The Veggies Over Pills Approach to Wellness with Dr. Noemi Adame
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Kara Wada, MD: Hello, welcome back everyone to this episode of the Becoming Immune Confident podcast. My name is Dr. Kara Wada. I am a board certified pediatric and adult allergy, immunology, lifestyle medicine physician, and autoimmune patient. And I am just thrilled to welcome our guest today. She is the veggies over pills doctor, Dr. Noemi Adame. She's a board certified pediatrician, a whole food plant-based home cook and baker, writer, public speaker, and holistic wellness expert. She is the owner of Culver Pediatric Center and founder of Culver Wellness Center, a transformational holistic wellness clinic for women. Culver Pediatric Center was voted one of the best physician offices in the best of Marshall County in 2023.
Dr. Adame earned her Doctor of Medicine from the University of Texas Medical Branch in Galveston and completed her pediatric residency training at the University of Utah, with most of her time spent at the nationally recognized Primary Children's Medical Center. Dr. Adame has also completed additional education on holistic wellness for adults through the American College of Lifestyle Medicine.
Dr. Adame writes a bi monthly column for the Culver Citizen, hosts the Veggies Over Pills radio show at a local radio station, and is the author of Metamorphosis Holistic Wellness Journal, her primary tool for guiding clients towards a holistic, transformational journey. She speaks about workforce wellness and other wellness topics.
Dr. Adame has over 20 years of experience as a physician and is now focusing her proprietary team based veggies over pills approach to help because she believes healthy children start with healthy adults in their lives.
I am so excited to connect with you and to have this conversation today.
Thank you so much for taking time.
Noemi Adame, MD: Oh, I'm really excited to be here. Yeah, I've been following your social media and I just I love your approach and your philosophy and your attitude about wellness and autoimmune disease.
Kara Wada, MD: We're going to have some mutual fangirling. I would love to hear kind of your journey towards finding lifestyle medicine and in this really cool area of medicine that you're practicing.
Dr. Noemi Adame's Journey to Lifestyle Medicine
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Noemi Adame, MD: Right, so I started off pretty standard. I did my residency at Primary Children's, you know through the University of Utah incredible Inpatient focused training incredible experience and so I did my first job. My first job was as a hospitalist in San Antonio, and I loved that job. I thrived in the academic hospitalist environment.
I had amazing colleagues. We did so much. We did so much more than inpatient. We did complex care. We did sedations. We did newborn nursery. And I loved, I loved that, that changing, constantly changing fast paced environment. I thrived in an academic setting with my little flock of medical students and interns and residents.
It was a great job. And after eight years there, I was developing a national reputation. But, my husband has wanderlust and he wanted to go live abroad. And I know I sound like I'm complaining when other people say, "Oh my gosh, that would be a dream come
Kara Wada, MD: But it's hard to do and to leave your career or, or take a break. Yeah.
Noemi Adame, MD: Exactly, I had to work so hard.
So hard to get to where I was. I had a strong foothold in medical education. I had a position that paid 20 percent of my salary. I was developing an emerging national reputation. But the way, Chris, my husband convinced me to leave was because he said, "Okay, we will go to a Spanish speaking country."
And I really my parents are Mexican immigrants and my kids were not learning Spanish. Even in San Antonio, even though I tried to talk Spanish to them. So we packed up, we sold our house, sold our car, sold most of our possession and moved to Costa Rica for a year where the kids went to a school down there.
And then the plan was initially was to stay there for two years, but then we, because that wasn't, that wasn't adventurous enough. We actually decided to travel around the world for a year and homeschool our kids during that time. And when it was time to come back, my husband had been the trailing spouse.
I mean, pretty much since he was my boyfriend in college, he followed me to medical school. He followed me to residency. He followed me to my first job. And so when it was time to come back, I said, you know what? You get a job and I'll figure it out. And lo and behold, he got a job in rural Indiana, where there were not a lot of hospitalist positions for me here.
So I got a corporate outpatient pediatric job for the local hospital oligarch. And my, my cocky academic self that, well, I used to work, in the ICU and the ER and doing sedations for kids with their, with their way issues.
The Struggles of Corporate Medicine and the Shift to Direct Primary Care
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Noemi Adame, MD: So of course, doing outpatient medicine is going to be a piece of cake, but I was not built for it.
I was just, I was miserable with the RVU and the ridiculously short times with patients and the filters like I didn't understand. I just, I did not understand the system. It just made no sense to me in the hospital. The system made sense to me because the system was there for patient safety and to make sure that I didn't make an error and it felt like it was a safety net where I felt like the system and outpatient was more to to capture billing and it felt like it was a filter between myself and the patient. And I was very unhappy. I was morally injured, so burnt out, it just made me nauseated when a patient would wait for an hour to see me for 10 minutes. It just physically made me and I'm sure you hear the story a lot with people who come into your show.
And it was very frightening for me because I didn't just hate the doctor that I had become, I really, I hated the person that I had become and it was scary for me. It was scary for my family and corporate medicine had become this monster that I just, I didn't even have the strength to fight. And I was worried that I either had to quit being a doctor and leave medicine completely, which I didn't want to do. I, I loved being a doctor, but around that time I discovered direct primary care, the direct primary care movement, a local doctor I'd heard about it. I went to visit his practice and it's basically a membership based model that doesn't take insurance.
And. I thought this is it. This is what I want to do. So yeah. So after being totally burnt out and morally injured, I left corporate medicine and I opened up my own practice in August of 2020.
Kara Wada, MD: Yeah.
Right in
Noemi Adame, MD: Right the middle of a global pandemic and worldwide economic crisis. But you know, I was so happy that I was practicing medicine in my own terms without non doctors dictating my relationship with my patients. I loved being a doctor again. Most, a lot of my previous patients followed me. And it really, I felt like we rekindled our relationship. I rekindled this relationship with my patients. And I loved that I could counsel families on whole foods plant-based focused anticipatory guidance. I didn't have to follow somebody else's educational tools. I designed them myself based on what I was learning about with lifestyle medicine.
But this is the big 'but,' there's always a but, right? I was still doing primarily sick care in the practice. And as a pediatrician, I realized I cannot tell a five year old or a 10 year old or even a 15 year old. "Well, you need to eat more veggies. You need to eat more fruit." In fact, I won't even discuss weight in front of a child.
And I have that option because I can communicate with families like by text. But I realized that I needed to address lifestyle with the person in charge of the grocery shopping, the meal planning, the cooking, and in most households, that's mom, right? So, I had done CME through the American College of Lifestyle Medicine.
And so it was just a very natural step to start applying those principles of to the anticipatory guidance that I was already offering families.
Kara Wada, MD: And, I mean, that's so true. And that's in part, like one of the things that keeps me going in regards to, like, the meal planning and cooking and all that stuff at home is knowing that if I'm taking care of, in the self care stuff, if I'm taking care of me, that is reflecting I'm also taking care of my kids.
They also are seeing what we value as a family and seeing, like, for instance, with workouts in the morning, my daughter will hop on her little mini Peloton bike next to me. And like she may or may not pedal, but like, my older one was trying to do a weights, arms, little lightweights workout with me the other day.
And so you see how these changes are a little bit contagious in the best way.
Noemi Adame, MD: Yeah, absolutely. And that's what I tell my families, it's they see you do it and they'll do it. They see you eating this way and then and it might take you putting the broccoli on that plate 20 times before they actually try it, but they'll try it eventually. Just need to be patient and not make it a power struggle.
Kara Wada, MD: Oh yes, that is the ever present struggle with 5-year old. Like she's the middle child. She just is always wanting to push back a little bit. Especially when it's like a little more, it's not plant based things that are kind of disguised as like, you know when it's a little more healthy looking on the plate, then she's a little more like, where's my mac and cheese?
Noemi Adame, MD: Yeah. Suspicion. Suspicion starts.
Kara Wada, MD: I think it's interesting sharing, one of the places where I hear so much similarity is our both shared struggles with burnout. And I'm wondering, are there specific things that you think helped you get out of that space and place?
Noemi Adame, MD: I really think it was these thoughts of, I hate myself. I did not sign up for this. Classic story of the physician sitting in the parking lot, gripping the steering wheel, going, "I don't want to go in. I don't want to do this anymore". That, that was me.
That was me, and, and it, and I tried to reach out for help. I left one job to go to another, to go thinking, okay, the grass is greener, it'll get better, but I realized now going from one corporate job to another is it was just you trade one set, one set of problems for another.
And I was very specific with what I wanted. I said, I want more time with my patients. I want one day off per week, just one day, one day. I can work 12 hour days. I can work, cause I had energy, I had energy. I could still function, but I just wanted one day off per week so that I could completely recharge, and not a weekend, like a day that, you know, that, that's how my kids were still home and, that I could actually just be home and recharge and not set an alarm and go for a long run. And so I was very specific with what I wanted and they said, no, and of course I was told, "Well, you're burnt out, you need therapy, you need counseling, you need to do yoga. Go be well on your own time." Was really the message that I, that I felt I got from, from both of my previous employees. Go be well on your own time. And you, you fix this. This isn't our problem. This is a you problem. And I think that for which is why I really feel morally, moral injuries are more accurate term than burnout and it's very much a systemic issue and not a issue of resilience, but it it was those thoughts of, I don't like my life anymore. I don't like this doctor. I don't like this person and that, and referring to, to me.
Kara Wada, MD: I've kind of reflected, I think I show up very different with my patients now than I did when I was burnt out.
Noemi Adame, MD: Oh yeah. Completely. Completely. I feel like the relationship that I have with my patients now, it really, it sounds cheesy and corny and I promise I'm not trying to be cheesy and corny. It really is like family. It really is like family. And that's one of the reasons I started doing lifestyle medicine because the mom started coming to me for advice.
And I felt like, "Okay, I need to learn about these grownups", about, you know, um, because they didn't feel comfortable and didn't have that type of relationship with their doctors. And not just because their doctors weren't interested or weren't caring. It's time, and I know that it was, it's time because I've been there.
I'm sure when I was in corporate medicine, my patients felt like I wasn't listening and I wasn't spending enough time with them. So it's a systemic issue. And I do a lot of I mean, we're, we're kind of like the medical detective. I'm like the pediatric medical detective in the area.
And when I meet with families, when they're first interested in joining the practice, the one thing I tell them is. I am not necessarily smarter than other doctors you've seen. I don't have secret drugs or secret treatments for your child. What I have is more time. I have time. So I have time to sit down with you, learn everything about your child, and talk with you and come up with a diagnostic and treatment plan for your child. That's the main difference.
Kara Wada, MD: Yeah. I think it's, it's so interesting that when we are burnt out or where you have moral injury. The way that we try to protect ourselves or defense mechanism, whatever you want to call it, is pulling back, right? But really what you're describing and what sounds like was so healing was that connection with the other, with your patients with their families and that the other human across from you.
Noemi Adame, MD: Right. Because that's why I became a pediatrician, right? That's why I became a radiologist. I wanted to connect meaningfully with my patients. So yeah, that's why the direct primary care model has been just wonderful, wonderful. But the main, my main concern after about a year of practicing was that, that, I was doing sick care and I wanted to, okay, what can I do? So I'm not just doing sick care. I want to do wellness.
The Impact of Personal Life on Professional Decisions
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Noemi Adame, MD: And one thing that happened this last summer in June, my mother died. My mother died very unexpectedly, four months before she turned 80 and she was not a typical 80 year old, the day that she, she had a stroke.
And the day that morning that she had the stroke, she woke up at 5 30 in the mornings, power walked three miles, had lunch with her friends, worked in her garden. She, that is how she, she lived alone. She was just very active. My sisters and I had plans to take her on vacation, later that fall.
So when I got the call, She was in the ICU. I was, it just, it rocked our world for myself and my sisters. I dropped everything and, and I went home to Texas the next day. I wasn't, and I told my husband and we were about to start, we had a contract with a summer camp to provide medical care for them.
And I called the director and said, I don't know when I'm coming back cause I didn't know she was going to survive. And I was going to come back three months later. So, or she wasn't going to survive the night. And so she was in the ICU for six days and then she transitioned and died.
And when she died, I did a real audit of my life. I did a real audit of my life and we thought, I thought I had her for another 10, 15, even 20 years, even though she was 80 or almost 80, cause she was so healthy. And then her mother had lived till 96. And so I decided that I was going to sort out my priorities and one of the things I needed was to spend more time with my family, but also have more freedom.
And so that if there was a crisis, cause I still have children, I have a husband, I have sisters and I needed to be able to walk away during times of a family emergency and I have amazing patients. Okay, I have amazing patients that, oh my gosh, they were so understanding because I you know before I left I sent an email saying Mom's in the hospital. I don't know when I'm coming back, but the typical "I won't be available to answer" texts. I know, I know. And I realized, okay, I, this, this needs to change.
The Transition to Holistic Wellness and Lifestyle Medicine
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Noemi Adame, MD: And so having already been familiar with lifestyle medicine, I thought, okay, you know what, I'm not going to close down the pediatric portion of the practice, but I am gonna, I'm not going to actively grow it and I'm going to focus on lifestyle medicine for adults and growing that part of the practice.
So that, and that's what we are. That's why we're rebranding to a transformational holistic wellness clinic for women. Cause again, we're trying to get to the person who's in charge of the grocery shopping, because that's how we're going to have healthy children. But just from a lifestyle perspective, my children are getting older and they're going to, I want to be able to go visit them.
And I want to be able to go on vacation with my husband and my sisters. And it's harder to do. It is hard to do that. And in the pediatric concierge world, I've done it, but there's always that, it's hard to let go. And so I just thought, well, doing the lifestyle medicine will make it a little bit easier to build a business that can function without me.
Cause right now I am the product. In the pediatrics, I am the product. I am what patients are paying for. And I love that and it makes for a very, very special relationship. But just from a sustainability standpoint, I want to keep that part of the practice small and grow the lifestyle medicine
Kara Wada, MD: I'd love to hear kind of what you know, what is in a holistic wellness center? Like what, take me in.
Noemi Adame, MD: Yes. Yeah, so we I follow, I designed a framework based on the principles of lifestyle medicine. That's what I call the veggies over pills, the veggies over pills method. And I really feel, I was very hesitant to use the word holistic for years and wellness because it just conjured up this image of this, like anti vax type of movement and, or an almost anti science.
And no matter what field of medicine we are as physicians, I really feel we need to reclaim those terms. We need to reclaim the terms holistic. We need to reclaim the word wellness and the world of wellness. And one of the ways we do that is by rebuilding and repairing the relationship with our patients.
Again, like old school doctors.
The Importance of Workforce Wellness
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Noemi Adame, MD: One of the things that I realized in working with women, for example, is in the wellness space is that when I ask about barriers, one of the most common things they say, " I don't have time to plan meals or prep meals because of work." I'm too tired to exercise because of work.
And that's when I started work, looking at corporate wellness and doing corporate wellness, speaking engagements and consultations. Because again, I'm always trying to go back to the source. Okay. Like what is the root cause. What's the root cause of this? And I was looking at corporate wellness, not just as a new vertical for the practice, but also to implement these strategies for myself as a business owner.
I have a tiny little practice, really rural Indiana. The practices is at my house. Behind those white double doors is my dining room and I felt like I very intentionally wanted to make sure I did not, I as a business owner, as an employer did not become the monster that I had left behind in corporate medicine.
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Noemi Adame, MD: So that's when I started doing a deep dive into corporate wellness, not just as a business decision, but just a very, very personal one too. And I really feel that physicians should be dominating in the wellness space, both at the individual and at the corporate level. We have been relegated to sick care by insurance companies, by hospitals, by private equity, by corporate systems that that tell us what to do. And we need to say, "Stop, I'm not just going to do sick care anymore". Every single doctor listening, I really hope that if there's one thing that I hope I inspire the people listening, the physicians listening is as physicians, we need to be the local authority in the wellness space, wherever we live.
So if someone needs a speaker at a local wellness conference, they're calling you as the doctor, where if a school needs to revamp their nutritional program, they're calling you. A company wants to design a workforce wellness ecosystem to promote natural movement amongst their employees, they're calling you, the local doc.
And I really feel that it is very important because there's people with less training, knowledge, experience, and education doing this. And we need to reclaim that holistic wellness space and step out of the shadows of the sick care system. We have to normalize the market for physicians in the wellness space.
And there's plenty, there's plenty for all of us. And by holistic, I mean, what lifestyle medicine teaches us is anti inflammatory nourishment or whole foods, plant based nourishment restorative sleep, natural movement, meaningful social connections, engaging with nature mindfulness based stress reduction, avoiding toxic, avoiding risky substances.
Going back to basics. It is simply going back to basics.
Kara Wada, MD: And helping support folks in those changes, knowing that it's hard to do, like you just mentioned, like it's really it's hard to do with all of the social structures in place, that just really make it challenging.
Learning from the Blue Zones
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Kara Wada, MD: I'm curious having read a bit of and watched a bit on the Blue Zones, and one of the Blue Zones is in Costa Rica they mentioned kind of in the book, and then I think in the Netflix program too, about their primary care system.
And I'm curious if you were able to like gather or learn anything kind of from your year abroad.
Noemi Adame, MD: So, I lived in Monteverde, which is was up in the mountains. But the blue zone in Costa Rica is in the Nicoya Peninsula, Nosara. And so it's down the mountain and off into the west coast from where I was living. But I, even though, yes, the area where I was living wasn't one of the designated blue zones, there's still some cultural aspects like the diet, like the social connections, like the walking, the natural movement that is countrywide.
So for example and I didn't, we never, we never needed to access the healthcare system, but I did meet a couple of doctors because I did think about maybe practicing down there and it's very hard, by the way. It is very hard for a foreign doctor. They have, they have plenty of doctors.
They actually have a pretty good help. They have a socialized healthcare system. They pay their doctors very well. Their doctors are very happy. They don't have a lot of administrative burden because they don't have to document to satisfy an insurance company or some sort of billing, you know, coder.
They document like the way doctors here used to document just patient has strep positive.
Kara Wada, MD: Amoxicillin it is.
Noemi Adame, MD: So there, yeah, their administrative burden was very low. One of the doctors that I met said I'd go on vacation three times a year all over the world, I mean, doctors here live very, very well.
And cause there's in some countries where, where they don't, right. But yeah, their system was amazing. And the people were were very healthy. They had an amazing children's hospital down in San Jose also. So yeah, I did look into becoming a doctor, but they very much are like, yeah, we got enough doctors here. Thank you very much for it.
Kara Wada, MD: I think I had heard that one point. One of, I'm pretty certain one of my classmates in medical school, it's been so many years now. But I'm pretty certain that is where he grew up and where his family was from and the plan, at least when we were in school, was he planned to go back, but I'm sure a little bit different situation and, in that that instance, but
Noemi Adame, MD: I was so happy. We didn't have a car. We walked everywhere. I did yoga almost every day to go anywhere you walked like if I had to go to the grocery store, I would put on a backpack because they don't have like plastic bags everywhere, right? Like the way we do. So I would put on a little backpack, go to the grocery store, put all my groceries in the backpack and then climb back up the hill with my backpack full of groceries, so and so it's not like they had gyms everywhere.
That's what Blue Zones is all about, right? It's not that there's gyms or juice bars it's just everything that their lifestyle is embedded into their everyday life like the natural the natural movement.
Kara Wada, MD: And that's what we struggle against here in the States, I mean, and to kind of put it in perspective, which I think it's just helpful to say yes, it is challenging and also we can maybe workshop or find some ways to make those decisions, sometimes hard decisions, in order to make those shifts if you really want to.
Noemi Adame, MD: Right, right. And, and it's also hard because even though someone could like, I call it blue, you can blue zone your house. You can blue zone your house to make healthy choices as far as nourishment, as far as physical activity. But when you, when as Americans, we spend one third of our waking hours in a lifetime at work, if our work isn't blue zoned, then it makes it even more challenging, because then that's an added burden with with just trying to make healthy decisions about our
lifestyle.
Kara Wada, MD: That brings us back to the workforce wellness and well, and thinking about how we can do that in our spaces.
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Noemi Adame, MD: That's one of the reasons. Yeah. That's one of the reasons I started doing that part of the practice of doing work for workforce, wellness audits and speaking engagements because it has to be a top down approach. People need to be, the workers need to, "Oh, okay, our the senior staff or the leadership is doing this." They're implementing these active designs so that we move more, so that we have healthy choices to eat. I'm actually giving a talk at, there's a pediatric DPC mastermind later this month. And I'm gonna, and I'm giving that talk precisely is how to create a workforce wellness ecosystem within your DPC micro practice.
And of course, DPC practices like mine, I mean, really we're small. We maybe have a couple of staff. So it's not about, "Ooh, you need to provide the state of the art gym, you know, to your staff." No, it really is very small things like, "Hey, make sure that you give people enough time that they can prepare meals that they cook from home or give them enough of a lunch break that they can go get a meal if they want to go out and purchase a meal that it's not fast food, that they actually have time, so even just little simple things like that".
Have walking meetings instead of sitting meetings, little simple things like that, that don't cost a lot of money, but can have a huge impact on morale and the health of the workforce are very, very doable.
Kara Wada, MD: I'm already I have little ideas going with our office. And I'm going to have to check. Yeah, I'm going to have to check two of my good friends have, within the last year, year and a half, have opened up direct care practices. One is a pediatrician. One is med peds. And she has a focus kind of on the fourth trimester too.
And so, I'm going to have to make sure that they are connected with you as well.
Noemi Adame, MD: Yeah. We've got, if they're on the Facebook groups, I might know them. Cause I'm both on the Fourth Try and
Kara Wada, MD: We'll trade, we'll trade names after.
Noemi Adame, MD: Yeah, sure. It's a small community. It's a small world. Yeah.
Kara Wada, MD: Well, this has been fantastic.
Conclusion and How to Connect with Dr. Adame
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Kara Wada, MD: Where can people connect with you? If they, if this is really resonating, they want to learn more from you. I'm sure we have some listeners maybe that are even local. How can they connect?
Noemi Adame, MD: Right. So we have a pretty strong online presence. So people can visit our website, www.culverpediatrics.com. They can learn more about our practice and the services that we offer. So in addition to being Pediatrics Concierge, we are also a holistic wellness clinic for women. And I do corporate wellness audits and consultations.
I do corporate wellness speaking engagements. All that info is on our website. I also designed a journal for my wellness patients to guide them on their journey called Metamorphosis Holistic Wellness. So if you have any docs that are listening that are, that practice lifestyle medicine or obesity medicine.
Do weight loss or wellness management. If they go to our website or my website they can they can find a link to purchase the journal and they can use it to guide their patients on, on their journey. And it's body positive encourages partnering with their doctor. It's totally holistic.
So it's not just like doc logging, food and exercise. It's also like mindfulness and sleep, right? Yeah. Everything right. Affirmations. There's a daily gratitude journaling part. There's a weekly self reflection. Yeah. Very much all that. All that crunchy stuff that, but that is evidence based and important.
We're on Facebook and Instagram at Culver Peds. And we offer a lot of wellness tips, it's there. I'm on LinkedIn, Noemi Adame MD, although that account mainly focuses on connecting a B2B, so corporate wellness, as a corporate wellness speaker. And so yeah, so go to our website, check out our socials check out my wellness journal.
And if anyone is looking for a speaker for their next conference or wellness event, hit me up, book me for a consult, and we can get the ball rolling.
Kara Wada, MD: Fantastic. We'll make sure to link to all of those in the show notes so that people can just so, easily click through and give you a follow or an email. And I hope you have a fantastic rest of your week and into the weekend. And I'm so glad we were able to connect Dr. Adame.
Noemi Adame, MD: Oh, same here. Thank
Kara Wada, MD: Take care.
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Hey there, amazing listeners. Before we wrap up today's episode, I want to take a quick moment to ask for your support. If you're enjoying the content of the Becoming Immune Confident Podcast, we're bringing you week after week, there's a simple, but incredibly impactful way you can show your appreciation.
You see, leaving a review is like giving us a virtual high five and it helps our podcast to reach even more people who could benefit from the valuable insights, entertainment, and inspiration we strive to provide week after week. So if you're finding value in what you hear, here's what you can do. Open up your podcast app, whether you're on Apple podcasts, Spotify, or any other platform, and give us a glowing five star review we're dedicated to bringing you the best and your feedback helps us fine tune our content to suit your interests and needs.
But, hey, don't stop there. If you have a moment leaving a few kind words in the review section goes a long way too.
Share what you love about the podcast, your favorite episodes, or how it's made a positive impact on your life. Your words, not only brighten our day, but they also encourage others to join our incredible community.
Remember every five star review and every word of encouragement counts, it's like fuel to keep us creating, innovating and striving to make your listening experience even better. So if you're up for it, show us some love by leaving us that virtual high five in the form of a five star review today.
And a huge shout out to all of you who have already taken the time to do so.
You rock!
Thank you for being a part of our podcast journey and we can't wait to keep bringing you more amazing episodes in the future.
Until next time, keep shining and keep listening and keep on building that confidence in yourself and your immune system health.
Take care.
