Dr. Alice Fong is a Naturopathic Doctor specializing in helping clients resolve health issues arising from stress by addressing environmental and physical factors to support optimal health and mental wellbeing.

Dr. Alice Fong, ND, helps hardworking professionals discover the lifestyle and self-care habits to support balanced health and resilience.

In this episode, we talk about:

•     The difference in naturopathic versus allopathic western medical care,
•     How stress affects our cravings, and what foods can provide relief,
•     Ways to create an exercise and mindfulness practice that fits in your busy schedule,
•     How specialized lab testing can unravel mysteries of health and help minimize physical stress,
•     Basic, go-to practices to promote balance and help resolve stress

Dr. Alice is offering a free guide to Fast and Easy Stress Relief on her website:https://www.amourdesoiwellness.com/freeguide

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Watch the episode here:

The Power Of A Holistic Medical Approach To Resolving Stress

I’m so glad you’re with us to join my conversation with Dr. Alice Fong. She’s a Naturopathic Doctor specializing in issues arising from stress and anxiety. She works with her patients online, shares information with corporate teams, and shares the ways, tools and techniques that you can use to support your health, boost your resilience, and become more resistant to stress and anxiety. I know you’re going to get a lot of great information from this talk. Enjoy.

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I’m so excited to have you with me and introduce you to Dr. Alice Fong. Let me tell you a little bit about Dr. Alice. She is a Naturopathic Doctor, also known as the Virtual Stress Doc. She helps busy professionals break free from stress, anxiety, and burnout without having to quit their jobs using a five-step holistic approach. She’s the Founder of Amour de Soi Wellness and her mission is to help people discover self-love and happiness. She speaks around the US and now, I’m sure has been seen around the world to groups, small and large about resolving the negative effects of stress and promoting resilience, sharing information with the public corporations and healthcare providers. This is a message that we are getting out from the more holistic space. It’s felt a little bit more woo to be digging into our emotions and stress and now recognizing how important it is to our holistic wellness.

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Thank you, Dr. Alice, for making time to join me.

Thanks for having me, Susi. It’s a pleasure to be here.

We were comparing notes a few minutes ago about the different places where we’ve lived. You studied at Bastyr University in Seattle, Kenmore in the area. It was something that I was familiar when I was working in Seattle and had the good luck to go to their student clinic. Could you tell our readers who aren’t familiar with the difference between a naturopathic doctor and the MD training? What your experience was like there?

It is a four-year medical program to become a naturopathic doctor. You do have to get your pre-med requirements from an undergraduate program. The first two years of our medical program is relatively similar to conventional medical school. We have to learn our basic sciences, anatomy, physiology, and pathology because we need to be able to diagnose properly. It’s very important for us to be able to address the root cause. It’s in the second year where we diverge and focus on treating the whole person and addressing the root cause rather than putting up a pharmaceutical band-aid on the problem. It’s not that I’m against pharmaceuticals by any means, there’s definitely a time and place in need for it depending on the severity and the condition that you’re dealing with, but I don’t think it should be our go-to response to everything in our first thing that we go to every time.

There are so many other things that we can do, especially with nutrition. It should be the foundation of health. We got to look at that. We put a lot of emphasis on our education on nutrition and lifestyle medicine, prevention, and dealing with stress management. We put a lot of training into counseling and all sorts of tools to help find more natural solutions for people as well as getting to the source of the underlying condition so we can resolve it rather than temporarily suppress the symptoms. Sometimes, that’s necessary if it’s bad, but we want to get to the source of the problem.

That’s an important point for people to be aware of. Prescriptions do have their time in place and they can bring down an acute situation that got someone sidelined so that they can at least be functioning. The trick is to be able to get to the root cause even after we’ve been suppressing some of those symptoms. It’s nice to be working with someone with a more holistic approach before we dwell on pharmaceutical intervention so that we can still see how it’s showing up. I tell people that I’m working with at the body issues requests for only so long and it starts issuing demands. How do you see people showing up or experiencing the impact of stress? Do they come in and they say, “I feel stressed and it’s an emotional situation,” or do you see physical situations that are common on this?

As the doctor, I’m always asking them about their stress levels and what’s going on in their life situation and circumstances. What’s their work situation, what’s their home life situation, their relationship status. All of those things can be stressors in people’s lives. I do usually attract people that are dealing with high levels of stress and anxiety specifically. In stress and anxiety, some people can have stress without anxiety, some people can have anxiety without stress, but I see a lot of it playing out in every similar way physiologically in our bodies.

When people are dealing with prolonged stress, that can manifest in a lot of physical symptoms. I do have a lot of patients that come in. Stress is a big thing, but that’s not necessarily the thing that they came in for. They want to address their migraine, digestive issues or lower their blood pressure. That’s all-important, and stress can be a major contributing factor or even the cause of those conditions. I can do natural things for it. I’ll always address the nutrition lifestyle but we got to manage that stress. That’s got to be key. That’s for a lot of different health conditions.

Even though we’re talking with the doctor, these are general recommendations and experiences. By no means, there any diagnosing or prescribing going on. You need to connect with a doctor in order to do this. Dr. Alice does work online, so you can reach out to her through her website.

This is for educational purposes. I need to interact with you, your case, and understand the situation because it’s almost like figuring out a puzzle like I’m a detective trying to solve a mystery. I need to know what your case is and understand it to be able to resolve it. One solution for one person might work great, but that same solution for another person with the same problem might not work as well. We have to look at lab work, the stressors you’re dealing with in your life, and a lot of different factors so we can get to the source of the issue.

That’s an important thing to recognize too. When people come to see you, talk with you, or meet you online might not understand what kind of an appointment they’re getting into. This isn’t your seven-minute or on a good day, twenty-minute doc visit that you would have with a medical doctor but with the naturopathic doctor. There’s a lot of questions you might not be expecting to have to answer.

It’s a pretty long visit. Usually, most naturopathic doctors’ first visit or 60 to 90 minutes typically. It’s a lot of time because we want to know the full picture and rather than give you a pill and send you on your way, which helps but it doesn’t get to the source of the problems.

Nutrition is an important thing to bring into the conversation. It’s funny I almost struggle with how to talk to it every time because I hate to say diet because diet is a bad angle on it, but it is. It’s the way in which we eat, especially in 2020, with life being exceptionally stressful. In my experience in the numbers that I’ve seen, I was surprised very early on in this time of working from home that people quickly jumped up to working an extra three hours per day on average, which blew my mind. We like to think, “We’re not commuting. Don’t we have more time to cook at home?” I think that our healthy habits have slipped over in 2020. What are some issues or commonalities that you see in the way that people are eating that are making them more susceptible to having issues with stress?

As far as nutrition, I’m in the same boat as you. I don’t use the word diet because, in people’s minds, they associate it with a temporary thing. “I’ll do this diet temporarily, then once I’m done, I’ll get back to eating how I want to eat.” That doesn’t work because it’s all about long-term solutions and developing that. What you put in your body makes a huge difference in how you feel and how you function. I didn’t know that statistic about people working three hours more, but I was wondering in my brain is that because there’s a lot of stay-at-home parents, so they’re not as productive with their work. They end up having to work away later into the night because they’re trying to homeschool and deal with that. Maybe that might be part of it. That might be a huge aspect that is hugely stressful. One of the things I always say and I tell a lot to all my patients is that we can’t change the stressors in our life but we can change how we respond to stress and learn to respond in a healthier way. There are so many tools that we can do, and one of those is what we put in our bodies and what we eat.

Nutritionally, it is common and normal when we’re stressed to go to the junk and the processed foods, something quick and convenient. There’s a lot of negative health impacts as well as that doesn’t help your stress situation because of the sugar and the processed foods. They make you crave more sugar and more processed foods. It’s this vicious cycle that doesn’t support your normal healthy gut flora. There’s a lot of negative health impacts from that. It’s like this vicious cycle that doesn’t relieve your stress, it’s a coping mechanism temporarily but not a healthy one to do. It’s okay to do it once in a while to want to make you feel bad or wrong if you’re eating terribly, but it’s like, “What can we do to slowly implement some vegetables in the diet?” Maybe those are your go-to snacks when you’re stressed. Filling your fridge with quality foods that are whole non-processed foods. That’s important not surrounding yourself.

For me, I’m guilty of falling off the wagon all the time. If it’s in my presence, if there’s a box of cookies in the house, they will be eaten. I cannot bring them into the house because they will be destroyed. It’s creating an environment that supports those healthy habits and having a supportive network, hopefully, your family. If it’s not your family, you’ve got to seek support outside of your family. If it’s the doctor, a weight loss support group, coach, or whatever that might be. It’s looking at what else you can do to help set you up for success.

Thank you for speaking to that because I’m the same way. I’m infamous for having a sweet tooth amongst my friends. I try not to bring it into the house. If I do, I know that’s where I’m going to be for that week. I need to bring some other alternatives in with it to try to stretch it out or portion it out into serving and keep the rest in the freezer. There are ways. When we’re honest with ourselves and recognize like, “I’m comfort eating right now,” rather than letting it be the habit and not having the awareness to say, “I could do better for myself. I deserve to do better for myself.” No one else is going to take that stance. It’s up to us.

It’s reframing a mindset thing too. You think in your brain that like, “If I go get a take out, it will be faster than me prepping a whole meal.” If you think about time-wise, if you spent an hour or two prepping ten meals over the weekend, so then you grab a meal from your fridge and go. That’s way faster than hopping in your car, getting sent take-out or fast food, and coming back home. You would save more time in that sense if you plan it correctly.

I’m making a movement for meal prep or that kind of attention to what you’re going to eat for the week being. That’s a form of self-care that makes more sense to you.

I need to do that because when I don’t, I will do what I feel like eating. It’s not always good. When you’re to the store, you’re hungry, and you’re like, “These cookies sound delicious or this pizza sounds fantastic.”

Stress spikes those cravings for exactly the foods that aren’t going to nourish us. I have been there and can relate to that. What else do you recommend to your patients? Exercise can be hard too. Inertia is a hard force to change. Are there ways in which you encourage them to keep on building or moving in the right direction?

People know what they need to do, but they struggle with the doing of what they know what to do. This is what I see all the time. That’s why I do the mindfulness mindset piece in my program because that’s so important and doing the things you know to do. For exercise, one of my recommendations is if you’re not doing any right now, start small to not set yourself to make it seem an overwhelming task. I’ll be honest, I’ll share from my own experience, I’m a busy person. I went into stress because I’ve often dealt with stress in my life and anxiety I’ve dealt with. I’ve learned a lot of tools along the way, but I used to be that person that was like, “I don’t have time to work out. I don’t have time to meal prep. I’m too busy. I got all these things I got to get done.” I had a crazy busy schedule but I decided to get in the habit of starting small. I would work out for ten minutes a day. A quick home workout, seven-minute workout app is great. I would meditate for five minutes a day. I used to be like, “I don’t have the time.”

When I did that regularly for three weeks solid, I was way more productive and more focused. I got way more done. I performed at a higher level. I had better energy. I felt good, but then when I fell off the wagon, this was around Thanksgiving, that’ll happen. I noticed a huge drop in my mood. I was depressed for no reason. I didn’t understand why. I was like, “I stopped doing my healthy habits, meditating, and exercise.” I know for me, I used to put it as a lower priority because I was like, “These work and deadlines are way more important.” Now, I feel like I got to put myself first and that includes my well-being. Exercise, sleeping, meditating, my eating, all of those things are my priority. Now, I work out 4 or 5 days a week for an hour and I’m like, “Everything can wait.” I will get more done if I exercise first versus waiting until the end of the day and like, “If I have time, maybe I’ll get a workout in,” because you will probably feel like, “I’m too tired. I can’t do it.”

You have to trick your brain a little bit. Don’t think you have to spend an hour every day when you do a workout. Maybe it’s a five-minute workout. You can do 20 pushups and 20 sit-ups. That’s a few minutes. That’s a start, then when you feel comfortable and you’re consistent with that, you can try to build up from there or you get to ten minutes. Doing some activity will get you an energy boost and help you manage your stress, feel more focused, and productive. You got to slow down sometimes to be able to speed up.

I’m all on board with everything we’ve talked about so far but that’s twelve minutes. I’m not a math whiz, but the 7-minute app is a big thumbs up in my book as well and 5 to 12 minutes to meditate. If we don’t deserve that time for ourselves, how can we be showing up and serving the work to people that we want to in our lives? We deserve to make ourselves and our well-being a priority.

Those are productive things. Somehow, you have time to scroll on your social media app for several minutes or get sucked into a YouTube black hole. You got to be straight and authentic with yourself when you’re making the excuses, “I don’t have time.” If you make it a priority, you can make the time for it.

It’s one of those things that’s a little sneaky, so I love that you had that experience that when you let that habit slip, you recognize what is missing. Where did my focus go? It doesn’t make sense that carving out that time to not “be productive” is going to help you, but it does. It makes such a big difference. It boosts your mood and improves your focus. It helps your brain be more clear. All of those impacts are so supportive. If any more justification is needed, then that little improvement and clarity is definitely worthwhile. You mentioned briefly sleep too. That’s what I hear the most often that people struggle with. In addition to I wish there was more time in the day, but to your point, what are we doing with our time? Many people struggle with sleep. Are there some things that you find are supportive in particular for the patients that you’ve recommended or heard work for them?

I always talk about creating a sleep routine and healthy habits around your sleep because that’s going to promote quality and developing mindfulness practices to have a better sleep so you can train your body to relax and settle down for bed. I always see the racing brain all the time and they’re like, “Go.” They have a bad sleep and they wake up feeling crappy, and it’s like, “Go,” then they’re slowly getting depleted over time, not that productive, and focused. They’re a frazzled mess. I went to med school and I had to learn this lesson the hard way. I was in my second quarter of med school on my first year, I had nine finals and I was always thinking, “You have to get out of that mindset. I got to do as much as possible to be able to do the best that I can,” but sometimes sleep is a bigger priority. That second quarter I would get four hours of sleep at night. I’d survive off Rockstar Energy Drinks thinking I got to study as much as possible, cram as much knowledge into my brain because I got nine finals.

What ended up happening was that I didn’t do that great on my finals. I got sick for a week after and spent the whole spring break in bed. It made me realize that it wasn’t me studying late into the night when my brain’s not functioning that well. It’s not very productive. It would be more productive for me and my performance if I got to sleep. The next quarter, I prioritize sleep to make sure that it was essential. No studying past 10:00 PM. That’s a deal-breaker and that’s what I decided. I’d eat well, meditate, all the things to support my well-being. I did infinitely better on my finals and finished out the school year strong. I learned and it’s like, “I got to take care of me for me to get the results that I want.” It’s not about doing as much as possible. It’s about being efficient with your time and sleeping is super important.

One of the things that I do is use sleep music. I get my brain into a nice, relaxed state. I turn it on. It’s playing in the background. I meditate regularly. I try to go to bed consistently and shut down my devices. I’m guilty sometimes. I’m not so great at that. It’s hard, but I’m usually a pretty good sleeper. I have a Fitbit watch, the Versa. That helps track my sleep. I usually score in the high 80s, thankfully. Although my partner, he’s not a great sleeper so he can mess my score. I’m helping him improve his sleep by getting him more into meditation.

The other thing I do, I’m not that great at but another recommendation that I’ve heard and I’ve tried, I’m not consistent, was doing the aromatherapy diffuser because the oligo factory response is you smell it and that triggers your brain to get ready for sleep. I have the six-step breathing exercise on my YouTube channel that I recommend to help your body quickly start into that parasympathetic nervous system. That’s one of the things I recommend for my patients as well. There’s a lot of things you can do, but the hard thing is building that habit and the routine.

I’m going to try to find that video because I think that breathwork is so powerful. Thanks for sharing that. That sounds an exciting one to check out. The bedtime ritual is super supportive. People think of drinking chamomile tea but don’t think of it as an essential oil. Lavender doesn’t appeal to everyone and Roman chamomile almost smells like apples to me. You mentioned in a way that you can assess your patients through your intake, asking them questions, and rating how they feel stress is showing up in their life but also the labs that you have available, which I think is so interesting because these are different from what people are seeing come back from standard medical practitioners. What do you get to work within that regard?

I order specialty functional medicine labs and they are very different than your basic lab work. Basic blood work, people can go in especially if they’re younger like in their 20s or 30s, most of the time their blood work is perfectly normal. They don’t say anything of significance unless you got something significant that you should know about, which is good. It’s good to get your basic blood work, but you can get your basic blood work and come back perfectly normal, but you still feel crappy, tired, and stressed. That doesn’t help with that. The labs that I look at specifically are addressing how to optimize your body and mind. Some of the things I look at are food sensitivities, which hugely impact your mood, energy, and all sorts of other functions in your body.

I call it sensitivities rather than allergies because usually, when people think of food allergies, they’re thinking of the IgG reaction, which is the anaphylaxis type of reaction. Most people usually know if they had those reactions because the onset is childhood typically. They have a life-threatening situation where their throat might swell up and they need an EpiPen to resolve the NFL hectic reaction. Usually, people know if they have those reactions, but there are these other types of reactions called IgG reactions which are delayed reactions. They can develop later in adulthood, and because they’re delayed, they’re harder to figure out because something you made three days ago could be affecting you now. It’s not necessarily life-threatening situations that they’re putting you in but it’s causing you disruption and the quality of your life, like digestive issues, headaches, fatigue, migraines, immune function, heart health, all of those things can make a difference in what you put in your body.

I look at food sensitivities through blood testing. I look at hormones and neurotransmitters because that hugely impacts your mood and your cognitive functioning. That’s helpful for people dealing with stress and anxiety, as well as adrenal functioning testing, which is your adrenals. For those reading, they are your little adrenal glands sitting on top of your kidneys that create your stress hormone called cortisol, which is important for you to have. If you’re overworking your adrenal glands, you’re overworking all this cortisol shooting out, but eventually, your adrenals get tired out and they can only shoot out so much cortisol. They slow down and are not functioning as well as they could be. Doing some adrenal testing is helpful to understand where your stress response is, how healthy or unhealthy it might be.

Another thing I look at is micronutrient testing, which is vitamins, minerals, amino acids, and antioxidants. This is helpful because one of the things I always say is I don’t like it when people are like, “I have this problem. What supplement would you recommend?” I was like, “I don’t know your whole situation. I’m not your doctor. You have to become a patient.” They’re like, “Why can’t you recommend a supplement?” I’m like, “I don’t know what’s going on in your body and the full context of your situation. I’d rather not guess what I think might be helpful. I’d like to look at the blood work and know what your body is deficient in so I can recommend a supplement accordingly to what your body specifically needing.” With anxiety and stress, there could be a lot of deficiencies that are contributing to that. It could be magnesium, which is a common thing. People are like, “Magnesium is great for anxiety.” Maybe your magnesium levels are perfectly fine, but it’s a vitamin D, B12 situation, or something else that we haven’t looked at.

Let’s treat the thing that’s you’re dealing with for your body specifically rather than guessing at it. That’s helpful to get more insight into the body and understanding there’s a lot of variables that impact our stress levels, our mood, and there are labs that can help us identify where we can adjust it. It’s not the only thing. I still recommend you got to work with a professional, whether it’s a therapist or counselor. You’ve got to look at your nutrition. That’s important but that’s a piece of the puzzle that we have in combination with everything else.

It’s so interesting to me too that people start to list off all of the supplements that they’re on because someone said this was good, and this one and they’re on 6 to 8. Some might be completely unnecessary. Some may be hurting more than helping. You don’t know what impact on your health when you’ve got this whole assortment or salad of supplements that you’re taking. I’m an omnivore. I’m not saying everybody has to go vegan in order to be healthy. Everybody’s body is different but if you start with balanced nutrition and address our own unique needs. It’s exciting, too with the way that genetic testing has come along. That can let us know what we might be predisposed to not metabolize well or what have you, but it’s so helpful to know what’s going on and get that current situation assessed in our body. It’s great to see how many different tests are available now. You can get a close look at all the different levers and switches. I’m an old-school soundboard. I’m getting it all dialed in so that you’ve got that good baseline.

A supplement is not necessarily going to resolve the anxiety but it goes back to my whole stance on pharmaceuticals. I don’t want to give you the expectation that this pill will magically solve all your problems. You got to do the deeper work, explore your childhood and your past, and get complete about any traumas you’ve been through because that’s usually at the source of a lot of anxiety too. You got to deal with that. Working with a trained professional rather than trying to figure it out in your head is important.

There’s that busy mind. We can get on that loop and not make any progress. Just keep wearing a groove and then that’s that emotion or mind space that we can get stuck in. That’s not healthy either. I love that you’re bringing the conversation to corporations too. I noticed that they are paying attention. Burnout is becoming so much more common, unfortunately. They’re becoming more aware but the problem is still growing. Are there one or two key tips that you to share with those groups when you’re talking with them in the office space?

I usually do a guided meditation or show him the breathing exercise. Also, think about the things that cause them stress and have an inquiry about the thoughts that they’re having that are stressful for them to notice the thoughts without judgment. The thoughts are going to be there. We can’t necessarily banish the thoughts away. You got to be able to interact with the thoughts in a way that isn’t causing you distress. If you can slow down your breathing so you can give your brain an opportunity to think more critically, you can ask yourself, “Is this worth the stress? Is this thought productive or helpful for what I’m trying to do or accomplish? What’s more important, being right about this situation or having my peace?” That’s another example. Having an inquiry or questioning like, “Is this helpful or productive for me?” Those stressful thoughts will come back. That’s why I always emphasize mindfulness.

Mindfulness has developed the practice of being present in the moment because the thoughts are going to come and go and stress you out. When you can bring your attention back into the present, you can be with the thought, recognize and acknowledge it but let it go, and bring your attention back to the focus, it’s like exercising a muscle. Your brain is the muscle, it’s not actually a muscle, but we’re exercising a muscle. The example I always say is we need to exercise our body to be healthy and fit, but it’s an ongoing thing. You can’t exercise a couple of times and expect to be healthy and fit for the rest of your life. It’s an ongoing thing. It might be challenging, especially when you’re starting a new exercise or a new workout routine. It’s going to be uncomfortable and not easy to start. It will be extra sore, but the more you do it, the easier it gets, the more benefits you’re going to reap. The same goes for mindfulness.

That’s what I always emphasize that I know a lot of people resist, “They’re like, ‘It’s not for me. I don’t like sitting there. I could be doing something else.’” You got to get that it’s going to be uncomfortable and challenging. That’s the point. Learning a new exercise is not easy right off the bat. You’re not a natural swimmer the moment you hit the water. The same goes for meditation. You’ve got to give it a chance. You’ve got to exercise your muscle of developing the practice of getting back into the present moment because again, your mind is going to constantly wander off or stress you out. You got to develop the practice in the muscle of becoming present in the moment so that those thoughts aren’t causing that stress in your body.

There are different exercises that people enjoy and there are different forms of meditation. The first one is you want to climb the wall because you can’t sit still and think about your breath anymore. Try a guided meditation, there are so many available on YouTube. My mother-in-law, I blew her mind when she discovered sleeping meditations. Now, she puts one on every night before she goes to sleep and it’s transformed her rest. Big win all around because we know how important sleep is. Try different times of the day and be willing to give it a try. I find that too that as we keep coming back to that mindfulness practice, it makes it so much easier to get curious about the thoughts that we’re having and to examine. It brings us out of that stress response. It brings us from the amygdala into that more considered thought, the prefrontal cortex, when we’re like, “Why are we so triggered right now? What is going on for me?” It totally changes the outcome.

I love that you’re doing your work and getting the message out there. From my own experience, when I went back and studied science several years ago after not wanting anything to do with it many years ago. How much we’ve learned? I’m excited to see how science is validating some of these old practices and traditions that have worked for thousands of years. I think that you’re right on that line of synergizing all of this. It’s so exciting. Thanks for doing the work that you do.

Thank you for that point. A lot of people think naturopathic doctors don’t like science and it’s the opposite of that. It’s like, “We love science. I love evidence. These things work. What I do work. That’s why I recommend the things that I do.”

In addition to the breathing practice that we’re going to find a link for, you have a little guide that you’re making available to our readers.

That breathing exercise, I have the instructions in my free stress guide, so there’s the written guide but there’s a link to the video in the stress guide. That way, they can access it.

You also host a podcast and interview show yourself.

Yes. HappyTalks.

Thank you so much again for taking the time to join me. I enjoyed our conversation.

Important Links:

• Dr. Alice Fong
• Six-step Breathing Exercise – YouTube
• HappyTalks – Apple Podcasts
• https://www.AmourDeSoiWellness.com/freeguide

About Dr. Alice Fong, ND

Dr. Alice Fong is a naturopathic doctor, known as the “Virtual Stress Doc,” and she helps busy professionals break free from stress, anxiety, and burnout without having to quit their jobs using a 5-step holistic approach.

She is the founder of Amour de Soi Wellness and her mission is to help people discover self-love and happiness. She speaks around the US to groups small and large about resolving the negative effects of stress and promoting resilience, sharing her information with the public, corporations, and healthcare providers.