Pediatric Care for the Heart, Mind, and Body

Interview with Dr. Julia Getzelman, founder of GetzWell Pediatrics, on her commitment to bringing pediatric functional medicine to San Francisco

This Article Originally Appeared on Natural Resources

By Lee Burgess, President, Natural Resources Board of Directors

Welcome to the “Listen and Learn” Interview Series…part of Natural Resources “It Takes a Village” Fundraising & Awareness Campaign

The turnstyle type of medicine practiced in most pediatric offices across the country wasn’t  Dr. Julia Getzelman’s cup of tea. It actually rocked her to her core. 

She was determined to change the system and practice medicine in a way that was different. That was based on relationships and felt like a family, a community… That became a “village” of support for families, like we used to have in a different time in our culture and human history. 

Dr. Getzelman leaned into her passion for functional medicine and founded GetzWell Pediatrics — and this style of pediatric care has been a game changer for many parents in San Francisco. We are so happy she’s with us today to share more about her practice. 

In this episode, we discuss: 

  • Julia’s background, work and creation of Getzwell. 
  • How Getzwell is different from other pediatrican’s offices.
  • Recommendations for parents thinking about the health of their children.
  • The importance of gut health for children.
  • Managing our children’s health during COVID.
  • Three things new and expecting families should know.
  • How to connect with Julia and Getzwell.

Lee Burgess: Welcome to the Natural Resources It Takes a Village interview series. We are speaking to contributing members of the parenting and birth community here in the San Francisco bay area. Thank you so much for being with us and for supporting Natural Resources as a community non-profit supporting new and expecting families. My name is Lee Burgess and I am the president of the board of directors at Natural Resources. 

Today it is my pleasure to introduce Dr. Julia Getzelman, pediatrician and founder of Getzwell Pediatrics in San Francisco. Julia, thank you so much for joining us today.

Julia Getzelman: Thank you for having me.

Lee Burgess: To get things kicked off, could you share a little bit more about yourself and what drove you to start GetzWell pediatrics in 2008?

Julia Getzelman: I think like a lot of people who go into medicine, we have this sort of image or fantasy for ourselves that a lot of times doesn’t pan out once we get into the real world. So I went from residency to clinic work where we had 10, 15 minutes per patient, per family. 

And after a few years of that turnstile medicine where there wasn’t really time to form relationships and I was always running behind so it was super stressful and I had no control over how the phone was answered or how people were treated or spoken to. So I decided that I needed to create my own space and to form a practice where I would want to take my kids or my family members.

So I wanted to achieve something that felt like the old fashioned doctor, but with all the modern amenities, all the modern tools. And I wanted to provide house calls, particularly for newborns, and I wanted to feel… I wanted people to feel like we were an extended family, or we were an important part of the village, because it really does take… I say this all the time. It does take a village to raise children, and we’re at a time in our culture and in human history where most people don’t live near their families and we don’t live in those communities that support us in raising our kids. 

So that’s a little bit about how and why I founded GetzWell. So we’ve achieved all of that, and we have had many parents over the years say, “Oh my gosh, you really are like family. We’re moving to New York, but one of the top three things that is so sad is leaving GetzWell.” So that warms my heart because that means that what I set out to do I think we’re doing for the most part, so that’s exciting.

Lee Burgess: So is there anything else about GetzWell that’s different from the typical pediatrician’s office?

Julia Getzelman: Yeah, great question. I mean, we’re all traditionally trained. I went to Yale Medical School and did my residency at Children’s Oakland, so we all have great CVs or resumes and very much traditionally trained chops, if you will. 

But one of my passions is functional medicine. There are a number of ways of talking about functional medicine. It’s science-based, it’s Western, but what’s exciting about functional medicine is there’s a focus on prevention and on systems. 

So the way that medicine is taught traditionally is the brain is separate from the heart, is separate from the kidney, so we have all these specialists. We have a gastroenterologist to treat digestive or abdominal complaints. You go to the neurologist if you have what seems to be related to the brain. But it’s almost as though these different specialties don’t interact and don’t communicate.

So with functional medicine, we’re talking about these elaborate systems that connect the organ systems of the body. When I first learned about functional medicine in 2007, it was the beginning of me actually conceptualizing a practice like GetzWell, because it was so exciting to me. 

I remember going to my first conference and the clouds parted and the sun came through and I thought, “I’ve come home. This is what I’ve been waiting for.” 

Because it’s extremely science-based, but it filled a hole for me in terms of how we think about the body and how we think about health. So I’ve brought that sensibility into GetzWell. 

And I think one of the other unique things about functional medicine is that there’s “bench to bedside,” if you will… Taking of information happens very quickly, whereas in traditional medicine, because you’re often dealing with pharmaceuticals, it can take decades before the standard of care changes.

But in functional medicine, if the scientists are saying that eating a rainbow treats overall health, then we should bring that information in immediately because we’re not going to cause any harm by using that information and we might actually do a whole lot of good. 

So there’s an exciting use of the information that comes from the scientific community and bringing it into clinical practice very quickly. So that’s one of the other things that really spoke to me about functional medicine. 

So we all have an appreciation of this underlying paradigm, if you will. So that’s part of, I think, how we distinguish ourselves. But again, we offer longer visits. A typical well-child visit or checkup is an hour, whereas in a traditional practice it might be 12 to 15 minutes. And sometimes an hour doesn’t even feel like enough, which is hard to believe.

But we really enjoy teaching and hearing people’s questions. There aren’t any stupid questions and we want parents to feel really comfortable with us and to be able to express themselves and have time. I don’t know if that answers your question completely, but there is a bigger perspective, I guess, is what I would say. It’s not one thing. It’s not Chinese medicine or homeopathy or… It’s just using the information as it becomes available and utilizing it.

Lee Burgess: So my son and daughter attend your practice and my son dressed up in full costume for his last well-child visit. He was very sure it was a special occasion and came in full costume. 

Lee Burgess: I think a lot of parents right now are focusing on keeping our kids as healthy and strong as we can, especially due to COVID. So how do you recommend parents think about this idea of health and what should we be doing with our healthcare providers and at home to protect our kids as much as possible, not just from COVID, even though that’s at the forefront of everybody’s mind, but other illnesses and viruses that are always circulating?

Julia Getzelman: So health is more than the body working well. Our brains are not separate from our bodies. Our emotions are part of who we are and are part and parcel of our meaning in life, in our health, and certainly that’s one of the beauties of having children is I think they take us back to this heart centered place. So health is love and community and nutrition and sleep and joy and meaning. So I think that’s part of the whole-ism that at GetzWell we try to address. So it’s not just the physical body.

But in terms of the physical body, one really important thing that parents can do is to encourage their kids to eat a rainbow. So the more diversity of plant-based foods, such as vegetables and fruits, that we can get our kids to eat, the greater their intestinal health is going to be. And because most of the immune system resides in the gut, then the immune system is going to be supported by that. 

And of course sleep is super important. So having sleep routines that foster sleep hygiene, as we like to say, but making sure kids get enough sleep. So having a routine around sleep and bedtime is fundamental.

Routine and boundaries and predictability are really important in a developing child, as I’m sure you know. And cuddling and love are super important, and having fun as a family. So I think all of those things are ways that parents can foster health in their kids. And it seems like that’s pretty obvious, but I think we forget that those very basic fundamental parts of a family’s life really are the foundation for health.

Lee Burgess: So you’ve mentioned it a few times in our discussion that you have a special interest in nutrition and intestinal health or gut health and how that contributes to a child’s overall wellbeing. So what do you wish that more new parents knew about gut health and how we should think about it in relation to our children?

Julia Getzelman: Well, one of the things that I think a lot of people don’t realize is that we have a symbiotic relationship with the bugs in our bellies, and that those microbes are in the trillions in our guts. 

And just as an example, an adult has… Three or four pounds of their body weight is comprised of these single celled organisms that help to keep us healthy. So those bugs occupy our intestinal tract, not just to produce poop, but to produce vitamins that are fundamental to our wellbeing. They do help us digest foods. They extract calories from our food. They talk to our immune systems. 

So in the first three years of life, a child’s immune system is learning. If I eat this peanut, am I going to have stomach pains or I’m just going to digest the peanut and have it all be okay. The microbes in our guts help to determine if a child is going to be allergic to peanuts.

So the more that those microbes are diverse and tolerant of the foods that we put in, the more they’re going to say to our immune systems, “It’s okay, chill out. No problem. I can handle the peanut.” 

So the first three years of life are when that all gets set up. The way that we can foster the diversity and the health of those bugs is to potentially not have a C-section, although most of us don’t have control over that. But the C-section deprives the baby of coming through the vaginal canal and being coated with mom’s bugs that nature intended to be there. 

Providing babies breast milk when we can, also has sugars in it that feed the bugs that nature intends to be in the baby’s belly. So whenever we can, we want to support moms in that breastfeeding process. 

And then not being exposed to antibiotics, which can kill the good bugs as well as bad bugs in the first few years of life.

So those are three ways in which we can try to support a healthy belly in the first few years of life. And granted, we don’t have control over all those things, so then there are probiotics to compensate, for example, and those are the things that we get into the weeds in at GetzWell, but hopefully that gives you some of how I begin to think about gut health and… Those first three years are pretty fundamental.

Lee Burgess: What changes after the three years? Is it just that the body doesn’t change at the same rate, your growth slows, or…

Julia Getzelman: Well, the immune system is educated during those three years in large part by the diversity of bugs in the belly, and the biome becomes more stable in those first three years. So it takes a lot more work to impact and change that gut diversity after those three years. It’s just a window when these things get set up.

Lee Burgess: Do you think we’ll have to be more aware of this… Post COVID, I think we’re so sanitized now, in a way… I wouldn’t have considered myself a hyper sanitizer. I was a good hand washer, but I was definitely more of the mom that’s like, “Dust it off, it’s okay.” And then my daughter laid on the sidewalk in San Francisco the other day, and I was like, “No, don’t do that.” I’ve read so many articles on viruses and bugs in the last 18 months. So what’s that balance, I think, as we can maybe hopefully come out of this COVID time? How do we want to think about this hyper clean environment we’ve been living in?

Julia Getzelman: No, that’s a great question, and I think it’s confusing because we don’t even have all the information on COVID. But I think one of the things that we learned during this time is that COVID doesn’t last on surfaces very long. That the transmission is usually airborne and that it would be a rare event for us to to infect ourselves via an object versus walking into a room where a COVID positive super spreader had been singing or something like that. 

And we were already in the US, in the first world, if you will, we were already sort of dealing with something called the hygiene hypothesis, which is that we’re already super sanitized, and is that one of the reasons why we are seeing such high rates of allergies and immune dysregulation in the form of eczema and asthma and other illnesses that historically haven’t plagued kids.

Lee Burgess: So do you think that people will maybe feel like we can settle with sanitizing, or are we all going to just have our hand sanitizers forever now? Am I going to always have my alcohol wipes in my purse?

Julia Getzelman: I think that pre COVID even I would say, “Well, if you live in the city you probably want to take your shoes off before you enter your home,” because you’re bringing in diesel soot and dog poop and God knows what else. But if you’re out in the country and your kid wants to crawl around and eat dirt, like let them eat dirt. That’s where the value is. 

So I don’t know that hand sanitizing is so much the problem. I think it’s more that we need to get our kids outdoors and into nature and allow them to explore plants and mud and things like that.

Lee Burgess: Just be dirty.

Julia Getzelman: Yeah, just be dirty. Exactly.

Lee Burgess: My kids are very good at that. Where did the mud come from? How did it get on that part of your body? Well, we’re asking all of our interviewees as part of this series, what are three things that you would like to share with new or expecting families?

Julia Getzelman: I mean, I think being a new parent for so many of us is obviously super exciting, but also most of us haven’t been around babies or small children, so there’s a lot that is obviously unknown and unpredictable. 

So I think one thing would be to practice your flexibility, because as you know, every time you think you know something, your kid throws you a curveball. So even in the lead up to birth, I think it’s important to have a vision for what you would like, but know that things don’t always go that way. So this notion of being flexible, even as you approach the time that the baby is going to be born, I think could be really helpful, because most of us want things to go a certain way.

And then as I mentioned earlier… Obviously C-section is something that happens emergently in many cases, but we know that the C-section rate is also inflated in terms of where it would be just to protect mom and baby’s health would be at 15% of births, something like that, and in many urban areas, it’s more like 30 or 40%. 

So if you have an opportunity to have that discussion with your obstetrician to try to have a vaginal birth, because the baby does get squeezed and coated, and those processes are important in terms of the baby’s long term health.

And then I think thirdly, again, as I mentioned, breast milk and antibiotics. So again, with this notion that the gut is the foundation for overall health. The other two things that can have a big impact are breast milk, which has, as I mentioned, human milk oligosaccharides, HMOs that don’t exist anywhere else on the planet, only in breast milk. And those human milk oligosaccharides feed the bugs in the baby’s belly. They don’t feed baby. 

Not every woman can breastfeed, not everyone can breastfeed 100%, and that’s okay. But if you would like to and intend to, it’s also, I think a really good idea to potentially connect with a lactation support person that can be on call after you get home from the hospital, because sometimes things come up and our moms and our extended families are not there to help us, unfortunately. And then the antibiotics avoidance if possible in the first few years of life is another way to really set up that belly for long-term health.

Lee Burgess: Well, if anyone listening is interested to learn more about you and your practice…

Julia Getzelman: Getzwell.com is our website and there’s lots of great information there. We have an articles tab where we are very frequently offering information about many of the things that we talked about and more, so I’d invite you to go to getzwell.com. 

And you can call the office and make a meet and greet appointment and spend 15, 20, 30 minutes with us and getting to know us and visiting our beautiful offices and getting more of a sense for who we are and what we represent.

Lee Burgess: Well, thank you so much for your time. I really appreciate it. And thank you all for attending this installment of the It Takes a Village interview series by Natural Resources. You can find this and additional information on our website at naturalresources-sf.com, and we hope you’ll learn more in support. We’ll see you next time.

Julia Getzelman: Thank you, Lee.

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