Barry Rotman, MD

More Than Medicine: Inside Banner Peak Health’s Community-Driven “Outperform” Concept

Most people think being healthy means not being sick. This limited view constrains how we approach our well-being and what we believe is possible.

At Banner Peak Health, we’ve developed a philosophy that shatters this traditional mindset. We call it “Outperform.”

Redefining Health Beyond Disease

We define medicine 2.0 as medical care that treats existing disease. When you’re sick, you see a doctor, get treatment, and return to “normal.” Health in this system means the absence of disease, nothing more.

Medicine 3.0 takes the next step: preventing disease before it occurs. We screen, test, and identify risk factors. This approach, which forms the foundation of concierge medicine, represents real progress.

But even prevention keeps the focus on disease.

What we’re pursuing at Banner Peak Health goes even further than medicine 3.0. We provide optimization: maximizing your potential, your function, your energy, and yes, your emotional well-being. It’s a different way to think about health.

Follow the Money

To understand this shift, we need to examine healthcare funding.

Traditional fee-for-service medicine relies on procedure codes based on either treating specific diseases or preventing specific diseases. There’s no funding mechanism for optimization.

Insurance companies don’t reimburse for helping someone feel extraordinary. Medicare doesn’t have billing codes for maximizing human potential. The financial structure of traditional healthcare ignores optimization.

Our practice operates on a different model. We’re funded by you, our patients. Not government programs. Not insurance companies. 

This direct relationship allows us to build healthcare strategies that meet your needs, including the pursuit of optimal health. Our Outperform program’s financial and philosophical underpinnings rest on this foundation.

From Passive Patient to Active Participant

Outperform changes the question of healthcare. Instead of asking, “What can the medical system do for me?” our patients ask, “What can I do for myself with the medical system’s support?”

Traditional healthcare creates passive relationships. You wait until something goes wrong, then seek treatment. Even preventive care often feels like something done to you rather than with you.

Outperform demands active participation. You own your journey. We teach you how to fish while providing the best equipment and guidance available.

This change happens through what we call MDEC: the Metric-Driven Empowerment Cycle. We leverage current technology to provide real-time, actionable, personalized data that puts you in the driver’s seat.

Take heart rate variability monitoring through the Oura Ring, our preferred wearable device. This technology tracks the balance between your sympathetic and parasympathetic nervous systems, measuring how well your body manages stress and recovery.

You generate the data. We guide you in understanding it. You own where that data takes you on your journey.

Continuous glucose monitoring is another example. Every five minutes, you know your blood sugar level. This integrates everything: stress, activity, sleep, nutrition, and meal timing. The data is personalized, actionable in real time, and yours to leverage.

Traditional medicine focuses on diagnostics and screenings, looking for problems. We focus on monitoring and metrics, tracking progress toward optimal function. One searches for what’s wrong. The other measures what’s possible.

Building Health Through Community

Traditional medicine focuses on individual behavior change. In reality, we all exist in a community. Why not approach healthcare through the lens of how we interact with others?

Society faces an epidemic of loneliness. Copious literature documents the negative biological outcomes of isolation. Social connection improves both emotional well-being and physical health. A human being connected in community is a healthier human being.

Many societal trends have decreased social cohesion. Life has become less social, a phenomenon the pandemic accelerated. Through Outperform, we’re connecting people wherever possible, using education and athletics as tools for bringing our community together.

We’ve launched a pilot program: weekly exercise classes open to the entire Banner Peak Health community and staff. These sessions create connection, shared goals, and mutual support.

The science of behavior change proves that people make better choices in a community. Whether through family relationships, friendships, or organized groups, connection drives healthier decisions. Data on marital status and health outcomes, social support and recovery rates, community involvement and longevity all point to the same conclusion.

Overcoming Traditional Healthcare Limitations

In traditional healthcare settings, implementing data-driven, personalized optimization is challenging.

The technology we use, including Oura Rings, continuous glucose monitors, and advanced metabolic testing, either lacks insurance coverage or requires too much time to implement under fee-for-service constraints.

Consider continuous glucose monitors. They’re available over the counter, but extracting meaningful insights from the data, understanding patterns, and making personalized recommendations requires labor-intensive processes that don’t fit into seven-minute appointment slots or insurance-reimbursable categories.

Traditional fee-for-service practices can’t provide this level of attention. We can.

Our position allows us to identify and adopt emerging technologies early. We evaluate innovations that improve the optimization process, from advanced sleep monitoring to new recovery tools. When something proves valuable, we can implement it without waiting for insurance approval or billing code creation.

Beginning Your Outperform Journey

For someone inspired to move from “not sick” toward optimal health, the most important step is openness.

Whatever approaches you’ve tried before and whatever you’re comfortable with won’t be as effective for moving forward as the new directions we can explore together. You don’t know what you don’t know.

The process we’re describing differs from traditional healthcare. If you’re open to rethinking the entire approach, we can take you somewhere extraordinary.

We’re reimagining what health means and what’s possible when you combine new technology, personalized data, community support, and medical expertise freed from insurance constraints.

Today’s Takeaways

Health means more than the absence of disease. It also means more than prevention.

True health optimization requires a change in how we approach well-being: from passive recipient to active participant, from isolated individual to connected community member, from accepting “normal” to pursuing extraordinary.

At Banner Peak Health, our Outperform philosophy makes this change possible. Through metric-driven empowerment, community connection, and freedom from traditional funding constraints, we’re creating healthcare that helps you maximize your potential.

The question isn’t whether you’re sick. The question is: How extraordinary could you feel?

by Barry Rotman, MD

Why Is Meditation Beneficial? The Physical and Mental Benefits to Meditation

I’ve written countless blogs encouraging people to “chill out.” What does this mean?

We’ve discussed heart rate variability (HRV), our need to decrease sympathetic tone in our autonomic nervous system while boosting parasympathetic function. I think of HRV as our “chill out meter” — a tool to measure how well we’re balancing these systems.

Meditation is a powerful technique for helping people chill out. It can change our brain waves, decrease sympathetic tone, and is one of the most robust ways to increase parasympathetic tone. Understanding why meditation is beneficial may motivate you to start a consistent practice.

Most forms of meditation include focused breath work. A study in the January 2025 Journal of Applied Psychophysiology and Biofeedback from Brigham Young University compared different breathing modalities for raising HRV. Researchers examined box breathing (for focus), 4-7-8 breathing (for calmness), and traditional six-breath-per-minute techniques. Their research found the six-breath-per-minute approach most effective for increasing heart rate variability.

With this evidence in mind, we’ve updated Banner Peak Health’s 12-step meditation guide. Instead of simply counting breaths, breathe in through your nose for five seconds, then out for five seconds. This timing achieves the optimal six breaths per minute rate.

The Banner Peak Health 12-Step Meditation Guide

1. Carve out a few minutes from your schedule for meditation.

Before taking your first meditative breath, you’ll need to consciously decide to prioritize meditation and carve out time for it.

We often place our physical and emotional needs at the bottom of our to-do list. It may seem selfish to focus on ourselves when there are more pressing tasks. Not infrequently, I work to convince patients to attend to their own care, not only for themselves but also to have more energy to give to others.

2. Find a comfortable, quiet place to sit.

There’s no special position necessary. Do what feels most comfortable. Remember, you’ll be in this position for several minutes.

3. Set a timer for a few minutes.

You can advance the duration as you improve. As you become more comfortable, you’ll be pleasantly surprised by how fast the time goes!

4. Close your eyes.

It’s that simple. You do it all the time.

5. Breathe in through your nose slowly for five seconds, then breathe out for five seconds.

A slow exhalation stimulates the parasympathetic nervous system (rest and digest).

Stress stimulates the sympathetic nervous system (fight or flight), but slow, deep exhalation suppresses it, allowing relaxation.

6. Count your inhalation and exhalation (five seconds each).

This counting technique helps time your breathing optimally while taking your mind off other worries.

7–8. Your mind will wander to other thoughts, and this will frustrate you.

You may even deem yourself a failure, doomed to never experience the benefits of meditation. Don’t.

Everyone is miserable at meditation because a perfect state of meditation doesn’t exist. Even monks who devote 20 hours per day to meditation humbly refer to their practice as “striving to improve.” That is the valuable lesson of meditation.

9. Gently and without self-recrimination, let go of these thoughts.

In meditation, as in life, we’re imperfect and will make mistakes. We achieve peace of mind by acknowledging this state of being and finding solace in our commitment to giving our best effort without reaching perfection.

Thus, one of the main benefits of meditation is that it teaches us to be kinder to ourselves when dealing with our inevitable failures.

10. Return to timed breathing (five seconds in, five seconds out).

You may lose your count. It’s okay. Start again.

11–12. Repeat this cycle. When the timer rings, open your eyes and slowly reorient yourself.

Try not to anticipate the sound of the timer. Allow yourself to fully immerse in the meditation and enjoy the experience. When it’s over, allow yourself time to adjust.

The Physical and Mental Benefits to Meditation

A growing body of evidence reveals why meditation is beneficial, addressing both physical and psychological benefits to meditation.

There is a direct connection between our thoughts and emotions and our bodies’ biology. Meditation leverages this connection in a very positive direction.

Cortisol is our most prominent stress hormone. Too much can damage every organ system we possess. Fortunately, meditation can reduce cortisol levels, offsetting the rise in our stress-filled lives. This cortisol reduction is just one example of why meditation is beneficial for long-term health.

Researchers studying the brain note that during meditation, the brain’s electrical activity can change with enhanced alpha and beta wave activity, which enhances relaxation and learning function.

There are many additional examples in medical literature of the health-enhancing benefits to meditation, including reducing pain, enhancing sleep, improving memory, and reducing the intensity of illnesses such as irritable bowel syndrome, depression, and post-traumatic stress disorder.

Using Wearables to Measure the Benefits to Meditation Through Biofeedback

The wearable revolution advances rapidly. New devices and features launch every week, giving us unprecedented access to our physiological data.

Biofeedback is using real-time monitoring of physiologic functions to teach voluntary control of those functions. Wearable devices now make this powerful technique accessible to everyone, helping you understand why meditation is beneficial through objective measurements.

The Oura Ring (Banner Peak Health’s preferred wearable) offers a meditation tracking feature that monitors three key physiologic parameters during your session:

1. Heart rate
2. Heart rate variability (HRV)
3. Peripheral skin temperature

This creates a Metric-Driven Empowerment Cycle, where you receive immediate feedback on your meditation’s effectiveness. How does this work in practice?

• Heart rate decreases as you become more relaxed, and sympathetic tone reduces.
• HRV increases as parasympathetic tone improves.
• Finger temperature increases (paradoxically, the more “chill” you are, the warmer your extremities become).

This occurs because sympathetic overdrive constricts your peripheral arteries (cold, clammy fingers), while enhanced parasympathetic tone dilates these vessels (warm fingers).

For optimal data accuracy, here’s a helpful tip: Move your Oura Ring to the finger where it fits most snugly, and keep it as still as possible during meditation. This improves the photoplethysmography measurements (how the LED light passes through your skin).

While using the Oura Ring during my own meditation sessions, I’ve seen up to a four-fold rise in my HRV, confirming that my practice is helping me “chill out.”

Today’s Takeaways

Key benefits to meditation include:

• Reduced stress through lower cortisol levels
• Improved heart rate variability
• Enhanced brain wave patterns
• Better sleep quality
• Reduced anxiety and depression symptoms
• Improved focus and memory
• Physical benefits like pain reduction
• Better emotional regulation

At Banner Peak Health, we continuously review the literature and update our recommendations to incorporate the latest evidence-based techniques. We look forward to working with you and your wearable device to optimize your meditation experience using these state-of-the-art approaches.

Starting with just a few minutes a day, you can change your outlook on life and equip your body to counter stress. The benefits to meditation are clear: from improved physiological markers to enhanced emotional well-being, understanding why meditation is beneficial can motivate you to maintain a consistent practice.

I hope I’ve helped you understand why meditation is beneficial for your health. Please give it a try. Best of luck!

by Barry Rotman, MD

Age-Proof Your Body: The Power of Resistance Training for Longevity

Most of us understand that exercise helps us live better and longer.

When we picture training for longevity, we likely envision the diligent hiker climbing a mountain or the dedicated runner rising at dawn. We picture aerobic exercise as the primary contributor to improved longevity and health span.

But resistance training and strength exercises also play a crucial role in successful aging. In fact, recent research demonstrates that strength training for longevity can significantly help extend healthspan and lifespan.

Muscle Mass and Longevity: Understanding Strength’s Impact

When exploring strength training for longevity, we need to distinguish between two highly correlated but distinct concepts:

• Muscle Mass: The quantity of muscle tissue in your body, measurable through techniques such as DXA scans or InBody analysis.
• Strength: Your muscles’ functional capability (what they can actually do).

If mass represents size, strength represents function. We all know people who don’t appear particularly muscular yet possess remarkable strength. Many who begin strength training notice functional improvements before visual changes.

Medical literature robustly links both higher muscle mass and greater strength with lower all-cause mortality, particularly in older adults. One meta-analysis examining nearly two million participants quantified strength using standardized measures like hand grip and knee extension strength, confirming that stronger individuals live longer.

How Muscle Mass Drives Longevity: The Science Behind Training

Astute readers know we must distinguish association from causation. Does muscle mass truly drive longevity, or does it merely distinguish those who are healthy enough to exercise?

While randomized controlled trials face many limitations, three powerful mechanisms explain how resistance training causally improves longevity.

1. Muscle as an Endocrine Organ

Just as fat tissue generates hormone signals throughout the body (most negative), muscle mass produces its own hormonal signals, but these benefit the body.

The more muscle mass you develop and use, the more it sends signals that:

• Improve glucose and lipid metabolism
• Support further muscle growth
• Stimulate bone formation
• Enhance fat metabolism
• Improve cognition
• Reduce inflammation

2. Muscle as Amino Acid Storage

While fat stores energy, muscle stores amino acids, the building blocks of proteins essential for bodily function.

During metabolic stress (famine, severe infection, cancer, or post-surgery), your body enters a catabolic state with limited ability to absorb and process nutrients. At these moments, skeletal muscle provides amino acids for the essential proteins your body needs.

Your body prioritizes proteins in a specific order:

• Hemoglobin for oxygen transport
• Clotting factors to prevent bleeding
• Immunoglobulins for immune function

Excess skeletal muscle serves as a reservoir, allowing amino acids to shift from less vital skeletal muscle to these survival functions.

3. Muscle Preserves Movement and Prevents Falls

Preserved muscle mass allows continued movement and exercise as we age. You need muscle mass to perform aerobic exercise, which itself contributes to longevity.

More importantly, strength and agility protect against falls, a highly lethal risk for older adults. A hip fracture carries a 25% mortality rate within one year. Muscle mass creates a positive feedback loop: more muscle enables more activity, which preserves more muscle.

The Challenge: Why We Lose Muscle as We Age

Think of muscle mass like money in the bank. We reach peak muscle mass in our thirties, then gradually decline. The more “savings” you accumulate early on, the more you can afford to “spend” slowly later.

Three factors drive age-related muscle loss:

1. Hormonal Changes: Testosterone and growth hormone levels decline with age.
2. Nutritional Gaps: Protein intake tends to decrease while our body’s protein demands increase.
3. Lifestyle Shifts: Our daily activities become less physically demanding. How many 60-year-olds climb trees or play on playgrounds?

Rebuilding and Preserving Muscle: The Science of Strength Training

To counter these challenges, we must:

1. Optimize Sleep: Testosterone and growth hormone are primarily released during deep sleep.
2. Increase Protein Intake: Compensate for age-related metabolic changes.
3. Add Resistance Training: Create the proper stimulus to preserve and build muscle mass.

While yoga, Pilates, and bodyweight exercises are beneficial, they can’t provide the supraphysiologic stimulus needed to maximize muscle preservation. For that, we need resistance training with weights.

Muscle Fiber Types: Why Weight Training Matters

Muscles contain two primary fiber types:

• Type I (slow-twitch) fibers excel at endurance, resist fatigue, contain abundant mitochondria, and efficiently use fatty acids for fuel.
• Type II (fast-twitch) fibers provide explosive power, fatigue more quickly, and primarily use glucose metabolism.

Aging disproportionately affects type II fibers. To preserve them, we need activities that stimulate these fast-twitch fibers through shorter, more explosive, powerful movements, which is exactly what resistance training provides.

Weight training enhances the neural connection between nerves and muscles, creates stress that stimulates testosterone and growth hormone secretion, and preferentially triggers type II fiber development.

Training for Longevity: Progressive Overload Techniques

To understand how resistance training strengthens muscles, we must explore progressive overload: gradually increasing demands placed on muscles to stimulate adaptation and growth.

Consider bench pressing. During your first few repetitions, you feel minimal strain. By repetition eight or nine, you feel the burn. By the end of your set, your arms can barely move.

The physiologic signal for muscle growth isn’t distributed equally across repetitions. The pain you feel marks the most powerful stimulus. This explains the adage “no pain, no gain” — the last, most difficult repetitions create the strongest physiologic signal for growth.

You can progressively overload by:

• Increasing weight
• Adding repetitions or sets
• Reducing rest between sets
• Improving technique to target specific muscles

The Creatine Connection

Creatine doesn’t increase muscle mass if you take it while watching Netflix.

Instead, it provides a short energy burst for type II fibers, helping you perform one or two additional repetitions, which deliver the most powerful physiologic signals.

Optimal Training for Longevity: Finding the Right Balance

Your body responds sensitively to strength training signals. Studies demonstrate a 10–17% reduction in mortality with just 30–60 minutes of strength training weekly. Training twice weekly provides substantial longevity benefits.

You don’t need to become a gym rat. You need awareness of why strength training matters and the diligence to incorporate it into your lifestyle.

Today’s Takeaways

At Banner Peak Health, we support your strength training journey through:

• InBody scans to track muscle mass progress
• Nutritional guidance to optimize protein intake
• Referrals to qualified fitness instructors for customized routines

Is there an age when you’re too old to benefit from resistance training? No! Evidence shows benefits in every decade of life.

Muscles aren’t just for aesthetics. They help you live longer.

by Barry Rotman, MD