When does a nutritionist come into play in the CCFM procedure? At what point do you usually recommend a patient consult with the nutritionist, before the case review or after? What about the fees? Does the patient pay CCFM, and CCFM pays the nutritionist afterwards?

We have a health coach who is also a registered dietitian, so she kind of plays both roles. She works in a different way depending on the practitioner. For me and the practitioners who I’ve trained, the way we typically do it is the nurse practitioner does the initial consult. For us, that’s Tracy, and then I do the case review. Then at the end of the case review when I’ve made all of my recommendations, I offer Danielle, our health coach nutritionist, the dietitian, as a resource to the patient if they feel like they need help implementing a treatment protocol. Even if they don’t, I suggest that patients who work with our health coach get better results, which is true, because we all think that we’ve got it, and often we don’t. Just having additional support in between appointments with the practitioners can really make a big difference. I suggest it now to everyone after the case review. We also recently started to just offer sessions with Danielle to people who are not yet patients at CFFM, and we’ve had some success with that. Sometimes people will start working with her just to clean up their diet and lifestyle, and then they’ll end up becoming patients for the for full functional medicine workup. We’re also about to launch groups and classes that will be led by the health coach, Danielle, and also Tracy, the nurse practitioner, on particular conditions like autoimmune disease, GI issues, weight loss, metabolic health, and so forth.

There are different ways to do it in terms of payment. What we do is we bill the client, so the client pays the clinic, and then we pay the health coach. Right now I believe she’s still being paid hourly, but she is working enough now that we may be offering her a salary position.