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Unhurried, Integrative, and Insurance-Free:
What a Membership-Based Integrative Medicine Practice Actually Looks Like
Insights from The Mindful Practice Podcast with Dr. Brutina Hooks
Yoon Hang Kim, MD, MPH
Board-Certified in Preventive Medicine | Integrative & Functional Medicine Physician
I was recently a guest on The Mindful Practice Podcast, hosted by Dr. Bertina Hooks, a show dedicated to helping physicians navigate burnout, entrepreneurship, and alternative career paths in medicine. Our conversation covered a lot of ground: how I arrived at integrative medicine, why I chose a membership-based model, what root-cause care actually means in practice, and how I think about low-dose naltrexone. What follows is a distillation of that conversation into the themes I think matter most for patients and clinicians alike.
The Path to Integrative Medicine Was Not a Straight Line
I came to medicine because I loved science but loved helping people more. I spent summers doing research, including a Howard Hughes fellowship, but I eventually realized that people interested me more than laboratory work. Family medicine appealed to me because of its breadth, but I later felt constrained and pursued preventive medicine at UC San Diego, where an innovative program director allowed me to design a residency experience that met competency requirements while also matching my interests.
The turning point was an Osher Fellowship to study with Dr. Andrew Weil at the University of Arizona. That fellowship was built around an uncompromising ideal of what integrative medicine could be, and it changed my professional trajectory. It taught me the importance of building a counterculture, a professional network, and broader acceptance for integrative medicine. From there, I moved through consulting, program-building for health systems, and eventually into a more focused integrative telemedicine practice.
Integrative Medicine Asks: "What Else May Be Driving This?"
A major theme of our conversation was that integrative medicine tries to look beyond the label of a diagnosis. A diagnosis can be useful, but it may not explain why a person developed the condition or what keeps it active. I used mast cell activation syndrome as an example: the syndrome may be connected to different underlying triggers in different people, including infections, environmental exposures, post-viral illness, or immune dysregulation.
This does not mean ignoring symptoms. Root-cause care still pays close attention to what a patient is experiencing, but it also asks whether there are deeper drivers that can be addressed. I contrasted this with what I sometimes call cookbook medicine, where conventional practice can become overly protocol-driven. Type 2 diabetes, for example, involves insulin resistance. That should prompt us to think about restoring insulin sensitivity through lifestyle strategies, not only through medication escalation.
Why I Chose Membership-Based, Insurance-Free Care
Dr. Hooks asked me to explain the direct care model for listeners who may have heard the term but not fully understood it. In simplest terms, the patient pays the clinician directly through a membership, and the practice does not bill insurance. This changes the incentive structure in important ways.
In a membership model, patient questions become part of the relationship rather than extra unpaid work squeezed into the margins. Proactive care improves satisfaction and trust because the clinician has a reason to reach out, follow up, and stay engaged. When a member goes quiet, I check in. I do not want to collect a membership fee without meaningful engagement. That kind of accountability runs in both directions.
My practice is intentionally capped. Active patients receive intensive, ongoing care. Maintenance memberships allow patients to stay engaged after the active phase. This structure creates predictable income and allows me to design how much I work, how I earn, and how deeply I engage with each patient.
Complex Patients Need More Time, Not Just More Tests
I repeatedly emphasized unhurried care in our conversation. In my practice, an hour may be blocked even if the face-to-face visit is shorter, because complex patients often require review, research, documentation, and follow-up planning that cannot be compressed into a fifteen-minute window. Complex chronic illness cannot be solved in rushed, fragmented visits. A good care model creates enough time for listening, adjustment, and communication.
I also described a "10 visits in 10 weeks" approach as a way to help patients develop the habit of reaching out before problems become severe and to learn how to communicate effectively with the clinician. Many people wait until symptoms become a crisis before seeking help. Frequent early follow-up trains a different pattern: reach out early, communicate clearly, stay engaged.
Telemedicine Is Powerful, but Not for Everyone
My multistate practice is not random. I target states and regions where I have practiced, understand the medical climate, or have a connection to the patient population. Telemedicine can be especially valuable for integrative medicine, where specialized clinicians are scarce and stable patients benefit from access that geography would otherwise deny them.
But telemedicine is not appropriate for everyone. Patients who are acutely unstable, afraid for their life, or unable to use basic technology may need an in-person clinician first. I use a simple readiness test: if a patient cannot send an email or participate in a video visit, telemedicine may not work well for them. Communication should begin with video visits so clinician and patient can read expression, tone, and context. As trust and skill improve, some patients may earn the privilege of phone or asynchronous communication.
Burnout Is a Systems Problem, Not Just a Resilience Problem
Dr. Hooks and I spoke about physician burnout at length. I have written about why a sick healthcare system makes its workers sick. Administrative complexity has grown dramatically. Physicians experience insurance rules, prior authorizations, and system incentives as disempowering. The system can push physicians to focus on RVUs, productivity metrics, and compliance burdens instead of relationships and care.
Patients experience the same system as rushed, confusing, and impersonal. Burnout is not only a physician problem. It affects the entire healthcare relationship. In my view, physicians need a "Plan B" that gives them agency, whether that is a side practice, an independent professional platform, or a different model of care delivery. For patients, the takeaway is simple: the quality of your healthcare relationship is shaped by the incentive structure your clinician works within.
Lifestyle Change Can Be Medically Meaningful
We discussed type 2 diabetes, insulin resistance, low-carbohydrate eating, ketosis, and fasting as examples of lifestyle strategies that may improve metabolic health for some people. These approaches are not appropriate for everyone and should be discussed with a qualified clinician, especially for people on diabetes medications, people who are pregnant, people with eating disorder history, or people with complex medical conditions.
The broader point is that food, timing of meals, sleep, movement, and stress can be medically meaningful. These are not afterthoughts or adjuncts. In the right patient, with the right support, lifestyle modification can be one of the most powerful interventions available. But it must be individualized and monitored.
Low-Dose Naltrexone: A Nuanced Tool, Not a Miracle Cure
Dr. Hooks shifted the conversation to low-dose naltrexone, and I was glad she did. Naltrexone is traditionally used in higher doses for opioid addiction, but at lower doses it may have different effects. I think about LDN through three lenses in clinical practice: supporting endorphin production, modulating immune inflammation, and addressing neuroinflammation through pathways such as toll-like receptor 4 activity on microglial cells.
LDN can be useful in selected patients with autoimmune imbalance, inflammatory conditions, and certain neuropathic pain patterns. But it is emphatically not a "give everyone the same dose" medication. In my framework, dosing depends on the patient's endorphin reserve. If that reserve is misjudged, some patients can feel profoundly unwell, with severe malaise or emotional distress. The public takeaway is important: avoid treating LDN as a one-size-fits-all, supplement-like intervention. It is a prescription medication and should be managed by a clinician familiar with its risks, benefits, and dosing strategies.
Technology and AI Are Tools, Not Substitutes for Judgment
We discussed technology and AI as tools for modern practice-building. I use multiple AI tools for research, writing, summaries, marketing, and verification, but the most important technology is a flexible mind. Physicians should not fight the direction society is moving but should learn to use tools responsibly. My approach is to use different tools for different tasks and to always verify AI-generated work rather than trusting any single platform.
For the general public, the takeaway is similar: technology can support healthcare communication and education, but it should not replace professional judgment, clinical context, or the human relationship at the center of good care.
It Starts with Relationship
Across the entire episode, the deepest theme was relationship. Enough time to understand the patient. Enough trust to communicate early. Enough structure to stay engaged. Enough honesty to say when a model is or is not a good fit.
For the general public, the central lesson is simple: the best healthcare is not only about having more options. It is about having the right relationship, the right plan, and the right follow-through. For physicians considering a different path, the lesson is equally direct: build something that lets you practice medicine the way you know it should be practiced.
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To hear the full conversation, listen to The Mindful Practice Podcast with Dr. Bertina Hooks MD. Episode links and show notes are available on the podcast's website.
To learn more about membership-based integrative care or to schedule a consultation, visit www.directintegrativecare.com
About Dr. Kim
Dr. Yoon Hang "John" Kim is a board-certified Preventive Medicine and Integrative & Functional Medicine physician with more than 20 years of clinical experience. He completed fellowship training through the University of Arizona's Andrew Weil Center for Integrative Medicine as an Osher Fellow, holds board certification in Integrative and Holistic Medicine, and maintains certifications in medical acupuncture (UCLA) and preventive medicine, with advanced training through the Institute for Functional Medicine (IFM Scholar).
Dr. Kim's clinical specialties include low-dose naltrexone (LDN) therapy, autoimmune disease, chronic pain, integrative oncology, fibromyalgia, chronic fatigue syndrome, mast cell activation syndrome, and mold toxicity. He is the author of three books and more than 20 published articles, with a particular focus on LDN and complex chronic illness.
Learn more at www.yoonhangkim.com | www.directintegrativecare.com
