Medicine is a relationship.
For ten years, FxMedSupport has been quietly building back the space for it to exist.

Somewhere in the last few decades, medicine stopped being a relationship and started being a transaction. Insurance reduced it. Volume reduced it. Technology, ironically, reduced it the most. The patient became a chart number. The provider became a clock-watcher. The thing that made medicine sacred in the first place — the trust between healer and patient, the slow work of paying real attention to a real person — got squeezed out of its own profession.

Kevin Mackey watched this happen, first from inside an ambulance and then from inside a medical practice, and decided he wasn’t going to accept it. So for the past decade he has been quietly building, application by application, the infrastructure that allows that relationship to exist again. Not through grand reform. Not through manifestos. Just through the patient, persistent removal of every piece of friction that was getting between healer and patient.

The company is called FxMedSupport. Inside the Cerbo electronic health record community — the ecosystem of choice for thousands of functional and integrative medicine practices across the country — Kevin’s team is known by another name. The Cerbo community gave it to them, and it stuck because it was true: the Dreammakers.

This May, after ten years and eighty production applications, FxMedSupport is stepping into what Kevin calls 2.0. Three flagship releases. A fundamental shift in how the company approaches the work itself. And underneath all of it, the same conviction that started everything: medicine is a relationship, and somebody has to build back the space for it to exist.

Medicine treated as a service job, not a profession

To understand what FxMedSupport is, you have to first sit with what it’s responding to.

Kevin grew up around professionals who built. His father in finance. His older brother an attorney. His younger brother also in finance. The pattern was unmistakable: when you earn a credential, you don’t just perform the work — you build a practice around your craft. You hold the relationship with your client. You charge appropriately for the value you create. You don’t hand the most important parts of the work away to someone with no investment in the outcome.

Then he became a firefighter and paramedic, and medicine entered his life from the inside out — not the polish of the doctor’s office, but the reality of human beings in their most vulnerable moments. Twelve years of that. He knew, in his hands and in his nervous system, what the trust between a caregiver and a person being cared for actually feels like. He had been on the receiving end of patients’ fear, gratitude, hope. He understood what it meant to be the person on the other side of someone’s worst moment.

So when an off-the-job injury ended his service career and life carried him into a chief operating officer role at an integrative medical practice, he was uniquely equipped to see what most software founders never see: the way modern medicine had been quietly stripped of its relational core.

It wasn’t just the volume. It wasn’t just the insurance billing. It was something more fundamental. The doctors he was working with had spent four, eight, twelve years of their lives mastering a craft. They had earned more letters at the end of their name than almost any other professional in any other field. And yet, when it came time to actually build around that mastery — to hold their patients, to charge appropriately, to leverage their training into the kind of life their education promised — they were treating themselves like service workers.

The clearest expression of this, the one that crystallized everything for him, was something almost embarrassingly simple. The practice he was running was sending its patients to third-party online supplement vendors. Patients who had built a relationship with their provider, who trusted that provider’s recommendations, were being handed off — for the supplements that the provider had themselves just prescribed — to some random vendor with no relationship, no continuity, no investment in their outcome.

“It wasn’t even about the eighteen to twenty-two percent margin we were giving away,” Kevin says. “It was about the fact that we were giving away the customer experience. We were giving away the relationship. We had this patient inside our ecosystem, and the moment we needed something tangible, we sent them outside it — to a stranger. An attorney would never do that with a client. A finance professional would never do that. Somewhere along the way, medicine forgot that the relationship is the whole thing.”

NutrimentRx, and the simple act of keeping the patient close

The first version of the company — NutrimentRx, founded in 2016 — was built around a single conviction: keep the patient inside the ecosystem of care. Set up an integrated supplement store, branded to the practice, controlled by the practice, with the same continuity the practice already delivered. Better margins, yes. But more importantly, better trust. Better stewardship. The relationship intact.

That was the first yes. A small one, by the standards of what came after. But it was the yes that established the pattern of everything to come: find the moment where the relationship is being given away, and build something that lets the practice keep it.

While Kevin was setting up these supplement stores for the first NutrimentRx clients, his partner at the time — a functional medicine physician — was traveling. So was he. The two of them ran a clinic and a young business from wherever they happened to be in the world. She belonged to a book club whose members were entirely MDs and DOs, and as the book club gathered in different cities, the other doctors started asking the same question.

How are you doing this? How are you so efficient? How are you both so relaxed? How are you traveling while you do it?

The answer always came back the same. “Kevin keeps building these little tools that make MDHQ” — Cerbo’s earlier name — “just become automatic.” The supplement store was one piece. But while it ran, Kevin had quietly started solving other things. Small annoyances. Workflow gaps. Specific moments inside the EHR where his partner and her staff were doing manual work that didn’t have to be manual — work that was eating into the time and presence they could give their patients.

The Zoom integration was an early one. An admin would create an appointment in Cerbo, then leave Cerbo to go to Zoom, create the matching appointment there, copy the link, come back to Cerbo, paste the link into the appointment box, then send the patient a separate confirmation message. Multiple systems, multiple tabs, multiple opportunities to forget a step. Multiple minutes of human attention spent on plumbing.

“I just thought, wait. We already integrate supplement stores. Why can’t we just make the Zoom links auto-populate?” That became the first version of what would later evolve into Auto Encounter.

Then he noticed: every appointment eventually generates an encounter in the chart. So he automated that. Then he noticed: every encounter requires chart prep before the provider walks into the room. So he automated that too — Auto Chart Prep. Each tool was a single step in a single workflow, lifted out of the manual world and dropped into the automatic one. And every minute of friction removed was a minute returned — to the patient, to the provider, to the relationship.

The book-club doctors started asking if Kevin could build similar things for their own practices. He said yes. They sent referrals. Those referrals sent more referrals. Within a year or two, Kevin had stumbled into an unofficial consulting role with the Cerbo team itself — the person providers went to when even Cerbo’s own support couldn’t solve their problem. Sometimes the provider knew what they wanted; sometimes the conversation surfaced a problem they hadn’t realized they had.

Fast-forward a few years. Kevin looks back at what he and his small team have built. It’s no longer one supplement integration. It’s thirty unique applications, then forty, then fifty. Each one optimizing, integrating, automating, or leveraging Cerbo in some specific way. By the time he stops to count, the picture is unmistakable.

“I looked at it and went, wait. We’re not a supplement dropship company anymore. By that point, we were barely even running supplement stores — maybe one practice still. And I wasn’t a medical consultant either. I was a software company.”

That recognition was the rebrand. In 2019, NutrimentRx became FxMedSupport — a name that no longer pointed to a product, but to a philosophy. Functional medicine support. Optimization, integration, automation, leverage. A platform built around the Cerbo EHR rather than around any single use case.

The community gave us the name. It stuck because it was true.

Somewhere along the way — Kevin can’t pinpoint exactly when — the Cerbo community started calling FxMedSupport “the Dreammakers.” It wasn’t a marketing exercise. Nobody on the team coined it. It just emerged from a pattern that had become unmistakable across years of work: when a Cerbo provider had an idea that sounded impossible, FxMedSupport said yes. And then they found a way.

“Every one of our applications was born because a provider somewhere said, I wish this existed. And we said, okay, let’s build it. And we built it.” The yeses, kept compounding, became a company. The company, kept honest, became a community. The community, kept faithful, gave it a name.

One of the cleanest examples of how this works is multi-state licensing. Cerbo, like most electronic health records, allows one state license per provider. That’s fine for a solo practitioner working in a single state. But functional and integrative medicine has been one of the largest beneficiaries of telehealth’s expansion, and many of the providers Kevin works with hold licenses in three, four, or five states. Every prescription order generated in Cerbo carries the provider’s primary state license — which means that any time the patient was located in a different state, a staff member had to manually edit the document before it went to the pharmacy.

“Repetitive document editing on every order. Imagine doing that thirty times a day,” Kevin says. “We wouldn’t change Cerbo — we love Cerbo, we’d never touch their core. But we could leverage around the limitation.”

FxMedSupport’s Multi-State License application watches for orders being created. The instant one fires, it checks which state the patient lives in, generates the correct document with the correct state-specific licensing information automatically, and hands it off cleanly. Staff never touches it. The pharmacy never sees an error. The provider never thinks about it. Multiply that across thousands of orders a month and you’ve quietly given an entire practice back hours of their lives every week.

The pattern repeats across every category. Auto Encounter watches for new appointments and prepares the encounter automatically. Auto Chart Prep watches for upcoming visits and lifts the relevant clinical context into place before the provider walks into the room. The Patient Mobile App — Android and iOS, built and maintained by FxMedSupport — pushes vitals from the patient’s phone seamlessly into the Cerbo chart, so the provider walks in already knowing how the patient has been doing all week. None of this is something Cerbo was designed to do natively. All of it makes Cerbo dramatically more powerful in service of the relationship.

The four pillars, repeated everywhere internally and now woven through every product description: Optimize. Integrate. Automate. Leverage. Of those four, leverage is the most important. It’s the verb Kevin uses to describe the entire premise of the company. You take what Cerbo already gives you, and you leverage it into things Cerbo was never designed to do — every one of them in service of the human work happening between the provider and the patient.

The 85% rule, the three-pillar stool, and a company that refuses to replace humans

Two principles, repeated almost reflexively across every conversation Kevin has with a Cerbo provider, anchor the company’s worldview.

The first is what he calls “85% Awesome.” For the average small or mid-sized integrative or functional medicine practice, FxMedSupport believes that 85% of all software needs can be solved out of the box. A practice signs up with Cerbo, signs up with FxMedSupport, and is ready to operate. The remaining 15% — the bespoke enterprise tooling that some practices need at scale — is something FxMedSupport stays deliberately agnostic about. Whatever enterprise platform the practice chooses, FxMedSupport connects to it cleanly and completes the picture.

“We already won the game by you joining our family,” Kevin says. “We’re agnostic to which fifteen percent you need outside of us. You picked us. That’s the whole win.”

The 85% is also a philosophy about people, not just software. “We never want to eliminate a human position,” Kevin says, with unusual force. “We set things up like a kid playing tee ball. The computer puts the ball on the tee — perfectly, every time, eighty-five percent of the work done. Your intelligent humans hit the home run on the last fifteen percent. The part that requires care. The part that requires judgment. The part that requires being a real person with a real patient.”

It’s a deliberate, almost defiant stand against a software industry that has spent the last decade promising to replace staff. FxMedSupport doesn’t promise that. It promises the opposite: take the rote work off your humans so they can do the work that actually requires being human. Protect the relationship by removing everything that gets in the way of it.

The second principle is what Kevin calls the three-pillar stool: patient, provider, practice. A medical practice, in his telling, is a stool with three legs. Each leg has to be the right length. If any one of them is too long or too short — if any one of them does too much work without the right compensation, or too little engagement to feel ownership — the stool tips. Care suffers. Trust erodes. The relationship the whole thing is supposed to be protecting falls apart.

Every application FxMedSupport ships is engineered with that balance in mind. Auto Encounter saves the provider time, which gives the patient more attention, which makes the practice more profitable. The Patient Mobile App gives the patient a seamless experience, which builds trust, which keeps the patient engaged, which makes the provider’s job easier. Every tool feeds all three legs simultaneously, or it doesn’t ship.

It’s also why Kevin is so adamant about Cerbo never being framed as lacking. “Cerbo is the best EHR for what they do. Period. We just see ourselves as the company that helps them — and the practices on them — go even further.”

The mom-and-pop practice finally has access

Ask Kevin what he’s proudest of, and the answer comes without hesitation.

“It’s the wow-how moment,” he says. “Every demo I do — whether it’s an existing Cerbo user thinking about FxMedSupport, or a practice considering Cerbo for the first time and trying to figure out if we have the missing piece — there’s this specific moment. They realize, wait, we are one of the least expensive products for the services we provide.“

Then they realize the second thing. “If I sign up with you, I can also cancel this application, and this application, and this application — because you do all of those better, and they’re all bundled in.” The third thing follows quickly: “And I’m going to get my time back. One minute becomes ten. Ten becomes twenty. Twenty becomes forty. Forty becomes an hour. An hour becomes two.”

For the small mom-and-pop independent functional medicine practice — the kind that has historically been priced out of enterprise-grade software — that moment is the unlock. They’re not just affording good software; they’re getting better software than the big practices, while saving money and staff hours simultaneously. And every hour they save is an hour they can pour back into the relationship.

“That’s what makes me proud,” Kevin says. “The mom-and-pop doc finally has an option for premier enterprise software that does every aspect of what their practice needs, out of the box. They open a practice. They sign up for Cerbo. They sign up for FxMedSupport. They go. And the patient on the other end of that practice gets the same quality of experience that someone walking into a hundred-million-dollar health system would get. That’s the equity part of this. That’s the part that matters.”

Asked what’s hard. “None of it.”

The conversation turns, as conversations with founders eventually do, to the difficult parts. What keeps him up at night? What part of running this company drains him? What would he change if he could?

The answer is unexpected.

“None of it,” Kevin says. “I’m energized all day long.”

He pauses, and the next thing he says lands differently than anything else in the conversation.

“I was once afraid — when I was a firefighter and a paramedic and got hurt off the job — that I’d never get to do the work I loved again. I felt amazing inside doing that work. Like I wasn’t going to a job. I was going to play with my friends and serve the community. And every day now I wake up and know that I get to connect with a medical practice — one that’s getting ready to be on Cerbo, or already is — and I get to play with Legos. I get to find the pieces of the puzzle that nobody thought were possible. Half of what we’ve built, Cerbo themselves said wasn’t possible at first.”

He stops, and clarifies the through-line of his entire life.

“I always knew I’d work again. I just didn’t think I’d ever love what I did again.”

It’s a striking thing to hear from a founder a decade in. Most founders, asked about the hard parts, will tell you. They’ll talk about hiring, cash flow, the loneliness of leadership, the pressure of being responsible for other people’s livelihoods. Kevin’s answer is something else entirely: the work itself, every day, feels like exactly what he’s supposed to be doing. The energy comes from inside. The play and the service are the same thing.

And underneath it, you can hear something more — the quiet pride of a man who once thought his calling had been taken from him, and who found, against all expectation, that the calling had simply been waiting for him in a different form. The firefighter who ran toward what others ran from is now, in a different way, still running toward it. Still showing up for people on what is sometimes the hardest day of their lives. Still serving. Still building the trust between the person who needs help and the person trained to give it.

What he does talk about, when pressed about leadership, is conducting the orchestra. Making sure everyone on the team knows the path forward. Bringing the right people into the right roles at the right time. “There’s always a way to yes,” he says, “as long as everyone on board knows what we’re playing. We just need to conduct the orchestra and get everybody playing the same tune. Bring them together under one cohesive empire. One team. And get that medical provider to be able to leverage the degree they have to live the life they want.”