Welcome to the Outcomes Rocket podcast where we inspire collaborative thinking, improved outcomes, and business success with today’s most successful and inspiring healthcare leaders and influencers. And now your host, Saul Marquez.

Saul Marquez: Welcome back to the podcast. Saul Marquez here. I have Dr. John La Puma. He’s an inventor and Founder at Chef Clinic. John is the leading physician voice for healthy eating and is a wellness and nutrition expert both a certified practicing internist and professionally trained chef which is a pretty awesome combo by the way. He’s a New York Times best selling author twice advocating healthy living, weight control, and nutrition as part of health. Dr. La Puma sees patients in Santa Barbara California for one on one personal medical programs with follow up by phone nation wide. He’s been called a secret weapon by the Wall Street Journal and is a regular health nutrition and culinary medical contributor in the national media. He hosts the national PBS series Dr. John La Puma’s Chef M.D. Shorts. The 90-minute PBS special: Eat and Cook Healthy with Dr. John La Puma and a 13 part youtube series Refuel Minute for Men. So if you haven’t checked any of these things out definitely check them out they’ll be in the show notes. But it’s definitely important to note as well that he’s been named one of America’s top physicians by Consumers Research Council and among many other accolades so it’s a true pleasure to to welcome John to the podcast. Welcome and thanks for joining us.

Dr. John La Puma: Thanks Saul. Happy to be with you.

Saul Marquez: So John you’ve done a lot of really cool things and you know we’ve had a chance to connect prior… Food Nutrition super key. But what is it that that got you into the healthcare sector to begin with?

Dr. John La Puma: I always have liked caring for others Saul. I like the idea that you can nurture people and food and plants and animals. I like the nurturance thing and medicine is I think fundamentally about well-being and nurturance as part of that well-being. So I like the idea that from an early age that I could express empathy, I had a lot of experience with older people. So my first job through an assisted living facility is at nursing homes and it’s 15 and 16 and I just like those people and I like the stories they told and I was interested in the science but the science wasn’t always the top thing for me, it was more… what we read the stories that other people told particularly older people that were about how they got to be where they are. So that’s how I was drawn into medicine and that probably explains why I’ve had a really non-traditional career and have just added things instead of changed them.

Saul Marquez: Hey I think it’s really cool the way that you’ve approached it and your personal touch has definitely created a lot of great value for the people that listen to your work, watch your work or you know your patients right that you’re treating. So what would you say is a hot topic that needs to be on every medical leader’s agenda John and how are you and in the things that you’re approaching it with… how you do it?

Dr. John La Puma: Well as you know Saul I’ve been interested in this idea called culinary medicine blending with the art of cooking with the science of medicine to give restaurant quality meals that help prevent and treat disease. And it’s pretty clear. I think now to people at every level of the healthcare system that food affects how you feel, how you think, what diseases you can prevent, what diseases can treat. And of course your overall well-being. But I think there’s even a step beyond this that I’ve been working on recently that has to do with the built patient environment, the climate inside of hospitals, inside of doctors offices and wherever medical care is delivered that we’re just beginning to learn about that. I think it has a significant effect on how people recover from illness and how they can prevent it once they get home. And I’m talking about the view from a hospital room I’m talking about the air quality in the hospital room. I’m talking about the presence of natural phenomena, plants, and water features available to hospital staff and to visitors as solace from the tough parts of medical care. We’re just really beginning to learn how nature and use of nature and the environment as a whole including climate change can change health. But I think it’s a next next topic that’s going to blossom in the next 10 years. And we’re excited to be part of it.

Saul Marquez: I think it’s a really cool topic and you know you yourself are a TED med speaker. I was there a couple months ago and actually was eating breakfast and sat next to this really bright woman who is an architect and was working on topics of this that you know it was architecture and healthcare and it was basically everything surrounding what you said around these elements of nature, water, plants, and the impact that it has on people when they’re getting treated. I think it’s so fascinating and and so this is kind of like the next chapter right and so I’d love to hear from you more about your current, chapter the cooking and the eating and the wellness. Can you give the listeners an example how you’ve created results by doing things differently?

Dr. John La Puma: Well actually sure. Speaking at about TED Med when I was there two or three years ago, I met some folks from NBBJ the internationally known architectural firm centered in Seattle in this country which invited me to consult with them about creating lifestyle gardens for Loma Linda University and for their own rooftop and for a clinic in eastern Washington. The idea that the plant selection could be used both for therapeutic reasons and for an educational instructive one. And so we did a great deal of research in designing a cardiovascular garden, a pediatric garden, an immune system garden. And I worked in very talented landscape architects at NBBJ which is really a leader in the health architecture and has created many of the leading hospitals and clinics in this country and really internationally. And they have the idea that the outside environment really affects healing and creating natural spaces which are on view as patients heal is in fact part of their therapy and they see architecture as… and the microbiome of the built environment for that matter as a way to contribute to getting better and to well-being. And so it was a privilege to work with them and I really admire their work and our own work is going to continue that by developing this idea of nature therapy and learning more about how nature works in the body as medicine.

Saul Marquez: Yeah that’s pretty neat. That’s pretty neat. And I didn’t know that about you that you definitely had engaged in this area definitely fascinating and so when you think about the things that you’ve done to make an impact what would you say one of the setbacks that you had? You know you’ve had a lot of success. What would you say one of the things that you had a setback in, what did you learn from that that has made you better as a result?

Dr. John La Puma: I had many more setbacks than I had successes. Its you just try to keep throwing stuff against the wall and hope that works. You know one example was that when I was in my first career in medicine and medical ethics and began a community clinical ethics centre within General Hospital in Park Ridge. Now part of the system.

Saul Marquez: You know I live in Park Ridge now right.

Dr. John La Puma: Really?

Saul Marquez: Yeah.

Dr. John La Puma: That’s awesome.

Saul Marquez: I actually just moved a couple months ago actually a month and a half ago down. So I’m very familiar with Lutheran.

Dr. John La Puma: No kidding.

Saul Marquez: Nah.

Dr. John La Puma: That 1775 Dempster, are you close by?

Saul Marquez: Yeah I’m about ten minutes away.

Dr. John La Puma: I loved my time there and developed a an ethics consultation service which is the first in a community hospital in the country and did a lot of academic research. It was very embracing of the idea that ethics consultation that the patients side in the clinical setting was an important clinical intervention that consultants could add to outside of committee although it also had committees and allowed me to do a great deal of research but I did so much of it and kind of 12 to 14 hours a day a lot that I gained 30 or 40 pounds and they’re constantly and worried constantly and I really didn’t mind my own health at all. And I as a consequence I kind of burned out on ethics although I still love it and loved the people and then I went to the University of Chicago a couple of months ago to attend the 30th annual fellows conference. But I was unable to keep balance in my life so I need to take a couple of years off and that’s when I went to cooking school and wrote my second book on clinical ethics and began to see how I might begin to fit my love for food and cooking into medicine where it seemed to fit but without that, two years away really I don’t think I would have had the possibility of recalibrating my goals and interests and passions. So burning out kind of had a silver lining. But for a long time I had to struggle to find it.

Saul Marquez: Yeah I’m sure it was tough. And so you rebuilt and you you found a way to weave in your passions into your profession and I think that’s really cool you know when people are able to piece together their passions with their professions it really becomes a calling rather than a career. You get paid to do it. It’s fun and you become even more successful. And I really believe that that’s what you’ve done John and so kudos to you for turning that around. A lot of us can find ourselves in in those moments right where you do feel burned out and so take this story from John and and know that there is a silver lining in what you’re doing right now and that there is an opportunity for you to turn this into even better. And so and speaking Oh you and better John, what would you say one of your proudest medical leadership experiences has been to date?

Dr. John La Puma: I was privileged to give the first lecture at Harvard on culinary medicine. That was fun.

Saul Marquez: Very cool. Congrats.

Dr. John La Puma: That subject could kind of arrived and then I could go off and do something else which use it as a bridge relate to this idea of nature therapy and teaching the first culinary medicine class in the medical school with my friend and colleague Michael Roizen and is now head of wellness at the Cleveland Clinic was also a really cool thing to be able to participate in just… we had twelve students the first year and there were 70 signed up the second year and students young people in particular seem to get that food can work like medicine in the body and wanted to know the practical skills of it. And the magic is that if you write recipes on prescriptions slips or share a passion for what you eat and how to eat or for that matter how you exercise and where you exercise, your patients see you as more human and more engaged and more on their side and you actually have fun together. And so I’ve been privileged to have many high moments and I hope I’ll have many more because the idea that you can actually change your health with plants that you know trees might be as powerful as statins and preventing heart disease is really novel but it’s not that different than what I was told in 15 years ago when I began in culinary medicine that the references in the medical literature were mostly about how different parts of the anatomy were named after different parts of the pathology were named after food like the early bird cherry NGO those. And there is a nutmeg liver. The only thing you find is how food causes disease or was associated with disease. Now although there’s a lot of controversy about how the sciences where we know that some food actually can help prevent disease or forestall it and some diets actually treat disease. I think that probably the same thing is true for environments that being in a forest for a short period of time certainly changes cortisol levels and that and the activity in the amygdala and hippocampus changes cognition, reduces anxiety, reduces depressive feelings inside into our household plants can filter airborne microbes and up to 20% of dust and according to NASA it can clean a room of indoor air pollutants which are five times as prevalent indoors as they are outside, using a car for 30 minutes weekly can prevent 9% cases of hypertension and reduces systolic and diastolic blood pressures by 8 and 6 points respectively on average. I mean the list just goes on about what is basically not yet considered a subject for medical science that’s serious. But that’s changing.

Saul Marquez: Yeah that’s definitely fascinating John and you know use your enumerating these things that you could do and immediately I’m sure folks you’re listening and you’re like wow those are really easy to do. Like I could go once a week to the park or I could put a plant in my house or one of the things that John just mentioned. Yeah sure it’s easy. What’s easy to do is also easy not to do and it really easily falls out of your priorities. So look you guys are listening to this podcast right. And the one thing that I would say is rather than passively listen, take a nugget and apply it. And so I invite you to take action and do one of these things, hit rewind, listen to John’s ideas again and implement some into your day to day because these things do make a difference. And and if you want go to the show transcript, you’ll be able to find those ideas there as well we’ll summarize them for you. Just go to outcomesrocket.health and under the search bar search for a chef clinic or La Puma and you’ll find the transcript there. What would you say an exciting project you’re working on today is John?

Dr. John La Puma: We’re working on this idea of nature therapy. We just finished a 21-minute TV pilot that we’re going to pitch to a streaming service. We finished a 20 page white paper on how you can use nature to improve your own health. We’re going to list for free it’s a PDF on my website, drjohnlapuma.com.

Saul Marquez: So was that available yet or not yet?

Dr. John La Puma: I think it’s just going up this week…

Saul Marquez: This week?

Dr. John La Puma: As early December here.

Saul Marquez: So when this interview goes live it’ll be available folks. So if you’re listening right now that means it’s available and it’s in the show notes. So again outcomesrocket.health, chef clinic get that. So tell us about that. That sounds really cool.

Dr. John La Puma: Yeah it’s a really practical way to look at some of the science of nature from forest bathing to aromatherapy to pet therapy a lot of things that have been kind of pooh poohed or not thought of as very serious. But if you start looking more closely, some of the science is actually the least suggestive and in some cases persuasive including these folks at Stanford did a MRI is on people who had walked in nature for 30 minutes and looked at their brain activity and found that the brain activity in this sub general prefrontal cortex for rumination starts was significantly lower which reduces both anxiety and depressive mood. There’s an epidemic of myopia particularly among young children and even worse in Asia sadly than it is in this year in the United States. But that’s thought to be almost certainly due to screen news and adults check their phones seventy seven times a day on average it’s 11 hours of screen time in one way or another for most adults in the United States. And similarly we spend like 93% literally, 93% according to the World Health Organization every time inside. 87% inside and 6% in cars. That’s a lot.

Saul Marquez: That’s a lot.

Dr. John La Puma: You know I think it’s it’s really out of balance. If you look at other areas that are not even directly related to digital distraction that are just directly about pain relief for example. We’ve done studies with virtual reality and and kids who are getting flu shots, we gave them 30 seconds of under the sea virtual reality where they were swimming with fish with a over that over the eyes inexpensive twenty dollar the hour holder and while they were getting their flu shot and for a few seconds afterwards it was actually a randomized controlled pilot in a clinic here in Santa Barbara. Two hundred kids from ages 2 to 14 with their parents permission and they had half the fear and half the pain according to our survey instruments that they did when they’ve been previously getting shot through fluids. Their parents loved it. They thought their kids were much less distressed and the nurses like that their clinic goes more smoothly rather than taking an extra step. So this is the power I think not just a distraction of being under the sea because the same things should not work. I think with a shoot em up video game but instead kind of the resetting of your brain by allowing it so it’s so focused softly instead of having your attention demanded which is what some of the other devices do.

Saul Marquez: I think that’s really interesting. You know one of the thoughts that I’ve that I’ve had so I was at a conference about two years ago John, it was the Health 2.0 conference and one of the vendors there had a headset. It was a meditation VR and so I put it on and it was…I mean I was just relax me so much. And she also had one of those ECG bands. I forget what you call it. It’s another company. And it shows kind of the change in brainwaves. And so I’ve been debating getting one of these VR meditation things but then the thing that crosses my mind is your point about the environment and being outside and the value and the fact that this VR is basically lights shining into my eyes in the form of nature environments. So like what are your thoughts on thatz?

Dr. John La Puma: Well I think almost anything you can do is a routine to relax and kind of reset your feeling of demanded attention is a good thing to do. I think if you have a favorite sitting spot even in view of nature, the data show that exercising in view of nature is almost as good as exercising outside.

Saul Marquez: Really?

Dr. John La Puma: Which is better than exercising inside without you with nature. Interesting. Sure changes your cortisol, changes your pulse rate and actually it improves performance. And I’m talking about here the studies were done with treadmill exercises, walking, and running.

Saul Marquez: Yeah.

Dr. John La Puma: So I think that trying the art with natural scenes is a good thing to do. I would try before you buy as they say. I would I like the idea of the earliest study by a guy named Albrecht in nature in 1984 was also landscape architect so that patients who have got and receives a closeness that can be a volunteer operation that was opened that we now do topically. But at the time was open who had a view of nature instead of out there a hospital window instead of a view of a brick wall which was the other side of the hallway essentially over three years and thousands of patients had required less opiate medication or aspirin, less pure opioids they got shorter hospital stays and they reported that their experience in the hospital was better than those who had a view of a brick wall. Though even a view of nature can change the way that you perceive pain, can change the way that you experience relaxedness and mood. And so I think everyone should work hard to have a view of nature every day if they can’t get outside and sometimes you can’t because the weather’s terrible or it’s unsafe. But we should work towards a place in healthcare where we give our patients a view of nature and even begin to think about it as a therapeutic tool.

Saul Marquez: Love it John. This is such great great advice and listeners again I hope you’re taking notes here because these are some very practical tips so make sure you’re surrounding yourself with these views of nature. It’s very good for you. So getting close to the end here John this has been a ton of fun. I love this topic and and glad you and I are chatting with this and sharing it with the listeners. Let’s pretend we’re building a leadership course on what it takes to be successful in healthcare. I’ve got five questions for you. Lightning round style followed by a book for the listeners. You ready?

Dr. John La Puma: Go.

Saul Marquez: All right. What’s the best way to improve healthcare outcomes?

Dr. John La Puma: Wow twenty five words or less. The best it’s stop drinking soda and drink more water.

Saul Marquez: Love that. What’s the biggest mistake or pitfall to avoid?

Dr. John La Puma: Dogmatism. Making… insisting that you’re right particularly about diet but almost about anything.

Saul Marquez: How do you stay relevant despite constant change?

Dr. John La Puma: I have a lot of different settings in which I see patients for healthcare, parks, cafeterias, their homes, it gives you a different view of what they care about in well-being and well-being as the bill of notes.

Saul Marquez: Love that. What’s one area of focus that drives everything in your work?

Dr. John La Puma: To help people help themselves and become more autonomous about their health especially as they get outside and choose better food.

Saul Marquez: And what would you say your number one success habit is?

Dr. John La Puma: Diligence.

Saul Marquez: Love it.

Dr. John La Puma: Well I try not to give up.

Saul Marquez: Love that, great quality. And what book would you recommend to the listeners, John?

Dr. John La Puma: I like Mindfulness too and I like a lot Thich Nhat Hanh’s Peace Is Every Step. It’s really thin. And it was written I don’t know 20 years ago but it’s…

Saul Marquez: What was the name of the second one John?

Dr. John La Puma: The author is Thich Nhat Hanh and the book is written many of them. But the book I like it specially is called Peace is Every Step. And it’s really about how to have mindfulness in everyday life and how how to meditate while walking actually. He does a lot of walking meditations which you don’t have to be transcendental to enjoy. You just have to be conscious of your surroundings and he teaches this really well in that book.

Saul Marquez: Peace Is Every Step and Mindfulness too, great resources John. Folks go to outcomesrocket.health check out chef clinic in the search bar. You’ll find this there. John did you have another comment there that you wanted to highlight?

Dr. John La Puma: Well I have favorite cookbooks, I have favorite medicine books, I have favorite fiction books.

Saul Marquez: Well if you have one more I’ll take it.

Dr. John La Puma: I work at Temple Bombo in Chicago for four years a great Mexican restaurant and raises this first Authentic Mexican I think is his best book and he’s written half a dozen or more since and that now has a half a dozen restaurants but Authentic Mexican regional in the heart of Mexico is his idea as result of his three or four years living there with his wife and partner of many years and really talking to a lot of grandmothers and finding ingredients that were basically unknown in the United States at the time and giving them a place in the American POW at an American table. And he also is really a teacher and I’m indebted to him for the opportunity to work at his restaurant for four years and be part of that culture.

Saul Marquez: That’s awesome John. Love that, some great recommendations and a reminder to remember our heritage and the things that could really enrich us with heritage and culture really is the rich… richness that we have in life. John before we conclude I’d love if you could just share a closing thought and then the best place for the listeners could get in touch with or follow your work.

Dr. John La Puma: My closing thought is that everybody has health within reach. Whether it’s outside or whether it’s in the kitchen and those are the two most powerful tools I think to feel better today. And people can get in touch with me through my website which is drjohnlapuma.com or at Twitter where I’m @johnlapuma or by email where I’m drjohn@chefclinic.com.

Saul Marquez: Outstanding John. This has been a pleasure. Folks I hope you’ve enjoyed this interview and looking forward to staying in touch.

Dr. John La Puma: Thanks so much Saul, my pleasure.

Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.com for the show notes, resources, inspiration, and so much more.

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