Episode 147 | Sep 11, 2025

How Health Coaching Heals the Heart, With Dr. Sanjay Bhojraj

What if treating heart disease meant going beyond prescriptions and procedures to ask what truly matters? In this episode of Health Coach Talk, Dr. Sandi welcomes Dr. Sanjay Bhojraj, a board-certified interventional cardiologist who found new purpose through functional medicine and personalized, lifestyle-based care.

“The most important person on the healthcare team is the patient, not the doctor. What we’ve done so successfully in conventional medicine is take away agency from the patients. It’s not the medicines that you take, but the lifestyle that you live… The air you breathe, the water you drink, the way you manage stress. All of these things have a much more central role in your health than any pill or surgery could possibly have.”

Dr. Sanjay Bhojraj

Dr. Bhojraj shares how years of treating heart attacks left him wondering why patients kept coming back, even when their numbers looked good. That question led him to functional medicine and eventually to the faculty of the Institute for Functional Medicine, where he now teaches cardiometabolic health. He opens up about burnout, the power of nutrition and genomics, and the emotional toll of chronic stress and disconnection. From the pitfalls of overmedication to the overlooked importance of asking “Do you feel safe?”, Dr. Bhojraj challenges the status quo and makes a compelling case for root-cause cardiology.

Health coaches, he says, are uniquely positioned to bridge the gap between clinical treatment and real-life behavior change. He speaks candidly about his early skepticism, the importance of proper training and boundaries, and the growing need for collaborative care. Coaches bring the time, heart, and support that many doctors simply can’t, and that’s why Dr. Bhojraj sees them as the missing link in a system that’s struggling to keep people healthy.

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Transcript

Dr. Sandi: Today, I have an inspiring story to share with you. How does an interventional cardiologist, conventionally trained, decide to study functional medicine and understand the value of diet and lifestyle changes, and understand and appreciate the value and benefits of health and wellness coaching? Well, today I’m going to share the story of Dr. Sanjay Bhojraj. He is my special guest. He is an interventional cardiologist and one of the few U.S. cardiologists who is certified by the Institute for Functional Medicine. Because after years of placing stents and prescribing medication, he shifted his focus to the root causes of chronic disease, integrating genomic testing, advanced imaging, nutrition, sleep science, breathwork, and personalized lifestyle medicine into his practice.

He is the founder of Well12, a 12-week health optimization program designed to reverse inflammation, restore energy, and promote longevity through evidence-based functional strategies. He also hosts “The Curious Cardiologist” podcast, where he explores cutting-edge insights at the intersection of cardiology, metabolism, and integrative health with leading experts. Blending deep clinical expertise with a passion for prevention, he is known for translating complex science into practical tools that empower individuals to take charge of their health and extend their healthspan, not just their lifespan. I know that you will enjoy my conversation with Dr. Sanjay Bhojraj. Dr. Sanjay, welcome to the podcast.

Dr. Bhojraj: Thank you so much for having me. I’m super excited to be here.

Dr. Sandi: So let’s start by talking about how you came to functional medicine. You were [inaudible 00:02:30] doctor in cardiology. What were the circumstances, or what was happening at the time that you discovered functional medicine?

Dr. Bhojraj: Yeah. So, by training, I’m an interventional cardiologist. So that’s the type of cardiologist that does procedures. So I was essentially the heart attack doctor, right? So you have a heart attack, you come in at 2 in the morning, they call in the team, I come in, lights and sirens blazing, we get your artery opened up, everyone’s super happy, we’ve cheated death, kind of all the great things. And as time went on, I kind of realized, “You know, why am I getting repeat business?” As a cardiologist, and particularly as someone who’s treating heart attacks, you know, if I’m managing blood pressure, if I’m managing cholesterol, if I’m getting blood sugar all in range, why are things still progressing? There’s got to be something that we’re not accounting for. And that was always kind of the fly in the ointment for me, so to speak, and I never really got a grasp of it.

And then one weekend call…so, when you’re on call, at least in my old practice, for interventional work, you’re on from Friday morning at 8 a.m. until Monday morning at 7.59 a.m. So 72 hours straight of call. And it can be pretty intense. And on that particular Saturday, I had eight back-to-back-to-back-to-back-to-back heart attack patients come in. And I had two realizations. Number one, for the first time, and this must have been when I was in my kind of mid 40s, that my job was taking a toll on my own health in terms of the stress level, and lack of sleep, and all these things. But number two, I thought to myself, “Wait, what are all the left turns that these people took when they should have been taking a right turn?” so to speak. So you’re at a binary decision point between carrots and Cheetos. You know, how many times are you choosing the convenience food over the healthy options? And I realized that in the conventional training that I’d received, and we’re talking about, like,12 years of training by the time you’re in med school, and residency, and fellowship, and all these things, we never really talked about diet and lifestyle.

And then, through a series of weird circumstances, I got an email from the Institute of Functional Medicine. And it was it was a one-hour talk on functional medicine approach to hypertension. And this is now, mind you, probably 10, 15 years or so ago before functional medicine was as well known as it is today. I mean, we definitely have a lot more kind of [inaudible 00:05:01] and awareness that needs to happen, but it was really a new concept. And I sat in on this lecture, I’m like, “Fine,” you know, “teach me something I don’t know,” you know, in that kind of arrogant way that cardiologists are. And they actually taught me a lot I didn’t know about food and diet. And, you know, most cardiologists just think about salt load as the dietary trigger of hypertension, but there was so much more, inflammation and oxidative stress. And it really just grabbed me, and it never let go. So I went to a functional medicine conference, got really engaged, did the full certification. Now, kind of coming full circle, I’m an educator for IFM now on their cardiology modules, cardiometabolic modules. So it’s been a really exciting and somewhat unexpected career deviation for me. Like, probably a lot of your listeners have a lot of second careers and something they never saw coming, but something that just grips your soul and makes you feel like, “You know what, this is really what I’m put on this earth to do.”

Dr. Sandi: I love that story. And it definitely parallels my own. This was probably around 2008, 2009, I think, and I got some random email, or something came to me, it was a physical mailing, and it was about IFM, they were having their annual conference. And the focus was on depression, I think, and things. And I thought, “Wow, this is up my alley as a psychologist.” I didn’t know anything about functional medicine, but decided…the conference was in Florida and sounded good. And so I decided to go. And I remember just, you know, hearing Mark Hyman and some of the other leaders in functional medicine and just being totally converted. Like, “This is amazing, I have to learn more about this.” And so, enrolled in the certification program, and yes, it is absolutely can…and, for me, that led to founding FMCA. And it sounds like, I mean, you have now completely transformed what you do and are now teaching in the cardiology module.

Dr. Bhojraj: Yeah, I definitely didn’t see this coming. And it’s funny, my first AFM…or IFM conference was in our hometown of Chicago. So I figured, you know, “If I go and these people are whackadoodlee, and it’s just not up my alley, I can hang out with my high school and college friends.” But it was just like, I felt like I’d finally found what I was looking for in terms of not just being a doctor, but truly being a healer. And I think that that’s where a lot of the practitioners, the health coaches who come to this functional medicine universe kind of differ. Kind of as I differentiate a doctor or in the normal kind of health care, conventional healthcare universe, we are treating things. You’re treating symptoms, you’re treating a number of blood pressure, you’re treating a number of cholesterol, or blood glucose, or whatever it may be. But we’re rarely healing things, right? We’re rarely getting to the root cause.

And I think those of us who are in this space…you know, you can put two functional medicine people who’ve never met, at whatever level, doctor, coach, you know, whatever it might be, and they’ll just have a great conversation together, because I think we’re all motivated and driven by the same, not just desire to help people, but to really understand the why and fix what’s going on. And functional medicine just really gives us that framework to be able to approach conventional problems in an “unconventional way,” which is really, in my mind, ancient wisdom, and getting to cellular healing, which is so important.

Dr. Sandi: Yeah, it’s so important. And yet we’re still living with a system, and particularly in cardiology, that is dysfunctional. It is so broken. And I was with somebody the other day, and just their answer was like, “Go for statins. Statins are for everybody. Everybody should be on a statin.” It’s the answer, or other medications, and looking at…kind of waiting for a problem. Or if they are thinking about prevention, “Well, we’ll prevent it through a statin.” So can you comment on this whole system in cardiology? Why is it so, so broken?

Dr. Bhojraj: Yeah. I mean, I think part of it is, in our medical education, as I mentioned before, we’re not really driven to understand the power that lifestyle interventions and dietary interventions can truly have. We have these multimillion-dollar pharma studies, where you take 20,000 people in one arm and 20,000 in another and put them on statins here, you know, drug XYZ, whatever it may be, here, and XYZ there. And we are now, you know, taught that the only way to show…the only true path to showing efficacy is through one of these large randomized clinical trials. And I’m not saying they’re not important, but over time, what’s happened, it’s eroded our ability to use diet, to use lifestyle. I mean, think of what medicine was like 200 years ago. I mean, we’re not talking that…the 1800s, right? It wasn’t that long ago, if you think about it, but we didn’t have statins. We didn’t have all these things. Now, people died from infection and public health issues and whatnot. But, you know, I think one of the things that we have not done very well is really, in medical education, highlight what our modern lifestyles had done to our health. Our body is programmed with an operating system that’s not designed for the current environment. And so, as a result, that leads to a lot of imbalances that happen.

And in the cardiology world, I think that we are treating numbers, as I mentioned, often. So, yeah, you know what? It takes work. It takes time for diet and lifestyle to make these shifts, you know, and see these improvements. But you give a medication, and that blood pressure drops 20 points within a week, right? That cholesterol drops 20, 30, 40, 50 points, depending on what’s needed. So we’ve fallen into this fallacy of medications are the only way. And that was exactly the dissonance that I had, is that, look, if I’m doing everything that the books are telling me to do, I’ve got this person’s LDL cholesterol at, you know, below 70 at the time, which was the goal, and their blood pressure was perfect, why are things still progressing? And even if you look at some of these clinical trials, you know, what people don’t realize about these multi-billion-dollar clinical trials is they’re designed not to fail. They’re too big to fail. So we look at something like Plavix, clopidogrel, which is a game changer in interventional cardiology. The absolute risk reduction was about 2.73%, meaning you went from, like, 11.7% to 9.3% risk of the outcome of major adverse cardiovascular deaths, which, in my mind, meant that even in the treatment group, just under 10% of people were still having events, right? So why are we applauding that? Right?

So we have to look at things a little bit differently. We have to be aware that there are factors beyond just these numbers. And one of the friction points, I guess, or things that a lot of my conventional colleagues say, is, you know, “Well, there’s no evidence. There’s no documentation.” Well, it’s hard to run a randomized clinical trial on broccoli. That doesn’t mean it doesn’t work, right? So lack of evidence does not mean lack of efficacy. That’s something from med school that, you know, still sticks with me. And I think, now, this push with what’s called N-of-1 medicine, personalized medicine, looking at genes, looking at proteomics, looking at all these advanced things, we’re kind of getting back to what works for you works for you. Because what works for Sandi is not the same thing that is going to work for Sanjay, right? So what we need to do now is go beyond just these population-based trials and look at individuals.

And that’s where I think that the power of functional medicine and the importance of health coaching comes into play, is that you can take the time, understand the person, understand their motivations, because what motivates me is going to be different than what motivates my wife. That comes up all the time. And having it make sense to the individual is so important. Because, as I often say in my clinics, is, you know, the most important person on the healthcare team is the patient, not the doctor. And what we’ve done so successfully in conventional medicine is take away agency, take away that decision-making capacity from the patients, so that they feel that the doctors were in charge. But now we’re seeing that wait times are elevated, doctors are leaving, you know, medicine, and in unprecedented numbers, the population is aging, we have to switch that back and help people realize that they’re the ones in control of their own fate, right? It’s not the medicines that you take, but it’s the lifestyle that you live, it’s the air that you breathe, it’s the water that you drink, it’s the way you manage stress. All of these things have a much more central role in your health than any pill or any, you know, surgery could possibly have.

Dr. Sandi: Absolutely. This is so true. And I think that sense of self-advocacy, and when we do studies of health coaching, time and time again, that’s what shows up, the sense that, yeah, you can have control of your destiny, you can become CEO of your health. Because it’s not just because you have a bad family history, certain conditions, it’s not that there are situations you can’t control. You look at what you can control, and those daily choices, those daily habits. And that’s where health coaching comes in. But even, you know, within lifestyle, we’ve talked about diet and lifestyle factors, which are so critical, and an area that I think is often ignored is, you mentioned it, stress and our response. You know, do we have meaning and purpose in our lives? And are we stressed?

And when I was practicing as a health psychologist, I saw so many times well-meaning cardiologists would say, “Oh, you know, we’re going to have to monitor that. You have a predisposition towards heart disease.” And what would happen is, these people who are prone to anxiety, they would get panic attacks, they would have anxiety, they were fearful, they’d get a little twinge. And they would call me up, “Oh, can this be a heart attack?” And so it is being able to look at the heart as a heart center organ. I remember Mimi Guarneri would talk about just the benefit of the heart in terms of love and connection to other people. And so I just wondered if you could comment on that, because, you know, it’s an area that I rarely see doctors pay attention to, like, you know, having people do some meditation, some breathing techniques, and focusing there, and is so important.

Dr. Bhojraj: Yeah, for sure. So, I mean, I think in the conventional cardiology universe, we think of the heart as an organ, a muscle, but it’s so much more than that when you talk the emotional seeding and the metaphysical nature of the heart. And, you know, there are studies that show when moms are breastfeeding, the heart of the baby and the mom come into sync with one another. So it’s an energy field, right? E equals mc squared. Anything that’s generating electricity is putting a field around it. That’s why when you meet certain people, you feel like you’ve met them your entire life, and some other people, you’re like, “Boy,” no matter what they say, it’s like nails on a chalkboard. “I will never be in phase with this person.” So there’s a lot of that as well. But you’re right, in the conventional cardiology world, we don’t think about the metaphysical of the cardiac status and cardiac health, emotional health, right? I mean, triggers from the past, you know, not big-T traumas but little-t traumas, right, these microtraumas, can center in the heart, particularly in anger and fear, and that can affect your cardiac function.

You mentioned stress. I think that’s one of the things that…we have become so addicted to stress in our lives, that we don’t realize what a toll it’s taking. And I always say, just think about when you go on vacation, that first day of vacation is always difficult for me because I’m jittery, I’m, like, looking around for something to do, because I’m so used to being go, go, go, go. And I think one of the hardest days is that first day back at work when you’re overwhelmed by your inbox, and everything is coming at you, and you kind of have this moment of realization, “How do I do this on a regular basis?” Right? Because your threshold, you’ve gotten so chill, and now you have to kind of raise that threshold. But cortisol, as a stress hormone, drives so much inflammation and leads to imbalance. I mean, our bodies were not meant to be on for a 24/7 period. You look at animals at the zoo or my dog when he’s in the office, right? We’re meant to be parasympathetic. We’re meant to be in a rest state, meaning a resting state, and then only be called to action every once in a while. But now I’ve got my screen over here, my inbox, we’ve got this, we’ve got phone calls. We’re just always in the state of go, go, go, and our bodies were just not designed for that.

And that’s why it’s so important to incorporate, you mentioned, mindfulness into our daily basis. Even something as simple…what I used to do in my clinic was twice a day, I would take 10 minutes to do a breathwork exercise. So, in the morning, before a.m. clinic started, and at the last kind of tail end of my lunch, before my afternoon clinic started, just taking 10 minutes of breathwork kind of brought my nervous system down, got me into better regulation. And when your nervous system is calm, your brain is calm, you’re able to make better decisions, right? So you just function at a higher level. Connection is so important. One of the first things I’ll ask a patient is, you know, “What are you doing? Who do you feel connected to?” Because we don’t realize how much loneliness affects our healthcare outcomes.

In fact, the Surgeon General, a few years ago, Vivek Murthy, called loneliness a public health crisis. People who experience loneliness oftentimes have less physical resilience, meaning that a small illness will oftentimes multiply and get much worse for them because they don’t have that push, that desire to get better. I’ll ask people, “What are you contributing to in your life?” You need to do volunteer work or feel like you’re part of something bigger than yourself. Right? That purpose, that sense of belonging, is so important. And I think that was one of the things that got eroded so heavily in COVID, was that we got so used to being isolated. I mean, we weren’t designed to be isolated. I mean, think about, you know, when you…my daughters are about to start school again, right, meaning after summer vacation, and, you know, they’re not looking forward to school, but they’re looking forward to seeing their friends, right, and being in that social environment. We’re just programmed for that.

So there’s so much more beyond just, you know, numbers, and statins, and, you know, beta blockers, and ACE inhibitors. When it comes to heart health, we really have to look at things holistically. And that’s why I’m so grateful for the functional medicine lens that I have now, because I just see patients differently. In fact, a few weeks ago, I had a woman present…I run a small telehealth practice. And so she was having palpitations, and I just sensed something was off. And after she had been finished explaining everything that she was…all her symptoms, and, you know, it happens with this and this and that, the first question I asked her is, “Do you feel safe?” And she says, “What do you mean?” I said, “Well, I don’t know, maybe I’m completely off base, but do you feel safe in your house?” You know, something kind of piqued. And then it turned out that she was in kind of a not great relationship, and she was having all these issues. And that was really what was driving her symptoms. Because, again, that fear and all those emotions were being centered in her heart.

And it is the most non-conventional-medicine kind of thing to ask, but it was the most important question for me to ask. Because then, even though I don’t have the expertise in being able to manage kind of all the things that she was going through, I was able to get her to the right people that had that expertise there. But had I not thought to ask such a screwball question….right? I’m supposed to ask, “When do your palpitations happen? What makes them worse? What makes them better? How often do they happen?” Right? That Sacred Seven we all learned in med school. But it completely changed the frame of the conversation. But as going from that role of doctor to healer, now, I was able to really get to that root of the issue, which was not medical for her. And, you know, hopefully…I haven’t followed up with her in a few weeks, but, you know, hopefully, gotten her into a better place where that emotional kind of upset or upheaval really is in a better place for her to be able to feel better about herself and her life.

Dr. Sandi: Thank you for sharing that example, and how important it was for you as now a healer to go there and focus on meeting in purpose relationships and having her then be that connection. And that’s, of course, what it is all about in functional medicine, and looking at not organ systems in isolation, but how everything’s connected and the importance of heart-centered communications. Because doctors have lost bedside manner, and they’re not asking the kind of questions that are having that kind of relationship that you created with her. And that’s one of the reasons health coaches are so important, is because they are bringing that back, and they have the time to ask those kinds of questions and help people to find meaning and purpose in their lives, looking at the quality of their relationships. And let’s talk about the other areas in terms of lifestyle. Because what I find of cardiologists is they’re so often stuck with a very often outmoded way of thinking. So can you comment on that?

Dr. Bhojraj: Yeah. I mean, I’ve had…

Dr. Sandi: Health coaches often get caught in the middle, where their client’s doctor says, “Oh, you know, you need to be low-fat and…” or, “vegan,” sometimes I’ve heard people being told. And, “Red meat’s horrible. It’ll give you a heart attack.”

Dr. Bhojraj: Yeah. I mean, there’s a lot of confusion when it comes to diet and nutrition. And I think physicians, not just cardiologists, but physicians in general, are oftentimes making decisions based on outmoded data. Right? I mean, if you think about, you know, in the 1980s and ’90s, the food pyramid, it was asking you to have 9 to 12 servings of grains a day. And that’s backwards, right? And so a lot of these nutritional, you know, thoughts, I guess, you know, unfortunately, kind of progress, and they never really get corrected over time. My father-in-law just went through this. So my father-in-law had heart bypass surgery years ago and now is developing diabetes. His hemoglobin A1c was 7, which for those of you who don’t know, that number is high, and that he’s frankly diabetic. And his doctor’s advice…I wasn’t at this appointment, but he reported his doctor’s advice was, “Well, eat less, and exercise more.” Right.

And I think that’s probably the most that that doctor is able to offer as in way of life, or in terms of lifestyle management, because that’s really as much as we get. Right? And then, you know, hopefully, you have someone who’s interested, but it takes a lot, you know, for physicians to seek out this training and to get the training in what are really the trends. Right? Eggs are a perfect example. Or, you know, if it’s Monday, Tuesday, Wednesday, Thursday, or Friday, that will drive the wind on are eggs healthy or not. It feels that way. Coffee is another one that I see. This article says coffee is great. This one says you’re going to die from it. And I think that the one size fits all, you know, just doesn’t work. Again, you have to look at the individual, everyone’s difference in terms of their genetics, and their genomics, and their exposures, and all these things.

And that’s where having someone who has updated information about diet, right, updated information about lifestyle, has the time to discuss and learn about the patient, that’s why kind of this role of health coaching is such an important adjunct to the medical team, because you need someone who has that knowledge, that ability, and also the ability to work with the team. Right? You don’t want someone popping off autonomously and doing these things, but explaining over time…you know, and I’ll tell you, it’s hard to change the mind of a doc once he or she is convinced of something, right? “Oh, the earth is flat. It’s flat until proven otherwise. I’m going to pull up 30…you know, 300 articles that say the earth is flat,” right? Because that confirmation bias, you know, and it happens in all of literature, you know, “I’ll find a study that proves what I’m trying to tell you,” right? But what we need to do is really kind of, again, look at the individual and see what’s going on with that person. I lost my train of thought. Sorry. What was the original question?

Dr. Sandi: Yeah. You know, I think, yeah, it is not one size fits all.

Dr. Bhojraj: Oh, we’re talking about…

Dr. Sandi: So it just says that for some people, low-fat might be good, but…

Dr. Bhojraj: Yeah. And that’s what we were talking about, was…

Dr. Sandi: …mantra, like, “Oh, you need to be low-fat,” or, “You need to eat less and exercise more.”

Dr. Bhojraj: Yeah. And I think that…you know, and nutrition data is tough to read, to be honest with you, because we don’t…there are so many things that aren’t controlled for. You can’t control for everything. I think a lot of it is trial and error. You know, some people may do great on a vegan diet. Others might not. Some people may do great on a carnivore diet. Others might not. We have to understand that there’s no one size fits all. And that’s where it’s important to follow up on lab testing, look at things. And, you know, I tend to be a very middle-of-the-road person in the sense that I’m never going to tell you, “Eat all of this or all of that.” I don’t think all-or-nothing diets are ever really that great in the long term. In the short term, there may be some benefits. But, you know, what we need to do is really, again, I mean, I’ll beat this drum till I die, is take account of the individual and what their needs are, right? Because some people might have these SNPs, these single-nucleotide polymorphisms, that make it difficult for them to make the conditional amino acids. And so they would not do well on an all-vegan diet because they can’t convert all the amino acids into something they can’t make on their own. And, you know, trying to kind of shove a square peg in a round hole because that’s what you think is supposed to happen, just, you know, you get yourself in trouble more often than not.

Dr. Sandi: That makes so, so much sense. So, you know, then health coaches, so we’ve seen the growth of coaching to support people making these kinds of lifestyle changes and to personalize it. Because people will just go and they’ll read a headline, or they’ll see some social media influencer, and they’ll think, “Oh, that might be right for me as well.” So can you comment on your experience with health coaches and where you see them fitting in?

Dr. Bhojraj: Yeah. I mean, I think that, yeah, you used the right word, the correct word, which is support, right? And I think that that role really is expanded, not just supporting the patient, but also, I think the physicians have to realize that the health coach is there to support the physicians as well. Right? I mean, I think a lot of times when I think back to some of my clinical encounters, particularly as I was talking about pretty advanced procedures, and heart valve replacements, and things like that, there’s what the doctor says and what the patient understands. Right? And oftentimes there’s a huge chasm in there. Well, you know, the, “I talked to you about this. I told you that the risk of stroke in this procedure is one out of XYZ,” and, you know, the patients didn’t realize what’s going on. So I think, number one, helps bridge that communication to make it a little bit more effective on the patient side. And I think the other aspect is, you know, the touchpoints and continue with the motivation, all in that same goal of, you know, whatever it may be for the patient, reversing cardiometabolic disease, supporting hormone health, whatever it may be, I think that there’s a lot of support that can be offered.

And I think that physicians think that they do this really well, when they don’t. Right? I mean, our outcomes, if you look at the outcomes, you know, we’re spending more per capita than any of, you know, the big countries, and our healthcare outcomes are among the lowest. Just because you’re spending money doesn’t mean you’re doing it in the right place. Right? And, again, getting back to the importance of diet and lifestyle, you know, you can have all the medicines in the world, but if you are still eating garbage food, and living poor lifestyle, and not sleeping, and stressed out all the time, there’s no amount of medicine in the world that will outpace that. I think to when I used to do triathlons, and my coach told me, “There’s no amount of exercise in the world that’ll fix a poor diet.” Right? And so, you know, you could run 100 miles a day, but if you’re eating fast food and all this stuff, you’re still going to have…you know, you’re still not going to be as healthy as you think you should be.

And so I think that role of coaching is now a natural extension of the holes and the blind spots in conventional medicine. I mean, if you think about how often can you possibly see your doctor? I know that when I was running my big clinic, I had a nine-month waiting list to get in to see me. So that’s almost a year, if you think about it. What happens in those nine months? I mean, that’s a long time. You need someone who can understand what your doctor is wanting you to do, who can understand what you as an individual can do, what motivates you, and then blend those worlds together and make it happen. So, you know, I think that the role of the health coach will continue to expand. I’m not going to say the road to that is paved with roses and unicorns, because I think there’s a lot of misunderstanding from the physicians about the role of the health coach, you know, and there may be some bad players.

My first experience with health coaching was not a great one, because I had a health coach tell me I’m smarter than most doctors, and I can order all these things. And she was misinterpreting labs. And, you know, that’s a whole other discussion. But when you have someone who is certified, like, through Functional Medicine Coaching Academy, someone who understands that they are the bridge, somebody who’s not trying to, you know, stroke their ego, but rather kind of be there for the patient and in the patient’s best interest, that’s the win. Right? That’s where, I think, health coaching is so key. And, you know, unfortunately, we see this in the functional medicine universe as well. There are people who get certified through programs, like IFM, and do the work, and there are people…like, I have a physician that I know, who said on their website, you know, “I’m a functional medicine doctor.” And I said, “Oh, wow. Great. I didn’t realize this is something you’re doing. What did you do?” And she told me, “Well, I saw a webinar online about functional medicine.” And me thinking to all the hours, I mean, that, you know, the functional medicine certification exam is not an easy exam.

Dr. Sandi: Yeah.

Dr. Bhojraj: And I’ve already studied for that more than I studied for cardiology board exams, and interventional cardio board, and internal medicine. I mean, it was a pretty…you know, the volume of what you need to learn is so big. So, you know, we’re seeing this kind of weirdness in the marketplace now, but my point is, it’ll settle out. Once we’ve got, you know, truly kind of heart-centric practitioners who are doing the right things for the right people, we have people with the proper certifications and training doing this, it’ll settle out. So I think the role of the health coach will only expand more and becomes even more important as time goes on. Because, again, as we’re trying to take the doctor a little bit more…I don’t want to say out of the equation, but allow him or her to step back, and then have a coach on a day-to-day basis doing that, that’s really where the change is going to happen.

It’s reminders and motivation to do those daily habits, that once every six months and once every nine months in my office visit, I can tell you, you know, “Oh, eat less, and exercise more,” but someone who can actually give you functional data, “Hey, you know what, I see that on your food log, you went to fast food four times this week. Maybe can we cut that back down to twice a week? Because I know that you love your fast food, but we need to start making better choices,” right, and kind of these incremental 1% shifts that coaching can have happen. That’s, you know, the compounding interest where health really happens.

Dr. Sandi: So well said. And it’s that team approach, it is the doctor and coach working collaboratively, and feeling like that person is being supported every step of the way by people who are legitimately trained and board certified and not passing themselves off as something that they are not, because they aren’t yet. I really think that is something that is buyer beware, but there are ways that you can check to make sure that that person went through the right type of training, went through board certification, or has those credentials. Because we do see that a lot, and at FMCA, we guard against that. They are not practicing without a license. There are people out there who think they can, and that’s something we need to be vigilant about.

Dr. Bhojraj: Well, and the certification shows that you have someone who cares, right? They want to get the right skills.

Dr. Sandi: Yes, exactly.

Dr. Bhojraj: There’s a selection bias there for people who are already going to be motivated, heart-centric, that want to do something. And I just wanna take a quick callout to, you know, a lot of times I think physicians feel like a health coach should have a medical background. They should be a nurse, or, you know, a physician assistant, or whatever it may be. And, you know, while knowledge of the healthcare system may be helpful, sometimes a fresh perspective, right, can add so much more. And it’s really about that human connection. Once someone is certified, right, they’ll have, you know, some background in medical stuff, but I almost sometimes feel that it gets in the way because you’re already indoctrinated into the system.

And although I know it’s completely fictional, but you look at a show like “Ted Lasso,” you need to take an American football coach, put ’em in, you know, British football, English football, and, you know, he may not understand what the offsides rule was, but there are certain fundamentals to coaching that are uniform throughout. There’s certainly ways to motivate people that are universal throughout. And, you know, the coaches that I’ve met who don’t have “conventional medical backgrounds” are often some of the most interesting people, people who I’m like, “Yeah, you know, I wanna talk to you more, and I wanna learn from your experience.” And I think they can pull from much different areas and concepts, and make different analogies and motivations that really work. So, you know, the more I learn about the role of health coach, the more I want to get them engaged with my practices, you know, because it is that missing link, you know, I really do feel.

And, you know, ultimately, we are in a healthcare crisis. You know, I remember in the height of COVID, they had the little ticker on the side of all the news channels of how many people died today, and it led to a lot of anxiety for me. But, you know, when we think about metabolic disease, and cancers, and all these things, there are epidemics going on in plain sight that are happening, and we just need to be better about how we’re delivering care. Right? How we’re getting people to heal. And, you know, you can’t create more doctors. It takes, you know, 12 years of training to be a physician. But you can engage health coaches to make that process so much more efficient. Right? And so I’m really excited about the prospect of what, you know, someone is looking to be a health coach, as long as they’re going down the proper channels, really, what they can contribute to patient care.

Dr. Sandi: Well, thank you for your support of health coaches, and really appreciate your kind words, because, absolutely, they can be the missing link. So, speaking of your practice, Dr. Sanjay, where can people find you?

Dr. Bhojraj: Yeah. So, online, we’ll link in the show notes. I’m @doctorsanjaymd, so D-O-C-T-O-R S-A-N-J-A-Y M-D. Once you see my last name, you’ll know why it’s not in my handles. And my website is lagunamedicine.com, so www.lagunamedicine.com. I focus mostly on cardiometabolic disease. So I run a small telehealth practice, and then I have an online program for optimization of diet and lifestyle. You know, I think that this is such an important aspect that I’ve devoted the next chapter of my career to really focusing on this. And I look forward to engaging health coaches to help me along the way. So I think it’ll be awesome.

Dr. Sandi: Well, we’ll help you with that. And thank you for finding functional medicine and now serving on the faculty at IFM. You are a brilliant teacher, passionate about root-cause medicine. And so I want to thank you for being our guest today.

Dr. Bhojraj: Thank you so much for having me. And I look forward to whatever help I can provide your community.

Dr. Sandi: Looking forward to that.