
and valued
profit:
– Higher price
friends.”
- Jay Abraham
– More frequency
– Additional items
(supplements, etc.)

90. Evansville Courier & Press: May 29,
2006
References: www.pharmanexmd.com ;
www.slideshare.net/lcadymd;
Dr. Oz show on YouTube:
http://www.youtube.com/watch?v=rX4oxxGWi_8

91. My position on supplements
• “The needs of the patient come first.” – W
Mayo
• Unique and patented. (Otherwise GNC is
fine).
• Guaranteed (risk reversal).
• Measurable changes
• Be a doctor and not a stock boy or inventory
clerk.

92. Jay Abraham References
(recommended)
www.amazon.com

93. Building CWI - what has worked
• Being nice to patients
– (on time, polite, compliment on questions, don’t be a
jerk or abrasive, put yourself into their shoes, etc.)
• Be good and get results. BE THE BEST!
• Be TRANSPARENT – give’em their labs.
– Write on them. Draw pictures. Take time (and BILL
FOR IT).
– Cenegenics model
• Be appropriately self-protective of your time and
talents. “If they show up, bill’em.” – Dan
Kennedy.

94. Be Awesome!
Note: NEW reference. Grab it.

95. MARKETING – what has and hasn’t
worked
Worked Hasn’t worked
• Word of mouth • Paid advertising (TV,
• Public seminars print, magazines)
• Web site
• Going to MD’s/DO’s • What I HAVEN’T tried:
– Marketing consultants
offices PERSONALLY
– Radio ads
• Free stuff – PR
opportunities New initiatives:
• Going to places and •Proprietary, paid websites
NETWORKING •“SEO” – search engine
optimization (Willie Sutton
principle)

97. Additional resources – handouts
down front at end of lecture
• “The 10 Commandments of Marketing a
Medical Practice” – Cady (handout, free)
• Additional resources handout sheet
• Practice Transformation Seminar – to be
scheduled 2013 - at Cady Wellness
Institute

98. Contact information:
Louis B. Cady, M.D.
www.cadywellness.com
www.indianaTMS-
cadywellness.com
Office: 812-429-0772
E-mail: lcady@cadywellness.com
4727 Rosebud Lane – Suite F
Interstate Office Park
Newburgh, IN 47630 (USA)
Download from
iTunes or Android App store
now!

100. A personal close:
How do you want to age?

101. Success and Failure (Jim Rohn)
What about you? You’ve only got one body.
• “Errors in judgement” - High glycemic eating,
no exercise, poor nutrition, lousy/no
supplementation, high stress practice.
- “Good disciplines” – appropriate diet,
supplementation, exercise, hormones. Stress
management. Decent practice and lifestyle.

102. Perhaps the ability not only to acquire
the confidence of the patient, but to
deserve it, to see what the patient
desires and needs, comes through the
sixth sense we call intuition, which in
turn comes from wide experience and
deep sympathy for and devotion to
the patient, giving to the possessor
remarkable ability to achieve results.
...William J. Mayo, 1935

103. BREAK!!