Healthcare is at a crossroads. While traditional primary care medicine continues to serve an important role, more physicians are discovering that meaningful patient outcomes require stepping outside the constraints of insurance-driven medicine.
Dr. Jill Sohayda exemplifies this evolution. The former primary care physician now owns Essex Medspa in Denver, Colorado, where she focuses on integrated wellness, combining evidence-based medicine with a holistic approach to patient care. Her transition offers valuable insights for both healthcare providers considering a similar path and patients seeking more comprehensive care.
The limitations of insurance-based medicine became clear to Dr. Sohayda during her years in primary care.
"With insurance, we're sometimes limited in terms of the options we can give our patients," she explains. "There's certain medications that they will allow us to prescribe, but there's some things that they won't allow us to charge for."
These restrictions extend beyond medications to include educational consultations, specialized testing like NMR lipid profiles, and compounded medications for hormone replacement therapy. The result is a healthcare system where time constraints and reimbursement limits often prevent physicians from addressing the root causes of health issues.
Dr. Sohayda points out a fundamental reality:
"Insurance really isn't there to make you healthy. If you want to be healthy, you have to be proactive and pay for that. Insurance is really there for when you're really sick."
Today's healthcare consumers are dramatically different from those of previous generations. Dr. Sohayda recalls treating a cancer patient early in her career who couldn't even remember what type of cancer he had or what treatment he received.
"This day and age, people are much more educated and they want to know there's other options out there," she observes.
This shift in patient expectations is driving demand for more comprehensive healthcare approaches. Patients no longer accept the traditional "doctor knows best" model without question. They arrive at appointments armed with research and specific requests for alternative treatments.
One of the most persistent challenges Dr. Sohayda faces involves educating patients about hormone replacement therapy. Two major misconceptions dominate the conversation: the fear that hormones cause cancer and concerns about the regulation of compounding pharmacies.
The cancer concern stems largely from the Women's Health Initiative study, but Dr. Sohayda emphasizes that the research findings have been misinterpreted. "The myth was that estrogen itself was cancer-provoking for breast cancer," she explains. "But when they went back and looked at it, it wasn't just the estrogen. It was the medroxyprogesterone, which is a synthetic version, in combination with estrogen."
The distinction matters enormously. The increased breast cancer risk was associated with the combination of estrogen and synthetic progesterone, not estrogen alone or bioidentical hormone combinations.
Dr. Sohayda's approach to cholesterol management illustrates the benefits of integrated medicine. Rather than immediately prescribing statins, she examines the complete picture: diet, sleep patterns, stress levels, inflammation markers, and lifestyle factors.
"We really got to look at the foundation of all of it, which is lifestyle," she says. This might include addressing poor sleep that increases cortisol levels and inflammation, or dietary changes that reduce the body's inflammatory burden.
When medications are necessary, she focuses on minimizing long-term side effects through targeted supplementation. "Our goal would be if you can, let's try to get you off them. But if you have to be on them long-term, let's look at the things that we can supplement you with to decrease those long-term side effects."
For physicians considering a move away from insurance-based medicine, Dr. Sohayda recommends a gradual approach.
"You educate your current patients on this transition that you're going to make," she suggests. "You can have certain days and times where you're like, today is my Western medicine clinic day, and these are the hours that we have to actually give to people when they want to come in and talk about these other therapies."
This hybrid model allows providers to test patient demand while maintaining financial stability during the transition period.
The transformation Dr. Sohayda witnesses in her patients reinforces her commitment to integrated medicine. She describes one client who entered a downward spiral of weight gain, depression, and social isolation that led to daily food deliveries and complete withdrawal from normal activities.
Through a comprehensive approach addressing weight management, nutrition, exercise, and mental health, the patient not only lost weight and discontinued blood pressure medications but also gained the confidence to pursue a new job. "It has transformed her world," Dr. Sohayda notes.
As more patients demand comprehensive care and more providers recognize the limitations of traditional medicine, integrated wellness approaches are becoming mainstream. Dr. Sohayda believes this trend will continue, driven by patient education and expectations.
However, she remains realistic about the pace of change in traditional healthcare systems. "The traditional medicine system is kind of a slow-moving bus," she observes. "Big corporations typically are going to move slower than a smaller business."
For patients seeking more comprehensive care, the solution may lie in seeking out practitioners who have already made the transition to integrated medicine. For healthcare providers, the message is clear: the future belongs to those who can successfully combine the best of evidence-based medicine with a holistic understanding of human health.
The conversation with Dr. Sohayda reveals that the evolution of healthcare isn't about abandoning proven medical practices, but rather expanding them to address the complete spectrum of factors that influence patient outcomes. In a world where chronic diseases continue to rise despite advanced medical technology, this integrated approach may represent the most promising path forward for both providers and patients.
The Akina Pharmacy Speaker Series explores the world of compounding care and personalized medicine through conversations with clinical specialists, partners, and subject matter experts. Each episode delves into how individualized approaches to healthcare are reshaping patient outcomes and empowering people to take control of their health.
At Akina Pharmacy, we're built on the Hawaiian principle of Kina'ole—doing the right thing in the right way for the right person at the right time, the first time. As a 503A compounding pharmacy, we don't just compound medications; we compound trust, quality, and innovation into every formulation we create.
To learn more about Jill's work, visit www.essexmedspa.com.