In this year of reinvention, we are going to need partners that can deliver incredible value to clinicians and make it easier for them to run successful practices. This week on the podcast, we spoke to Josh Crolle from Evexia Diagnostics, who are going to be one of our new partners. We talked about the genesis of Evexia, what it means. Also, we talked about how Evexia can become an extension of your practice and remove and reduce the administrative burden of being in functional medicine practice. It was a really important half an hour for the movement of the reinvention of medicine.

Highlights include:

  • How we became partners with Evexia and their story
  • What they offer and how it can be essential for your practice
  • The scam that is the price of lab testing
  • And so much more!

Resources mentioned in this episode:

New Models #4: Making Lab Ordering Easier

James Maskell: Welcome to the Evolution of Medicine podcast, the place health professionals come to hear from innovators and agitators leading the charge. We cover the latest clinical breakthroughs in health technology, as well as practical tools to help you transform your practice and the health of your community. This podcast is brought to you by the Lifestyle Matrix Resource Center, who provide a range of options to help you deliver successful, effective, functional, and integrative medicine. To find out more and to get started, go to goevomed.com/lmrc. That’s goevomed.com/lmrc.

Hello, and welcome to the podcast. This week, we are talking lab testing and we’re doing it with Evexia Diagnostics. In this year of reinvention, we are going to need partners that can deliver incredible value to clinicians and make it easier for them to run successful practices. This week, we spoke to Evexia Diagnostics who are going to be one of our new partners. We talked about the genesis of Evexia, what it means, we talked about the scam that is the price of lab testing, conventional lab testing. We talked about how extensions of the practice and how partners like Fullscript, like Evexia can become extensions of your practice and remove and sort of reduce the administrative burden of being in functional medicine practice. It was really important half an hour for the movement. Enjoy. So, a warm welcome to the podcast, Joshua. Welcome, Josh.

Joshua Crolle: And thank you, James. I am grateful and honored to be with you today.

James Maskell: Yeah. We’re excited to be here too. So, just to give the audience a little bit of context. This is the year of reinvention and if you’d be listening to the podcast over the last few weeks, if you’ve been following this year, we’ve been really like laying out the case for this reinvention of medicine around functional medicine. But one of the big things that we see is that in order for practitioners to deliver functional medicine in an effective, organized way, efficient way, enough to be the standard of care, there needs to be other partners. And so, we wanted to talk about labs today, and I guess I just want to start by sharing my experience, my first experience of how I found out about Evexia.

So in 2016, we started the Practice Accelerator and we brought in about 500 doctors that year into our program who were all interested in building efficient, functional medicine micro practices. And in 2017, at the beginning of 2017, a doctor by the name of Rick Henriksen, who is out of Salt Lake City came into the Practice Accelerator into the Facebook page and sort of put together his review of the different lab companies that service the functional medicine community and sort of like what their prices were, what their services were, what labs they had, mainly because I think a lot of doctors were trying to work out this super cumbersome world of diagnostics, right? You’ve got all of the regular diagnostics and you have a lot of people paying cash already in functional medicine practices. You have a lot of people trying to use these functional labs and there’s multiple functional labs. And sometimes you want to use a DUTCH test and sometimes you want to use a GI-MAP.

And so he just put together his review of four or five different organizations and sort of his rating score based on ease of use, number of tests, and pricing of the labs for sort of the basic labs, cash labs. And this was the first time I heard of Evexia because Evexia came out on top of there. And so, that started a process of me learning about Evexia and what you guys were doing, and really starting to understand sort of some of the deep issues inside the lab industry, both from a practitioner perspective of like ordering and interpreting and logistics. And then also just like the industry, the greater industry of how patients feel about it and how things are priced and took me down kind of a rabbit hole at one point, but we’ll get into that as we go along. So, that’s how we first connected and yeah, I’d love to hear from your end, just sort of like the history of Evexia, where it came from, why it was started and where you guys are now?

Joshua Crolle: Very cool. I appreciate you sharing that. That’s a great story. So James, I want to start with this. I don’t know if you’re aware, but the word Evexia actually translates into wellness in Greek. And like wellness, Evexia as a company continues to evolve. So, it’s not a static thing, right? And Evexia isn’t either, it’s something that we continue to improve and work on to serve the integrative and functional medicine community. So, we’re constantly growing, incorporating new and better solutions for healthcare providers to improve their practice, deliver better patient outcomes. But to understand where we are today, as you had asked about the history, let’s go back and talk about some origins. So I think a particularly compelling aspect of our origins and why we’re so well-suited to serve clinicians and support their practices today is largely due to the fact that our president and CEO, Dr. Kevin K. Bodling had himself built and grown a very successful cash-based functional medicine practice in Dallas.

Now, at the time, Dr. Bodling was primarily treating patients with complex and chronic illnesses, and he quickly learned that he needed to contain the costs associated with that comprehensive level of patient care as much as possible. And so, in trying to do that, he realized that a significant factor in that was lowering costs on laboratory testing. For many integrative and functional medicine practitioners, that’s a cornerstone of how they engage with their patients. So, he started by taking matters into his own hands, and he built the first and only DC-owned and operated CLIA, moderate complexity physician operated lab in his clinic. And while that served a purpose of convenience, it still wasn’t sustainable, it was still too expensive. And so, that really spurred him to take it to the next level and he began aggressively negotiating with commercial laboratories and using his significant testing volume as leverage to reduce the cost of testing, which he could then pass on to his patients.

So, that approach proved to be successful and as a result, he started to market this to other clinicians in the area and was able to aggregate their volume as well. So, it further increased the level of discount he was able to achieve with these labs. So, at that point, he was able to step back and see that he was at a place where he was really making something of value, not just for himself and his practice, but something that could be translated and shared with other clinicians. And so, that was something that he wanted to be able to bring to the marketplace to serve other clinicians so that they could better take care of their patients.

James Maskell: Yeah. It’s really interesting you mentioned that. And particularly the cost consciousness piece, because a few podcasts ago, we were talking with one of our other partners, our long-term partner Fullscript, and they’ve actually done a ton of research into adherence and what drives adherence in functional medicine. And a couple of podcasts ago, we talked to Alex Keller. He shared on the five characteristics of clinics that had high levels of adherence. And the first thing was cost consciousness, right? Clinics that are conscious of the fact that this is costing money for patients and try and do everything they can to reduce that cost by and large get better adherence from patients. Patients not only take their recommendations, but continue to take their recommendations and stay engaged in the process.

So I think it’s a critical piece. Let’s just get into this whole lab pricing thing, because another part of this story is that around that same time in 2017 when that came into the Accelerator, I was building Knew Health and a year later I’d go on a tour around the whole country. And one of the things that I recognized from that was just sort of like the depths of the pricing scam for conventional labs and forget about functional labs for a minute, but just the way in which if you walk into a hospital and they ought to use some labs, the pricing of those labs might be five, 10, 20 times higher than if you were to get it through Evexia. And actually, when I went on the KNEW Vision Tour, this is one of the things that we talked about a lot was the fact that patients kind of know, right? They know if they’re being scammed, right? There’s high deductible plans. There’s a lot more details.

And whether or not you’re knowingly participating in that scam or whether or not it says a lot about the kind of practice you’re running and for most practices that aren’t taking insurance or aren’t doing anything like that, being able to solve this problem and say, “Hey, look, we’ve gone above and beyond to find the cheapest labs for you because this is just a service that we provide,” really builds trust, right? Really builds trust with the patient because it shows that you’ve become like an advocate for them. And as I started to look at all the practices that I really admired out in the functional medicine landscape, this was something they all did. And it seems to me that those clinics that partnered with Evexia were able to make those kinds of claims with their patients and be able to sort of position themselves as a trusted advisor to their patients which is difficult to do if you’re constantly up-marking all the things, particularly the labs that you’re recommending for patients.

Joshua Crolle: Yeah, absolutely. We all know that there’s a lot that goes into patient care and especially for patients that are struggling with, they’re dealing with complex and chronic illness it’s not a quick turnaround. Sometimes there is a long path to get back to wellness. And oftentimes the foundation of that is testing. And if that is creating a situation where patients are not able to get the level of care that they deserve, that’s problematic. And so, we see that as another avenue to help support our clients really reach their patients and help them to get back to wellness. It’s a primary piece of our business. And frankly, I think it’s a primary component of functional medicine. And so that’s really a focal point for us.

At this point, we’ve got our primary reference lab is LabCorp. So they’ve got patient service centers across the country. There’s thousands of them. We’ve also been able to develop and establish relationships with 16 other specialty labs. So, in that way, we offer the best of both worlds, but it starts with, as you had mentioned, the conventional testing, that really is kind of the foundation, that’s the bedrock that everything else is kind of built from. And that has to be cost-effective.

James Maskell: Yeah, absolutely. Well, I want to talk a little bit about that because this year is the reinvention of medicine as our theme. And I think one of the things that has kept functional medicine from entering the mainstream has been the fact that the testing that is used in functional medicine is not used in conventional medicine. And so when doctors come across, they don’t just see, “Oh, we’re going to focus on lifestyle first or we’re going to focus on using supplements or otherwise.” They see a whole new world of diagnostics opening up to them, right? They see the courses or saliva tests, they see that gut diagnostics tests, they see all those kinds of tests and it can be a little overwhelming. And in some cases I think a little off-putting.

And again, when I spoke to doctors who had made the switch and being in integrative and functional medicine for a while and had spoken to many other clinicians, they realize that if you really get to the heart of what we’re doing, making changes in lab ranges and using labs that doctors already understand has to be the bridge for the rest of conventional medicine to come to functional medicine. Like if they can see significant changes in A1C…in this last year, suddenly all these doctors realizing, “Hey, maybe I need to get a vitamin D test.” Looking at changes in inflammation. Things like CRP, these kinds of markers, if we can make a significant impact on those markers using functional medicine testing, the ripple effect of that to the patients, other doctors, and even in the data that’s collected in the practice is significant.

And so that’s why I really think that bedding the reinvention of medicine inside the lab system that is being used in conventional medicine, gives us a chance of sort of entering this big blue ocean of medicine, which functional medicine has yet to sort of infiltrate. But if last year and the last year and a half taught us anything, is that we need, like the rest of medicine needs this and needs it desperately because we have such an irresilient population. And so, we have to get results in the language that the rest of medicine understands and that is conventional labs.

Joshua Crolle: No question about that. Yeah, no, you have to start at a common ground as you said to bridge that gap. But as you astutely pointed out, that’s where the opportunity is. That’s where medicine is going, is into that functional sphere. It hasn’t quite fully taken hold in the mainstream yet, but it’s growing and we’re starting to see the impact, which is really exciting, but it’s taken a long time to get there, but you’re absolutely right. It has to start at the common ground, which is the conventional side of testing that will bleed into and demonstrate, it will begin to highlight the real profound impact that other specialty labs can bring into the forefront of medicine and patient care.

James Maskell: Absolutely. So just give me an example of like the sort of common problems that Evexia is solving. Like who’s the doctor that comes along and you have a conversation with them. And then they’re like, “Oh man, why didn’t I know about this already?” And then they start using the service. Like, what are the problems that they’re facing in the practice and how do you guys solve it?

Joshua Crolle: Sure. So I’m going to start with this. We had touched on it already, functional medicine and the task of a clinician these days is not simple. It’s a complicated process and there’s a lot of options out there. And so, we help to simplify their practice. We help to simplify how they’re able to engage their patients. And one of the primary ways that we do that, which we’ve started discussing is lab testing. Again, as I mentioned, we’ve got our primary reference lab LabCorp, but then we’ve got relationships established with 16 other specialty labs and that continues to grow. But what we do is we’re able to manage those relationships rather than have a clinician sign up with 16, 17 different labs and have that many accounts to deal with, to have to not only just establish that account, but then maintain that with billing, with tracking specimens, with addressing issues, following up with patients, the whole nine yards, it gets very cumbersome.

And we manage that relationship. So it’s one call to Evexia and we take care of the rest, but the clinicians have access to all of the different labs that have demonstrated real value in the functional medicine sphere.

James Maskell: Can you just give us an example of like half a dozen labs that you guys have and sort of what are the most popular functional tests that are being ordered through Evexia?

Joshua Crolle: Yeah, certainly. So you had mentioned the DUTCH test with Precision Analytical. So, we offer their suite of tests. We offer testing with Genova, the NutrEval, the ION is very popular. The SIBO Test is extremely popular. Intestinal permeability, the GI Effects. Those tend to be very popular. The Organic Acids Test we’ll be bringing on shortly here, Doctor’s Data, we offer the GI360 and a suite of other tests with them. Labrix is another one. So we offer salivary hormones, neurotransmitter testing. We offer Quicksilver for heavy metals. We just announced 3X4, and I believe that you had a recent podcast with Dr. Yael Joffe who’s amazing. That test is an incredible genetic test that’s going to be going live in July. We’ve got a number of different food sensitivity tests. The YorkTest we just recently brought on, that’s been extremely popular. We offer US BioTek. We offer a number of different environmental tests as well. So, we really run the full gamut. Of course the GI-MAP is also popular. So not only they have great solutions, but they’ve got choices for these solutions. So, if a clinician prefers one lab or another, they’ve got those options.

James Maskell: Yeah, that’s great. So yeah, I see how so many those needed coming together. I can definitely understand the value proposition for the doctor, right? So it’s like you have all these things in one place. You don’t have to sign up for all these accounts. You’re not dealing with all of that data coming into all these different places. What about for the patient? What is the benefit to the patient and working with a provider that is using Evexia as opposed to using multiple different organizations?

Joshua Crolle: Sure. So a few different things, James, primarily we are able to serve as an extension of the clinician’s practice. So, not only are they able to focus more on the patient, but our client service and our client success agents are there to not just assist our clients, but their patients as well. So it doesn’t all just fall on the clinician. Again, that’s where it’s instrumental because in order to really effectively serve the needs of your patient in this day and age in personalized medicine, you need help. It’s not something that one person can solely do on their own. And that’s where we come in because we’re able to provide the additional support and services to make sure that their patients get questions addressed to ensure that if there’s an issue with sample collection, that clients know that we’re going to help their patients.

James Maskell: Beautiful. Well, Josh, look, I really appreciate you coming on. And I guess I just want to finish this by sharing just how I see this fitting into the reinvention of medicine. So I really when we started the Functional Forum, we recognized that functional medicine was the operating system for the future of healthcare. And over the next few years, what we started to realize is that we could make it a lot easier for doctors to go out and build these kinds of practices because for the first time there were organizations showing up that could take the burden off the clinician to build a successful practice, right? A lot of that was technology. So you didn’t need to have a front desk person if you had an online scheduler at the beginning. You didn’t need to have a whole inventory of all the supplements if you could have Fullscript have a virtual supplement, and you could essentially run your practice off a laptop with minimum cost.

And that was what led to the book, The Evolution of Medicine, and sort of like the journey to see that there’s this journey to fall back in love with medicine and practice medicine on your own terms and start to use and take advantage of these organizations that add a ton of value to the practice of medicine. Now, two weeks ago, we heard from Fullscript where not only do they have that whole backend technology that helps you get the supplements, not have to hold inventory and drive adherence, but also they had a new service that they were sharing called Treatment Plus where if the patient didn’t fulfill their prescription, they would actually get a call from someone at Fullscript and this was another way that they were adding value. And sort of the phrase they use that I love is to become an extension of your team. Right?

And so, you can see that with supplements there. You can see here with Evexia, it’s a similar thing. It’s easy, it’s becoming an extension of your team. It’s meaning you don’t have to hire all these people to answer all these questions for your patients, because there’s a team there. Ultimately, the system works and there’s a solid technology behind it, but ultimately that there’s other people taking the load of the administration organization of sort of like a cumbersome part of functional medicine. And I’ll just show one other piece you guys will be hearing about, HealCommunity, which is something that we’ve been working on for the last year here is an extension of clinicians’ practices when it comes to the delivery of lifestyle.

And ultimately, this reinvention of medicine for us is really about making it easy for doctors to build a successful practice, introducing them to partners who can make it easy for them to go out and deliver great medicine to their patients and make it easy for doctors to practice on their own terms. And I feel like today, we’re just like sticking in the slot for labs and possibly we could have done this a few years ago, but realistically today I think with all the changes and improvements that you guys have made, not just in the lab testing space, but also interpretation of functional labs and getting the team on board we’re really excited to put Evexia into our suite of referral sources for practitioners.

And as we open up the doors to the big ocean of medicine, as doctors realize that they weren’t well-trained on how to build resilience in the population, that ultimately as they start to come across functional medicine, and also as big organizations start to realize the value of functional medicine, it’s going to take organizations that are taking care of a lot of the details, because ultimately if we’re always reliant on the physician entrepreneur to solve the problem, and they’ve got a million problems and patient care is just one of them, it’s going to be a slow, slow burn. And I think we’ve seen that over the last, like 30 years, it’s slow and slow, but now it’s starting to speed up. And this reinvention of medicine is coming at a time where we really need to see a significant acceleration in this shift if we want to solve the scope of the problem that we have in front of us.

And I’m super grateful to recommend Evexia to our community and I would say that if anyone wants to start an account with Evexia, you can go to goevomed.com/evexia. That’s E-V-E-X-I-A and we will continue over the next five, 10 years to be able to continue to bring in partnerships that facilitate ease in delivering great medicine and making a big impact in your community. So Joshua, I want to thank you for everything that you guys do over that. And as new exciting things like the 3X4 partnership come along, we’d love to invite you back to discuss this because it’s going to take a team effort for this reinvention of medicine, and we’re grateful to have Evexia on the team.

Joshua Crolle: Absolutely. Thank you so much for the time today, James. We’re very thankful to be a part of the community and help to provide these solutions for better outcomes.

James Maskell: Beautiful. Well, this has been the Evolution of Medicine podcast. As I mentioned again, you can go to goevomed.com/evexia. With Fullscript, Evexia, these are the companies that are coming on to support this reinvention of medicine. We’re grateful here at the Evolution of Medicine to be able to continue to take this movement and work forward. If you have any questions, feel free to get in touch with us, or you can get in touch with Evexia where you could certainly get started with a new account at goevomed.com/evexia. Thanks so much for tuning in. This is the reinvention of medicine. This is the Evolution of Medicine podcast. I’ve been with Joshua Crolle from Evexia Diagnostics. I’m your host, James Maskell and will see you next time.

Thanks for listening to the Evolution of Medicine podcast. Please share this with colleagues who need to hear it. Thanks so much to our sponsors, the Lifestyle Matrix Resource Center. This podcast is really possible because of them. Please visit goevomed.com/lmrc to find out more about their clinical tools like the Group Visit Toolkit. That’s goevomed.com/lmrc. Thanks so much for listening, and we’ll see you next time.

James Maskell: Thanks for listening to the evolution of medicine podcast. Please share this with colleagues who need to hear it. Thanks so much to our sponsors, the Lifestyle Matrix Resource Center. This podcast is really possible because of them. Please visit goevomed.com/lmrc to find out more about their clinical tools like the group visit toolkit. That’s goevomed.com/lmrc. Thanks so much for listening and we’ll see you next time.

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