Member of the Month: Warren Willey, DO, ABAARM

A4M valued member Warren Willey, DO, ABAARM shares insight from his professional experience in this Member of the Month feature. 

Q1: Before joining A4M, what was your medical background?

I started going to A4M conferences not long after residency. My core philosophy and practice style mirrors A4M and its members. I focus on the actual cause of disease (not just hiding it with a drug) and working toward a better quality of life for people.

Q2: What anti-aging techniques have you incorporated into your practice? And how did you so?

I teach all aspects of lowering stress and inflammation. This is done through diet and exercise optimization, hormone balance, controlling and modifying the body’s reaction to stress, and maintaining good cognitive/brain function no matter what the age.

Q3: What are the benefits of practicing anti-aging medicine: as a professional, and for your practice?

This type of practice gets people well. It treats the cause of discomfort, not just the symptom of discomfort and disease. It empowers people (patients and doctors) to improve their quality of life, and in doing so, getting a little side effect called life extension!

Q4: What are the changes you see in your patients?

So many to list, but they can all be summed up with better quality of life. More healthiness and more happiness!

Q5: Why would you recommend Anti-Aging Medicine to your peers?

I recommend it to all my peers so each of them can really make a difference in peoples lives. The whole reason most of us went into this profession. Get out of the rat race, the readmissions, the paperwork, and all the things that take the pleasure out of practicing medicine!

Q6: Where do you see the future of Anti-Aging medicine 20 years from now?

Current Anti-Aging medicine and its continued advancement IS the future of medicine. It’s the only future our society can afford, both monetarily and for patients care and peoples quality of life. What standard western medicine is doing now has not, is not, and will not work in the future. The system has to change, and this type of medicine will pave the way for it to do so.

Chronic Illness in Complex Patients: Lyme Disease

Andrew Heyman, MD, MHSA, an internationally recognized expert in Integrative Medicine and the current Director of Integrative Medicine at The George Washington University, spends much of his time as a ‘last resort’ practitioner. Dr. Heyman treats patients who have continuously been seeking treatment–some for months, others for years–but who have received no cure, no explanation, no answers.

Dr. Heyman’s ability to treat these unique patients may stem from his training at the University of Michigan, as a clinical working group co-chair of the Consortium of Academic Health Centers for Integrative Medicine, or from his educational background editing medical journals. Yet his exceptional aptitude in finding answers despite puzzling patient presentations is most likely a result of his background in Traditional Chinese Medicine combined with his conventional medicine training. “Traditional Chinese Medicine taught me how to listen very closely to patients, and to look for patterns of illness expression that sometimes escapes a standard evaluation. My research now seeks to bridge the gap between what we observe in patients and their underlying metabolic and genomic expression, especially in complex presentations.”

Although it is but one of his specialties among a litany of syndromes and diseases, Dr. Heyman has become known as the ‘go-to’ doctor for an often misdiagnosed, misunderstood disease that has recently gained heightened visibility: Lyme disease. Introduced to Lyme through personal and practical experience, Dr. Heyman first became involved in the treatment of the disease after a group of his patients in Virginia presented with a similar pattern of symptoms, and failed to respond to conventional or integrative therapies.

First recognized in the United States in 1975 after a puzzling and unexplainable outbreak of debilitating health issues near Lyme, Connecticut, it was not until 1982 that doctors identified the correlation between deer ticks and Lyme disease. The disease is caused by several strains of the bacteria Borrelia burgdorferi, transmitted to humans through the bite of an infected tick. Once a tick emerges from an egg, it frequently becomes infected during its larval or nymph stage, as it feeds off small animals like squirrels, mice, or birds that carry the Lyme-causing bacteria. During the tick’s subsequent feeding cycle, it passes the bacteria to a human, or another animal.

Early symptoms of the disease often manifest as a flu-like illness, with accompanying fever, chills, muscle aches, and joint pain. While the characteristic ‘bulls-eye’ rash called erythema migrans is often present, many people develop a different type of rash, or none at all. Moreover, a host of Lyme symptoms occur in other diseases, and as a result, many patients suffering from Lyme disease are misdiagnosed with conditions like fibromyalgia, multiple sclerosis, and other psychiatric illnesses, before being correctly treated.

If Lyme is not diagnosed or treated in its early stages, it transitions to a chronic, highly problematic late-stage disease, and symptoms increase in their severity. Untreated Lyme disease will eventually infect joints, the heart, and the nervous system-causing nerve paralysis and meningitis, and difficulty with memory and concentration. While one of the defining features of chronic Lyme disease is fatigue, Dr. Heyman discusses his own cases in which there were a myriad of presentations without any one defining symptom. Many of his patients had suffered severe cognitive decline, loss of executive function, memory problems, mood disturbances, chronic pain, cardiopulmonary problems and more. The debilitating effects of the disease then led to more devastating results: these patients often are unable to work, function in personal relationships, or complete simple daily activities without experiencing profound exhaustion.

There are approximately 329,000 new cases of Lyme disease each year, and the number of those infected is expected to increase. According to Rick Ostfeld, a disease ecologist at the Cary Institute of Ecosystem Studies, the illness is on track to produce its worst numbers in 2017. Moreover, many experts believe the true number of Lyme cases is higher than reported, as the Centers for Disease Control and Prevention require ‘objective measures’ like positive blood tests or rashes; therefore, estimates indicate that CDC surveillance only captures approximately 10% of reportable Lyme cases. There is currently no vaccine for Lyme disease, and Dr. Heyman notes that the FDA-approved blood tests are often inaccurate.

Dr. Heyman’s own research has pinpointed neurological inflammation and even damage that can occur in patients with Lyme. He and his colleagues have utilized specialized brain MRIs originally designed for Alzheimer’s and Parkinson’s, and found significant injury to the brain in many individuals infected with Lyme. “We have gone even further to show how the genetic material of the body actually starts behaving inappropriately in Lyme patients…as we dug and dug, we have realized the degree to which people were sick-and that we have to characterize this illness not just in terms of being an infectious disease, but re-characterize it as being a brain injury disease that has a very strong genomic component.”

Because of the multi-faceted and complex nature of Lyme, neither standard nor functional medical treatments work very well in this patient population, nor is it enough only to treat the infection in many patients. “In my ‘island of misfit toys,'” says Dr. Heyman, “common complaints such as fatigue and weight gain can be wrapped in a much deeper problem such as Lyme that may be underlying the clinical presentation. To successfully treat Lyme patients, one must eradicate the infection, resolve the chronic inflammatory response and repair the injury to the brain – all of which is possible with targeted therapies to restore patients back to health.” A true specialist in this field, therefore, must have an extraordinary ability and capacity to treat the patient as a whole, with experience and skill in not only hormonal balance, stress management, microbiome health, and detoxification, but also genomics, brain trauma and injury, chronic infections, and mold exposure-along with managing other complicated factors associated with Lyme disease.

Physician Burnout: A National Epidemic

“In nothing do men more nearly approach the gods than in giving health to men.” -Cicero

‘Burnout:’ loss of enthusiasm, low sense of accomplishment, along with persistent feelings of exhaustion and ineffectiveness pervade the medical profession according to a spate of recent studies and articles. The statistics are jarring: research demonstrates that the level of physician burnout has trended upwards in the past two years, with a 25% increase over a four-year period, and all indications suggest no change in course.

An article in the Archives of Internal Medicine about a 2012 study reveals a gloomy picture. The study supporting this conclusion included responses and data from a large sample of physicians nationwide representing a range of disciplines. The findings demonstrated that not only was burnout more common among physicians than other workers throughout the United States, but physicians in specialties at the front line of care were found to be at the greatest risk. The 2016 Medscape Physician Lifestyle Report delivered similar findings, reporting that almost half of all physicians stated that they had experienced burnout. An analysis from researchers at the Mayo Clinic and the American Medical Association likewise reported that doctors’ work-life balance is worsening, with the conclusion that patient care will be negatively impacted.

Even more concerning was data reported in a study published in The Journal of the American Medical Association, suggesting that the rate of depression among doctors in training is much greater than in the general population. The negative effect of burnout among doctors is, moreover, linked to alarming consequences including higher rates of medical error with increased malpractice exposure, larger numbers of staff turnover, physician alcohol and drug abuse, and even suicide. While it is believed that fatalities from physician burnout are underreported, research does reveal that the suicide rate among doctors surpasses that of the general population.

In response to the national epidemic of physician burnout, a chief wellness officer has been added to the staff of Stanford Medicine. In an unprecedented move for an American academic medical institution, Tait Shanafelt, MD is now leading Stanford Medicine’s pioneering program in the area of health care provider wellness. At a time when physician burnout has “nationally reached an all-time high,” Dr. Shanafelt directs the WellMD Center at Stanford Medicine, while serving as associate dean.

Shanafelt has broken new ground in the field of wellness among medical professionals by creating and assessing numerous national surveys that have collected information from over 30,000 physicians and 9,000 workers from other disciplines nationwide. The survey results have confirmed increasing rates of burnout among doctors; in 2014, more than 50% of those surveyed were suffering from “emotional exhaustion, loss of meaning in work, or a sense of ineffectiveness and a lack of engagement with patients.” Shanafelt’s studies have established that while physicians suffer, patients do as well, since burnout leads to increased errors and higher rates of mortality among hospitalized individuals.

Shanafelt opines that the trend of physician burnout is “eroding the soul of medicine.” While many leaders in healthcare recognize that burnout is a serious problem, most do not know how to effectively address it. Complicating the problem, physician distress remains a fairly taboo subject in the workplace. To date, stress management and burnout prevention are not covered comprehensively in medical school or residency training. Shanafelt is working to build and strengthen Stanford’s innovative WellMD Center, where more than 200 physicians have worked since 2016, by implementing peer support, stress reduction, and programs aimed at cultivating compassion and resilience. Another focus of the center’s work is a reduction of pressure among physicians through an improvement in efficiency and simplification of workplace systems.

The first American Conference on Physician Health took place in October at the center, co-sponsored by the American Medical Association and the Mayo Clinic. The primary goal of this event was the creation of a national dialogue surrounding the issue of physician burnout, and the implementation of tools to address physician distress with programs that promote “physician autonomy, efficiency, collegiality, and a sense of community.”

At A4M/MMI, we recognize that the significant and growing problem of physician burnout poses a direct threat to quality of patient care. We believe that there must a collective shift in attitude so that we can move towards an optimal system of healthcare. Only with recognition of the problem will we reach our goal, and help physicians feel motivated and passionate, while moving away from those traditional practices that inevitably lead to doctor burnout. For the past quarter of a century, we have continued the journey to help reshape and redefine the face of medicine, with the goal of reinvigorating physicians so that they can more effectively heal their patients. A4M/MMI faculty emphasize the importance for healthcare practitioners and professionals to rediscover and renew their professional passion, while learning new and innovative methods to prevent burnout before it takes hold.