As many of you may know, the Rentea Metabolic Clinic came about as a result of my frustrations in the primary care setting. Despite my passion for patient care, the brief appointments meant I couldn’t effectively tackle underlying metabolic challenges like insulin resistance, which are key for long-term health.
I recently learned that nurse practitioner and TikTok star Chase Franks faced similar challenges in his experience of primary care. Chase shares my passion for debunking myths about anti-obesity medications and his TikTok fans—over 118K strong—love his relatable approach and straightforward explanations.
In this episode, join us as we discuss the challenges we both faced in addressing weight management issues in primary care, our shift into exclusive weight management roles, and why educating and empowering patients is at the heart of what we do.
01:08 - We meet Dr. Rentea’s podcast guest, nurse practitioner Chase Franks, who shares how and why he built his TikTok presence in the weight management field.
03:30 - Dr. Rentea asks about Chase's experience with weight management in primary care and the challenges he faced due to time constraints and stigma.
05:50 - We hear about the differences in approaching weight management, particularly in terms of patient readiness, between specialty care and primary care settings.
09:55 - Chase and Dr. Rentea discuss the challenges in primary care, particularly the constraints in time and resources for effective weight management, highlighting the gap between patient needs and available support.
15:30 - Chase encourages listeners to seek specialized obesity management specialists for support, acknowledging that not all primary care doctors may have the expertise to address weight management effectively.
Quotes
“I hate that in the medical establishment everything is blamed on weight and people are made to feel bad about their weight.” - Chase Franks, NP
“What I came to realize is this is not something that I can tackle in the primary care setting.” - Matthea Rentea MD
“I don't think that people know when they're going into this, how complex it is, the level of help that they're going to need, and how often.” - Matthea Rentea MD
“If you're seeing a primary care doctor and you feel like they're not supportive in this, they might not have the education, so they're just the wrong person to steer you.” - Matthea Rentea MD
“Obesity is a very complex chronic medical condition that more often than not would require specialized care. And there are providers out there that are well versed in it who do care.” - Chase Franks, NP
“You don't have to white knuckle it your whole life. There are people that care and want to help you out there and have the education to do so.” - Chase Franks, NP
As many of you may know, the Rentea Metabolic Clinic came about as a result of my frustrations in the primary care setting. Despite my passion for patient care, the brief appointments meant I couldn’t effectively tackle underlying metabolic challenges like insulin resistance, which are key for long-term health.
I recently learned that nurse practitioner and TikTok star Chase Franks faced similar challenges in his experience of primary care. Chase shares my passion for debunking myths about anti-obesity medications and his TikTok fans—over 118K strong—love his relatable approach and straightforward explanations.
In this episode, join us as we discuss the challenges we both faced in addressing weight management issues in primary care, our shift into exclusive weight management roles, and why educating and empowering patients is at the heart of what we do.
01:08 - We meet Dr. Rentea’s podcast guest, nurse practitioner Chase Franks, who shares how and why he built his TikTok presence in the weight management field.
03:30 - Dr. Rentea asks about Chase's experience with weight management in primary care and the challenges he faced due to time constraints and stigma.
05:50 - We hear about the differences in approaching weight management, particularly in terms of patient readiness, between specialty care and primary care settings.
09:55 - Chase and Dr. Rentea discuss the challenges in primary care, particularly the constraints in time and resources for effective weight management, highlighting the gap between patient needs and available support.
15:30 - Chase encourages listeners to seek specialized obesity management specialists for support, acknowledging that not all primary care doctors may have the expertise to address weight management effectively.
Quotes
“I hate that in the medical establishment everything is blamed on weight and people are made to feel bad about their weight.” - Chase Franks, NP
“What I came to realize is this is not something that I can tackle in the primary care setting.” - Matthea Rentea MD
“I don't think that people know when they're going into this, how complex it is, the level of help that they're going to need, and how often.” - Matthea Rentea MD
“If you're seeing a primary care doctor and you feel like they're not supportive in this, they might not have the education, so they're just the wrong person to steer you.” - Matthea Rentea MD
“Obesity is a very complex chronic medical condition that more often than not would require specialized care. And there are providers out there that are well versed in it who do care.” - Chase Franks, NP
“You don't have to white knuckle it your whole life. There are people that care and want to help you out there and have the education to do so.” - Chase Franks, NP
Okay. All right. Welcome. Welcome. Welcome everybody. I'm so excited today. So we have a really special guest where I'm just going to let him introduce himself, but I'm going to give you a little bit of background here. So I have followed him on tech talk. He's a nurse practitioner. He's in the weight management space. I have followed him for years now. I feel like we're colleagues in this space because we're both talking about the same stuff. But the reason I brought Chase on is because I heard a video of his the other day and he was talking about how when he came from primary care, which is the same as me, that he actually wouldn't often bring up the weight management conversation and patients would say, Hey, you're not going to get on me about this. And I realized, Oh, there is so much to talk about here. So. Chase, can we start out with you introducing yourself and just tell us a little bit about kind of why did you get on a TikTok? Kind of what do you talk about? You know, kind of just tell us a little bit in general. Absolutely. Well, yeah, like you said, my name's Chase. On TikTok, I go by bourbonrx. I'm from Kentucky, so I thought that just had a ring to it. So bourbonrx is the name. I got on Tiktok during COVID because I was bored. You know, primary care, I was in primary care at that time. So like you said, I'm a nurse practitioner. I've been practicing about 10 years and, I started in cardiology, a brief stint, three years with interventional cardiology. Then went to, primary care for about five years. five. But during that time, COVID hit. And as you know, our, you know, patient loads dropped by 50%. We were doing mostly telemed. So I was stressed and looking for an out. So I was like, what am I going to do? Let's make a tick tock. So got on tick tock. And, soon after the, the boom of, of GLP ones came about and I started noticing a lot of misinformation. Honestly. Yes. I'd like to reach out to this because this is, I want, sorry, I don't mean to interrupt, but it was like, I think probably you noticed what I did, which is we probably didn't even want to talk about this so much, but it was so insane what was being said that we had, it's like, you had to speak up. Like, did you feel any of that? Like, I have to make this video because it's like, how can I not with what's being said? Yeah, and that, that is legit what bred my, my current TikTok, was I was seeing these things about, you know, the medications themselves, the possible side effects, the copay cards, all this stuff, and I was like, I have first hand knowledge of this stuff. I see it every day, not only through training, but just like the copay cards and dealing with the shortages and all that. And I was like, I can fix the, or not fix it, but educate the public, in, you know, 60 seconds. And so that, that is where it came from. And, it's just kind of grown and, been having a great time since. Yeah. Oh, I love that. I love that so much. And I, all the stuff that you put out, it, it's always such good perspective. Cause I can always tell, This is a lot of what I like about the podcast. People are actively practicing medicine because I feel like it's, it's always different, the content compared to, I don't know, I'm not going to call anyone out here, but you can always tell when people are sort of just like reading studies and talking theoretical versus if they've actually seen someone. But like, I don't need to look up the credentials. I know what's going on here. So, let's get into this a little bit though. So we both did the same thing where we came from primary care and then we went exclusively into weight management. And when you spoke about not bringing it up, I thought to myself, that's a hundred percent what I did because people would have, I don't know, you know, I'm, I'm internal medicine, you know, before doing primary care and people have a lot of problems. And usually the thing that you don't have time to address is weight. And often that's contributing to a lot of it. but you have no time, right? So what was your experience in primary care like with that? I think that's, that, that hits the nail on the head, you know, in primary care settings, I don't know how yours was, but mine was, you know, 15 minute follow ups, 25 minute new patients, something like that. And, you know, when you get in the primary care world, I'm, you know, I'm from, you know, rural ish Kentucky. And so you can, you know, imagine the health issues that come along with that. And so, people. Came in with complex issues. And you know, whether it be diabetes, high blood pressure, depression, anxiety, suicidal ideation, I mean, you've been there and at, obviously, you know, weight can contribute to those things, but Not necessarily the root cause of those things. So I guess I tried to prioritize what I could, could break down in 15 minutes. And, gosh, I don't know. It's even hard to explain, but yeah, I tried to prioritize what I did. And then honestly, from, I think I've seen it on some of your videos and stuff like that too, there's so much stigma behind weight anyways, and I, and I hate that in the medical establishment. Everything is blamed on weight and people are made to feel bad about their weight. And so, A, I wanted to prioritize other, you know, other conditions, but B, I also, I wanted to empower my patients. And if I just, especially the diabetic or the high blood pressure or the CHF, if I, if they have this chronic condition, I'm like, it'll fix if you lose weight. It just. They're out. They're out. It's so disempowering. Yeah. Yeah. I think that's where it came from. Yeah, completely. I like how you bring up like there's this triage of problems. So you're always going to put other things to the top. Like the blood pressure being off, the diabetes numbers, things like that. But then this is exactly what you said with the stigma with weight. So I find, and I want to hear your experience too, when I'm, when I'm exclusively dealing in the weight management space, I have time. To really have, have, it might be just a quick question or two, but to say, Hey, is it okay if we talk about your weight and then to ask about the history, even if it's just a minute or two, someone you'd be shocked. No one really talks as long as we think they will. Right. I think we fear this in primary care, but But when people are talking, I say, Hey, what did, when did you first notice that this was a challenge? Often someone's going to tell me eight, 10 years old, what have they tried all these things? I would never have time to do this history in a primary care setting. And no one, I w I think you said the same thing when, when you were in clinic, I was booked so far out, no one would be able to make a follow up with me in a month or two to just talk about weight. I mean, that's a joke, right? Not possible. So when, when people say that, when I think about what goes into having a tactful conversation about it, I remember the patients in my mind where I tried to engage in the conversation when they would instantly change the personality in front of me. I had triggered a nerve, there was no coming back from it. I knew I had done it. I didn't know how to change it. And honestly, it took more training for me to realize like, even me with my own struggle, but how to approach it with someone else. But then what I came to realize is this is not something that I can tackle in the primary care setting. I knew I will never successfully be able to do everything that's needed, right? Like, have you seen that where you're like, I just can't do this in primary care? And like you said, it's a total shift when you bring it up and like, you know, I would, I would, I would let them bring it up because a lot of the times they would, if they wanted to discuss it, they would. And that's, that's almost where that you're not going to get onto me about my weight. And I'm like, And that's when I would say, I mean, do you want to discuss it? We'll definitely discuss it. But yeah, it's in, like you said, now that I'm more, or completely obesity management focused, we can get into those tough conversations or not, not even tough, but sometimes, sometimes long, sometimes not, but, it's different because they made an appointment with you for that issue. And so your mindset going in as a provider knows, like, they want my help. It's okay to ask the tough questions. This conversation might be a little hard, but I, it definitely takes a little burden off me, I think, and the patient to do it in a, in a, in a specialty practice versus primary care where you talk about their blood pressure and high blood and their diabetes and you mentioned weight and it brings up trauma. Yeah, I think for a lot of people, from, you know, when they were eight and ten years old. So, I've really enjoyed being able to be a little free and dig in and, and, and help people because like I said, when they come to you or come to me or your clinic, they're there for a specific reason and we can, we can address it head on as, you know, from a more specialized approach. Yeah. Yeah. And I find that just like you said, when they're bringing it up, like they're also receptive to what's being said verse if, if we brought it up and they never wanted to talk about it and everyone's always bringing it up in a way that's really causing a lot of shame and, and bias and things like that. They're not open to what's being said. 100 percent shut off. Don't have, don't want to hear anything verse. I feel like visits are pretty darn productive because everyone's like, let's figure out the next thing. When did we, when did anyone ever come into primary care? Like I'm ready for this. It was almost like bringing them along. Yeah, never, never, you know, the only thing I can compare it to is like people come to obesity management practice and wanting to treat it is like. People coming into primary care for anxiety or depression. Like they were really excited. They're in a bad state, but they're really excited to figure it out and they want to talk and they want answers. And that's, that's the only probably disease state that I can almost compare it to because, people, people want to feel better and they want to be healthier and they won't change. And it's, It's like I said, it's like freeing as a provider, you know, yeah, yeah, I think the other thing with primary care that I really struggled with was, okay, let's say you get someone that they do come in, I hear this from my patients all the time that they actually tried to talk to their doctor. And we, we, as weight management people, like we can't take everyone on, like, we know that like, there's not enough of us that we, the facts. But what's interesting is I, cause I tried actually to not exit primary care and to, I made handouts. I would recommend podcasts. I was doing a lot behind the scenes to try to support, I'm going to help them. I would tell them, Hey, send me a message at this week. I was trying to do all the things. I would recommend these programs. Like, I believed in it so much. And what I realized was the level of support that people needed, it would far outpace either what me, my admin or what the organization at a whole, I was at a really big organization. And I even asked them, like I went to them and I was like, Hey, you've got this weight management program. Can we do this? Can we do that? And no, no, no, no, no. All over the place. And what I realized, and this is the same with me and your clinic set up, like we have, there's dietician help. There's this, there's that. Like, I don't think that people know when they're going into this, how complex it is, the level of help that they're going to need and how much help they're going to need and how often. And so did you ever have patients like that where you were like, look, I can help you with this, but here's what it's going to take. Were you able to have those conversations in primary care? Rarely. Yeah. Rarely. I'll just say that. But Because yeah, you know, I, I worked at a private practice. It was smaller, it was me, a PA and two MDs. That was pretty much it. And, of course you can refer to dietary, you can, you know, do this, do that. But at the end of the day, I couldn't oversee the way I wanted to. The only time I could say that I did have those, the time to do that was when my TikTok started blowing up and I started getting patients just coming to me for weight management. Yeah, before I got out of primary care because, I think it was from one of your TikToks. Correct me if I'm wrong. There's like 1600 obesity specialist MDs in the country. There's like a few thousand and the problem is it's and that's like all specialties are in there. So there might be like, like I'll give you an example of my, at the same time I certified my friend who's a dermatologist at her obesity medicine boards. Well, she's a dermatologist she's not practicing obesity medicine. And so even though there are. It's less than 10, 000. I know that for sure, but it's like not a lot, right? So a crazy small amount. And I can tell you in my town in Kentucky, there are zero. Probably the closest would be like probably Louisville or Lexington. I would assume that they have Vanderbilt, you know, big city. So like providers that really want to focus on it, I had to do the education myself the CMEs and reach out and like, you know, do read the studies and look deep into it because, and that's the only way that people can learn about it because a lot of primary care is not that they're not trained on it. It's just we're, I don't know school, but we didn't learn a ton about it. And so no one does. No one does like, well, we're kind of the same time with training, but no one learns this stuff. You bring up a good point, which is I don't think people understand that if you've got a primary care doctor, that's willing to go do all the extra training and cares about it. Awesome. But a lot of people either don't have the bandwidth. I mean, they're already busy to begin with. Then it, it's really one of those things, I don't know if you had this experience, but like before I read the studies and before I did additional training, I just didn't understand the disease state. I understood, okay, this is active, it's a problem. No one can really lose it and keep it off. But I didn't understand truly less than one out of 20 can do this over 10%. I didn't really, you know, and when you know the number, then it decreases so much. When you talk to patients, they're shamed because they say, oh. That one person that has a program that keeps selling that supplement, like they're the only one, but no one else could do that. It really, it helps to understand. And then also like what the studies show and not just kind of talking out your arse, but like really knowing what it is. And I think that everyone doesn't have the time for that. And so then they get the answer of, Oh, I'm not going to write it because your blood sugar isn't up or something like that, which is like totally not an indication. So, I mean, you know, in the grand scheme of things, it doesn't have to be there. Yeah, you're absolutely correct. And it's just, it's so complex. And that's like, I became fascinated with it, honestly. And like, I was like, Whoa, when I started looking at the numbers, like you're talking about, I was like, okay, so this is way bigger. Like, even that I like, I'm embarrassed to admit that I thought it was so simple at first. I mean, I have struggled with weight in the past, but like, if I really try, I can probably I can have some success, but it. it comes back. So then I started looking at myself and I was like, wait a minute, it was even hard for me. And then I started looking more into the actual science. I was like, wait a minute, it's hard for everybody. Like what the hell? And, but yeah, I just became fascinated. And so like, I spend my time at home reading random studies and looking into random things. And, but to your point, some people don't have that bandwidth. Some people, once they're done with work, they're like, I don't care about this. I want to watch TV. But, it was just, I just became fascinated with it. And, but there's a lot of primary carers that don't have time for that. And they're. Burnout. I mean, burnout's huge in primary care. I'm sure you know that. Yeah. Yeah. It just, it's really hard. So, I think this has been just an awesome conversation because I think that people can hopefully hear that if you're seeing a, I mean, I just want to put it out there that if you're seeing a primary care doctor, And you feel like they're not supportive in this. They literally might not have the education, so they're just the wrong person to steer you. If they are absolutely amazing, you have a gem, hold on to them for dear life, right? But what do you think you would say to those people that are kind of out there searching for help? What words of wisdom would you, would you give them or like hope to keep going to find someone. There are obesity management specialist MDs, I mean, they're specially trained in that. Of course, you know, I know you've made videos on how to find that, but there are people that care. There are people that do have that education, for people with, congestive heart failure, AFib, or Hashimoto's, you know, you, you look for an endocrinologist or a cardiologist. There are versions of that for you, and obesity is a very complex chronic medical condition that, that sometimes probably More often than not would, require specialized care and, people, there are providers out there that are well versed in that that do care. And, there is hope, just seek out whether it be, you know, on social media or other places, seek out options because, you don't have to white knuckle it your whole life. And, Yeah, there's people that care and want to help you out there and have the education to do so. Yeah, you don't need to white knuckle it. And I want to say one last thing, you know, how you were talking about, you're like, wait, I looked at my own experience. I was like, wait, but I put the weight back on. So I thought again, this was like years ago before really learning about the meds. I was like, but I can do this on my own, you know? And I was like, and then I did the math when I took my obesity medicine board certification. I was like, Like, but shit, I'm following the pattern all the patients do with the percentage loss and where I hit the wall and everybody that ever has come in to me, like they can lose some, but then they hit the wall and that's the 10, 15%. And it was just so fascinating. I was like, I'm like every other patient, I surrender. I have a doctor, you know, so it's just. No, it's just fascinating. So, okay. Thank you for sharing that. All right. Now, now tell us where can people find you on social? How can they find you? I know you see different, different states and you're in a different clinic. Like tell us all of that so people can find you. Yeah, absolutely. So like I said, I got started on social media. It's bourbon rx, that's on tick tock. Most of my stuff is there. I'm talking about GLP ones and insurance and the shortages and whatever. I try to stay in the know on that, but. As far as seeing me as a provider, I work with IVM Health, IVIM Health. We're a telemed provider. I personally do the South mostly. So Kentucky, South Carolina, Virginia, Oklahoma for the, for the most part, I branch out a little bit. So we'll make sure to put the links to everything. Thank you so much for everybody for listening. We're talking at an evening. We've both seen patients all day. So I want to say so much for having come on today and talk with us. It's an absolute pleasure.