Maggie McKay (Host): Medicine evolves constantly and one area of that is integrative and functional medicine. So today, we'll get an introduction into both and bringing it to a critical access hospital in Carthage, Illinois. Chief Wellness Officer, Dr. Yoon Hong Kim will fill us in.

Welcome to Say Yes to Good Health, a podcast from Memorial Hospital. I'm Maggie McKay. It's so wonderful to have you here today, Dr. Kim. Would you please introduce yourself?

Yoon Hang Kim, MD: Yes. My name is Yoon Hang Kim. I am a Chief Wellness Officer for Memorial Hospital. And my primary job right now is to develop integrative medicine, functional medicine, and lifestyle medicine through Memorial Institute of Health and Healing.

Host: So, let's start with what is integrative and functional medicine.

Yoon Hang Kim, MD: So, integrative medicine is the term, basically, you're putting together elements of medicine that is not taught in conventional medical school. So, things would be like acupuncture, mind-body medicine, using food as medicine, using meditation in lieu of medicine, using exercise or other lifestyle as medicine. And the functional medicine means that you are embracing late-breaking technology that is not yet adopted in medicine.

So for example, there is GI map testing that would give you access to mapping out your microbiome in your gut. There are micronutrient testing that will give you 33 of most important analytes in your body that your physician will not be able to test all of those. And then, there are expanded allergy testing that can differentiate between a true allergy and food sensitivity.

Host: I love that idea. What's the main difference between integrative and functional medicine? Are they powered the same? Were you trained in both?

Yoon Hang Kim, MD: So, that's an excellent question. Power is where they differ. Integrative medicine is powered by the wisdom of healing. So, they draw upon traditions like Chinese medicine, Ayurveda, mind-body medicine, meditation, mindfulness, relaxation response, whereas functional medicine really leveraged the technology, so the DNA testing, the analyte testing of the micronutrients, expanded allergy testing. For example, in the Western medicine, we only test IgE, which screened for true allergy. But some of the functional medicine tests will give us an option to test IgG complement system, IgG4 which then gives us much more comprehensive picture of what's going on.

Host: And were you trained in both?

Yoon Hang Kim, MD: Yes. I was very fortunate to be trained with Dr. Andrew Weil, who pioneered the integrative medicine. And while I was training with Dr. Weil, he gave me pretty much unlimited budget to travel and learn, and I would go to every conference there was. And the other portion of that was what was prior to functional medicine. When I started, even functional medicine didn't really exist in the current form. So, I would go to all conferences, and then I would learn from colleagues, I would learn from the labs. And probably the biggest place you learn is from the laboratory that holds these new technologies and then patients who teach you, because their symptoms drive you to find a solution until you find a solution.

Host: And what makes a hospital critical access? How do they qualify for that designation?

Yoon Hang Kim, MD: It's a federal term that allows for rural hospitals to be reimbursed at more favorable rates so they can stay in business. There's a minimum distance between hospitals and whatnot. And for our program, what is really important is that we are able to accept most insurances and be sustainable because of rural health clinic. And that means that in most places in the U.S., when you go to functional medicine, integrative medicine, lifestyle medicine provider, they take cash. And in our case, because of the rural health clinic, we are able to take most insurances.

Host: And so, is it the same thing, rural healthcare clinic and critical access? Or is there any difference?

Yoon Hang Kim, MD: Yes, the difference is critical access refers to the hospital. So, it can't be, I think, larger than a number of patients, like 15, 12 to 15. There's a distance between minimum. The rural health clinic talks about the composition of the clinic, location of the clinic, and it's an outpatient service. So one's more inpatient, and then the other one's more outpatient. And because my services at this time is more outpatient-oriented, so the rural health clinic is critical for the way that we deliver care and allow our system or services to be sustainable also makes our service accessible to our patients.

Host: So, that's the advantage of having the distinction of rural.

Yoon Hang Kim, MD: Right.

Host: Dr. Kim, at Memorial, I know you're committed to holistic care. What do you offer as a result?

Yoon Hang Kim, MD: The big thing is that a lot of my patients come to me because the conventional medicine is not getting the results for them. And it's not unusual for patients with seven or eight conditions on top of each other. And I'm able to spend up to 90 minutes in the first visit and 60 minutes in subsequent visits if they have complex conditions. And by leveraging both wisdom of healing, integrative medicine, and late-breaking sciences, functional medicine, by combining it all together, we are able to solve some of these mysteries for our patients.

Host: It sounds like the best of both worlds. I mean, and you get 60 to 90 minutes with your doctor. My goodness. When does that ever happen? Because then, you can really dive into it, I would think. How did Memorial Institute of Health and Healing come about? What do you focus on?

Yoon Hang Kim, MD: The Memorial Institute of Health and Healing came about because we wanted a way to house the older services that I envisioned. So for example, integrative oncology, we're using medicine and functional medicine to support patients undergoing cancer, integrative pain management, and integrative functional medicine consultation, and lifestyle Medicine to reverse type 2 diabetes. In many places, they just list the services they do. In here, I wanted to have specific service line, and it just made sense that we have an institute which can then launch different services and advocate these services to our community.

Host: Is most of your work in hospitals or private practice or split up?

Yoon Hang Kim, MD: So, I would say, currently 100% of my practice is outpatient. And the Institute of Health and Healing is located on the Memorial Hospital ground in the Memorial Medical Clinic space.

Host: Can you talk a little bit about integrative oncology, what it is and what mindful choices are?

Yoon Hang Kim, MD: Integrative oncology means that we are supporting patients undergoing cancer treatments using evidence approach to supporting those patients so that they would be most likely to complete the active cancer treatment. And then after they survive, to assist them so that their quality of life would be the highest and the outcome can be optimum.

One of the things that is a bit different than other integrative oncology practices is the emphasis on patient empowerment. And we want patients to be empowered. We want patients to know as much as an expert in that area of the cancer they have. And we really ask our patients to engage with their oncologists, surgical oncologists, and radiation oncologists, so that they can make mindful choices at each time so that we can shoot for the optimal results.

Host: I love that. So they can support themselves and know everything that they need to rather than just relying on what they're told. Dr. Kim, what is the integrative approach to chronic pain medicine?

Yoon Hang Kim, MD: That was developed when I was working for a large insurance company, and Medicare Advantage Program. And there, we combine novel treatments such as a low-dose naltrexone, which has been shown to be very helpful to reduce inflammation, especially nerve pain, where we don't really have good treatments for nerve pain. And then, there's acupuncture treatments that I also perform that is really focusing on re-education of the nervous system. So, I use acupuncture, not just for treating pain, but educating the nervous system to let go of pain.

Host: Wow. So, kind of resetting it?

Yoon Hang Kim, MD: Correct.

Host: What's the connection between food and medicine?

Yoon Hang Kim, MD: Food and medicine, it's very interesting. Because I say that every time our medical system declares a war on a condition, actually, we get in trouble. So, we declared war on pain, and then we had opioid epidemic. We declared war on obesity, we failed, and we had diabetes epidemic. So, the idea that you want to do is get to the root cause, and address and utilize food in a systemic way to get to the root cause.

So, for example, for diabetes, the problem is that people cannot take glucose normally anymore. So, in this case, we would put them on a treatment known as ketosis, where people are not burning sugar in their metabolism, they are burning fat, mostly. So, two things happen, they're not taking sugar and they're burning fat. The result is that a lot of them lose weight. When you lose weight, insulin resistance goes down. Then, your diabetes improves and the blood sugar improves. So instead of where you are feeding people or giving them medication, it works for a little bit. And then, what happens is that the appetite increases or some medications, a side effect is to gain weight. So, it does the opposite. You gain weight and then you're less sensitive to the treatment, and then you need more of the treatment, and then you gain more weight. So, I've seen so many patients suffer and one of the patients had to sell their home to afford insulin, and I was looking for a way to help them. And what had happened is that I discovered this way of treating when I was in University of Kansas. And then, I started using it on my patients in University of Kansas. And then since then, for the last about 10 years, I've used this approach and helped patients to reverse type 2 diabetes.

Host: That's amazing. You mentioned treating cancer patients and patients with diabetes. Is there anybody who would not be able to seek your help? It sounds like no matter what ailment you have, they could come to you. Is that right?

Yoon Hang Kim, MD: I think that's correct though. That's why the integrative medicine, functional medicine, lifestyle medicine, the consultation services are open for referral as well as self-referral. And occasionally, there's not much I can offer because some of the patients are so proactive they have fear of missing out. So, they'll come to me and they'll say, "I'm doing all these things. And is there anything more?" And I just congratulate them on a job well done and I'll share with them things to watch out for.

But occasionally, there's like a patient that came in, perfect weight. So I said, "What's wrong?" And she said, "I have prediabetes. And my doctors want me to wait until I have diabetes and then they will treat it." So, "What would you like me to do?" She's like, "I want this prediabetes resolved, reversed." So, it took us about three months and she did it, and she's no longer at the range of even prediabetes.

Host: I love those stories, doctor. They're so hopeful to everybody else. You mentioned earlier, and we talked about it, that you see patients for 60 minutes, 90 minutes sometimes. Do you see this being applied to primary care, general medicine in the future?

Yoon Hang Kim, MD: I'm so glad you asked. One of the things I'm hoping to do in the future is to develop integrative primary care model based on membership. And I think that can be one of our episodes, but places that use this model have put a stop or slowed down increase of their spending in healthcare.

That's like a passion for me. This is what I do for a living, but the passion for me is how do we solve the problem that we have? In terms of escalating cost of healthcare and the access to healthcare at the same time is less, people are paying higher deductible. And basically, your premiums go up, what you get from those premiums or the benefits go down. And we have to put a stop to it. You can't solve problems like these by just coming up with more technology that's expensive. And that is our way of doing things in America. But I think that there is a movement growing called direct primary care that I think the integrative medicine and direct primary care can be combined. And through membership and corporate participation, what we can do is create win-win-win for all the parties involved.

Host: That sounds like a good plan to me. Very promising. In closing, is there anything else you'd like to add that we didn't cover?

Yoon Hang Kim, MD: Yes, this was all possible through my CEO, Ada Bair, who is a phenomenal leader who envisioned this in 2015. And coincidentally, that was about the time I began to look for a system to join to do the job that I'm doing. And it took us seven years to find each other, but I'm very, very grateful for that. And we have been just accepted to Academic Consortium of Integrative Medicine and Health, which I think about 80 of the most prominent systems belong to that consortium and we are part of it now.

Host: Congratulations. That's amazing. Thank you so much, Dr. Kim, for this informative introduction into integrative and functional medicine. It's really been eye-opening and fascinating.

Yoon Hang Kim, MD: Thank you.

Host: Again, that's Dr. Yoon Han Kim. And if you would like to find out more, you can visit mhtlc.org. If you found this podcast helpful, please share it on your social channels and check out the entire library for topics of interest to you. I'm Maggie MacKay. Thanks for listening to Say Yes to Good Health, presented by Memorial Hospital.