I get referred patients regularly because I practice what people call “holistic medicine.” And the story is almost always the same: they’ve been through conventional medicine, they keep getting more prescriptions, their numbers may look fine on paper, but they don’t feel any better. Sometimes they feel worse. There’s a lack of vitality that nobody seems to be addressing, and nobody is asking why.

That conversation stuck with me, because it’s exactly the kind of gap Chris Miller MD and I discussed in our latest live. Chris is a physician I trust, someone I go to when I have clinical questions that sit outside my own lane. She’s board-certified in lifestyle medicine like I am, and she’s gone further into integrative and functional medicine training. She practices in 23 states via telemedicine, and she brings a perspective shaped by her own health challenges, including managing lupus.

What follows is a summary of our conversation, along with some practical guidance if you’re trying to find a physician who actually sees you, not just your lab results.

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The Problem With “Holistic”

I deliberately chose the phrase “whole person medicine” for this conversation instead of “holistic.” Not because holistic is a bad word, but because it carries so much baggage that it can mean almost anything. For some people, holistic means walking away from conventional medicine entirely. That’s not what Chris and I practice, and it’s not what we’d recommend for anyone.

Whole person medicine, the way we define it, means something specific. It means your physician doesn’t just treat the complaint that brought you through the door. If you come in with high blood pressure, a whole person approach doesn’t stop at a prescription. It looks at your blood sugar. It checks inflammatory markers. It asks about your sleep, your stress, your diet, how connected you feel to the people around you. It recognizes that inflammation in one system doesn’t stay in one system. Your cardiovascular health, your brain, your gut, your immune function are all talking to each other.

And the treatment plan reflects that. Diet and lifestyle come first. Integrative tools like yoga, acupuncture, or mind-body practices can support recovery. Supplements fill actual documented gaps (not guesswork). And medications are used when they’re indicated, because keeping someone safe is always the priority. As Chris put it during our conversation, her first job with every patient is to keep them safe. If something is dangerously abnormal, you address it with whatever tools you have, including pharmaceuticals. Then you build the lifestyle foundation underneath.

Evidence-Based Shared Decision-Making

One of the things I talked about in the live was an article by Greg Katz, MD, a cardiologist on Substack, about a patient who came in with exertional chest pain during exercise. His primary care doctor hadn’t been too alarmed. That would have set off alarm bells for me. The patient eventually ended up seeing Dr. Katz, had imaging that showed significant blockage in the LAD (sometimes called the “widowmaker”), and then faced a decision: stent, or medical management?

What made Dr. Katz’s approach stand out was the shared decision-making process. He looked at the data, including the ISCHEMIA trial, which shows that for stable patients, stenting and medical management produce comparable long-term outcomes. He discussed it with colleagues. He presented the evidence to the patient. And together, they decided.

That model is what whole person medicine looks like in action. It doesn’t mean your doctor avoids modern interventions. It means your doctor uses evidence to guide the conversation and treats you as a partner in the decision, not a passive recipient.

Where Lifestyle Medicine Fits (and Where It Stops)

Chris and I are both board-certified in lifestyle medicine through the American College of Lifestyle Medicine (lifestylemedicine.org). That certification means a physician has foundational training in nutrition, physical activity, sleep, stress management, and behavior change as therapeutic tools.

For a lot of people, that foundation is enough. Shift to a more plant-forward diet, improve sleep quality, add consistent movement, manage stress, and many chronic conditions start to improve.

But Chris’s own story is a good example of when it’s not enough. She changed her diet. She optimized sleep and stress management. Her lupus didn’t budge. So she went deeper. She trained in integrative medicine with Dr. Andrew Weil, studying mind-body techniques, vagal nerve activation, and the role of the parasympathetic nervous system in healing. Then she trained in functional medicine, which uses more advanced testing (microbiome analysis, heavy metals, mold exposure) when standard approaches haven’t uncovered the root problem.

What she found was that she had genetic variants affecting methylation and B vitamin activation. No amount of dietary change alone was going to correct those abnormalities. She needed targeted supplementation and a more precise approach.

The lesson isn’t that diet and lifestyle don’t matter. They remain the foundation for the vast majority of people. The lesson is that autoimmune disease, and really any chronic condition, is not one-size-fits-all. If you’ve made meaningful lifestyle changes and you’re still not getting better, that doesn’t mean you’re doing something wrong. It may mean there’s a layer underneath that hasn’t been addressed yet.

Inflammation: What to Know, What to Ask For

Chris and I spent a good chunk of our conversation on inflammation, because it sits at the crossroads of so many conditions. Joint stiffness, brain fog, depression, difficulty sleeping, waking up sore. These can all be signs of chronic low-grade inflammation. And at its worst, acute inflammation is what triggers heart attacks and strokes.

There are a few basic markers your doctor can check. A CBC (complete blood count) is drawn at most annual visits, and shifts in your white blood cell count from your personal baseline can signal something brewing, even if the number still falls in the “normal” range. If you usually run around 3.5 and now you’re at 6 or 7, that’s worth investigating.

Beyond the CBC, high-sensitivity C-reactive protein (hs-CRP) is one of the most useful inflammatory markers. It’s produced by the liver in response to inflammatory signals anywhere in the body, and research has linked elevated hs-CRP to increased risk for cardiovascular events, neurodegenerative disease, and autoimmune flares. A target of less than 1.0 mg/L is generally considered protective.

One caveat Chris raised that I think is important: hs-CRP can spike temporarily after an intense workout or during an acute viral infection. If you just ran 20 miles or you’re fighting a cold, recheck it a week later before drawing conclusions.

ESR (erythrocyte sedimentation rate) is another inflammatory marker, and it can sometimes catch what CRP misses, particularly in certain autoimmune conditions. The two tests use different mechanisms and respond to different inflammatory signals, so it’s not uncommon to see one elevated while the other is normal.

The point is this: if you’re feeling off and your doctor isn’t checking inflammatory markers, it’s worth asking.

The Bigger Metabolic Picture

I’ve been spending more time writing and thinking about metabolic health, and one statistic has stuck with me. Research looking at cardiometabolic health criteria in American adults found that only a small fraction, roughly one in fourteen, met all five markers of optimal metabolic health. That data only goes through 2018, so the real number now is likely worse.

Metabolic health is, at its simplest, how well your body processes and uses energy. Insulin resistance is part of it. Blood sugar regulation is part of it. And poor metabolic health doesn’t just show up as diabetes. It accelerates heart disease, contributes to cognitive decline, worsens GI issues, and fuels chronic inflammation.

This is where every conversation about whole person medicine eventually leads. The daily habits, what you eat, how you move, whether you sleep well, how you manage stress, whether you have meaningful social connection, build or erode your metabolic health over time. No single doctor’s visit can undo years of accumulated damage. But the right physician can help you understand where you stand and build a plan that actually addresses the full picture.

A Word on GLP-1 Medications

Chris and I both shared that our thinking on GLP-1 medications has evolved. Neither of us is a pill-first physician. But the data on these drugs keeps expanding in directions that are hard to ignore.

The most obvious use is for food noise, that constant mental chatter about the next meal that some people experience no matter how carefully they eat. For patients who have solid lifestyle habits and are still battling that relentless drive, GLP-1 medications can lower the volume enough to let everything else work.

Beyond weight management, emerging research suggests GLP-1 medications may lower systemic inflammation, reduce cardiovascular events in high-risk individuals, and show protective effects for brain health and cognitive decline. There’s also growing interest in their role for autoimmune conditions, where they may help quiet an overactive immune response that persists even after lifestyle optimization.

None of this means GLP-1s are for everyone. But they’re a tool, and a whole person physician uses every appropriate tool available while keeping lifestyle as the foundation.

Menopause Hormone Therapy: Evolving With the Data

I also brought up menopausal hormone therapy in our conversation, because roughly 90% of my patients are women in this age group, and it’s one of the first things I discuss. My own experience going through perimenopause at 53, despite being extremely active and metabolically healthy, shook me. The hormonal fluctuations hit hard even when everything else was dialed in.

Chris and I have both evolved our thinking here as the data has matured. FDA-approved (not compounded) menopausal hormone therapy, picked up at your local pharmacy, has compelling evidence for bone health, brain health, and cardiovascular protection when used in the right window for the right patient. Hot flashes are not just an inconvenience; they’re driven by cytokine release, and severe vasomotor symptoms carry their own health risks.

This is highly individualized. But a physician who dismisses hormone therapy without looking at the current evidence isn’t practicing whole person medicine. They’re practicing 2002 medicine.

Supplements: Less Is More (With Four Exceptions)

Patients come to me on 20 or 30 supplements sometimes, stacked up from different practitioners, internet recommendations, and well-meaning friends. My approach is to strip it back and focus on what the evidence actually supports.

For most of my patients, four supplements cover the bases:

Vitamin B12 is non-negotiable for plant-based eaters, and it’s also commonly depleted in people over 65, anyone on metformin, or anyone taking proton pump inhibitors like omeprazole. I recommend 500 to 1,000 micrograms daily and want to see blood levels between 500 and 1,100.

Vitamin D is one I check routinely. Even people with significant sun exposure can run low due to genetic differences in conversion. I couldn’t get my levels above 27 or 28 despite training for marathons in Florida without supplementation. For most people, around 2,000 IU daily is a reasonable starting dose, adjusted based on labs. Insurance doesn’t always cover vitamin D testing, but services like Jason Health or similar direct-to-consumer lab companies can make it affordable. [Link to direct-to-consumer lab options]

Algae-based omega-3s matter especially for people who aren’t eating much fish or who are limiting nuts and seeds. You can check your omega index to see where you stand.

Creatine isn’t technically a vitamin, but I’m a fan. The research on brain health and muscle performance, particularly for women over 40, is growing. It’s one I take daily.

Chris added a few others she watches closely in her patients. Zinc can be difficult to absorb, especially without seafood in the diet, and it’s a cofactor for immune function and gut repair. She checks levels before supplementing. Magnesiumtends to run low even in people eating plant-rich diets, possibly due to declining soil quality, and she optimizes based on labs. And B vitamins beyond B12 can matter for people with methylation variants like hers.

One important note Chris raised: if you’re supplementing zinc at higher doses (above 30 mg), you need to add copper, because zinc competes with copper for absorption.

The principle here is straightforward. Don’t guess. Test. Supplement what’s actually low. And reassess annually, because your needs change over time.

How to Actually Find a Whole Person Physician

So what do you do with all of this? Here are concrete steps you can take.

Start at lifestylemedicine.org. The American College of Lifestyle Medicine has a provider directory. Any physician listed there has, at minimum, foundational training in using diet and lifestyle as therapeutic tools. It’s not a guarantee of a perfect fit, but it’s a much better starting point than a random internet search.

Ask about visit length. Fifteen-minute appointments are a red flag for the kind of care we’re describing. Chris’s minimum appointment is 30 minutes, and most of her patients see her for an hour. That time matters. It’s what allows a physician to actually listen, investigate, and explain.

Pay attention to how they handle your questions. A good physician will tell you when they don’t know something, and then go find the answer or refer you to someone who has it. If a doctor dismisses your concerns because your numbers are “technically normal” or because you’re “healthier than most of their patients,” that’s information about whether they’re the right fit.

Be cautious of practitioners who order expensive, unvalidated tests or stack you on dozens of supplements without clear clinical reasoning. Every test should have a purpose. Every supplement should have a documented deficiency or clear clinical indication behind it.

Look at their willingness to evolve. Medicine changes. The data on GLP-1s, menopausal hormone therapy, protein needs, and nutrient testing has shifted meaningfully in the past five years. A physician who hasn’t updated their approach in a decade is not practicing whole person medicine. They’re practicing old medicine.

Consider telemedicine. Chris is licensed in 23 states and is accepting new patients at chrismillermd.com. If you don’t have access to this kind of care locally, telemedicine can bridge the gap.

Your Next Steps

If this conversation sparked something for you, here are three things you can do this week:

Check your most recent labs. Pull up your last blood work and look at your white blood cell count, your fasting glucose, and whether hs-CRP was included. If it wasn’t, ask for it at your next visit.

Write down your top three health concerns. Not diagnoses. Concerns. How you feel. Fatigue, stiffness, brain fog, poor sleep, whatever it is. Bring that list to your next appointment and see how your physician responds to it. Their response will tell you a lot.

Search the ACLM provider directory. Even if you’re happy with your current doctor, it’s worth knowing who’s in your area or available via telemedicine who practices with this lens. You can find the directory at lifestylemedicine.org. [Link to ACLM directory]

Chris Miller MD is a board-certified lifestyle and integrative medicine physician licensed in 23 states and accepting new patients. You can learn more at chrismillermd.com.

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