The Iyer Clinic Update
June 2024
The Value of Small Actions
By; Dr. Ravi Iyer
Collectively society values the big over the small, the grandiose over the insignificant. We grow up with this prejudice in our value system so much so, that we become conditioned to seek answers to our biggest problems only in large, big, and usually expensive solutions. The bigger the strategy the better and if it doesn’t cost a huge sum then it simply cannot be good enough!
However, after spending over 40 years trying out various approaches to solving health problems, I have come to the inescapable conclusion that small and simple strategies are by far the most effective in 99 cases out of 100.
Take for example the problem of diabetes. After years of trying various solutions, we now use a management strategy for Type 2 diabetics that we developed in house by trial and error in our clinic called “6-in-6”. Simply put we work with patients to get them to a HbA1c goal of 6.0 in 6 months regardless of where their current HbA1c reading may be. The most important tool in this program is not medications, even though I do prescribe all the standard anti-diabetic drugs. It is a combination of continuous blood sugar monitoring and logging along with fortnightly office visits where I review these logs as well as their logs of food choices and exercise patterns. But that is not all. The real motivator is a contract wherein each patient understands that if he/she does not perform their part in this program they are encouraged to seek health care elsewhere. The coach-trainee relationship in this program is what makes this program have a 99% success rate.
The national average HbA1c score among diabetics is about 8.0. In our clinic, it is 6.2! That is almost at the non-diabetic level! A simple daily diary with 15 minutes of counseling every 15 days for 3 months and holding patients accountable for their performance produces results that outclass the most expensive medication regimen available!
The value of small incremental interventions is not restricted to diabetes. I have found the same principle applies to weight loss also. In this area, I find that those patients who perform intense exercise and drastic diets do not achieve the greatest results. Instead, the patient who does no more than walk 2 miles in about 30 minutes, 5 days a week, and insists on getting up from every meal before he/she is full always produces the most dramatic reductions in weight. One hour of gardening a small vegetable plot on your hands and knees does more for your health than that expensive gym membership. What is more, these reductions are always sustainable too.
The greatest impact is not that these strategies are simple, even though they often are. It is not that they are inexpensive, though the best is usually so. But the profound revelation in all this is that invariably the most successful solutions are so because they empower the patient to directly influence the outcome. The act of developing the daily discipline of checking your blood sugar using a continuous glucose monitor every time before during and after you eat creates a framework for a different dialogue in your daily life. Remembering to bring it with you to your doctor's office every 2 weeks and knowing that you will be sent home if you show up for your appointment without your log creates over time a different mindset of accountability in you. An accountability that spills over into the choices that you make in what you eat, how you eat, and how you go about your life.
Similarly, walking is far superior to running as a form of exercise not because it burns more calories, but because even though you burn only 85 calories by walking for every 100 you burn by running, you do so at less expense. You pay a much lower price in terms of wear and tear on joints. You burn calories at a more steady state that results in a more sustained elevation of your basal metabolic rate for longer periods even after you stop the exercise….. finally, the pace of walking allows you to notice the birds and the butterflies in a way that slows the incessant mental chatter that keeps all of us in the vibrating high strung state that characterizes today’s lifestyle.
Indeed, this is not new. The Japanese have a word for this: Kaizen, which means improvement in small steps. “Rather than a single intense burst of effort, Kaizen is a daily activity, the purpose of which goes beyond simple productivity improvement. It is also a process that, when done correctly, humanizes the entire endeavor, eliminates unproductive, inefficient, and wasteful work, and teaches people how to perform experiments on their work using simple measuring tools and how to learn to spot and eliminate waste in work processes”…. (Source: Wikipedia).
The amazing success of the “6-in-6” diabetic management program in our clinic is rooted in Kaizen and in the way it allows patients to identify and eliminate unproductive behavior… the Muda (an activity that is wasteful and doesn't add value or is unproductive), Mura (unevenness, inconsistency in actions) and Muri (an action that is burdensome relative to the value produced by it) that was made famous by Japanese automakers.
The results are inescapable. The number of diabetics in our clinic that require insulin to control their diabetes is less than a dozen. Less than 1% of diabetics in our clinics who completed the “6-in-6” program have an HbA1c greater than 6.5. And over 85% of successful graduates maintain their HbA1c below 7.0 three years after program completion.
After all, I see no reason why a process that is used by successful companies cannot be used to help someone avoid a heart attack, preserve their kidney or protect himself or herself from a paralytic stroke…. Do you?
NEW INITIATIVES
June 2024 | Health Education Workshops
A CONVERSATION ABOUT STRESS:
Beginning in June, The Iyer Clinic will host a workshop for the general public on living powerfully without stress and engaging with your lives in a manner that allows you to truly harvest the rewards of the life you work so hard to create.
Dr. Iyer has over 40 years of experience in the human condition and has trained in some of the most profound transformational methodologies in the world. These skills, however, are reproducible and transferable. Come learn how you can create a more powerful, engaged, and stress-free existence for yourself. Call our clinic to ask how you can enroll in this evening workshop.
A BODY FOR LIFE:
The advent of GLP-1 drugs has revolutionized the world of weight loss. A lot of clinics have capitalized on these drugs to market high-dollar weight loss programs to their clientele. You may have seen the ads on social media also. At The Iyer Clinic, we have created a GLP-1 program that combines, metabolic management, oversight, and affordably priced ($100-$350/- per month cost of the drug) program that is in line with our philosophy of concierge quality care on an every-man budget. Call our office to see if a Body for Life program would be ideal for you.
Your PCP is auditioning at TEDx!
TED assembles some of the finest speakers in the world to illuminate bold, brilliant, and transformative ideas and insights that can change the world. This June 29th, Dr Iyer will be auditioning at TEDxUStreetSalon in Washington DC to be selected as the next People's Choice TEDx Speaker!
You can attend in person/or follow online and VOTE to see Dr Iyer on the TEDx stage at UStreetSalon, Washington DC. The Iyer Clinic would love to see y'all there. It would be an awesome afternoon in DC for everyone with great food, great convo, and amazing people.
Our Services
Preventative Care
Good health includes taking precautionary measures that will help you avoid future illnesses. We provide a number of preventive care services including physicals, lifestyle and stress management counseling, and cardiac stress testing . Talk to us to find out more about how you can take the first step towards truly good health.
Illness Care
You can rely on us to get you in quickly and take decisive steps to get you back on your feet. We understand that being sick can be very stressful. We'll do everything in our capacity to make it less stressful for you.
Chronic Care Management
Count on us for expertise and support if you have a chronic medical conditions or need hospitalization. To manage health issues related to chronic illness, you need a physician who understands the chronic illness and, more importantly, knows your unique circumstances.
Main Office - Herndon
13505 Dulles Technology Drive,
Suite 1A,
Herndon, VA 20171
Sterling Office
21495 Ridgetop Circle,
Suite 102,
Sterling, VA 20166
Aldie - South Riding Office at Stone Springs
24430 Stone Springs Blvd,
Suite 100B,
Dulles, VA 20166
An experienced doctor's practice you can trust.
Since 1995, Dr. Ravi Iyer has led a group of talented and dedicated professionals to provide comprehensive medical care for families in Northern Virginia. With over 15 years of experience and equipped with state-of-the-art equipment, Dr. Iyer's team continues to serve the people of Herndon, Reston, Ashburn, Chantilly, and Sterling, with the same commitment to the highest quality of service today as they did on the day they started.