Integrating wellness into aesthetics, with Dr Mayoni Gooneratne

In this episode of The Cosmetic Cast, we talk to Dr Mayoni Gooneratne, a functional medicine doctor, aesthetic practitioner and former NHS surgeon with a passion for female wellness.

The aesthetics industry is increasingly recognising the importance of a holistic approach that integrates treatments with lifestyle and wellness advice. This approach considers the whole person and seeks to enhance not just physical appearance, but also overall quality of life.

Together with Hamilton Fraser's founder and CEO, Eddie Hooker, and journalist Vicky Eldridge, Dr Gooneratne explores how this fusion of aesthetics and wellness has created opportunities for practitioners to diversify their service offering. Tune in to find out about her journey from aesthetics into functional medicine and how you too can integrate this into your practice.

Dr Mayoni Gooneratne is co-founder of the British College of Functional Medicine and founder of Human Health Clinic, both of which are referred to during this podcast.

For more relevant reading, see our article, ‘Integrating wellness and a holistic approach into your practice’.

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Vicky Eldridge: Welcome to Hamilton Fraser's Cosmetic Cast. My name's Vicky Eldridge and I'm joined today by CEO and founder of Hamilton Fraser, Eddie Hooker. And our guest is Dr Mayoni Gooneratne. She's been a doctor for over 24 years. She's practised in the NHS and now she's focused on functional medicine. She takes an integrative approach to aesthetics and she founded her clinic, Human Health, in 2020. Although she's been working in aesthetics a lot longer than that, but with a focus on mind, body and soul. And we're going to be talking to her today about wellness and functional medicine.

Mayoni, thank you so much for joining us. So we've seen a real synergy now between aesthetics and wellness. Why do you think that is?

Maynoi Gooneratne: Well, I think fundamentally most aesthetic practitioners, ideally, have got a medical clinical background and a significant degree of training. And we come to this space with that hat on primarily. And it's not just ‘do some injectables and get out of there’, I'd like to think on the whole. And it's just a brilliant space in which to engage with people. We generally as a group of professionals love talking and we really enjoy hearing stories and engaging. I know certainly I love knowing about my patients, you know, weddings and their family arrangements and all those things. Yeah, because otherwise what are we doing in this space, you know? And so then inevitably you will end up hearing about their poor sleep or their stress levels or the fact they're having hot flushes.

Because that is normal. That's a conversation with a human being, isn't it? And I think the beauty of what we do is actually, we also have the privilege of the education to help someone, to then take it to the next level. So we don't just listen as a friend, we're listening as a clinician.

Eddie Hooker: But are you seeing more patients, customers, consumers, whatever we want to label them as, that are turning to the aesthetic industry because of issues in the NHS? I mean, I heard a story that for a woman going through menopause or to even be diagnosed as going through perimenopause or the menopause, it takes on average three trips to the GP to get a proper relative diagnosis. Do you think, are you seeing more women turning now to more their friendly clinic salon?

Mayoni Gooneratne: Absolutely and I think just to kind of really bring it to a current point now, I saw a patient today for a discovery call and she told me, and I know her, but we were talking about her health and she told me about the fact that she has expressed the fact she does get suicidal intention for the week running up to her period, she has severe brain fog, and she knows her ADHD is particularly bad around her period. And she was told by her GP to go away and just to have some time out and to think about whether this really, how much it impacted on her.

There was no recognition of any of those symptoms. I mean, just the suicidal ideation is a red flag. I mean, that needs immediate kind of fast-routing.

Eddie Hooker: Is that a lack of training for the GP?

Mayoni Gooneratne: Possibly, but unfortunately this particular GP had also said, had been grumbling about how she was really annoyed about the amount of coverage about the menopause and hormonal changes and was really like, I can't believe the number of patients that I'm seeing now who are talking about hormones.

And that conversation to a woman who's saying to you that she wants to commit suicide for about a week before a period is horrendous. She's clearly got something called PMDD. Therea are specialist pathways that exist for that. The fact that that is not known is worrying. And so going back to your question, absolutely. I think three things have really emerged for me in the landscape of health since COVID.

One is that there's a real treat mentality and not a prevent mentality. I think there is a massive influence of bloggers and you know, people in the kind of biohacking field, which is great. And I think anything that kind of increases the coverage of this is important. But my patients say to me they are overwhelmed. They, you know, how can we have and actually the stats show, how can we have so much knowledge? Yet the rate of disease is unfathomable. Yeah.

How is that possible? So these women are saying, I am so overwhelmed with the data, I don't know where to go. And so they're asking me for advice. And finally, yeah, the NHS is unfortunately not fit for purpose. And we love it, I love it truly deeply. I've worked in it for a long time. I have family members still in it, friends, but it is not doing, able to do what it was set out to do anymore.

Eddie Hooker: And do you think the aesthetic sector is set out to pick up this gap?

Mayoni Gooneratne: I think with the right sort of direction, yes, I wouldn't be doing it otherwise. I think we have to be really careful that we don't, you know, sometimes in aesthetics, we see the kind of jumping on the bandwagon type mentality and they all do a quick overnight course and I can prescribe BHRT and I really, obviously, that makes me feel very anxious because it's not offering the best standards to people who are already vulnerable, people who have already been taken through the hoop, you know, so many times had doors shut in their face and potentially already paid for very expensive tests.

You know, it's, we've got to be able to take this into that space in a very professional and safe way. But yes, in theory, we've got the time, we've got the kind of mindset, we're clinically trained, we've got the structures in place, insurance, CQC, processes and protocols. We're very used to working independently and privately safely.

So there is no reason we shouldn't. I think we need to just really be careful about how it's done.

Eddie Hooker: Absolutely.

Vicky Eldridge: It really enhances what you're doing in terms of aesthetics as well, doesn't it? Because I know you're all about the inside out approach, you know, encompassing body, mind, spirit, you know, all of these things. And we hear all these terms, wellness, functional medicine, lifestyle medicine, biohacking. What comes under this sort of wellness banner? And I think after that let's dive into what this actually means, what all these terms mean.

Eddie Hooker: Especially functional medicine, that's a new one on me and I've been around a long time!

Mayoni Gooneratne: I think you're being a bit harsh!

Yeah, I think it's really interesting and actually I was at a longevity summit last week in Portugal. It's the hardships of the job! And it was fantastic but what was really obvious was that this space is, number one it's exploding but number two there's lots of terminology and words banded around all the time.

I think for the general public it's very confusing. I mean, for us it's confusing. I don't think we can keep up with the rate of this sort of, the terminology, but ultimately, I think whatever we do, we are wanting to potentially increase years on life, but we really want to increase the life within that time that's spent alive in a qualitative way. We want to improve well-gevity, as well as longevity.

We want to make sure that all of our cells are working in their optimal way, not just on a blood test, is this normal or not? Okay, and you’ve got to remember that the NHS, you know, not bashing it, but it's set up for population medicine. It's designed to be functioning on a financial basis as well much as anything else. And we can't help everyone. So a lot of the data that's used for to drive our decision making in the NHS is population based. It's not individual, it's not personalised, it's not looking at that one person. And as much as I am a scientist, I did a long period of research and I understand the value of randomised controlled studies, they are the gold standard for a lot of things. But I think an N equals one study is also really powerful. And I say to patients all the time, you are the N equals one. You know, I can't tell you how your genetics, how your personal life story, how all those things have impacted on your health compared to you, because they're totally different.

Eddie Hooker: Absolutely.

Mayoni Gooneratne: I can tell you, overall what a basic kind of population might have experienced based on PTSD, for example, or a childhood event. But how does that impact on your health? It is going to be individual. And I think that's the bit I love because...

Eddie Hooker: Well, it's the classic, isn't it? It's the classic, you're not alone. You're not the only person going through what you're going through.

Mayoni Gooneratne: Yeah, absolutely. And I think it's wonderful to be able to use the science that exists, beautiful science is being produced all the time now in some really cutting edge lab testing and I kind of always say that I try and then put back in some of the most ancient techniques and tools that we've got in our body, which is actually sleeping really well. It's all the stuff that sort of feels boring, it's like, oh, it's not doing anything. But actually getting people to really look at their sleep and really look at their nutrition, look at how they move their bodies, how do they manage stress, these are all things we kind of take for granted. But actually, let's unpack them properly - who does that with you, you know.

Eddie Hooker: Do you think patients look for the silver bullet

Mayoni Gooneratne: They do, they do, but I think less and less so now, and I make it very clear you know, again this morning I said to this lady you know that's great but I'm not going to be able to give you a magic wand yeah or a silver bullet or anything that's going to take it away and she actually said you know what, I don't want one, no I don't want one because I want to spend some time really understanding what those tests mean and how I'm going to move forward.

And I think the other beautiful thing about women, I mean, I look after women who are perimenopausal and beyond, it's this window where they've, the Japanese call it seasons, don't they? So women are often in their fourth or fifth season by the time they, so they've done it. They've already had four or five ghosts.

Eddie Hooker: Absolutely, yeah.

Mayoni Gooneratne: And they're now evolving and they are actually flourishing. They should be flourishing. Yet there are all these pieces that are kind of tripping them up that they don't know what it means. And actually a lot of the time I just sit and unpack it and help them understand what these signs and symptoms, these are all like red flags, your body's just going, help, this is what this means. And so it's just, you know, functional medicine therefore is understanding the why and not the what. I think I went to medical school, a fantastic medical school, St. George's and we did, you know, Western allopathic medicine, which is fantastic. But it's very much designed to deal with the what, it's like. OK, so you've got brain fog. Right. What can I give you to help you with that? You know, what's the answer? This this lady also had really bad reflux. So she's been, you know, plugged full of anti-acid medication, which unfortunately isn't going to help because it's going to stop the way that her stomach digests, which is going to feed into her celiac disease. So actually, something that was being done to help her reflux is not addressing the root cause. No, no, no. And so functional medicine is really what we call upstream medicine. It's going back as far as we can. And that involves taking a really thorough history from someone, understanding what their genetics are, the story of even their mother's birth, mother's life, so how they were carried, because we understand that maternal stress is going to have a massive impact on the way that our genetics plays out.

Eddie Hooker: What are the challenges the cosmetic aesthetic sector, do you think the challenge is that sector has got in dealing with more of these stories? I think, because I'd love to come and see you, but it could well be...

Vicky Eldridge: I have come to see you!

Mayoni Gooneratne: Thank you…I think, but I think, as I say to my patients, it all sounds overwhelming because everything's connected and when I first started doing this, I remember thinking, oh my God, how am I going to ever help anyone? But actually, because it's all connected, that's the beauty of it, that's why impacting on your sleep is gonna have about a thousand different manifold things. If you change the way you exercise that, you know, and actually all the evidence shows that if there was a pill that was gonna give you the equivalent results of exercise, you'd be a multi, multi trillionaire, you know. It's just a waste of time.

Eddie Hooker: We spoke about that earlier.

Mayoni Gooneratne: It's got so many mechanisms of action. So I think what I'm saying is, you don't need to understand the science all of it. Yes. I think there's a fine balance between just being really gung-ho and just saying, yeah, take this supplement because I get a shed load of free ones from this company. But balancing it with the really basic advice, I think you can talk to patients very knowledgeably about, and I think I've done talk on it, it was called Why It's Not Just The Frown Lines, why do they have them? Are they stressed? Are they seeking?

Eddie Hooker: I've never thought of it.

Mayoni Gooneratne: Are they looking in front, are looking at, and I've seen a lot more actually because of screen-based activity, because these are women I've looked after for eight plus years now, so I've seen their faces and I've seen them now post-Covid, and it's a real frowny thing that they've got going on, and it's specifically these, and I think it is the amount of screen time that they've got to engage with. And possibly really annoying bosses. I don't know.

Eddie Hooker: The reason I ask this question, I worry a little bit sometimes is that, you know, new fads come along. This is not a fad, by the way, but new fads come along into the industry where people think, you know, clinics think, well, here's another way of making some money. But this is a lot deeper. This is a lot more important.

Vicky Eldridge: You invest a lot of time as a practitioner into this. I think I've spoken to yourself and to other doctors who are doing more of the functional medicine or the lifestyle medicine or particularly the menopause care where they're like this isn't just a quick buck you're going to make, you're investing a lot more time into your consultations and people want to be heard don't they, like you were saying often they haven't been heard by their GP - that was my experience, you know, as a perimenopausal woman, not being heard by my GP and then being lucky enough to reach out to people in the sector because I'm in the sector, and then getting that help. But for so many of my friends you know and people they’re just not being heard, but it's a lot of time and investment as a practitioner, isn't it? If you're coming into this space, you're delving much deeper than you are if you're just like, right, okay, you've got this and here's the solution.

Mayoni Gooneratne: Yeah, and you can see, I mean, I know, aesthetics is like all the other kinds of ologies and isms in medicine. You know, it is an end organ that we're treating. And you don't have to go all the way back if you don't want to. You know, there are different scales of kind of interrogation, I suppose, that you can do as a practitioner.

But equally, I think it really enhances that patient's experience and their journey. You've got patients for life. And like I said, this lady that I spoke to today, I've known her for like six years, I've been doing her botox and she's got to this point, I never knew these things about her. I knew she wasn't always happy, but I didn't know about all the details about her. And I feel very privileged that she's opened up to me and told me that. And I think it may not be, so if that was me, it may not be that I'm the one that deals with it. It's important that she sees a specialist that can.

I think also when I set this up, when I set up Human Health - you're absolutely right, I thought, oh god, how is this gonna be scalable? How is this going to be something, am I gonna be able to teach people to do this? And it is tricky, it is an art form, but I think that's why I set up Human Health Affiliates, so that other clinicians could refer in to me. But it's taking time for people to realize that there is no catch, I think. They're kind of a bit like, hmm, I don't want anything to do with the patient aesthetically, I'm never gonna kind of be disloyal, as it were, but I would help them optimize their health and hand them back to that aesthetic practitioner, because there, is sounds awful, but there is not a huge amount of ROI in setting this up from scratch as a practice as an aesthetics clinic, I think, to kind of go into and go, right, I'm going to set up a functional medicine clinic.

It's really hard work. It's not something to just do overnight. And yet it's not got the biggest return at all.

Vicky Eldridge: You just mentioned there about referrals. And I think this is one of the things, isn't it, like operating outside of the scope of your practice, because as Eddie said sometimes something will become a new popular thing and everyone thinks right … I've just spoken about integrating wellness into your practice at the SIAB at Aesthetic Medicine which I know obviously Hamilton Fraser supports as well, and it's a really interesting topic and you were sat there in the audience and it was great to see that but of course people think oh great I can add something else new into my practice but they might also be then going outside of their own scope of practice and that's not necessarily what you want to be doing either is it?

Mayoni Gooneratne: No and I think you know I think we sort of said as well you don't want someone who's maybe say got a pediatric background suddenly deciding to invest in women's health and take that on as their new training. I think it has to feel, it's got to be something that's of interest to you, but also clinically of interest to you. Really, I mean, we can't stipulate these things and aesthetics is kind of renowned for this sort of jumping onto something. But I think if you want to be of true service to your patients, stay within your scope of practice, it's definitely GMC guidance and I'm sure it's GDC and NMC guidance that you do stay within your scope of practice and refer out, refer out if it starts to feel uncomfortable, if yours starts suddenly going. Y

Eddie Hooker: Yeah, I mean, it feels like an enhanced consent discussions or pre treatment. I mean, most practitioners I know will have, they will look at the lifestyle background, what we were talking weight loss injections before and you know a lot of practitioners will do the initial consultation but then that's it. But of course your lifestyle changes and we all love to, as you said, take a pill and we never have to exercise or eat again, you know and it's done. But of course life, people's lives change and for me I always encourage practitioners when from an insurance point of view, to manage risk is to have more and more regular, especially when you're on a series of treatments, a programme so to speak, is to have more of those conversations, which is probably where you've had with that patient this morning, suddenly something's changed or she felt more comfortable talking about something because you've seen her probably once every six months over the last six years.

Eddie Hooker: Talk to me a bit about safeguarding. Is that a challenge you see as practitioners are moving into these new areas? Do you feel, because that came up at the menopause at the seminar, didn't it?

Vicky Eldridge: Particularly in the menopause space, isn't it, within the menopause?

Eddie Hooker: Is that a concern for you looking into the industry?

Mayoni Gooneratne: Yes, absolutely. And I think it's really important, again, it kind of comes back to this sort of area of capacity, you know, within your own skillset, but also things like safeguarding your patients. Are there, why are they having intimate treatments? What are the kind of issues around that? Are they being coerced into it? And the same could be said, I think, even within the wellness space, is it because they're desperate to try and keep hold of their husband? What are the reasons? And I think getting under the skin, so to speak, of all of this is really, really critical for patients and keeping them safe.

And again, I'll be having, you know, I've been recently referred, so it was a 12 year old and that's totally not within my scope of practice, you know, but by their mother and you're looking through the, so I always have a discovery call, I think that's a really important and really useful way of gently introducing yourself to someone without there being any obligation on either side other than, and for you, you're kind of doing your red flag assessments, and the patient's also getting a feel for you because this is a totally different way of doing things.

And yeah, and it was quite obvious that this child had been repeatedly seen. So, you know, you kind of think, okay, well, what's happening here? Are they gonna be over, why are they being over-tested, and why are they not eating? And so you do have to really kind of consider, you do, you wear your medical hat. You know, you are, I'm a doctor first, always.

And I think all the other bits follow, don't they, if you're doing your job properly.

Vicky Eldridge: Do you think your background, you know, your NHS background was what inspired you to branch off as early as you did into this area? Because I know everybody's interested in it now. But when you set up your clinic, you always had that hat on of that it was more than just skin. But when you set up Human Health, that was, I guess, ahead of the curve, what was it that inspired you to do that? And do you think your own sort of background in the NHS influenced that at all?

Mayoni Gooneratne: Do you know what? I was desperately sad when I left the NHS. I was so sad because all I'd ever wanted to do was be a doctor from about the age of nine. My mum remembers me clearly saying that. But that whole time was really quite traumatic. They call it moral injury now actually post-COVID because clinicians, doctors were being asked to do things that they really clinically knew was not the right thing, but they had to. And that's how I felt. And that's great that there's a word for it now, a phrase for it. And that was daily, daily trauma and it was quite stressful, you know, and I think you really have to factor that in.

So when I left, I never thought, I really never thought I'd be doing something that was basically taking all of my negative experiences and totally turning them on their head. All I remember when I set up my aesthetics clinic was, I just thought I just don't want my patients to have the struggles that my NHS wants to do. I don't want them to struggle to get through to reception. I want them to be able to book in online. I went on to a digital system straight away. I didn't have any paper because I just thought I've been there in clinic where no one can find Mrs X's notes because they're that big. But there's I'm the first person to see and I've got no idea what's going on. I just thought it's so bad. Let's just take all the negatives and instead of sitting there getting more depressed about it, let's really turn it on its head and make it something that's a brilliant experience. And yes, I'm you know, it's not perfect. But I do keep, we keep refining it. And a lot of what we do now, my clinic is now virtually online entirely, I'm just actually looking whether I need a bricks and mortar practice for my Human Health work, you know, and I do need CQC. I quite like to hit the bloods myself because I know they've been done properly, it's a control freak in me.

But there are other services that do that. But you know, but I'm actually looking at other potential services that could do that. So I could be completely online. But that's only happened through learning and COVID was a brilliant learning experience because suddenly I had to go from being a payroll of 10 people to furloughing, looking after people. I had one person who just missed furlough, but she stayed on payroll and then I've now got people who work for me remotely, I've got my user service that delivers skin care for me remotely and now my supplements remotely as well. So I've just had to keep taking all of the negatives I think, all of the clunkiness and all the barriers that really drove me mental as a clinician to change how I do things.

Eddie Hooker: And focus on the end user.

Mayoni Gooneratne: And the good stuff.

Eddie Hooker: Yeah, that's the most important thing.

What do practitioners need to keep in mind if they want to enter into this space?

Mayoni Gooneratne: I think we've touched on the things about background and training but on a really positive note, keep it close to something you love. You know, I'm about to do my meditation training in a couple of weeks because I personally have a meditation practice and I thought, and I bring it into all of my group programmes and people love it. And I would never dedicate time for something now that I don't love – why would you? You know, time is our biggest commodity.

So if you're going to go away and train and spend probably a lot of money on something, do something you love. Do something, I think that's the brilliant thing about the aesthetic space is that we've got the privilege of taking it into any direction that we keep our patient in mind, but also us. You know, it's that whole thing about Dr. Heal Thyself first. If we're not happy, we're just doing things to tick boxes patients know about it. And I think you know, if you are offering something that you are passionate about, it feels authentic, it feels like something that's really true to who you are.

Eddie Hooker: I say the same too when I do my talks. I always say, what is the driver? What is your you need to sit down as a practitioner, certainly if you're coming out of the NHS, or thinking of what is the driver for you doing this? Because there's lots of other ways of making money if it's purely about money. And if you don't enjoy it, you're not passionate about it. You're never ever going to truly deliver what you think is in your mind. You know, if you're going to set up a new business, yes, you've got to be passionate also about what you're doing, but all of the other bits around it. It's hard work. I  mean you have 10 people as you said, and then COVID hits and you're, you know, you've got to be able to deal with all of those things but what keeps you there is your passion for it.

Mayoni Gooneratne: It is and they honestly, there have been times in the last couple of years, I think COVID was one set of problems but the post COVID era is like totally different set of problems and there have been days when I've literally just gone, oh dear, and it sounds awful, it is my patients, I literally just can't tell Mrs X I'm not coming in today, I just can't do that to her. Again it's a… It's a hat that we are not comfortable wearing as clinicians.

Vicky Eldridge: Exactly what you do at ABC.

Mayoni Gooneratne: It's the money chat, the business plan. You know, if you'd asked me X number of years ago to put together a business case for introducing wellness, I would have just gone, oh, it's fine. I quite like it. I can't do it. And now I'm like, nothing gets into my business without a business plan. Me bouncing it off, usually my husband, who’s my biggest advocate, but also my sort of most sensible set of ears is just like, do you really need another thing? And then I have to kind of get it past him. And then he's like, yeah, that's probably quite good, actually. And I'm like, well, we can do that. But you need to have a business case, you need to know your numbers. Do not go through that pain of then introducing the next best, shiniest, flashiest machine, process member of staff, if they can't pay for themselves.

Eddie Hooker: Absolutely.

Mayoni Gooneratne: You have to pay yourself. So, you know, are you paying yourself and are you able to put a really good case together for why you're introducing it?

Eddie Hooker: Too many, there's too many other things people think about because they are passionate about what they do and we see it with even on the insurance side. We can insure some of these more intimate treatments, but not as standard, you know, so we'll do the toxin on the face or we'll do hyperhidrosis or we'll do, you know, upper body. But once you go into the more intimate areas, the last thing practitioners think about, oh, I need to change my insurance. Oh, I'm covered for that. Well, you're not. And it's having those conversations and thinking, as you say, you know, not just about the machinery and the the potions and the drugs that you might have to buy. But actually, are you protecting yourself if anything goes wrong?

I mean, this industry is very, very intimate, if I can call it that, you know, me sitting with you, you know, and you can build a business over years and five minutes, an allegation of sexual misconduct or you touched me in an area which I wasn't prepared for and, you know, these sorts of things can ruin one reputation, but financially.

So I caution practitioners, think about everything that you're doing and talk to people. You've got your husband. Fantastic. I've got a board of directors here. And if I want to introduce something to Hamilton Fraser, you know, I might think it's right. But someone might say, have you thought about that? You know, very important that practitioners think about that.

Vicky Eldridge: That was one of the reasons that when you've been involved in, say, at the British College of Functional Medicine as well, haven't you? And that's giving a support to practitioners who are coming into this area.

Mayoni Gooneratne: So that came about because when I discovered functional medicine, I kind of thought, my God, this is it. This is like, this is the medicine I've been waiting for. I think actually I've stolen that quote from one of my patients. He said to me, this is the medicine I've been waiting for. And I just thought, she's right.

Eddie Hooker: Put that at the bottom of your list.

Mayoni Gooneratne: Yeah, this is the medicine you've been waiting for. And it's brilliant. So I then kind of busily did some training and was like trying to find other doctors like me. And I just realized it's quite, it's had a murky past in the UK. And I think it's been thrown out of court quite a few times, literally sometimes, but because it's quite misunderstood, I think. And actually I found one of my colleagues who is a GP and she's one of the longest serving GPs, Indra. And she is my co-founder for the British College of Functional Medicine. I said, go on, you do it, you be president, I'll be vice president. And she said, okay. So she's done it and I've helped her. But it's brilliant because it's a safe space, for doctors specifically to really practice FM. And when we kind of, you know, it can be, it can ruffle a few feathers because people are kind of like, well, I'm not a doctor, why are you so exclusive? Why are you doctors so exclusive? And I'm like, actually, we're really late to the party.

We should have been in this space a long time ago, and actually we've got specific needs, CQC, you know, GMC regulations, where do we get our appraisals done, and insurance. So there are practical, logistical, and legal aspects to what we do, which is not covered by any of the other bodies around there. There are many bodies that help FM practitioners but not FM doctors and so that's really why we exist.

Eddie Hooker: So where can people find out more? Is the association open to membership? Are you looking to expand it? Can they join on your website?

Mayoni Gooneratne: Absolutely all of those things. All of the above. We have got a membership, we've got a fantastic board and we sit monthly but we've also got monthly meetings, which are usually online because that's what our members have asked for.

Eddie Hooker: Wonderful, yeah.

Mayoni Gooneratne: Workshops, we bring cases to it, we change what we talk about, we cover the legal aspects and insurance and all these things as well and we are meeting in a couple of weeks at the Integrative and Personalised Medicine Conference which is, it's been curated by the College of Medicine which was also set up by another kind of real visionary Dr Dixon who actually is the King's doctor, that's not private knowledge. Just checking. But he's, and he is wonderful. And we approached him a couple of years ago and went, I think you're doing this, what do you think? And he's just one of those guys who went, yeah, great, why don't you have a stand next year? So he's supported us from the beginning and we are gonna be there again this year with the hope that one day we'll have our own conference and series of talks and stuff.

But we are very much there for the practitioner, for the doctor who wants to practise. Within the NHS, FM is still not kind of the thing to do, but we know it is, and we know that there is a movement towards this. The GMC are supporting what we want to do. So we're really hoping that this is the beginning of the change, and that then we would be a resource for patients, eventually the aim is to have a kind of a place that patients could go to find an FM registered doctor.

And equally, we want to try and create change within the NHS at medical school level, because where does this start? We kind of actually learned all this stuff at medical school. That's the thing we learned about the Krebs cycle and detox pathways and kidney and metabolic acidosis. And then promptly we're told to go out and get Mrs. Smith out of bed and home.

It's a very different attitude to it, so yeah, that's all right.

Eddie Hooker: Fantastic. Thank you. Lovely discussion, and thank you.

Mayoni Gooneratne: Thanks for having me.

Eddie Hooker: No, no, thank you for being open and giving us the benefit of all those years' experience, but also talking very much about where you see FM going in the future and what to look out for if you're a practitioner and actually where to go to get more information.

Mayoni Gooneratne: Yeah, fantastic.

Vicky Eldridge: Thank you.

Eddie Hooker: Thank you so much.

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